Cover Page
Cover Page | 9 Months Ended |
Sep. 30, 2021 | |
Cover [Abstract] | |
Document Type | S-1/A |
Amendment Flag | false |
Entity Central Index Key | 0001716621 |
Entity Registrant Name | Ra Medical Systems, Inc. |
Entity Filer Category | Non-accelerated Filer |
Entity Small Business | true |
Entity Emerging Growth Company | true |
Entity Ex Transition Period | false |
Condensed Balance Sheets (Unaud
Condensed Balance Sheets (Unaudited) - USD ($) $ in Thousands | Sep. 30, 2021 | Dec. 31, 2020 | Dec. 31, 2019 |
Current Assets | |||
Cash and cash equivalents | $ 20,616 | $ 23,906 | $ 14,584 |
Short-term investments | 15,993 | ||
Accounts receivable, net | 17 | 24 | 223 |
Inventories | 997 | 877 | 1,292 |
Prepaid expenses and other current assets | 1,169 | 1,100 | 1,628 |
Current assets of discontinued operations | 1,713 | 2,280 | |
Total current assets | 22,799 | 27,620 | 36,000 |
Property and equipment, net | 2,030 | 2,527 | 4,144 |
Operating lease right-of-use assets | 2,205 | 2,484 | 2,835 |
Other long-term assets | 45 | 45 | 45 |
Long-term assets of discontinued operations | 762 | 1,057 | |
TOTAL ASSETS | 27,079 | 33,438 | 44,081 |
Current Liabilities | |||
Accounts payable | 543 | 471 | 1,220 |
Accrued expenses | 2,632 | 4,147 | 2,360 |
Current portion of operating lease liabilities | 301 | 356 | 318 |
Current portion of equipment financing | 265 | 293 | |
Current portion of PPP promissory note | 421 | ||
Current liabilities of discontinued operations | 2,102 | 2,623 | |
Total current liabilities | 3,476 | 7,762 | 6,814 |
Operating lease liabilities | 2,054 | 2,264 | 2,620 |
Equipment financing | 265 | ||
PPP promissory note | 1,579 | ||
Long-term liabilities of discontinued operations | 686 | 1,232 | |
Total liabilities | 5,530 | 12,291 | 10,931 |
Commitments and contingencies (Note 14) | |||
Stockholders' Equity | |||
Preferred stock, $0.0001 par value; 10,000 shares authorized; no shares issued | |||
Common stock, $0.0001 par value; 300,000 shares authorized; 7,042 and 3,189 shares issued and outstanding as of September 30, 2021 and December 31, 2020, respectively | 7 | 7 | 1 |
Additional paid-in capital | 191,527 | 174,342 | 150,280 |
Accumulated deficit | (169,985) | (153,202) | (117,157) |
Accumulated other comprehensive income | 26 | ||
Total stockholders' equity | 21,549 | 21,147 | 33,150 |
TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY | $ 27,079 | $ 33,438 | $ 44,081 |
Condensed Balance Sheets (Una_2
Condensed Balance Sheets (Unaudited) (Parenthetical) - $ / shares | Sep. 30, 2021 | Dec. 31, 2020 | Dec. 31, 2019 |
Preferred stock, par value | $ 0.0001 | $ 0.0001 | $ 0.0001 |
Preferred stock, shares authorized | 10,000,000 | 10,000,000 | 10,000,000 |
Preferred stock, shares issued | 0 | 0 | 0 |
Common stock, par value | $ 0.0001 | $ 0.0001 | $ 0.0001 |
Common stock, shares authorized | 300,000,000 | 300,000,000 | 300,000,000 |
Common stock, shares issued | 7,042,000 | 3,189,000 | 550,814 |
Common stock, shares outstanding | 7,042,000 | 3,189,000 | 550,814 |
Previously Reported [Member] | |||
Common stock, shares issued | 3,188,679 | ||
Common stock, shares outstanding | 3,188,679 |
Condensed Statements of Operati
Condensed Statements of Operations (Unaudited) - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | 9 Months Ended | 12 Months Ended | |||
Sep. 30, 2021 | Sep. 30, 2020 | Sep. 30, 2021 | Sep. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | |
Net revenues | ||||||
Total net revenues | $ 5 | $ 68 | $ 17 | $ 259 | $ 259 | $ 1,273 |
Cost of revenues | ||||||
Total cost of revenues | 246 | 568 | 1,213 | 1,746 | 2,172 | 4,133 |
Gross loss | (241) | (500) | (1,196) | (1,487) | (1,913) | (2,860) |
Operating expenses | ||||||
Selling, general and administrative | 4,211 | 4,695 | 11,285 | 18,154 | 24,533 | 45,302 |
Research and development | 2,942 | 2,312 | 8,521 | 5,534 | 8,955 | 4,445 |
Total operating expenses | 7,153 | 7,007 | 19,806 | 23,688 | 33,488 | 49,747 |
Operating loss | (7,394) | (7,507) | (21,002) | (25,175) | (35,401) | (52,607) |
Other income (expense), net | ||||||
Other income (expense), net | 16 | (8) | 5 | 97 | ||
Interest income | 129 | 1,038 | ||||
Interest expense | 41 | 71 | ||||
Gain on extinguishment of PPP promissory note | 2,023 | |||||
Total other income (expense), net | 16 | (8) | 2,028 | 97 | 88 | 967 |
Loss from continuing operations before income taxes | (7,378) | (7,515) | (18,974) | (25,078) | (35,313) | (51,640) |
Income taxes | 7 | 15 | ||||
Loss from continuing operations | (7,378) | (7,515) | (18,974) | (25,078) | (35,320) | (51,655) |
Discontinued operations (Note 3) | ||||||
Income (loss) from discontinued operations (including gain on sale of $3,500 in 2021) before income taxes | 3,080 | (264) | 2,191 | (523) | (725) | (5,302) |
Income (loss) from discontinued operations | 3,080 | (264) | 2,191 | (523) | (725) | (5,302) |
Net loss | $ (4,298) | $ (7,779) | $ (16,783) | $ (25,601) | $ (36,045) | $ (56,957) |
Net (loss) income per share, basic and diluted | ||||||
Continuing operations | $ (1.15) | $ (3.15) | $ (4.23) | $ (19.32) | $ (20.79) | $ (98.20) |
Discontinued operations | 0.48 | (0.11) | 0.49 | (0.40) | (0.43) | (10.08) |
Total net loss per share, basic and diluted | $ (0.67) | $ (3.26) | $ (3.74) | $ (19.72) | $ (21.22) | $ (108.28) |
Weighted average number of shares used in computing net income (loss) per share, basic and diluted | 6,415 | 2,386 | 4,487 | 1,298 | 1,699 | 526 |
Product Sales [Member] | ||||||
Net revenues | ||||||
Total net revenues | $ 5 | $ 66 | $ 17 | $ 254 | $ 254 | $ 1,255 |
Cost of revenues | ||||||
Total cost of revenues | 68 | 323 | 676 | 1,131 | 1,369 | 3,375 |
Service and Other [Member] | ||||||
Net revenues | ||||||
Total net revenues | 2 | 5 | 5 | 18 | ||
Cost of revenues | ||||||
Total cost of revenues | $ 178 | $ 245 | $ 537 | $ 615 | $ 803 | $ 758 |
Condensed Statements of Opera_2
Condensed Statements of Operations (Unaudited) (Parenthetical) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended |
Sep. 30, 2021 | Sep. 30, 2021 | |
Income Statement [Abstract] | ||
Gain on sale of business | $ 3,473 | $ 3,473 |
Consolidated Statements of Comp
Consolidated Statements of Comprehensive Loss (Unaudited) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | 12 Months Ended | |||
Sep. 30, 2021 | Sep. 30, 2020 | Sep. 30, 2021 | Sep. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | |
Statement of Comprehensive Income [Abstract] | ||||||
Net loss | $ (4,298) | $ (7,779) | $ (16,783) | $ (25,601) | $ (36,045) | $ (56,957) |
Other comprehensive loss: | ||||||
Unrealized losses related to short-term investments | (26) | (26) | 26 | |||
Total other comprehensive (loss) income | (26) | 26 | ||||
Comprehensive loss | $ (4,298) | $ (7,779) | $ (16,783) | $ (25,627) | $ (36,071) | $ (56,931) |
Condensed Statements of Cash Fl
Condensed Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands | 9 Months Ended | 12 Months Ended | ||
Sep. 30, 2021 | Sep. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | |
CASH FLOWS FROM OPERATING ACTIVITIES | ||||
Net loss | $ (16,783) | $ (25,601) | $ (36,045) | $ (56,957) |
Adjustments to reconcile net loss to net cash used in operating activities: | ||||
Gain on sale of discontinued operations | (3,473) | |||
Gain on extinguishment of PPP promissory note | (2,023) | |||
Stock-based compensation | 1,967 | 3,044 | 4,082 | 23,543 |
Depreciation and amortization | 1,250 | 1,845 | 2,365 | 1,750 |
(Gain) loss on sales and disposals of property and equipment | (489) | 64 | 99 | 123 |
Provision for doubtful accounts | 25 | 42 | 254 | |
Changes in operating assets and liabilities: | ||||
Accounts receivable | 93 | 286 | 368 | 251 |
Inventories | (262) | 78 | 352 | (2,185) |
Prepaid expenses and other assets | 9 | 1,437 | 642 | (338) |
Accounts payable | 171 | (633) | (961) | 407 |
Accrued expenses | (1,875) | 1,678 | 1,706 | (184) |
Deferred revenue | (234) | (876) | (774) | 417 |
Other liabilities | (265) | (237) | (318) | (283) |
Net cash used in operating activities | (21,914) | (18,890) | (28,304) | (33,173) |
CASH FLOWS FROM INVESTING ACTIVITIES | ||||
Purchases of available-for-sale securities | (36,461) | |||
Proceeds from sale of discontinued operations | 3,700 | |||
Payment of fees related to sale of discontinued operations | (227) | |||
Proceeds from sales of property and equipment | 554 | |||
Purchases of property and equipment | (224) | (72) | (67) | (268) |
Proceeds from maturities of available-for-sale securities | 16,000 | 16,000 | 20,697 | |
Net cash provided by investing activities | 3,803 | 15,928 | 15,933 | (16,032) |
CASH FLOWS FROM FINANCING ACTIVITIES | ||||
Proceeds from issuance of common stock and warrants, net | 15,430 | 19,887 | 19,887 | |
Payments of offering costs related to the issuance of common stock and warrants | (370) | (499) | (770) | |
Payments on equipment financing | (265) | (218) | (293) | (338) |
Proceeds from purchases under employee stock purchase plan | 26 | 27 | 42 | 37 |
Proceeds from PPP promissory note | 2,000 | 2,000 | ||
Proceeds from issuance of common stock in connection with the exercise of warrants | 827 | 827 | ||
Payments for restricted stock tax liability on settlement | (225) | |||
Net cash provided by financing activities | 14,821 | 22,024 | 21,693 | (526) |
NET CHANGE IN CASH AND CASH EQUIVALENTS | (3,290) | 19,062 | 9,322 | (49,731) |
CASH AND CASH EQUIVALENTS, beginning of period | 23,906 | 14,584 | 14,584 | 64,315 |
CASH AND CASH EQUIVALENTS, end of period | 20,616 | 33,646 | 23,906 | 14,584 |
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING AND FINANCING ACTIVITIES: | ||||
Unpaid property and equipment | 26 | |||
Unpaid offering costs | 281 | |||
Transfer of lasers from inventories to property and equipment | 107 | 207 | 1,505 | |
SUPPLEMENTAL CASH FLOW INFORMATION: | ||||
Cash payments for interest | 2 | $ 23 | 28 | 49 |
Cash payments for taxes | $ 2 | 30 | ||
Previously Reported [Member] | ||||
Adjustments to reconcile net loss to net cash used in operating activities: | ||||
Provision for doubtful accounts | $ 180 | $ 283 |
Condensed Statements of Cash _2
Condensed Statements of Cash Flows (Unaudited) (Parenthetical) $ in Thousands | 12 Months Ended |
Dec. 31, 2020USD ($) | |
Statement of Cash Flows [Abstract] | |
Underwriters' discount | $ 2,113 |
Condensed Statements of Stockho
Condensed Statements of Stockholders' Equity (Unaudited) - USD ($) shares in Thousands, $ in Thousands | Total | Common Stock | Additional Paid-in Capital | Accumulated Other Comprehensive Income (Loss) | Accumulated Deficit |
Balances at Dec. 31, 2018 | $ 66,726 | $ 1 | $ 126,925 | $ (60,200) | |
Balance (in shares) at Dec. 31, 2018 | 508 | ||||
Common stock issued, net | (188) | (188) | |||
Common stock issued (in shares) | 43 | ||||
Stock-based compensation | 23,543 | 23,543 | |||
Other comprehensive loss | 26 | $ 26 | |||
Net loss | (56,957) | (56,957) | |||
Balances at Dec. 31, 2019 | $ 33,150 | $ 1 | 150,280 | 26 | (117,157) |
Balance (in shares) at Dec. 31, 2019 | 551 | 551 | |||
Common stock issued (in shares) | 5 | ||||
Stock-based compensation | $ 1,047 | 1,047 | |||
Other comprehensive loss | (22) | (22) | |||
Net loss | (7,701) | (7,701) | |||
Balances at Mar. 31, 2020 | $ 26,474 | $ 1 | 151,327 | 4 | (124,858) |
Balance (in shares) at Mar. 31, 2020 | 556 | ||||
Balances at Dec. 31, 2019 | $ 33,150 | $ 1 | 150,280 | 26 | (117,157) |
Balance (in shares) at Dec. 31, 2019 | 551 | 551 | |||
Net loss | $ (25,601) | ||||
Balances at Sep. 30, 2020 | $ 30,538 | $ 7 | 173,289 | (142,758) | |
Balance (in shares) at Sep. 30, 2020 | 2,898 | ||||
Balances at Dec. 31, 2019 | $ 33,150 | $ 1 | 150,280 | 26 | (117,157) |
Balance (in shares) at Dec. 31, 2019 | 551 | 551 | |||
Common stock issued, net | $ 11,625 | $ 5 | 11,620 | ||
Common stock issued (in shares) | 2,551 | ||||
Warrants issued, net | 7,492 | 7,492 | |||
Exercise of warrants | 827 | $ 1 | 826 | ||
Exercise of warrants (in shares) | 74 | ||||
Common stock issued pursuant to the vesting of restricted stock units and ESPP | 42 | 42 | |||
Common stock issued pursuant to the vesting of restricted stock units and ESPP (in shares) | 13 | ||||
Stock-based compensation | 4,082 | 4,082 | |||
Other comprehensive loss | (26) | (26) | |||
Net loss | (36,045) | (36,045) | |||
Balances at Dec. 31, 2020 | $ 21,147 | $ 7 | 174,342 | (153,202) | |
Balance (in shares) at Dec. 31, 2020 | 3,189 | 3,189 | |||
Balances at Mar. 31, 2020 | $ 26,474 | $ 1 | 151,327 | 4 | (124,858) |
Balance (in shares) at Mar. 31, 2020 | 556 | ||||
Common stock issued, net | $ 5,284 | 2 | 5,282 | ||
Common stock issued (in shares) | 889 | ||||
Warrants issued, net | $ 3,464 | 3,464 | |||
Exercise of warrants | $ 827 | 1 | 826 | ||
Exercise of warrants (in shares) | 73 | ||||
Common stock issued pursuant to the vesting of restricted stock units and employee stock purchase plan | $ 27 | 27 | |||
Common stock issued pursuant to the vesting of restricted stock units and employee stock purchase plan (in shares) | 9 | ||||
Stock-based compensation | $ 1,033 | 1,033 | |||
Other comprehensive loss | (4) | $ (4) | |||
Net loss | (10,121) | (10,121) | |||
Balances at Jun. 30, 2020 | $ 26,984 | 4 | 161,959 | (134,979) | |
Balance (in shares) at Jun. 30, 2020 | 1,527 | ||||
Common stock issued, net | $ 6,341 | 3 | 6,338 | ||
Common stock issued (in shares) | 1,371 | ||||
Warrants issued, net | $ 4,028 | 4,028 | |||
Stock-based compensation | 964 | 964 | |||
Net loss | (7,779) | (7,779) | |||
Balances at Sep. 30, 2020 | $ 30,538 | 7 | 173,289 | (142,758) | |
Balance (in shares) at Sep. 30, 2020 | 2,898 | ||||
Balances at Dec. 31, 2020 | $ 21,147 | $ 7 | 174,342 | (153,202) | |
Balance (in shares) at Dec. 31, 2020 | 3,189 | 3,189 | |||
Common stock issued, net | $ 65 | 65 | |||
Common stock issued (in shares) | 35 | ||||
Stock-based compensation | $ 1,169 | 1,169 | |||
Stock-based compensation (In shares) | 35 | ||||
Net loss | $ (7,236) | (7,236) | |||
Balances at Mar. 31, 2021 | $ 15,145 | $ 7 | 175,576 | (160,438) | |
Balance (in shares) at Mar. 31, 2021 | 3,259 | ||||
Balances at Dec. 31, 2020 | $ 21,147 | $ 7 | 174,342 | (153,202) | |
Balance (in shares) at Dec. 31, 2020 | 3,189 | 3,189 | |||
Net loss | $ (16,783) | ||||
Balances at Sep. 30, 2021 | $ 21,549 | $ 7 | 191,527 | (169,985) | |
Balance (in shares) at Sep. 30, 2021 | 7,042 | ||||
Balances at Mar. 31, 2021 | $ 15,145 | 7 | 175,576 | (160,438) | |
Balance (in shares) at Mar. 31, 2021 | 3,259 | ||||
Common stock issued, net | $ 10,645 | 10,645 | |||
Common stock issued (in shares) | 2,582 | ||||
Common stock issued pursuant to the vesting of restricted stock units and employee stock purchase plan | $ 26 | 26 | |||
Common stock issued pursuant to the vesting of restricted stock units and employee stock purchase plan (in shares) | 6 | ||||
Stock-based compensation | $ 696 | 696 | |||
Stock-based compensation (In shares) | 56 | ||||
Net loss | $ (5,249) | (5,249) | |||
Balances at Jun. 30, 2021 | $ 21,263 | 7 | 186,943 | (165,687) | |
Balance (in shares) at Jun. 30, 2021 | 5,903 | ||||
Common stock issued, net | $ 4,350 | 4,350 | |||
Common stock issued (in shares) | 1,139 | ||||
Warrants issued, net | $ 132 | 132 | |||
Stock-based compensation | 102 | 102 | |||
Net loss | (4,298) | (4,298) | |||
Balances at Sep. 30, 2021 | $ 21,549 | $ 7 | $ 191,527 | $ (169,985) | |
Balance (in shares) at Sep. 30, 2021 | 7,042 |
Organization and Nature of Oper
Organization and Nature of Operations | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | ||
Organization and Nature of Operations | Note 1. Organization and Nature of Operations The Company Ra Medical Systems, Inc. (the “Company”) is a medical device company that develops, manufactures and markets an advanced excimer laser and single-use On August 16, 2021, the Company completed the sale of its Pharos dermatology business (the “Dermatology Business”). As a result, the Company has reported the operating results of the Dermatology Business as discontinued operations in the condensed statements of operations for all periods presented. In addition, the related assets and liabilities associated with the Dermatology Business were reported as assets of discontinued operations and liabilities of discontinued operations in the condensed balance sheets. Unless otherwise noted, discussion within these notes to the unaudited condensed financial statements relates to continuing operations. See Note 3. Discontinued Operations Reverse Stock Split On November 16, 2020, the Company filed a certificate of amendment to the Certificate of Incorporation with the Secretary of State of the State of Delaware to affect a reverse stock split of the Company’s common stock at a ratio of one-for-twenty-five COVID-19 The global spread of the novel coronavirus (“COVID-19”) COVID-19 COVID-19 COVID-19 Going Concern The Company has experienced recurring net losses from operations and negative cash flows from operating activities, has a significant accumulated deficit and expects to continue to incur net losses into the foreseeable future. The Company had an accumulated deficit of $170.0 million at September 30, 2021. For the nine months ended September 30, 2021, the Company used cash of $21.9 million in operating activities from continuing and discontinued operations. As of September 30, 2021, the Company had cash and cash equivalents of $20.6 million. Management expects operating losses and negative cash flows to continue for the foreseeable future with the Company’s reduced commercial footprint, and as the Company continues to incur costs related to its atherectomy clinical trial, engineering efforts to improve the shelf life of its catheters and develop next generation products and legal costs associated with ongoing litigation. In September 2020, the Company paused commercial sales of the DABRA catheter not being used for the atherectomy clinical trial while it conducted further studies on the stability of its shelf life. The Company submitted additional test data with respect to the DABRA catheter shelf life in March 2021, which was cleared by the U.S. Food and Drug Administration in July 2021. Although eligible, the Company has not resumed commercial sales and is evaluating its commercial catheter strategy. The Company also expects the COVID-19 Management believes that, based on the Company’s liquidity resources, there is substantial doubt about the Company’s ability to continue as a going concern for a period of at least 12 months from the date of issuance of the financial statements. Although the Company bolstered its liquidity resources in 2021 and 2020, has an effective shelf registration statement and an “at the market” (“ATM”) offering to allow it to raise additional capital when the opportunities permit and may receive additional funds from the exercise of its warrants depending on market conditions, management has concluded that the aforementioned conditions, including the ongoing uncertainty related to the negative impacts of the COVID-19 The accompanying financial statements have been prepared on a going concern basis, which contemplates the realization of assets and settlement of liabilities in the normal course of business, and do not include any adjustments to reflect the possible future effects on the recoverability and classification of assets or amounts and classification of liabilities that may result from the outcome of this uncertainty. | Note 1—Organization and Nature of Operations Ra Medical Systems, Inc. (the “Company”) was formed in September 4, 2002, in the state of California and reincorporated in Delaware on July 14, 2018. The Company is a medical device company that develops, manufactures and markets advanced excimer laser systems for use in the treatment of vascular and dermatological diseases. The Company’s product development centers around proprietary applications of its advanced excimer laser technology for use as a tool in the treatment of peripheral artery disease (“PAD”) and psoriasis, vitiligo, atopic dermatitis and leukoderma. Reincorporation paid-in Initial Public Offering— S-1 In October 2018, in connection with the IPO, the Company filed an Amended and Restated Certificate of Incorporation which authorizes the issuance of 300,000,000 shares of common stock with a par value of $0.0001 and 10,000,000 shares of preferred stock with a par value of $0.0001. Reverse Stock Split 1-for-25. On 1-for- 25 Discontinued Operations Note 3. Discontinued Operations Segment Information After the sale of the Dermatology Business, the Company began operating its business in one segment, which includes all activities related to the research, development and manufacture of the DABRA system. The chief operating decision-maker reviews the operating results on an aggregate basis and manages the operations as a single operating segment. COVID-19 (COVID-19) COVID-19 its revenue will continue to be adversely impacted and enrollment in its atherectomy clinical trial will continue to be delayed or slowed, as patients elect to postpone voluntary treatments and many physicians’ offices have been either closed or operating at a reduced capacity. In addition, some customers are requesting more flexible payment terms on a temporary basis. The Company’s manufacturing facility located in Carlsbad, California is currently operational. Employee travel is limited to essential travel only and many employees are working from home when feasible. The Company has experienced minor delays in receiving shipments of parts, which has not had a material impact on the timing of its key engineering efforts, nor ability to support its atherectomy indication clinical trial. However, the extent to which COVID-19 COVID-19 Going Concern As of December 31, 2020 the Company had cash and cash equivalents of $23.9 million. Management expects operating losses and negative cash flows to continue for the foreseeable future with the Company’s reduced commercial footprint, and as the Company continues to incur costs related to its atherectomy clinical trial, engineering efforts to improve the shelf-life of its catheters and develop next generation products and legal costs associated with ongoing litigation. In September 2020, the Company paused commercial sales of DABRA catheters not being used for the atherectomy clinical trial while it conducts further studies on the stability of its shelf life. We submitted additional test data in March 2021, which will need to be cleared by the FDA prior to resuming commercial shipments of catheters. The Company also expects the COVID-19 Although the Company bolstered its liquidity resources in 2020, has an effective shelf registration statement and an “at the market” offering to allow it to raise additional capital when the opportunities permit and may receive additional funds from the exercise of its warrants depending on market conditions, management concluded that the aforementioned conditions, including the ongoing uncertainty related to the negative impacts of the COVID-19 The financial statements have been prepared on a going concern basis, which contemplates the realization of assets and settlement of liabilities in the normal course of business, and do not include any adjustments to reflect the possible future effects on the recoverability and classification of assets or amounts and classification of liabilities that may result from the outcome of this uncertainty. |
Significant Accounting Policies
Significant Accounting Policies | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Accounting Policies [Abstract] | ||
Significant Accounting Policies | Note 2. Significant Accounting Policies Basis of Presentation The unaudited interim condensed financial statements have been prepared on the same basis as the annual financial statements and reflect all adjustments of a normal and recurring nature that are necessary for the fair presentation of the Company’s condensed balance sheets, results of operations, cash flows and statements of stockholders’ equity for the periods presented. The results of operations for the three and nine months ended September 30, 2021 are not necessarily indicative of the results to be expected for the year ending December 31, 2021 or for any other future annual or interim period. The balance sheet as of December 31, 2020 included herein was derived from the audited financial statements as of that date after reclassifications related to discontinued operations. These unaudited condensed financial statements should be read in conjunction with the Company’s audited financial statements included in the Company’s Annual Report on Form 10-K Reclassifications Certain prior period amounts have been reclassified to conform to the current period presentation. Use of estimates The unaudited condensed financial statements have been prepared by management in accordance with accounting principles generally accepted in the United States (“GAAP”). The preparation of the financial statements requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities and reported disclosures of contingent liabilities at the dates of the financial statements and the reported amounts of revenue and expenses during the reporting periods. Actual results could differ from those estimates. The Company’s financial statements are based upon a number of estimates, including but not limited to, allowance for doubtful accounts, evaluation of impairment of assets, reserves for warranty costs including product recalls, evaluation of probable loss contingencies, fair value of stock option awards granted and revenue recognition for multiple performance obligations. Fair Value Measurements Fair value represents the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants and is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. A three-tier value hierarchy is used to identify inputs used in measuring fair value as follows: Level 1—Observable inputs that reflect quoted market prices (unadjusted) for identical assets or liabilities in active markets; Level 2—Inputs other than the quoted prices in active markets that are observable either directly or indirectly in the marketplace for identical or similar assets and liabilities; and Level 3—Unobservable inputs that are supported by little or no market data, which require the Company to develop its own assumptions. The hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value. The Company measures its cash and cash equivalents and short-term investments at fair value. Inventories Inventories are stated at the lower of cost (first-in, first-out Catheters are manufactured in-house, re-tested. Revenue The Company generates revenue from the sales of products and services. Product sales consist of the sales of catheters for use with the DABRA laser system. The Company has paused selling commercial product and is only selling catheters for use in the atherectomy clinical trial. The Company’s sales agreements generally do not include right-of-return Catheter Revenue When engaged in commercial sales, the Company enters into a DABRA laser commercial usage agreement or DABRA laser placement acknowledgement with each customer that is supplied a DABRA laser, collectively the “usage agreement”, which provides for specific terms of continued use of the DABRA laser, including a nominal periodic fee. The terms of a usage agreement typically allow the Company to place a DABRA laser at a customer’s specified location without a specified contract term. Under the usage agreement terms, the Company retains all ownership rights to the DABRA laser and is permitted to request the return of the equipment within 10 business days of notification. While the periodic fees are nominal, the usage agreement provides the Company the exclusive rights to supply related single-use The Company recognizes revenue associated with the usage agreements and catheter supply arrangements in accordance with Financial Accounting Standards Board (“FASB”) “ Revenue from Contracts with Customers (Topic 606),” Distributor Transactions In certain markets outside the U.S., the Company sold products and provided services to customers through distributors that specialize in medical device products. The terms of sales transactions through distributors were generally consistent with the terms of direct sales to customers. The Company accounted for these transactions in accordance with the Company’s revenue recognition policy described herein. The following accounting policies are specifically related to the Company’s discontinued operations: Laser Sales The Company recognized revenue on laser sales at the point in time that control transferred to the customer. Control of the product typically transferred upon shipment. Warranty Service Revenue The Company typically provided a 12-month 12-month Contract Costs The Company capitalized costs to obtain contracts that were considered incremental and recoverable, such as sales commissions. The capitalized costs were amortized to selling, general and administrative expense over the estimated period of benefit of the asset, which was the contract term. The Company elected to use the practical expedient to expense the costs to obtain a contract when the amortization period was less than one year. These lease arrangements contained one lease component (the laser) and one non-lease non-lease Rental Income The Company also derived income pursuant to its product operating lease agreements for its Pharos laser systems, prior to the sale of the Dermatology Business. Consequently, the Company retained title to the equipment. Depreciation expense on the leased lasers was recorded to cost of revenues on a straight-line basis. The costs to maintain the leased lasers were charged to cost of revenues as incurred. These lease arrangements contained one lease component (the laser) and one non-lease non-lease Segment Information After the sale of the Dermatology Business, the Company began operating its business in one segment, which includes all activities related to the research, development and manufacture of the DABRA system. The chief operating decision-maker reviews the operating results on an aggregate basis and manages the operations as a single operating segment. Recent Accounting Pronouncements From time to time, new accounting pronouncements are issued by the FASB or other standard setting bodies that the Company adopts as of the specified effective date. The Company has evaluated recently issued accounting pronouncements and, based on its preliminary assessment, does not believe any will have a material impact on the condensed financial statements or related footnote disclosures. | Note 2—Significant Accounting Policies Use of estimates Company estimates. The Company’s financial statements Short-term Investments — Investments with original maturities of greater than three months are classified as short-term investments. Debt investments are classified as available-for-sale Fair value measurements — Level 1—Observable inputs that reflect quoted market prices (unadjusted) for identical assets or liabilities in active markets. Level 2—Inputs other than the quoted prices in active markets that are observable either directly or indirectly in the marketplace for identical or similar assets and liabilities; and Level 3—Unobservable inputs that are supported by little or no market data, which require the Company to develop its own assumptions. The hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value. The Company measures its cash and cash equivalents and short-term investments at fair value. Fair value of financial instruments The fair value of the Company’s debt, which is classified as equipment financing liability on the balance sheets, is estimated based on current rates offered to the Company for similar debt and approximates carrying value. Cash and cash equivalents The Accounts receivable, net The Company sells or leases its lasers to distributors or physicians directly with various forms of financing options. The Company extends credit based on an evaluation of the customers’ financial condition generally without requiring collateral. Exposure to losses on trade receivables is expected to vary by customer due to the financial condition of each customer. The Company monitors exposure to credit losses and maintains allowances for anticipated losses considered necessary under the circumstances. The Company maintains an allowance for doubtful accounts for balances that appear to have specific collection issues and expected credit losses. The collection process is based on the age of the invoice and requires attempted contacts with the customer at specified intervals. If, after a specified number of days, the Company has been unsuccessful in its collection efforts, provision for doubtful accounts is recorded for the balance in question. Delinquent accounts receivable are charged against the allowance for doubtful accounts once the Company has determined the amounts are uncollectible. The factors considered in reaching this determination are the apparent financial condition of the customer and the Company’s success in contacting and negotiating with the customer. If the financial condition of the Company’s customers were to deteriorate, resulting in an impairment of their ability to make payments, additional allowances may be required. The following table shows the allowance for doubtful accounts activity (in thousands): Year Ended December 31, 2020 2019 Balance at beginning of period $ 305 $ 193 Provision for doubtful accounts 42 254 Deductions (263 ) (142 ) Balance at end of period $ 84 $ 305 Inventories (first-in, first-out Catheters are manufactured in-house re-tested. Property and equipment, net Computer hardware and software 4 Furniture and fixtures 5 years Machinery and equipment 5 Lasers 3 5 Automobiles 5 years Leasehold improvements are depreciated over the shorter of the useful life of the leasehold improvement or the term of the underlying property’s lease. When assets are retired or Impairment of long-lived assets Company Product warranty Product warranties are included for the first year after the sale for laser sales. For lasers, the customer may purchase an extended service contract, which is either negotiated in the contract or sold as a separate component for which revenue is recognized over the term of the agreement. The warranty accrual is included in accrued expenses in the accompanying balance sheets. Warranty expenses are included in cost of revenue in the accompanying statements of operations. Changes in estimates to previously established warranty accruals result from current period updates to assumptions regarding repair and product recall costs and are included in current period warranty expense. Revenue recognition Revenue from Contracts with Customers The Company generates revenue from the sale of products and services. Product sales consist of the sale of DABRA and Pharos laser systems, the sale of catheters for use with the DABRA laser, and the sale of consumables and replacement parts. The Company’s sales agreements generally do not include right-of-return The Company determines revenue recognition incorporating the following steps: • Identification of each contract with a customer; • Identification of the performance obligations in the contract; • Determination of the transaction price; • Allocation of the transaction price to the performance obligations in the contract; and • Recognition of revenue when, or as, performance obligations are satisfied. The Company accounts for a contract with a customer when it has a legally enforceable contract with the customer, the arrangement identifies the rights of the parties, the contract has commercial substance, and the Company determines it is probable that it will collect the contract consideration. The Company recognizes revenue when control of the promised goods or services transfers to customers, in an amount that reflects the consideration the Company expects to be entitled to in exchange for those goods or services. Taxes collected from customers relating to goods or services and remitted to governmental authorities are excluded from revenue. Catheter Revenue The Company enters into a DABRA laser commercial usage agreement or DABRA laser placement acknowledgement with each customer that is supplied a DABRA laser, collectively the “usage agreement”. The usage agreement provides for specific terms of continued use of DABRA laser, including a nominal periodic fee. The terms of a usage agreement typically allow the Company to place a DABRA laser at a customer’s specified location without a specified contract term. Under the usage agreement terms, the Company retains all ownership rights to the DABRA laser and is permitted to request the return of the equipment within 10 business days of notification. While the laser periodic fees are nominal, the laser usage agreements provide the Company the exclusive rights to supply related single-use The Company recognizes revenue associated with the usage agreement and catheter supply arrangements in accordance with Topic 606 as the contract primarily includes variable payments, the catheters are priced at their standalone selling price and the laser equipment is insignificant in the context of the contract. Revenue is recognized when the performance obligation is satisfied, which is generally upon shipment of the catheter. Laser Sales Sales of laser systems and are included in product sales in the statements of operations. The Company recognizes revenue on laser sales at the point in time that control transfers to the customer. Control of the product typically transfers upon shipment. Warranty Service Revenue The Company typically provides a 12-month 12-month Distributor Transactions In certain markets outside the U.S., the Company sells products and provides services to customers through distributors that specialize in medical device products. The terms of sales transactions through distributors are generally consistent with the terms of direct sales to customers. The Company accounts for these transactions in accordance with the Company’s revenue recognition policy described herein. Contracts with multiple performance obligations Certain of the Company’s contracts with customers contain multiple performance obligations. For these contracts, the Company accounts for individual products and services as separate performance obligations if they are distinct, which is if (i) a product or service is separately identifiable from other items in the arrangement and (ii) the customer can benefit from the product or service on its own or with other readily available resources. The transaction price is allocated to the separate performance obligations on a relative standalone selling price basis. The Company determines standalone selling prices based on observable prices of products or services sold separately in comparable circumstances to similar customers. Significant Financing Component For multi-year warranty service contracts in which there is a difference between the cash selling price and the consideration in the contract and a significant amount of time between the payment, which is due up-front, For services contracts that have an original duration of one year or less, the Company uses the practical expedient applicable to such contracts and does not adjust the transaction price for the time value of money. Practical expedients elected As part of the Company’s adoption of Topic 606, the Company elected to use the following practical expedients: • not to adjust the promised amount of consideration for the effects of a significant financing component when the Company expects, at contract inception, that the period between the Company’s transfer of a promised product or service to a customer and when the customer pays for that product or service will be one year or less; • to expense costs as incurred for costs to obtain a contract when the amortization period would have been one year or less; • to exclude government assessed taxes from the transaction price; and • not to recast revenue for contracts that begin and end in the same fiscal year. Contract Costs The Company capitalizes costs to obtain contracts that are considered incremental and recoverable, such as sales commissions. The capitalized costs are amortized to selling, general and administrative expense over the estimated period of benefit of the asset, which is the contract term. The Company elected to use the practical expedient to expense the costs to obtain a contract when the amortization period is less than one year. The Company has contract costs of $0.2 million and $0.4 million capitalized at December 31, 2020 and December 31, 2019, respectively. The capitalized costs are recorded as assets of discontinued operations in the balance sheets at December 31, 2020 and 2019. Rental Income The Company also adopted ASC Topic 842, Leases The Company also derives income pursuant to product lease agreements for its Pharos laser systems, as operating leases. Consequently, the Company retains title to the equipment and the equipment remains on Company’s balance sheet within property and equipment. Depreciation expense on these leased lasers is recorded to cost of revenues on a straight-line basis. The costs to maintain these leased lasers are charged to cost of revenues as incurred. These lease arrangements contain one lease component (the laser) and one nonlease component (warranty service) for which the Company elected the practical expedient to not separate the nonlease component from the lease component. The Company accounts for the combined lease component as an operating lease and recognizes lease income on a straight-line basis over the lease term. Rental income from lease arrangements for the years ended December 31, 2020 and 2019 was $0.6 million and $0.7 million, respectively. Shipping and handling costs handling Advertising expense expenses There Research and development Patents costs Stock-based compensation — Stock-based compensation expense for equity instruments issued to employees and directors is measured based on estimating the fair value of each stock option on the date of grant using the Black Scholes option pricing model. Equity instruments issued to nonemployee consultants and service providers are valued using the Black Scholes option pricing model and are subject to revaluation as the underlying equity instruments vest. The Company recognizes forfeitures as they occur. The Company recognizes stock-based compensation expense as follows: Employees Nonemployees Service condition only Straight-line In the same period and in the same manner as if the Company paid cash for services. Performance criterion is probable of being met: Service criterion is complete Recognize the grant date fair value of the award once the performance criterion is considered probable of occurrence Recognize the grant date fair value of the award once the performance criterion is considered probable of occurrence Service criterion is not complete Straight-line Straight-line unless a performance condition is not probable Performance criterion is not probable of being met No expense is recognized until the performance criterion is considered probable, at which point expense is recognized per above No expense is recognized until the performance criterion is considered probable, at which point expense is recognized per above Income taxes The Company accounts for uncertainty in income taxes using a two-step Concentrations of credit risk Financial instruments, which potentially subject the Company to concentration of credit risk, consist of cash, cash equivalents and short-term investments balances maintained in excess of Federal Depository Insurance Corporation limits, and accounts receivable which have no collateral or security. The Company monitors the financial condition of the banks in which it currently has deposits. The Company has not experienced any significant losses in this respect and believes that it is not exposed to any significant related risk. Exposure to losses on accounts receivable is dependent on the individual customer’s financial condition. The Company monitors its exposure to credit losses and reserves for those accounts receivable that it deems to be not collectible. The Company had four and three individual customers that represented greater than 10% of total net revenue for the years ended December 31, 2020 and 2019, respectively. One and three individual customers represented 10% of accounts receivable for each of the years ended December 31, 2020 and 2019, respectively. Recently Adopted Accounting Pronouncements non-public non-public In June 2018, the FASB issued ASU 2018-07, Improvements to Nonemployee Share-Based Payment Accounting 2018-07 Compensation—Stock Compensation 2018-07 Subtopic 505-50, Equity—Equity-Based Payments to Non-Employees In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820) —Disclosure Framework—Changes to the Disclosure Requirements for Fair Value Measurement No. 2018-13 In June 2016, the FASB issued ASU No. 2016-13, Financial No. 2016-13 In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes 2019-12 |
Discontinued Operations
Discontinued Operations | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Payables and Accruals [Abstract] | ||
Discontinued Operations | Note 3. Discontinued Operations Consistent with the Company’s continued focus on the PAD market, the Company completed the sale of its Dermatology Business to Strata Skin Sciences, Inc. (“Strata”) on August 16, 2021 for cash proceeds of $3.7 million. The Company paid broker and legal fees of approximately $0.2 million related to the sale of the Dermatology Business. In addition, the Company issued a warrant to the broker to purchase 74,247 shares of common stock at an exercise price of $2.99 per share. The warrant is immediately exercisable and expires five years following the date of issuance. The warrant was valued at approximately $0.1 million on the grant date using the Black-Scholes option pricing model based on the following assumptions: expected volatility of 104.55%, risk-free interest rate of 0.32%, expected dividend yield of 0% and an expected term of 2.5 years The Dermatology Business was previously disclosed as a separate reportable segment of the Company. The sale of the Dermatology Business resulted in a gain of $3.5 million which is included as a component of income (loss) from discontinued operations in the condensed statements of operations for the three and nine months ended September 30, 2021. Beginning in the third quarter of 2021, the Company has reported the results of the Dermatology Business in income (loss) from discontinued operations in the condensed statements of operations and excluded them from continuing operations for all periods presented. The assets and liabilities of the Dermatology Business are recorded as assets of discontinued operations and liabilities of discontinued operations, respectively, in the condensed balance sheets. Certain overhead costs previously allocated to the Dermatology Business for segment reporting purposes did not qualify for classification within discontinued operations and have been reallocated to continuing operations for all periods presented. The following table summarizes the carrying amounts of the assets and liabilities included as discontinued operations in the condensed balance sheet at December 31, 2020 (in thousands): December 31, Assets of discontinued operations Accounts receivable, net $ 214 Inventories 1,341 Prepaid expenses and other current assets 158 Property and equipment, net 684 Other long-term assets 78 Total assets of discontinued operations $ 2,475 Liabilities of discontinued operations Accounts payable $ 100 Accrued expenses 201 Deferred revenue 2,487 Total liabilities of discontinued operations $ 2,788 The assets and liabilities of discontinued operations have been classified as current and long-term, as applicable, in the condensed balance sheet at December 31, 2020. The following table summarizes the major classes of items constituting income (loss) from discontinued operations in the condensed statements of operations for each of the periods presented (in thousands): Three Months Ended Nine Months Ended 2021 2020 2021 2020 Net revenues Product sales $ 140 $ 118 $ 852 $ 670 Service and other 349 729 1,748 2,259 Total net revenues 489 847 2,600 2,929 Cost of revenues Product sales 158 347 1,201 1,127 Service and other 238 504 1,089 1,296 Total cost of revenues 396 851 2,290 2,423 Gross income (loss) 93 (4 ) 310 506 Operating expenses Selling, general and administrative 330 236 1,110 958 Research and development 134 21 388 47 Total operating expenses 464 257 1,498 1,005 Operating loss (371 ) (261 ) (1,188 ) (499 ) Interest expense, net (22 ) (3 ) (94 ) (24 ) Loss from discontinued operations (393 ) (264 ) (1,282 ) (523 ) Gain on sale of the Dermatology Business 3,473 — 3,473 — Income (loss) from discontinued operations $ 3,080 $ (264 ) $ 2,191 $ (523 ) Depreciation expense for the Dermatology Business was $0.1 million for each of the three months ended September 30, 2021 and 2020 and $0.3 million for each of the nine months ended September 30, 2021 and 2020. There were no capital expenditures for the Dermatology Business during the nine months ended September 30, 2021 and 2020. Stock-based compensation expense for the Dermatology Business was de minimis and approximately $14,000 for the three months ended September 30, 2021 and 2020, respectively. Stock-based compensation expense was approximately $18,000 and $0.1 million for the nine months ended September 30, 2021 and 2020, respectively. Stock-based compensation expense of approximately $4,000 and $30,000 was capitalized to inventory and property and equipment during the three months ended September 30, 2021 and 2020, respectively. Stock-based compensation expense of approximately $0.1 million was capitalized to inventory and property and equipment during each of the nine months ended September 30, 2021 and 2020. | Note 3—Discontinued Operations Consistent with the Company’s continued focus on the PAD market, the Company completed the sale of its Dermatology Business to Strata Skin Sciences, Inc. (“Strata”) on August 16, 2021 for cash proceeds of $3.7 million. The Company paid broker and legal fees of approximately $0.2 million related to the sale of the Dermatology Business. In addition, the Company issued a warrant to the broker to purchase 74,247 shares of common stock at an exercise price of $2.99 per share. The warrant is immediately exercisable and expires five years following the date of issuance. The warrant was valued at approximately $0.1 million on the grant date using the Black-Scholes option pricing model based on the following assumptions: expected volatility of 104.55%, risk-free interest rate of 0.32%, expected dividend yield of 0% and an expected term of 2.5 years. The Dermatology Business was previously disclosed as a separate reportable segment of the Company. The sale of the Dermatology Business resulted in a gain of $3.5 million which is included as a component of income (loss) from discontinued operations in the condensed statements of operations for the three and nine months ended September 30, 2021. Beginning in the third quarter of 2021, the Company has reported the results of the Dermatology Business in income (loss) from discontinued operations in the condensed statements of operations and excluded them from continuing operations for all periods presented. The assets and liabilities of the Dermatology Business are recorded as assets of discontinued operations and liabilities of discontinued operations, respectively, in the condensed balance sheets. Certain overhead costs previously allocated to the Dermatology Business for segment reporting purposes did not qualify for classification within discontinued operations and have been reallocated to continuing operations for all periods presented. The following table summarizes the carrying amounts of the assets and liabilities included as discontinued operations in the balance sheets at December 31, 2020 and 2019 (in thousands): December 31, 2020 2019 Assets of discontinued operations Accounts receivable, net $ 214 $ 563 Inventories 1,341 1,485 Prepaid expenses and other current assets 158 232 Property and equipment, net 684 906 Other long-term assets 78 151 Total assets of discontinued operations $ 2,475 $ 3,337 Liabilities of discontinued operations Accounts payable $ 100 $ 312 Accrued expenses 201 282 Deferred revenue 2,487 3,261 Total liabilities of discontinued operations $ 2,788 $ 3,855 The assets and liabilities of discontinued operations have been classified as current and long-term, as applicable, in the balance sheets at December 31, 2020 and 2019. The following table summarizes the major classes of items constituting income (loss) from discontinued operations in the statements of operations for each of the periods presented (in thousands): Years Ended 2020 2019 Net revenues Product sales $ 1,154 $ 2,604 Service and other 2,992 3,320 Total net revenues 4,146 5,924 Cost of revenues Product sales 1,522 2,483 Service and other 1,789 2,236 Total cost of revenues 3,311 4,719 Gross income (loss) 835 1,205 Operating expenses Selling, general and administrative 1,440 6,242 Research and development 54 86 Total operating expenses 1,494 6,328 Operating loss (659 ) (5,123 ) Interest expense, net (66 ) (179 ) Loss from discontinued operations $ (725 ) $ (5,302 ) Depreciation expense for the Dermatology Business was $0.4 million for each of the years ended December 31, 2020 and 2019. Capital expenditures for the Dermatology Business for the years ended December 31, 2020 and 2019 were nil and approximately $32,000, respectively. Stock |
Fair Value Measurements
Fair Value Measurements | 9 Months Ended |
Sep. 30, 2021 | |
Fair Value Disclosures [Abstract] | |
Fair Value Measurements | Note 4. Fair Value Measurements Cash equivalents of approximately $9.4 million and $18.4 million at September 30, 2021 and December 31, 2020, respectively, were comprised of money market funds which were measured at fair value on a recurring basis based on Level 1 of the fair value hierarchy. |
Short-term Investments
Short-term Investments | 12 Months Ended |
Dec. 31, 2020 | |
Short-term Investments [Abstract] | |
Short-term Investments | Note 4—Short-term Investments A summary of debt securities by major security type is as follows as of December 31, 2019 (in thousands): Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Debt Securities-available-for-sale: U.S. agency securities $ 1,000 $ — $ — $ 1,000 U.S. government securities 14,967 26 — 14,993 Total debt securities $ 15,967 $ 26 $ — $ 15,993 All debt securities were due in less than one year. The following table presents the hierarchy for assets measured at fair value on a recurring basis (in thousands): Total Fair Value Quoted Market Prices for Identical Assets (Level 1) Other Observable Inputs (Level 2) Unobservable Inputs (Level 3) As of December 31, 2020 Money market funds $ 18,394 $ 18,394 $ — $ — As of December 31, 2019 Money market funds $ 13,219 $ 13,219 $ — $ — U.S. government securities $ 14,993 $ 14,993 $ — $ — U.S. agency securities $ 1,000 $ — $ 1,000 $ — |
Inventories
Inventories | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Inventory Disclosure [Abstract] | ||
Inventories | Note 5. Inventories Inventories consisted of the following (in thousands): September 30, 2021 December 31, 2020 Raw materials $ 884 $ 547 Work in process 60 270 Finished goods 53 60 Total inventories $ 997 $ 877 | Note 5—Inventories Inventories consisted of the following (in thousands): December 31, 2020 2019 Raw materials $ 547 $ 977 Work in process 270 215 Finished goods 60 100 Inventories $ 877 $ 1,292 |
Property and Equipment
Property and Equipment | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Property, Plant and Equipment, Net [Abstract] | ||
Property and Equipment | Note 6. Property and Equipment Property and equipment consisted of the following (in thousands): September 30, 2021 December 31, 2020 Lasers $ 3,151 $ 3,194 Machinery and equipment 812 834 Computer hardware and software 353 353 Construction in progress 209 51 Leasehold improvements 119 119 Automobiles 62 1,054 Furniture and fixtures 48 48 Property and equipment, gross 4,754 5,653 Accumulated depreciation (2,724 ) (3,126 ) Total property and equipment, net $ 2,030 $ 2,527 Depreciation expense was $0.2 million and $0.4 million for the three months ended September 30, 2021 and 2020, respectively, and $0.7 million and $1.3 million for the nine months ended September 30, 2021 and 2020, respectively. During the nine months ended September 30, 2021, automobiles were sold for a gain of $0.5 million which is included in selling, general and administrative expenses in the accompanying condensed statements of operations. | Note 6—Property and Equipment, net Property and equipment consisted of the following (in thousands): December 31, 2020 2019 Lasers $ 3,194 $ 3,307 Machinery and equipment 834 809 Automobiles 1,054 1,109 Computer hardware and software 353 348 Leasehold improvements 119 119 Furniture and fixtures 48 48 Construction in progress 51 23 Property and equipment, gross 5,653 5,763 Accumulated depreciation (3,126 ) (1,619 ) Property and equipment, net $ 2,527 $ 4,144 Depreciation expense was $1.6 million and $1.0 million for the years ended December 31, 2020 and 2019, respectively. |
Accrued Expenses
Accrued Expenses | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Payables and Accruals [Abstract] | ||
Accrued Expenses | Note 7. Accrued Expenses Accrued expenses consisted of the following (in thousands): September 30, 2021 December 31, 2020 Accrued legal expenses $ 1,393 $ 957 Compensation and related benefits 496 2,479 Accrued warranty (Note 8) 195 204 Other accrued expenses 548 507 Total accrued expenses $ 2,632 $ 4,147 | Note 7—Accrued Expenses Accrued expenses consisted of the following (in thousands): December 31, 2020 2019 Compensation and related benefits $ 2,479 $ 985 Accrued warranty (Note 8) 204 234 Accrued services 1,464 1,141 Accrued expenses $ 4,147 $ 2,360 |
Accrued Warranty
Accrued Warranty | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Product Warranties Disclosures [Abstract] | ||
Accrued Warranty | Note 8. Accrued Warranty Activity in the warranty accrual is included in accrued expenses in the condensed balance sheets and consisted of the following (in thousands): Nine Months Ended Year Ended Balance at beginning of period $ 204 $ 234 Increase in warranty accrual — 19 Change in liability for pre-existing — 4 Claims satisfied (9 ) (53 ) Total accrued warranty $ 195 $ 204 The accrued warranty balances at September 30, 2021 and December 31, 2020 each included $0.1 million related to the voluntary recall of catheters, which occurred in September 2019. Warranty expense is included in cost of revenue in the accompanying condensed statements of operations. | Note 8—Accrued Warranty Activity in the product warranty accrual is included in accrued expenses above and consists of the following (in thousands): Year ended 2020 2019 Balance at beginning of period $ 234 $ 50 Increase in warranty accrual 19 709 Change in liability for pre-existing 4 (28 ) Claims satisfied (53 ) (497 ) Accrued warranty $ 204 $ 234 Warranty expense was approximately $19,000 and $0.7 million for the years ended December 31, 2020 and 2019, respectively. The accrued warranty balances at December 31, 2020 and 2019 include $0.1 million and $0.2 million, respectively, relating to the voluntary recall of catheters, which was initiated in September 2019. Warranty expense is included in cost of revenue in the accompanying statements of operations. |
Paycheck Protection Program Pro
Paycheck Protection Program Promissory Note | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Paycheck Protection Program Promissory Note [Abstract] | ||
Paycheck Protection Program Promissory Note | Note 9. Paycheck Protection Program Promissory Note In May 2020, the Company entered into a $2.0 million Paycheck Protection Program Promissory Note and Agreement (“PPP Promissory Note”) with a commercial bank under the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”). The PPP Promissory Note bore an interest rate of 1.0% per annum. Under the terms of the PPP Promissory Note, payments would have been due monthly beginning November 1, 2020, and the principal amount of the PPP Promissory Note, along with any unpaid interest, would have been due in May 2022 | Note 9—Paycheck Protection Program Promissory Note In May 2020, the Company entered into a $2.0 million Paycheck Protection Program Promissory Note and Agreement (“PPP Promissory Note”) with a commercial bank under the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act. The PPP Promissory Note bears interest at 1.0% per annum. Under the terms of the PPP Promissory Note, payments would be due monthly beginning November 1, 2020 and the principal amount of the PPP Promissory Note along with any unpaid interest would be due on May 3, 2022. On June 5, 2020, the Paycheck Protection Program Flexibility Act of 2020 (the “PPPFA”) extended the deferral period for all loans to 10 months after the last day of the covered period. Under the revised terms, payments are due beginning August 2021 and the principal amount along with unpaid interest is due in May 2022. The Company has requested from its lender an extension of the loan maturity from two years five years |
Leases
Leases | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Leases [Abstract] | ||
Leases | Note 10. Leases The Company has two operating leases for office and manufacturing space which require it to pay base rent and certain utilities. Monthly rent expense is recognized on a straight-line basis over the terms of the leases, which expire in 2027 and December 2021 At September 30, 2021, the weighted average remaining lease term was 6.3 years. The operating leases are included in the condensed balance sheets at the present value of the lease payments at a 7% discount rate which approximates the rate of interest that the Company would have to pay to borrow on a collateralized basis over a similar term and amount equal to the lease payments in a similar economic environment, as the leases do not provide an implicit rate. For each of the three months ended September 30, 2021 and 2020, operating lease expense and cash paid for leases was $0.1 million. For each of the nine months ended September 30, 2021 and 2020, operating lease expense and cash paid for leases was $0.4 million. Amortization for operating lease right-of-use Maturities of operating lease liabilities as of September 30, 2021 were as follows (in thousands): Years Ending December 31, 2021 (remaining three months) $ 132 2022 432 2023 445 2024 459 2025 472 2026 486 Thereafter 501 Total operating lease payments 2,927 Less: imputed interest (572 ) Total operating lease liabilities $ 2,355 | Note 10—Leases The Company recognized non-cash right-of-use 2016-02 At December 31, 2020 the weighted average remaining lease term was seven years For the years ended December 31, 2020 and 2019, operating lease expense and cash paid were each $0.5 million. Operating lease right-of-use The following table presents the lease liabilities within the balance sheet, related to the Company’s operating leases as of December 31, 2020 (in thousands): Years Ending December 31, 2021 $ 528 2022 432 2023 445 2024 459 2025 472 Thereafter 987 Total operating lease payments $ 3,323 Less: imputed interest (703 ) Total operating lease liabilities $ 2,620 |
Net Loss per Share
Net Loss per Share | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Earnings Per Share [Abstract] | ||
Net Loss per Share | Note 11. Net Loss per Share The Company calculates basic net loss per share by dividing net loss by the weighted average number of common shares outstanding during the reporting period. A net loss cannot be diluted, so when the Company is in a net loss position, basic and diluted loss per common share are the same. If in the future the Company achieves profitability, the denominator of a diluted earnings per common share calculation will include both the weighted average number of shares outstanding and the number of common stock equivalents, if the inclusion of such common stock equivalents would be dilutive. Dilutive common stock equivalents include warrants, stock options and non-vested The Company’s outstanding warrants to purchase common stock have participation rights to any dividends that may be declared in the future and are therefore considered to be participating securities. Participating securities have the effect of diluting both basic and diluted earnings per share during periods of income. During periods of loss, no loss is allocated to the participating securities since the holders have no contractual obligation to share in the losses of the Company. Anti-dilutive share equivalents excluded from the computation of diluted net loss per share at September 30, 2021 consisted of warrants of 2,419,280, stock options of 126,998, restricted stock awards of 312,380, restricted stock units of 45,832 and Employee Stock Purchase Plan shares of 10,462. Anti-dilutive share equivalents excluded from the computation of diluted net loss per share at September 30, 2020 consisted of warrants of 2,345,033, stock options of 144,851, restricted stock awards of 5,000, restricted stock units of 20,678 and Employee Stock Purchase Plan shares of 3,772. | Note 12—Loss per Share The Company calculates basic loss per share by dividing net loss by the weighted average number of common shares outstanding during the reporting period. A net loss cannot be diluted, so when the Company is in a net loss position, basic and diluted loss per common share are the same. If in the future the Company achieves profitability, the denominator of a diluted earnings per common share calculation will include both the weighted-average number of shares outstanding and the number of common stock equivalents, if the inclusion of such common stock equivalents would be dilutive. Dilutive common stock equivalents potentially include warrants, stock options and non-vested The Company’s outstanding warrants to purchase common stock have participation rights to any dividends that may be declared in the future and are therefore considered to be participating securities. Participating securities have the effect of diluting both basic and diluted earnings per share during periods of income. During periods of loss, no loss is allocated to the participating securities since the holders have no contractual obligation to share in the losses of the Company. Anti-dilutive common share equivalents excluded from the computation of diluted net loss per share at December 31, 2020 consisted of warrants of 2,345,033, stock options of 142,171, restricted stock units of 33,548, restricted stock awards of 290,536 and Employee Stock Purchase Plan shares of 3,200. Anti-dilutive common share equivalents excluded from the computation of diluted net loss per share at December 31, 2019 consisted of stock options of 125,579, restricted stock units of 10,864 and Employee Stock Purchase Plan shares of 2,473. |
Equipment Financing
Equipment Financing | 12 Months Ended |
Dec. 31, 2020 | |
Equipment Financing [Abstract] | |
Equipment Financing | Note 11—Equipment Financing During 2018, the Company entered into four loan agreements to finance 25 automobiles. The loans mature in 2021 and bear interest at a weighted average interest rate of 6.5%. These loans are secured by the automobiles. March 2021 |
Equity Offerings
Equity Offerings | 9 Months Ended |
Sep. 30, 2021 | |
Equity [Abstract] | |
Equity Offerings | Note 12. Equity Offerings In February 2021, the Company completed an ATM offering of 35,768 shares of common stock at a price of $8.39 per share. The Company received approximately $0.3 million in net proceeds, after deducting placement agent’s fees. The Company also incurred $0.2 million in offering fees and other expenses in association with filing the related Registration Statement on Form S-3 On various dates in May 2021 and June 2021, the Company completed ATM offerings of 2,582,019 shares of common stock at a weighted average price of $4.29 per share. The Company received approximately $10.6 million in net proceeds, after deducting placement agent’s fees. On various dates in July 2021 and August 2021, the Company completed ATM offerings of 1,139,306 shares of common stock, at a weighted average price of $4.00 per share. The Company received approximately $4.4 million in net proceeds, after deducting offering fees. |
Stockholders' Equity
Stockholders' Equity | 12 Months Ended |
Dec. 31, 2020 | |
Stockholders' Equity Attributable to Parent [Abstract] | |
Stockholders' Equity | Note 13—Stockholders’ Equity Common stock The warrants and placement agent warrants were valued at an aggregate $3.5 million using the Black-Scholes option pricing model based on the following assumptions; expected volatility 59.86%, risk-free interest rate 0.34%, expected dividend yield 0.00% and an expected term of 2.5 years. In June 2020, the Company issued 73,506 shares of common stock in connection with the exercise of warrants issued in the May 2020 Offering. At December 31, 2020, the Company had 815,382 shares and 62,222 shares of common stock reserved for issuance pursuant to the warrants and placement agent’s warrants, respectively, issued by the Company in the May 2020 Offering, at an exercise price of $11.25 per share and $14.0625 per share, respectively. In August 2020, the Company completed another public offering (the “August 2020 Offering”) of an aggregate of 1,371,429 shares of common stock, together with accompanying warrants to purchase up to an aggregate of 1,371,429 shares of common stock, at a public offering price of $8.75 per share and accompanying warrant. Each share of common stock was sold in the offering with one warrant to purchase one share of common stock. The warrants have an exercise price of $8.75 per share, are immediately exercisable, and expire five years following the date of issuance. Placement agent warrants were issued to purchase up to an aggregate of 96,000 shares of common stock, are immediately exercisable for an exercise price of $10.9375, and expire five years following the date of issuance. The Company received approximately $10.4 million in net proceeds, after deducting placement agent’s fees and other estimated offering expenses of $1.6 million payable by it. The warrants and placement agent warrants were valued at an aggregate $4.0 million using the Black-Scholes option pricing model based on the following assumptions; expected volatility 59.72%, risk-free interest rate 0.17%, expected dividend yield 0.00% and an expected term of 2.5 years. At December 31, 2020, the Company had 1,371,429 shares and 96,000 shares of common stock reserved for issuance pursuant to the warrants and placement agent’s warrants, respectively, issued by the Company in the August 2020 Offering, at an exercise price of $8.75 per share and $10.9375 per share, respectively. Preferred stock |
Stock-Based Compensation
Stock-Based Compensation | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Share-based Payment Arrangement [Abstract] | ||
Stock-Based Compensation | Note 13. Stock-Based Compensation A summary of the stock option activity under the 2018 Equity Incentive Plan (the “2018 Plan”) and the 2018 Stock Compensation Plan is presented below: Stock Options Weighted Average Exercise Price Weighted Average Remaining Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding at December 31, 2020 124,171 $ 363.31 6.42 Forfeited (15,173 ) $ 87.28 Outstanding at September 30, 2021 108,998 $ 401.74 4.82 $ — Exercisable at September 30, 2021 95,096 $ 455.95 4.32 $ — Vested and expected to vest at September 30, 2021 108,998 $ 401.74 4.80 $ — A summary of the stock option activity under the 2020 Inducement Equity Incentive Plan (the “2020 Plan”) is presented below: Stock Options Weighted Average Exercise Price Weighted Average Remaining Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding at December 31, 2020 18,000 $ 25.50 9.24 Outstanding at September 30, 2021 18,000 $ 25.50 8.50 $ — Exercisable at September 30, 2021 6,750 $ 25.50 8.50 $ — Vested and expected to vest at September 30, 2021 18,000 $ 25.50 8.50 $ — A summary of the restricted stock unit activity under the 2018 Plan is presented below: Restricted Stock Units Weighted Average Grant Date Fair Value Outstanding at December 31, 2020 33,548 $ 21.93 Granted 29,614 $ 3.99 Vested (1,845 ) $ 64.80 Forfeited (15,485 ) $ 14.67 Outstanding at September 30, 2021 45,832 $ 11.06 A summary of the restricted stock award activity under the 2018 Plan is presented below: Restricted Weighted Average Grant Date Fair Value Outstanding at December 31, 2020 286,161 $ 4.77 Granted 103,939 $ 4.82 Vested (31,388 ) $ 6.96 Forfeited (50,082 ) $ 5.10 Outstanding at September 30, 2021 308,630 $ 4.51 A summary of the restricted stock award activity under the 2020 Plan is presented below: Restricted Stock Awards Weighted Average Grant Date Fair Value Outstanding at December 31, 2020 4,375 $ 25.50 Vested (625 ) $ 25.50 Outstanding at September 30, 2021 3,750 $ 25.50 Stock-based compensation expense recorded in operating expenses was as follows (in thousands): Three Months Ended Nine Months Ended 2021 2020 2021 2020 Selling, general and administrative $ 78 $ 757 $ 1,551 $ 2,424 Research and development 27 115 251 317 Stock-based compensation in operating expenses $ 105 $ 872 $ 1,802 $ 2,741 Stock-based compensation expense of approximately $5,000 and $48,000 was capitalized to inventory and property and equipment during the three months ended September 30, 2021 and 2020, respectively. Stock-based compensation of approximately $0.1 million was capitalized to inventory and property and equipment during each of the nine months ended September 30, 2021 and 2020. Unrecognized compensation expense for stock options issued as of September 30, 2021 was $0.4 million and is expected to be recognized over a weighted average period of 1.9 years. Unrecognized compensation expense for the restricted stock units as of September 30, 2021 was $0.3 million and is expected to be recognized over a weighted average period of 2.0 years. Unrecognized compensation expense for the restricted stock awards as of September 30, 2021 was $0.8 million and is expected to be recognized over a weighted average period of 2.4 years. | Note 14—Stock-Based Compensation On June 4, 2018, the 2018 Stock Compensation Plan was established (the “Compensation Plan”) whereby 132,000 shares of the Company’s common stock were reserved for issuance. On June 4, 2018, the Company’s board of directors authorized 76,076 replacement equity awards of stock options for awards that had been granted under a previous plan, and, on June 8, 2018, 53,633 restricted stock units (collectively, the “Replacement Awards”) to eligible employees, directors, consultants and service providers. The Compensation Plan terminated in connection with the adoption of the Company’s 2018 Equity Incentive Plan, described below, and, accordingly no new awards are available for issuance under this plan. The Compensation Plan continues to govern awards granted thereunder. Stock options granted under the Compensation Plan, including those granted as a component of the Replacement Awards, generally vest 33% on the first anniversary of the grant date with the balance vesting monthly over the remaining two years. The restricted stock units granted under the Compensation Plan, including those granted as a component of the Replacement Awards, include a service condition and a performance condition. The service condition generally begins on the grant date and continues through January 2020 The restricted stock units granted under the Compensation Plan, including those granted as a component of the Replacement Awards, include a service condition and a performance condition. The service condition generally begins on the grant date and continues through January 2020 and the restricted stock units vest at various times commencing the day following the expiration of the lock-up In September 2018, the Company’s board of directors adopted, and the Company’s stockholders approved, the Company’s 2018 Equity Incentive Plan (the “2018 Plan”). As of December 31, 2020, 110,329 shares of common stock are reserved for future issuance pursuant to the Company’s 2018 Plan. In addition, the shares reserved for issuance under the 2018 Plan include (1) those shares reserved but unissued under the Compensation Plan as of the date of stockholder approval of the 2018 Plan and (2) shares of common stock subject to or issued pursuant to awards granted under the Compensation Plan that, after the date of stockholder approval of the 2018 Plan, expire or otherwise terminate without having been exercised in full or are forfeited to or repurchased by us (provided that the maximum number of shares that may be added to the 2018 Plan pursuant to (1) and (2) is 132,000 shares). The 2018 Plan provides for the grant of incentive stock options, within the meaning of Section 422 of the Internal Revenue Code to the Company’s employees and any of the Company’s parent and subsidiary corporations’ employees, if applicable, and for the grant of nonstatutory stock options, restricted stock, restricted stock units, stock appreciation rights, performance units and performance shares to the Company’s employees, directors and consultants and the Company’s parent and subsidiary corporations’ employees, if applicable, and consultants. The number of shares available for issuance under the Company’s 2018 Plan also includes an annual increase on the first day of each fiscal year beginning with our 2019 fiscal year, equal to the least of 1) 65,285 shares; 2) five percent (5%) of the outstanding shares of our common stock as of the last day of the immediately preceding fiscal year; or 3) such other amount as our board of directors may determine. In March 2020 the Company adopted the 2020 Inducement Equity Incentive Plan (the “2020 Plan”) with the purpose of attracting, retaining and incentivizing employees in furtherance of the Company’s success. The 2020 Plan was adopted without stockholder approval pursuant to Rule 303A.08 of the New York Stock Exchange rules. In accordance with New York Stock Exchange rules, this plan is used to offer equity awards as material inducements for new employees to join the Company. On adoption, 32,000 shares of common stock were reserved solely for the granting of inducement stock options, restricted stock, restricted stock units and other awards. The 2020 Plan provides for the granting of stock options with exercise prices equal to the fair market value of our common stock on the date of grant. During the year ended December 31, 2020 there were 18,000 stock options granted with a weighted average exercise price of $25.50. There are 3,375 exercisable options in the 2020 Plan at December 31, 2020. During the year ended December 31, 2020, 5,000 restricted stock awards were granted, of which 625 vested, with a grant date fair value of $0.1 million, under the 2020 Plan. A summary of the activity and related information of the stock options issued under the 2018 Equity Incentive Plan and the Compensation Plan is presented below: Stock Options Weighted Average Exercise Price Weighted Average Remaining Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding at December 31, 2018 76,804 $ 714.75 9.43 $ — Granted 60,854 30.50 Forfeited (12,079 ) 670.25 Outstanding at December 31, 2019 125,579 $ 387.50 9.43 $ — Granted 11,729 30.69 Forfeited (13,137 ) 297.57 Outstanding at December 31, 2020 124,171 $ 363.31 6.42 $ — Exercisable at December 31, 2020 84,376 $ 466.78 5.89 $ — Vested and expected to vest at December 31, 2020 124,171 $ 363.31 6.42 $ — A summary of the activity and related information of the restricted stock units is presented below: Restricted Stock Weighted Average Grant Date Fair Value Outstanding at December 31, 2018 59,767 $ 672.75 Granted 12,010 98.75 Vested and released (48,269 ) 698.25 Forfeited (12,644 ) 497.75 Outstanding at December 31, 2019 10,864 $ 128.82 Granted 32,019 10.82 Vested and released (7,906 ) 114.55 Forfeited (1,429 ) 101.79 Outstanding at December 31, 2020 33,548 $ 21.93 A summary of the activity and related information of the restricted stock awards is presented below: Restricted Stock Awards (in shares) Weighted Average Grant Date Fair Value Outstanding at December 31, 2019 — $ — Granted 286,161 4.77 Forfeited — — Vested — — Outstanding at December 31, 2020 286,161 $ 4.77 Stock-based compensation expense recorded in operating expenses was as follows (in thousands): Year Ended December 31, 2020 2019 Selling, general and administrative $ 3,235 $ 16,141 Research and development 444 1,537 Stock-based compensation in operating expenses $ 3,679 $ 17,678 Stock-based compensation amounts of $0.2 million and $1.0 million were capitalized to property and equipment and inventory during the years ended December 31, 2020 and 2019, respectively. Unrecognized compensation expense for stock options issued as of December 31, 2020 was $1.8 million and is expected to be recognized over a weighted-average period of 1.2 years. Unrecognized compensation expense for the restricted stock units as of December 31, 2020 was $0.6 million and is expected to be recognized over a weighted-average period of 1.9 years. Unrecognized compensation expense for the restricted stock awards as of December 31, 2020 was $1.4 million and is expected to be recognized over a weighted-average period of 2.8 years. The fair value of the stock options issued under the 2018 Plan was estimated using the Black Scholes option pricing model and the weighted-average assumptions used in the model are noted in the following table: Year Ended December 31, 2020 2019 Risk-free interest rate 1.3 % 1.6 % Volatility 58.96 % 59.26 % Expected dividend yield 0.00 % 0.00 % Expected life (in years) 5.8 5.9 The fair value of the stock options issued under the 2020 Plan was estimated using the Black Scholes option pricing model and the weighted-average assumptions used in the model are noted in the following table: Year Ended December 31, 2020 Risk-free interest rate 0.5 % Volatility 58.33 % Expected dividend yield 0.00 % Expected life (in years) 6.3 The Company’s 2018 Employee Stock Purchase Plan (ESPP) became effective in September 2018. A total of 19,463 shares of common stock were available for sale under our ESPP as of December 31, 2020. Under the Company’s ESPP, eligible employees are allowed to purchase the Company’s stock at a discounted price, which is 85% of the lower market price of the Company’s common stock at the beginning or at the end of the six-month |
Income Taxes
Income Taxes | 12 Months Ended |
Dec. 31, 2020 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | Note 15—Income Taxes A reconciliation of the differences between the United States statutory federal income tax rate and the effective tax rate as provided in the statements of operations is as follows: Year Ended 2020 2019 Tax computed at the federal statutory rate 21.0 % 21.0 % State income taxes, net of federal benefits 5.1 1.9 Nondeductible expenses (0.1 ) (0.4 ) Stock-based compensation (2.2 ) (9.5 ) Deferred tax adjustments (57.0 ) — Change in valuation allowance 33.2 (13.0 ) — — The federal and state income tax provision is summarized as follows (in thousands): Year Ended 2020 2019 Current Federal $ — $ — State 7 15 7 15 Deferred Federal — — State — — — — Income tax expense $ 7 $ 15 Deferred income taxes reflect the net tax effects of (a) temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for tax purposes, and (b) operating losses and tax credit carryforwards. The tax effects of significant components of the Company’s deferred tax assets (liabilities) are as follows (in thousands): December 31, 2020 2019 Deferred Tax Assets: Net operating loss carryforwards $ 3,720 $ 16,096 Operating lease liabilities 691 766 Other accruals 101 61 Accrued compensation 448 — Reserves 299 301 Deferred revenue 642 850 Intangible assets 32 253 Stock-based compensation 4,910 4,821 Total gross deferred tax assets $ 10,843 $ 23,148 Deferred Tax Liabilities: Property and equipment (805 ) (1,026 ) Operating lease right-of-use (655 ) (739 ) Other (61 ) (92 ) Total gross deferred tax liabilities $ (1,521 ) $ (1,857 ) Valuation allowance (9,322 ) (21,291 ) Total deferred taxes $ — $ — At December 31, 2020, the Company had available federal and state net operating loss carryforwards of approximately $14.3 million and $13.4 million, respectively, which may be used to offset future federal and state taxable earnings. The federal net operating loss can be carried forward indefinitely and the state net operating losses begin expiring in 2032. Use of these net operating loss carryforwards may be significantly limited under the tax rules regarding the use of losses following an ownership change under Internal Revenue Code (“IRC”) Section 382. The Company has completed an IRC Section 382 analysis regarding the limitation of net operating losses through December 31, 2020 and determined that an ownership change occurred in May 2020. The Company calculated the limitation on net operating losses and other tax attributes and reduced the value of the deferred tax assets resulting in a tax expense impact of $20.8M. The tax expense was offset by tax benefit recorded on the reduction in valuation allowance recorded for the deferred tax assets for the year ended December 31, 2020. As of December 31, 2020, the Company does not have any unrecognized tax benefits. The Company does not anticipate that the amount of unrecognized tax benefits will significantly increase in the next 12 months. There were no interest and penalties accrued as of December 31, 2020. The Company files U.S. federal and various states income tax returns, which are subject to examination by the taxing authorities for years 2016 and later. However, the federal net operating loss carryover may be adjusted three years from the date the loss is utilized on an income tax return. ASC 740, Income Taxes On March 27, 2020, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security (CARES) Act (H.R. 748) which includes a number of provisions relating to refundable payroll tax credits, deferment of employer side social security payments, net operating loss carryback periods, alternative minimum tax credit refunds, modifications to the net interest deduction limitations and technical corrections to tax depreciation methods for qualified improvement property. Under ASC 740, the effects of new legislation are recognized upon enactment. Accordingly, the effects of the CARES Act have been incorporated into the income tax provision computation for the year ended December 31, 2020. These provisions did not have a material impact on the income tax provision. The Consolidated Appropriations Act, 2021 (CAA 2021), which was signed into law on December 27, 2020, provided that deductions are allowed for otherwise deductible expenses paid with the proceeds of a Paycheck Protection Program (PPP) loan that is forgiven and that the tax basis and other attributes of the borrower’s assets will not be reduced as a result of the loan forgiveness. Prior to the enaction of the CCA, the deductions paid with proceeds of a PPP loan that was forgiven were not allowed. These provisions did not have a material impact on the income tax provision. |
Commitments and Contingencies
Commitments and Contingencies | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Commitments and Contingencies Disclosure [Abstract] | ||
Commitments and Contingencies | Note 14. Commitments and Contingencies Legal In the normal course of business, the Company is at times subject to pending and threatened legal actions. In management’s opinion, any potential loss resulting from the resolution of these matters will not have a material effect on the results of operations, financial position or cash flows of the Company. Securities Litigation On June 7, 2019, a putative securities class action complaint captioned Derr v. Ra Medical Systems, Inc., et. al., On October 1, 2019, a shareholder derivative complaint captioned Noel Borg v. Dean Irwin, et. al 1:99-cm-09999) Settlement Agreements with the Department of Justice and Participating States As previously announced on December 28, 2020, the Company entered into a Settlement Agreement with the U.S., acting through the Department of Justice (“DOJ”) and on behalf of the Office of Inspector General (“OIG”), and other settlement agreements with certain state attorneys general to resolve investigations and a related civil action concerning its marketing of the DABRA laser system and DABRA-related remuneration to certain physicians. Pursuant to the terms of the Settlement Agreement and the agreements with the participating states, (a) if the Company’s revenue exceeds $10 million in any of fiscal years 2021-2024, the Company also is required to pay for the corresponding year: $500,000 for 2021, $750,000 for 2022, $1 million for 2023, and $1.25 million for 2024; (b) if the Company is acquired or is otherwise involved in a change in control transaction before the end of 2024, the Company is required to pay an additional settlement amount of $5 million, plus 4% of the value attributed to the Company in the transaction, so long as the attributed value is in excess of $100 million, with the total change in control payment never to exceed $28 million; and (c) if the Company’s obligations under the Settlement Agreement are avoided by bankruptcy, the U.S. may rescind the releases and bring an action against the Company in which the Company agrees is not subject to an automatic stay, is not subject to any statute of limitations, estoppel or laches defense, and is a vali | Note 16—Commitments and Contingencies Legal Securities Litigation On June 7, 2019, a putative securities class action complaint captioned Derr v. Ra Medical Systems, Inc., et. al., voluntarily dismissed the underwriter defendants without prejudice. On March 13, 2020, defendants filed a motion to dismiss the amended complaint. On July 14, 2020, the court informed the parties that the motion to dismiss is suitable for decision without oral argument. At this time, the Company cannot predict how a court or jury will rule on the merits of the claims and/or the scope of the potential loss in the event of an adverse outcome. Should the Company ultimately be found liable, the liability could have a material adverse effect on the Company’s financial condition and its results of operations for the period or periods in which it is incurred. The Company is unable to predict the ultimate outcome and is unable to make a meaningful estimate of the amount or range of loss, if any, that could result from any unfavorable outcome. On October 1, 2019, a shareholder derivative complaint captioned Noel Borg v. Dean Irwin, et. al 1:99-cm-09999) Government Investigations As previously announced in the Form 8-K 8-K On December 28, 2020, the Company entered into a Settlement Agreement with the United States of America, acting through the DOJ and on behalf of the OIG, to resolve the pending DOJ investigation and a related civil action concerning our marketing of the DABRA laser system and DABRA-related remuneration to certain physicians. In connection with the Settlement Agreement, the Company also has reached tentative agreements that, if executed by participating states, resolve previously disclosed related investigations conducted by certain state attorneys general. The Settlement Agreement recites that a complaint filed by a former employee on behalf of the federal government in the United States District Court for the Eastern District of Michigan, and subsequently amended to assert claims on behalf of certain states, alleged, among other things, that the Company violated the False Claims Act, 31 U.S.C. § 3729, and certain state false claims acts by paying kickbacks to certain physicians in order to induce them to use the DABRA laser system, promoting off-label off-label Under the Settlement Agreement, and the tentative agreements with the participating states, the Company is required to make an initial payment of $2.5 million, of which the Company paid $2.4 million in December 2020 and will pay the remaining $0.1 million when the agreements with the participating states are finalized. Pursuant to the terms of the Settlement Agreement, (a) if its revenue exceeds $10 million in any of the next four fiscal years (2021-2024), it also is required to pay an additional amount in settlement for the corresponding year: $500,000 for 2021, $750,000 for 2022, $1 million for 2023, and $1.25 million for 2024; (b) if it is acquired or is otherwise involved in a change in control transaction in the years 2020 through 2024, it is required to pay an additional settlement amount of $5 million, plus 4% of the value attributed to the Company in the transaction, so long as the attributed value is in excess of $100 million, with the total change in control payment never to exceed $28 million; and (c) if its obligations under the Settlement Agreement are avoided by bankruptcy, the United States may rescind the releases and bring an action against the Company in which the Company agrees is not subject to an automatic stay, is not subject to any statute of limitations, estoppel or laches defense, and is a valid claim in the amount of $56 million, minus any prior change in control payments. Under the Settlement Agreement, the Company also paid the former employee’s reasonable expenses, costs and attorneys’ fees, which amount to $0.2 million. The Company has expensed $2.7 million and has remaining accrued expenses of $0.3 million at December 31, 2020 relating to this matter. The OIG has agreed, conditioned upon our full payment of amounts owed in the Settlement Agreement, and in consideration of the Company’s obligations under a Corporate Integrity Agreement, to release its permissive exclusion rights and refrain from instituting any administrative action seeking to exclude it from participating in Medicare, Medicaid, or other federal health care programs as a result of the Covered Conduct. The Corporate Integrity Agreement has a five-year term and imposes monitoring, reporting, certification, documentation, oversight, screening, and training obligations on the Company, including the hiring of a compliance officer and independent review organization. Pursuant to the terms of the Settlement Agreement, the United States and the former employee have dismissed the complaint against the Company with prejudice, and have released the Company from any civil or administrative monetary liability arising under the Covered Conduct. The Settlement Agreement does not include a release for any conduct other than the Covered Conduct or any criminal liability related to the Covered Conduct. The Settlement Agreement does not release any claims under investigation by the SEC. As also previously announced, the Company voluntarily contacted the SEC’s Enforcement Division regarding the Audit Committee’s investigation. On November 13, 2019, the SEC notified the Company that it is conducting an investigation. The Company has been, and intends to continue, cooperating with the SEC in this ongoing investigation. The Company is unable to predict the ultimate outcome and is unable to make a meaningful estimate of the amount or range of loss, if any, that could result from any unfavorable outcome. On November 21, 2019, the Company became aware that the Criminal Division, Fraud Section of the DOJ has an open investigation related to the Company. At this time, it is unclear if the Company is a target in this investigation. The Company has been, and intends to continue, cooperating with the DOJ in its active and ongoing investigation. The Company is unable to predict the ultimate outcome and is unable to make a meaningful estimate of the amount or range of loss, if any, that could result from any unfavorable outcome. Other Litigation On August 30, 2018, Strata Skin Sciences, Inc. (“Strata”) and Uri Geiger, a member of the board of directors of Strata Skin Sciences, Inc. (collectively “Strata”) filed an action against the Company in Court of Common Pleas of, Montgomery County, Pennsylvania (Civil Action No. 18-21421) e-mail On May 16, 2019, the Company filed an action against Strata, Mr. Geiger and Accelmed Growth Partners, L.P. (collectively, the “Strata Parties”) in the United States District Court for the Southern District of California (Civil Action No. 19-cv-0920-AJB-MSB On August 11, 2020, the Company and the Strata Parties executed a settlement agreement, dated as of August 6, 2020, that includes a mutual release of claims and an agreement to terminate the Pennsylvania Case and the California Case. On February 12, 2020, Dean Irwin, the Company’s former Chief Executive Officer, filed a Demand for Arbitration, alleging that the Company attempted to coerce him into signing a non-standard 401(k) — |
Net Revenue by Geography
Net Revenue by Geography | 12 Months Ended |
Dec. 31, 2020 | |
Segment Reporting [Abstract] | |
Net Revenue by Geography | Note 17—Net Revenue by Geography Net revenue, classified by the major geographic areas in which our customers are located, was as follows (in thousands): Year Ended 2020 2019 United States $ 259 $ 1,273 All other countries — — Net revenue $ 259 $ 1,273 |
Significant Accounting Polici_2
Significant Accounting Policies (Policies) | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Accounting Policies [Abstract] | ||
Basis of Presentation | Basis of Presentation The unaudited interim condensed financial statements have been prepared on the same basis as the annual financial statements and reflect all adjustments of a normal and recurring nature that are necessary for the fair presentation of the Company’s condensed balance sheets, results of operations, cash flows and statements of stockholders’ equity for the periods presented. The results of operations for the three and nine months ended September 30, 2021 are not necessarily indicative of the results to be expected for the year ending December 31, 2021 or for any other future annual or interim period. The balance sheet as of December 31, 2020 included herein was derived from the audited financial statements as of that date after reclassifications related to discontinued operations. These unaudited condensed financial statements should be read in conjunction with the Company’s audited financial statements included in the Company’s Annual Report on Form 10-K | |
Reclassifications | Reclassifications Certain prior period amounts have been reclassified to conform to the current period presentation. | |
Use of Estimates | Use of estimates The unaudited condensed financial statements have been prepared by management in accordance with accounting principles generally accepted in the United States (“GAAP”). The preparation of the financial statements requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities and reported disclosures of contingent liabilities at the dates of the financial statements and the reported amounts of revenue and expenses during the reporting periods. Actual results could differ from those estimates. The Company’s financial statements are based upon a number of estimates, including but not limited to, allowance for doubtful accounts, evaluation of impairment of assets, reserves for warranty costs including product recalls, evaluation of probable loss contingencies, fair value of stock option awards granted and revenue recognition for multiple performance obligations. | Use of estimates Company estimates. The Company’s financial statements |
Short-term Investments | Short-term Investments — Investments with original maturities of greater than three months are classified as short-term investments. Debt investments are classified as available-for-sale | |
Fair Value Measurements | Fair Value Measurements Fair value represents the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants and is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. A three-tier value hierarchy is used to identify inputs used in measuring fair value as follows: Level 1—Observable inputs that reflect quoted market prices (unadjusted) for identical assets or liabilities in active markets; Level 2—Inputs other than the quoted prices in active markets that are observable either directly or indirectly in the marketplace for identical or similar assets and liabilities; and Level 3—Unobservable inputs that are supported by little or no market data, which require the Company to develop its own assumptions. The hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value. The Company measures its cash and cash equivalents and short-term investments at fair value. | Fair value measurements — Level 1—Observable inputs that reflect quoted market prices (unadjusted) for identical assets or liabilities in active markets. Level 2—Inputs other than the quoted prices in active markets that are observable either directly or indirectly in the marketplace for identical or similar assets and liabilities; and Level 3—Unobservable inputs that are supported by little or no market data, which require the Company to develop its own assumptions. The hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value. The Company measures its cash and cash equivalents and short-term investments at fair value. |
Fair Value of Financial Instruments | Fair value of financial instruments The fair value of the Company’s debt, which is classified as equipment financing liability on the balance sheets, is estimated based on current rates offered to the Company for similar debt and approximates carrying value. | |
Cash and Cash Equivalents | Cash and cash equivalents The | |
Accounts Receivable, Net | Accounts receivable, net The Company sells or leases its lasers to distributors or physicians directly with various forms of financing options. The Company extends credit based on an evaluation of the customers’ financial condition generally without requiring collateral. Exposure to losses on trade receivables is expected to vary by customer due to the financial condition of each customer. The Company monitors exposure to credit losses and maintains allowances for anticipated losses considered necessary under the circumstances. The Company maintains an allowance for doubtful accounts for balances that appear to have specific collection issues and expected credit losses. The collection process is based on the age of the invoice and requires attempted contacts with the customer at specified intervals. If, after a specified number of days, the Company has been unsuccessful in its collection efforts, provision for doubtful accounts is recorded for the balance in question. Delinquent accounts receivable are charged against the allowance for doubtful accounts once the Company has determined the amounts are uncollectible. The factors considered in reaching this determination are the apparent financial condition of the customer and the Company’s success in contacting and negotiating with the customer. If the financial condition of the Company’s customers were to deteriorate, resulting in an impairment of their ability to make payments, additional allowances may be required. The following table shows the allowance for doubtful accounts activity (in thousands): Year Ended December 31, 2020 2019 Balance at beginning of period $ 305 $ 193 Provision for doubtful accounts 42 254 Deductions (263 ) (142 ) Balance at end of period $ 84 $ 305 | |
Inventories | Inventories Inventories are stated at the lower of cost (first-in, first-out Catheters are manufactured in-house, re-tested. | Inventories (first-in, first-out Catheters are manufactured in-house re-tested. |
Property and Equipment, Net | Property and equipment, net Computer hardware and software 4 Furniture and fixtures 5 years Machinery and equipment 5 Lasers 3 5 Automobiles 5 years Leasehold improvements are depreciated over the shorter of the useful life of the leasehold improvement or the term of the underlying property’s lease. When assets are retired or | |
Impairment of Long-lived Assets | Impairment of long-lived assets Company | |
Product Warranty | Product warranty Product warranties are included for the first year after the sale for laser sales. For lasers, the customer may purchase an extended service contract, which is either negotiated in the contract or sold as a separate component for which revenue is recognized over the term of the agreement. The warranty accrual is included in accrued expenses in the accompanying balance sheets. Warranty expenses are included in cost of revenue in the accompanying statements of operations. Changes in estimates to previously established warranty accruals result from current period updates to assumptions regarding repair and product recall costs and are included in current period warranty expense. | |
Revenue Recognition | Revenue recognition Revenue from Contracts with Customers The Company generates revenue from the sale of products and services. Product sales consist of the sale of DABRA and Pharos laser systems, the sale of catheters for use with the DABRA laser, and the sale of consumables and replacement parts. The Company’s sales agreements generally do not include right-of-return The Company determines revenue recognition incorporating the following steps: • Identification of each contract with a customer; • Identification of the performance obligations in the contract; • Determination of the transaction price; • Allocation of the transaction price to the performance obligations in the contract; and • Recognition of revenue when, or as, performance obligations are satisfied. The Company accounts for a contract with a customer when it has a legally enforceable contract with the customer, the arrangement identifies the rights of the parties, the contract has commercial substance, and the Company determines it is probable that it will collect the contract consideration. The Company recognizes revenue when control of the promised goods or services transfers to customers, in an amount that reflects the consideration the Company expects to be entitled to in exchange for those goods or services. Taxes collected from customers relating to goods or services and remitted to governmental authorities are excluded from revenue. Catheter Revenue The Company enters into a DABRA laser commercial usage agreement or DABRA laser placement acknowledgement with each customer that is supplied a DABRA laser, collectively the “usage agreement”. The usage agreement provides for specific terms of continued use of DABRA laser, including a nominal periodic fee. The terms of a usage agreement typically allow the Company to place a DABRA laser at a customer’s specified location without a specified contract term. Under the usage agreement terms, the Company retains all ownership rights to the DABRA laser and is permitted to request the return of the equipment within 10 business days of notification. While the laser periodic fees are nominal, the laser usage agreements provide the Company the exclusive rights to supply related single-use The Company recognizes revenue associated with the usage agreement and catheter supply arrangements in accordance with Topic 606 as the contract primarily includes variable payments, the catheters are priced at their standalone selling price and the laser equipment is insignificant in the context of the contract. Revenue is recognized when the performance obligation is satisfied, which is generally upon shipment of the catheter. Laser Sales Sales of laser systems and are included in product sales in the statements of operations. The Company recognizes revenue on laser sales at the point in time that control transfers to the customer. Control of the product typically transfers upon shipment. Warranty Service Revenue The Company typically provides a 12-month 12-month Distributor Transactions In certain markets outside the U.S., the Company sells products and provides services to customers through distributors that specialize in medical device products. The terms of sales transactions through distributors are generally consistent with the terms of direct sales to customers. The Company accounts for these transactions in accordance with the Company’s revenue recognition policy described herein. Contracts with multiple performance obligations Certain of the Company’s contracts with customers contain multiple performance obligations. For these contracts, the Company accounts for individual products and services as separate performance obligations if they are distinct, which is if (i) a product or service is separately identifiable from other items in the arrangement and (ii) the customer can benefit from the product or service on its own or with other readily available resources. The transaction price is allocated to the separate performance obligations on a relative standalone selling price basis. The Company determines standalone selling prices based on observable prices of products or services sold separately in comparable circumstances to similar customers. Significant Financing Component For multi-year warranty service contracts in which there is a difference between the cash selling price and the consideration in the contract and a significant amount of time between the payment, which is due up-front, For services contracts that have an original duration of one year or less, the Company uses the practical expedient applicable to such contracts and does not adjust the transaction price for the time value of money. Practical expedients elected As part of the Company’s adoption of Topic 606, the Company elected to use the following practical expedients: • not to adjust the promised amount of consideration for the effects of a significant financing component when the Company expects, at contract inception, that the period between the Company’s transfer of a promised product or service to a customer and when the customer pays for that product or service will be one year or less; • to expense costs as incurred for costs to obtain a contract when the amortization period would have been one year or less; • to exclude government assessed taxes from the transaction price; and • not to recast revenue for contracts that begin and end in the same fiscal year. Contract Costs The Company capitalizes costs to obtain contracts that are considered incremental and recoverable, such as sales commissions. The capitalized costs are amortized to selling, general and administrative expense over the estimated period of benefit of the asset, which is the contract term. The Company elected to use the practical expedient to expense the costs to obtain a contract when the amortization period is less than one year. The Company has contract costs of $0.2 million and $0.4 million capitalized at December 31, 2020 and December 31, 2019, respectively. The capitalized costs are recorded as assets of discontinued operations in the balance sheets at December 31, 2020 and 2019. Rental Income The Company also adopted ASC Topic 842, Leases The Company also derives income pursuant to product lease agreements for its Pharos laser systems, as operating leases. Consequently, the Company retains title to the equipment and the equipment remains on Company’s balance sheet within property and equipment. Depreciation expense on these leased lasers is recorded to cost of revenues on a straight-line basis. The costs to maintain these leased lasers are charged to cost of revenues as incurred. These lease arrangements contain one lease component (the laser) and one nonlease component (warranty service) for which the Company elected the practical expedient to not separate the nonlease component from the lease component. The Company accounts for the combined lease component as an operating lease and recognizes lease income on a straight-line basis over the lease term. Rental income from lease arrangements for the years ended December 31, 2020 and 2019 was $0.6 million and $0.7 million, respectively. | |
Shipping and Handling Costs | Shipping and handling costs handling | |
Advertising Expense | Advertising expense expenses There | |
Research and Development | Research and development | |
Patents | Patents costs | |
Share-based Compensation | Stock-based compensation — Stock-based compensation expense for equity instruments issued to employees and directors is measured based on estimating the fair value of each stock option on the date of grant using the Black Scholes option pricing model. Equity instruments issued to nonemployee consultants and service providers are valued using the Black Scholes option pricing model and are subject to revaluation as the underlying equity instruments vest. The Company recognizes forfeitures as they occur. The Company recognizes stock-based compensation expense as follows: Employees Nonemployees Service condition only Straight-line In the same period and in the same manner as if the Company paid cash for services. Performance criterion is probable of being met: Service criterion is complete Recognize the grant date fair value of the award once the performance criterion is considered probable of occurrence Recognize the grant date fair value of the award once the performance criterion is considered probable of occurrence Service criterion is not complete Straight-line Straight-line unless a performance condition is not probable Performance criterion is not probable of being met No expense is recognized until the performance criterion is considered probable, at which point expense is recognized per above No expense is recognized until the performance criterion is considered probable, at which point expense is recognized per above | |
Income Taxes | Income taxes The Company accounts for uncertainty in income taxes using a two-step | |
Concentrations of Credit Risk | Concentrations of credit risk Financial instruments, which potentially subject the Company to concentration of credit risk, consist of cash, cash equivalents and short-term investments balances maintained in excess of Federal Depository Insurance Corporation limits, and accounts receivable which have no collateral or security. The Company monitors the financial condition of the banks in which it currently has deposits. The Company has not experienced any significant losses in this respect and believes that it is not exposed to any significant related risk. Exposure to losses on accounts receivable is dependent on the individual customer’s financial condition. The Company monitors its exposure to credit losses and reserves for those accounts receivable that it deems to be not collectible. The Company had four and three individual customers that represented greater than 10% of total net revenue for the years ended December 31, 2020 and 2019, respectively. One and three individual customers represented 10% of accounts receivable for each of the years ended December 31, 2020 and 2019, respectively. | |
Revenue | Revenue The Company generates revenue from the sales of products and services. Product sales consist of the sales of catheters for use with the DABRA laser system. The Company has paused selling commercial product and is only selling catheters for use in the atherectomy clinical trial. The Company’s sales agreements generally do not include right-of-return Catheter Revenue When engaged in commercial sales, the Company enters into a DABRA laser commercial usage agreement or DABRA laser placement acknowledgement with each customer that is supplied a DABRA laser, collectively the “usage agreement”, which provides for specific terms of continued use of the DABRA laser, including a nominal periodic fee. The terms of a usage agreement typically allow the Company to place a DABRA laser at a customer’s specified location without a specified contract term. Under the usage agreement terms, the Company retains all ownership rights to the DABRA laser and is permitted to request the return of the equipment within 10 business days of notification. While the periodic fees are nominal, the usage agreement provides the Company the exclusive rights to supply related single-use The Company recognizes revenue associated with the usage agreements and catheter supply arrangements in accordance with Financial Accounting Standards Board (“FASB”) “ Revenue from Contracts with Customers (Topic 606),” Distributor Transactions In certain markets outside the U.S., the Company sold products and provided services to customers through distributors that specialize in medical device products. The terms of sales transactions through distributors were generally consistent with the terms of direct sales to customers. The Company accounted for these transactions in accordance with the Company’s revenue recognition policy described herein. The following accounting policies are specifically related to the Company’s discontinued operations: Laser Sales The Company recognized revenue on laser sales at the point in time that control transferred to the customer. Control of the product typically transferred upon shipment. Warranty Service Revenue The Company typically provided a 12-month 12-month Contract Costs The Company capitalized costs to obtain contracts that were considered incremental and recoverable, such as sales commissions. The capitalized costs were amortized to selling, general and administrative expense over the estimated period of benefit of the asset, which was the contract term. The Company elected to use the practical expedient to expense the costs to obtain a contract when the amortization period was less than one year. These lease arrangements contained one lease component (the laser) and one non-lease non-lease Rental Income The Company also derived income pursuant to its product operating lease agreements for its Pharos laser systems, prior to the sale of the Dermatology Business. Consequently, the Company retained title to the equipment. Depreciation expense on the leased lasers was recorded to cost of revenues on a straight-line basis. The costs to maintain the leased lasers were charged to cost of revenues as incurred. These lease arrangements contained one lease component (the laser) and one non-lease non-lease | |
Segment Information | Segment Information After the sale of the Dermatology Business, the Company began operating its business in one segment, which includes all activities related to the research, development and manufacture of the DABRA system. The chief operating decision-maker reviews the operating results on an aggregate basis and manages the operations as a single operating segment. | |
Recent Accounting Pronouncements | Recent Accounting Pronouncements From time to time, new accounting pronouncements are issued by the FASB or other standard setting bodies that the Company adopts as of the specified effective date. The Company has evaluated recently issued accounting pronouncements and, based on its preliminary assessment, does not believe any will have a material impact on the condensed financial statements or related footnote disclosures. | Recently Adopted Accounting Pronouncements non-public non-public In June 2018, the FASB issued ASU 2018-07, Improvements to Nonemployee Share-Based Payment Accounting 2018-07 Compensation—Stock Compensation 2018-07 Subtopic 505-50, Equity—Equity-Based Payments to Non-Employees In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820) —Disclosure Framework—Changes to the Disclosure Requirements for Fair Value Measurement No. 2018-13 In June 2016, the FASB issued ASU No. 2016-13, Financial No. 2016-13 In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes 2019-12 |
Significant Accounting Polici_3
Significant Accounting Policies (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Accounting Policies [Abstract] | |
Schedule of Allowance for Doubtful Accounts Activity | The following table shows the allowance for doubtful accounts activity (in thousands): Year Ended December 31, 2020 2019 Balance at beginning of period $ 305 $ 193 Provision for doubtful accounts 42 254 Deductions (263 ) (142 ) Balance at end of period $ 84 $ 305 |
Property And Equipment Estimated Useful Lives [Table Text Block] | Property and equipment are recorded at cost and are depreciated on a straight-line basis over their estimated useful lives as follows: Computer hardware and software 4 Furniture and fixtures 5 years Machinery and equipment 5 Lasers 3 5 Automobiles 5 years |
Discontinued Operations (Tables
Discontinued Operations (Tables) | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Fair Value Disclosures [Abstract] | ||
Summary of Assets and Liabilities Included as Discontinued Operations and Income (Loss) from Discontinued Operations | The following table summarizes the carrying amounts of the assets and liabilities included as discontinued operations in the condensed balance sheet at December 31, 2020 (in thousands): December 31, Assets of discontinued operations Accounts receivable, net $ 214 Inventories 1,341 Prepaid expenses and other current assets 158 Property and equipment, net 684 Other long-term assets 78 Total assets of discontinued operations $ 2,475 Liabilities of discontinued operations Accounts payable $ 100 Accrued expenses 201 Deferred revenue 2,487 Total liabilities of discontinued operations $ 2,788 The following table summarizes the major classes of items constituting income (loss) from discontinued operations in the condensed statements of operations for each of the periods presented (in thousands): Three Months Ended Nine Months Ended 2021 2020 2021 2020 Net revenues Product sales $ 140 $ 118 $ 852 $ 670 Service and other 349 729 1,748 2,259 Total net revenues 489 847 2,600 2,929 Cost of revenues Product sales 158 347 1,201 1,127 Service and other 238 504 1,089 1,296 Total cost of revenues 396 851 2,290 2,423 Gross income (loss) 93 (4 ) 310 506 Operating expenses Selling, general and administrative 330 236 1,110 958 Research and development 134 21 388 47 Total operating expenses 464 257 1,498 1,005 Operating loss (371 ) (261 ) (1,188 ) (499 ) Interest expense, net (22 ) (3 ) (94 ) (24 ) Loss from discontinued operations (393 ) (264 ) (1,282 ) (523 ) Gain on sale of the Dermatology Business 3,473 — 3,473 — Income (loss) from discontinued operations $ 3,080 $ (264 ) $ 2,191 $ (523 ) | The following table summarizes the carrying amounts of the assets and liabilities included as discontinued operations in the balance sheets at December 31, 2020 and 2019 (in thousands): December 31, 2020 2019 Assets of discontinued operations Accounts receivable, net $ 214 $ 563 Inventories 1,341 1,485 Prepaid expenses and other current assets 158 232 Property and equipment, net 684 906 Other long-term assets 78 151 Total assets of discontinued operations $ 2,475 $ 3,337 Liabilities of discontinued operations Accounts payable $ 100 $ 312 Accrued expenses 201 282 Deferred revenue 2,487 3,261 Total liabilities of discontinued operations $ 2,788 $ 3,855 The following table summarizes the major classes of items constituting income (loss) from discontinued operations in the statements of operations for each of the periods presented (in thousands): Years Ended 2020 2019 Net revenues Product sales $ 1,154 $ 2,604 Service and other 2,992 3,320 Total net revenues 4,146 5,924 Cost of revenues Product sales 1,522 2,483 Service and other 1,789 2,236 Total cost of revenues 3,311 4,719 Gross income (loss) 835 1,205 Operating expenses Selling, general and administrative 1,440 6,242 Research and development 54 86 Total operating expenses 1,494 6,328 Operating loss (659 ) (5,123 ) Interest expense, net (66 ) (179 ) Loss from discontinued operations $ (725 ) $ (5,302 ) |
Short-term Investments (Tables)
Short-term Investments (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Short-term Investments [Abstract] | |
Summary of Debt Securities by Major Security Type | A summary of debt securities by major security type is as follows as of December 31, 2019 (in thousands): Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Debt Securities-available-for-sale: U.S. agency securities $ 1,000 $ — $ — $ 1,000 U.S. government securities 14,967 26 — 14,993 Total debt securities $ 15,967 $ 26 $ — $ 15,993 |
Summary of Hierarchy for Assets Measured at Fair Value on a Recurring Basis | The following table presents the hierarchy for assets measured at fair value on a recurring basis (in thousands): Total Fair Value Quoted Market Prices for Identical Assets (Level 1) Other Observable Inputs (Level 2) Unobservable Inputs (Level 3) As of December 31, 2020 Money market funds $ 18,394 $ 18,394 $ — $ — As of December 31, 2019 Money market funds $ 13,219 $ 13,219 $ — $ — U.S. government securities $ 14,993 $ 14,993 $ — $ — U.S. agency securities $ 1,000 $ — $ 1,000 $ — |
Inventories (Tables)
Inventories (Tables) | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Inventory Disclosure [Abstract] | ||
Schedule of Inventories | Inventories consisted of the following (in thousands): September 30, 2021 December 31, 2020 Raw materials $ 884 $ 547 Work in process 60 270 Finished goods 53 60 Total inventories $ 997 $ 877 | Inventories consisted of the following (in thousands): December 31, 2020 2019 Raw materials $ 547 $ 977 Work in process 270 215 Finished goods 60 100 Inventories $ 877 $ 1,292 |
Property and Equipment (Tables)
Property and Equipment (Tables) | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Property, Plant and Equipment, Net [Abstract] | ||
Schedule of Property and Equipment | Property and equipment consisted of the following (in thousands): September 30, 2021 December 31, 2020 Lasers $ 3,151 $ 3,194 Machinery and equipment 812 834 Computer hardware and software 353 353 Construction in progress 209 51 Leasehold improvements 119 119 Automobiles 62 1,054 Furniture and fixtures 48 48 Property and equipment, gross 4,754 5,653 Accumulated depreciation (2,724 ) (3,126 ) Total property and equipment, net $ 2,030 $ 2,527 | Property and equipment consisted of the following (in thousands): December 31, 2020 2019 Lasers $ 3,194 $ 3,307 Machinery and equipment 834 809 Automobiles 1,054 1,109 Computer hardware and software 353 348 Leasehold improvements 119 119 Furniture and fixtures 48 48 Construction in progress 51 23 Property and equipment, gross 5,653 5,763 Accumulated depreciation (3,126 ) (1,619 ) Property and equipment, net $ 2,527 $ 4,144 |
Accrued Expenses (Tables)
Accrued Expenses (Tables) | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Payables and Accruals [Abstract] | ||
Schedule of Accrued Expenses | Accrued expenses consisted of the following (in thousands): September 30, 2021 December 31, 2020 Accrued legal expenses $ 1,393 $ 957 Compensation and related benefits 496 2,479 Accrued warranty (Note 8) 195 204 Other accrued expenses 548 507 Total accrued expenses $ 2,632 $ 4,147 | Accrued expenses consisted of the following (in thousands): December 31, 2020 2019 Compensation and related benefits $ 2,479 $ 985 Accrued warranty (Note 8) 204 234 Accrued services 1,464 1,141 Accrued expenses $ 4,147 $ 2,360 |
Accrued Warranty (Tables)
Accrued Warranty (Tables) | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Product Warranties Disclosures [Abstract] | ||
Schedule of Warranty Accrual Included in Accrued Expenses | Activity in the warranty accrual is included in accrued expenses in the condensed balance sheets and consisted of the following (in thousands): Nine Months Ended Year Ended Balance at beginning of period $ 204 $ 234 Increase in warranty accrual — 19 Change in liability for pre-existing — 4 Claims satisfied (9 ) (53 ) Total accrued warranty $ 195 $ 204 | Activity in the product warranty accrual is included in accrued expenses above and consists of the following (in thousands): Year ended 2020 2019 Balance at beginning of period $ 234 $ 50 Increase in warranty accrual 19 709 Change in liability for pre-existing 4 (28 ) Claims satisfied (53 ) (497 ) Accrued warranty $ 204 $ 234 |
Leases (Tables)
Leases (Tables) | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Leases [Abstract] | ||
Schedule of Maturities of Operating Lease Liabilities | Maturities of operating lease liabilities as of September 30, 2021 were as follows (in thousands): Years Ending December 31, 2021 (remaining three months) $ 132 2022 432 2023 445 2024 459 2025 472 2026 486 Thereafter 501 Total operating lease payments 2,927 Less: imputed interest (572 ) Total operating lease liabilities $ 2,355 | The following table presents the lease liabilities within the balance sheet, related to the Company’s operating leases as of December 31, 2020 (in thousands): Years Ending December 31, 2021 $ 528 2022 432 2023 445 2024 459 2025 472 Thereafter 987 Total operating lease payments $ 3,323 Less: imputed interest (703 ) Total operating lease liabilities $ 2,620 |
Stock-Based Compensation (Table
Stock-Based Compensation (Tables) | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Schedule of Restricted Stock Units Activity | A summary of the restricted stock unit activity under the 2018 Plan is presented below: Restricted Stock Units Weighted Average Grant Date Fair Value Outstanding at December 31, 2020 33,548 $ 21.93 Granted 29,614 $ 3.99 Vested (1,845 ) $ 64.80 Forfeited (15,485 ) $ 14.67 Outstanding at September 30, 2021 45,832 $ 11.06 | A summary of the activity and related information of the restricted stock units is presented below: Restricted Stock Weighted Average Grant Date Fair Value Outstanding at December 31, 2018 59,767 $ 672.75 Granted 12,010 98.75 Vested and released (48,269 ) 698.25 Forfeited (12,644 ) 497.75 Outstanding at December 31, 2019 10,864 $ 128.82 Granted 32,019 10.82 Vested and released (7,906 ) 114.55 Forfeited (1,429 ) 101.79 Outstanding at December 31, 2020 33,548 $ 21.93 |
Schedule of Restricted Stock Awards Activity | A summary of the activity and related information of the restricted stock awards is presented below: Restricted Stock Awards (in shares) Weighted Average Grant Date Fair Value Outstanding at December 31, 2019 — $ — Granted 286,161 4.77 Forfeited — — Vested — — Outstanding at December 31, 2020 286,161 $ 4.77 | |
Schedule of Stock-based Compensation Expense Recorded in Operating Expenses | Stock-based compensation expense recorded in operating expenses was as follows (in thousands): Three Months Ended Nine Months Ended 2021 2020 2021 2020 Selling, general and administrative $ 78 $ 757 $ 1,551 $ 2,424 Research and development 27 115 251 317 Stock-based compensation in operating expenses $ 105 $ 872 $ 1,802 $ 2,741 | Stock-based compensation expense recorded in operating expenses was as follows (in thousands): Year Ended December 31, 2020 2019 Selling, general and administrative $ 3,235 $ 16,141 Research and development 444 1,537 Stock-based compensation in operating expenses $ 3,679 $ 17,678 |
Stock Options [Member] | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Schedule of Options Activity | A summary of the stock option activity under the 2018 Equity Incentive Plan (the “2018 Plan”) and the 2018 Stock Compensation Plan is presented below: Stock Options Weighted Average Exercise Price Weighted Average Remaining Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding at December 31, 2020 124,171 $ 363.31 6.42 Forfeited (15,173 ) $ 87.28 Outstanding at September 30, 2021 108,998 $ 401.74 4.82 $ — Exercisable at September 30, 2021 95,096 $ 455.95 4.32 $ — Vested and expected to vest at September 30, 2021 108,998 $ 401.74 4.80 $ — | A summary of the activity and related information of the stock options issued under the 2018 Equity Incentive Plan and the Compensation Plan is presented below: Stock Options Weighted Average Exercise Price Weighted Average Remaining Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding at December 31, 2018 76,804 $ 714.75 9.43 $ — Granted 60,854 30.50 Forfeited (12,079 ) 670.25 Outstanding at December 31, 2019 125,579 $ 387.50 9.43 $ — Granted 11,729 30.69 Forfeited (13,137 ) 297.57 Outstanding at December 31, 2020 124,171 $ 363.31 6.42 $ — Exercisable at December 31, 2020 84,376 $ 466.78 5.89 $ — Vested and expected to vest at December 31, 2020 124,171 $ 363.31 6.42 $ — |
Stock Option Activity Two Thousand Twenty Equity Incentive Plan [Member] | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Schedule of Options Activity | A summary of the stock option activity under the 2020 Inducement Equity Incentive Plan (the “2020 Plan”) is presented below: Stock Options Weighted Average Exercise Price Weighted Average Remaining Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding at December 31, 2020 18,000 $ 25.50 9.24 Outstanding at September 30, 2021 18,000 $ 25.50 8.50 $ — Exercisable at September 30, 2021 6,750 $ 25.50 8.50 $ — Vested and expected to vest at September 30, 2021 18,000 $ 25.50 8.50 $ — | |
Two Thousand Eighteen Restricted Stock Plan | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Schedule of Restricted Stock Awards Activity | A summary of the restricted stock award activity under the 2018 Plan is presented below: Restricted Weighted Average Grant Date Fair Value Outstanding at December 31, 2020 286,161 $ 4.77 Granted 103,939 $ 4.82 Vested (31,388 ) $ 6.96 Forfeited (50,082 ) $ 5.10 Outstanding at September 30, 2021 308,630 $ 4.51 | |
Schedule of Fair Value of Options Using the Black Scholes Option Pricing Model and Assumptions Used | The fair value of the stock options issued under the 2018 Plan was estimated using the Black Scholes option pricing model and the weighted-average assumptions used in the model are noted in the following table: Year Ended December 31, 2020 2019 Risk-free interest rate 1.3 % 1.6 % Volatility 58.96 % 59.26 % Expected dividend yield 0.00 % 0.00 % Expected life (in years) 5.8 5.9 | |
Two Thousand Twenty Restricted Stock Plan | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Schedule of Restricted Stock Awards Activity | A summary of the restricted stock award activity under the 2020 Plan is presented below: Restricted Stock Awards Weighted Average Grant Date Fair Value Outstanding at December 31, 2020 4,375 $ 25.50 Vested (625 ) $ 25.50 Outstanding at September 30, 2021 3,750 $ 25.50 | |
Schedule of Fair Value of Options Using the Black Scholes Option Pricing Model and Assumptions Used | The fair value of the stock options issued under the 2020 Plan was estimated using the Black Scholes option pricing model and the weighted-average assumptions used in the model are noted in the following table: Year Ended December 31, 2020 Risk-free interest rate 0.5 % Volatility 58.33 % Expected dividend yield 0.00 % Expected life (in years) 6.3 |
Income Taxes (Tables)
Income Taxes (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Income Tax Disclosure [Abstract] | |
Reconciliation of Differences between United States Statutory Federal Income Tax Rate and Effective Tax Rate | A reconciliation of the differences between the United States statutory federal income tax rate and the effective tax rate as provided in the statements of operations is as follows: Year Ended 2020 2019 Tax computed at the federal statutory rate 21.0 % 21.0 % State income taxes, net of federal benefits 5.1 1.9 Nondeductible expenses (0.1 ) (0.4 ) Stock-based compensation (2.2 ) (9.5 ) Deferred tax adjustments (57.0 ) — Change in valuation allowance 33.2 (13.0 ) — — |
Summary of Federal and State Income Tax Provision | The federal and state income tax provision is summarized as follows (in thousands): Year Ended 2020 2019 Current Federal $ — $ — State 7 15 7 15 Deferred Federal — — State — — — — Income tax expense $ 7 $ 15 |
Significant Components of Deferred Tax Assets (Liabilities) | The tax effects of significant components of the Company’s deferred tax assets (liabilities) are as follows (in thousands): December 31, 2020 2019 Deferred Tax Assets: Net operating loss carryforwards $ 3,720 $ 16,096 Operating lease liabilities 691 766 Other accruals 101 61 Accrued compensation 448 — Reserves 299 301 Deferred revenue 642 850 Intangible assets 32 253 Stock-based compensation 4,910 4,821 Total gross deferred tax assets $ 10,843 $ 23,148 Deferred Tax Liabilities: Property and equipment (805 ) (1,026 ) Operating lease right-of-use (655 ) (739 ) Other (61 ) (92 ) Total gross deferred tax liabilities $ (1,521 ) $ (1,857 ) Valuation allowance (9,322 ) (21,291 ) Total deferred taxes $ — $ — |
Net Revenue by Geography (Table
Net Revenue by Geography (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Segment Reporting [Abstract] | |
Schedule of net revenue, classified by the major geographic areas | Net revenue, classified by the major geographic areas in which our customers are located, was as follows (in thousands): Year Ended 2020 2019 United States $ 259 $ 1,273 All other countries — — Net revenue $ 259 $ 1,273 |
Organization and Nature of Op_2
Organization and Nature of Operations - Additional Information (Details) $ / shares in Units, $ in Thousands | 9 Months Ended | 12 Months Ended | ||||||
Sep. 30, 2021USD ($)$ / sharesshares | Sep. 30, 2020USD ($) | Dec. 31, 2020USD ($)$ / sharesshares | Dec. 31, 2019USD ($)$ / sharesshares | Nov. 16, 2020shares | Nov. 15, 2020shares | Jul. 14, 2018$ / sharesshares | Jul. 13, 2018shares | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | ||||||||
Accumulated deficit | $ | $ 169,985 | $ 153,202 | $ 117,157 | |||||
Net cash used in operating activities for continuing and discontinued operations | $ | 21,914 | $ 18,890 | 28,304 | 33,173 | ||||
Cash and cash equivalents | $ | $ 20,616 | $ 23,906 | $ 14,584 | |||||
Common stock, shares issued | 7,042,000 | 3,189,000 | 550,814 | 2,900,000 | 73,000,000 | |||
Common stock, shares outstanding | 7,042,000 | 3,189,000 | 550,814 | 2,900,000 | 73,000,000 | |||
Stock split ratio | 0.04 | |||||||
Stockholders' Equity, Reverse Stock Split | In November 2020, the board of directors approved a Reverse Stock Split ratio of 1-for-25. | |||||||
Common Stock, Par or Stated Value Per Share | $ / shares | $ 0.0001 | $ 0.0001 | $ 0.0001 | $ 0.0001 | ||||
Common Stock, Shares Authorized | 300,000,000 | 300,000,000 | 300,000,000 | 25,000,000 | 10,000,000 | |||
Preferred Stock, Par or Stated Value Per Share | $ / shares | $ 0.0001 | $ 0.0001 | $ 0.0001 | |||||
Preferred Stock, Shares Authorized | 10,000,000 | 10,000,000 | 10,000,000 |
Significant Accounting Polici_4
Significant Accounting Policies - Schedule of Allowance for Doubtful Accounts Activity (Details) - USD ($) $ in Thousands | 9 Months Ended | 12 Months Ended | |
Sep. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | |
Accounting Policies [Abstract] | |||
Balance at beginning of period | $ 305 | $ 305 | $ 193 |
Provision for doubtful accounts | $ 25 | 42 | 254 |
Deductions | (263) | (142) | |
Balance at end of period | $ 84 | $ 305 |
Significant Accounting Polici_5
Significant Accounting Policies - Schedule of Property and Equipment Estimated Useful Lives (Details) | 12 Months Ended |
Dec. 31, 2020 | |
Furniture and Fixtures [Member] | |
Finite-Lived Intangible Assets [Line Items] | |
Estimated useful lives | 5 years |
Automobiles [Member] | |
Finite-Lived Intangible Assets [Line Items] | |
Estimated useful lives | 5 years |
Minimum [Member] | Computer Hardware And Software [Member] | |
Finite-Lived Intangible Assets [Line Items] | |
Estimated useful lives | 4 years |
Minimum [Member] | Machinery and Equipment [Member] | |
Finite-Lived Intangible Assets [Line Items] | |
Estimated useful lives | 5 years |
Minimum [Member] | Lasers [Member] | |
Finite-Lived Intangible Assets [Line Items] | |
Estimated useful lives | 3 years |
Maximum [Member] | Computer Hardware And Software [Member] | |
Finite-Lived Intangible Assets [Line Items] | |
Estimated useful lives | 5 years |
Maximum [Member] | Machinery and Equipment [Member] | |
Finite-Lived Intangible Assets [Line Items] | |
Estimated useful lives | 10 years |
Maximum [Member] | Lasers [Member] | |
Finite-Lived Intangible Assets [Line Items] | |
Estimated useful lives | 5 years |
Significant Accounting Polici_6
Significant Accounting Policies - Additional Information (Details) $ in Millions | 9 Months Ended | 12 Months Ended | |||
Sep. 30, 2021Segment | Dec. 31, 2020USD ($)Customer | Dec. 31, 2019USD ($)Customer | Jan. 01, 2020USD ($) | Jan. 01, 2019USD ($) | |
Deferred revenue | $ 3.3 | $ 2.8 | |||
Deferred revenue, recognized | $ 2 | $ 1.9 | |||
Remaining service period to recognize deferred revenue, description | 2024 | ||||
Capitalized contract cost, net | $ 0.2 | 0.4 | |||
Laser revenue | $ 0.6 | $ 0.7 | |||
Tax benefit likely of being realized upon ultimate settlement description | measure the tax benefit as the largest amount that is more than 50% likely of being realized upon ultimate settlement. | ||||
Number of operating segments | Segment | 1 | ||||
Customer Concentration Risk | Revenue Benchmark | |||||
Number of individual customers representing greater than 10% of bench mark | Customer | 4 | 3 | |||
Customer Concentration Risk | Revenue Benchmark | Four And Three Individual Customers | |||||
Concentration risk, percentage | 10.00% | ||||
Customer Concentration Risk | Revenue Benchmark | One And Three Individual Customers | |||||
Concentration risk, percentage | 10.00% | ||||
Customer Concentration Risk | Accounts Receivable | |||||
Number of individual customers representing greater than 10% of bench mark | Customer | 1 | 3 | |||
Customer Concentration Risk | Accounts Receivable | Four And Three Individual Customers | |||||
Concentration risk, percentage | 10.00% | ||||
Customer Concentration Risk | Accounts Receivable | One And Three Individual Customers | |||||
Concentration risk, percentage | 10.00% | ||||
Shipping and Handling | |||||
Shipping and handling costs | $ 0.1 | $ 0.5 | |||
Advertising expense | $ 0 | $ 0.1 | |||
Minimum [Member] | |||||
Regular warranty service contracts term | 12 months | 12 months | |||
Maximum [Member] | |||||
Extended warranty service contracts term | 60 months | 60 months | |||
Capitalized contract cost amortization period | 1 year | 1 year |
Discontinued Operations - Addit
Discontinued Operations - Additional Information (Details) - USD ($) | Aug. 16, 2021 | Sep. 30, 2021 | Sep. 30, 2020 | Sep. 30, 2021 | Sep. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | Nov. 16, 2020 | Nov. 15, 2020 | Jul. 14, 2018 |
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||||||||
Common stock, shares issued | 7,042,000 | 7,042,000 | 3,189,000 | 550,814 | 2,900,000 | 73,000,000 | ||||
Common stock, par value | $ 0.0001 | $ 0.0001 | $ 0.0001 | $ 0.0001 | $ 0.0001 | |||||
Gain on disposition of business | $ 3,473,000 | $ 3,473,000 | ||||||||
Dermatology [Member] | ||||||||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||||||||
Depreciation expense | 100,000 | $ 100,000 | 300,000 | $ 300,000 | $ 400,000 | $ 400,000 | ||||
Capital expenditure | 0 | 0 | 0 | 32,000 | ||||||
Stock based compensation expense | 14,000 | 14,000 | 18,000 | 100,000 | 200,000 | 4,900,000 | ||||
Stock based compensation expense capitalized to inventory and property and equipment | 4,000 | $ 30,000 | 100,000 | $ 100,000 | $ 200,000 | $ 1,000,000 | ||||
Dermatology [Member] | Disposition by Sale [Member] | ||||||||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||||||||
Gain on disposition of business | $ 3,500,000 | $ 3,500,000 | ||||||||
Dermatology [Member] | Discontinued Operations [Member] | Disposition by Sale [Member] | ||||||||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||||||||
Cash on disposition of business | $ 3,700,000 | |||||||||
Broker and legal fees on disposal | $ 200,000 | |||||||||
Dermatology [Member] | Discontinued Operations [Member] | Disposition by Sale [Member] | Warrant [Member] | ||||||||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||||||||
Common stock, shares issued | 74,247 | |||||||||
Common stock, par value | $ 2.99 | |||||||||
Warrant expiry period | 5 years | |||||||||
Warrant | $ 100,000 | |||||||||
Expected volatility rate | 104.55% | |||||||||
Risk free interest rate | 0.32% | |||||||||
Expected dividend rate | 0.00% | |||||||||
Expected term | 2 years 6 months |
Discontinued Operations - Summa
Discontinued Operations - Summary of Carrying Amounts of Assets and Liabilities Included as Discontinued Operations in Condensed Balance Sheet (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Assets of discontinued operations | ||
Accounts receivable, net | $ 214 | $ 563 |
Inventories | 1,341 | 1,485 |
Prepaid expenses and other current assets | 158 | 232 |
Property and equipment, net | 684 | 906 |
Other long-term assets | 78 | 151 |
Total assets of discontinued operations | 2,475 | 3,337 |
Liabilities of discontinued operations | ||
Accounts payable | 100 | 312 |
Accrued expenses | 201 | 282 |
Deferred revenue | 2,487 | 3,261 |
Total liabilities of discontinued operations | $ 2,788 | $ 3,855 |
Discontinued Operations - Sum_2
Discontinued Operations - Summary of Major Classes of Items Constituting Income (Loss) from Discontinued Operations in Condensed Statements of Operations (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | 12 Months Ended | |||
Sep. 30, 2021 | Sep. 30, 2020 | Sep. 30, 2021 | Sep. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | |
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||||
Total net revenues | $ 489 | $ 847 | $ 2,600 | $ 2,929 | $ 4,146 | $ 5,924 |
Total cost of revenues | 396 | 851 | 2,290 | 2,423 | 3,311 | 4,719 |
Gross income (loss) | 93 | (4) | 310 | 506 | 835 | 1,205 |
Total operating expenses | 464 | 257 | 1,498 | 1,005 | 1,494 | 6,328 |
Operating loss | (371) | (261) | (1,188) | (499) | (659) | (5,123) |
Interest expense, net | (22) | (3) | (94) | (24) | (66) | (179) |
Loss from discontinued operations | (393) | (264) | (1,282) | (523) | (725) | (5,302) |
Gain on sale of the Dermatology Business | 3,473 | 3,473 | ||||
Income (loss) from discontinued operations | 3,080 | (264) | 2,191 | (523) | ||
Service and Other [Member] | ||||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||||
Total net revenues | 349 | 729 | 1,748 | 2,259 | 2,992 | 3,320 |
Total cost of revenues | 238 | 504 | 1,089 | 1,296 | 1,789 | 2,236 |
Selling, General And Administrative [Member] | ||||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||||
Total operating expenses | 330 | 236 | 1,110 | 958 | 1,440 | 6,242 |
Research And Development [Member] | ||||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||||
Total operating expenses | 134 | 21 | 388 | 47 | 54 | 86 |
Product Sales [Member] | ||||||
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | ||||||
Total net revenues | 140 | 118 | 852 | 670 | 1,154 | 2,604 |
Total cost of revenues | $ 158 | $ 347 | $ 1,201 | $ 1,127 | $ 1,522 | $ 2,483 |
Fair Value Measurements - Addit
Fair Value Measurements - Additional Information (Details) - USD ($) $ in Millions | Sep. 30, 2021 | Dec. 31, 2020 |
Money Market Funds [Member] | Level 1 [Member] | ||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items] | ||
Fair value disclosure of cash equivalents | $ 9.4 | $ 18.4 |
Short-term Investments - Summar
Short-term Investments - Summary of Debt Securities by Major Security Type (Detail) $ in Thousands | Dec. 31, 2019USD ($) |
Debt Securities, Available-for-sale [Line Items] | |
Amortized cost | $ 15,967 |
Gross unrealized gains | 26 |
Fair value | 15,993 |
U.S. Agency Securities [Member] | |
Debt Securities, Available-for-sale [Line Items] | |
Amortized cost | 1,000 |
Fair value | 1,000 |
U.S. Government Securities [Member] | |
Debt Securities, Available-for-sale [Line Items] | |
Amortized cost | 14,967 |
Gross unrealized gains | 26 |
Fair value | $ 14,993 |
Short-term Investments - Summ_2
Short-term Investments - Summary of Hierarchy for Assets Measured at Fair Value on a Recurring Basis (Detail) - USD ($) $ in Thousands | Sep. 30, 2021 | Dec. 31, 2020 | Dec. 31, 2019 |
Fair Value, Inputs, Level 1 [Member] | Money Market Funds [Member] | |||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||
Total Fair Value | $ 9,400 | $ 18,400 | |
Fair Value, Recurring [Member] | Money Market Funds [Member] | |||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||
Total Fair Value | 18,394 | $ 13,219 | |
Fair Value, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Money Market Funds [Member] | |||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||
Total Fair Value | $ 18,394 | 13,219 | |
Fair Value, Recurring [Member] | U.S. Government Securities [Member] | |||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||
Total Fair Value | 14,993 | ||
Fair Value, Recurring [Member] | U.S. Government Securities [Member] | Fair Value, Inputs, Level 1 [Member] | |||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||
Total Fair Value | 14,993 | ||
Fair Value, Recurring [Member] | U.S. Agency Securities [Member] | |||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||
Total Fair Value | 1,000 | ||
Fair Value, Recurring [Member] | U.S. Agency Securities [Member] | Fair Value, Inputs, Level 2 [Member] | |||
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items] | |||
Total Fair Value | $ 1,000 |
Short-term Investments - Additi
Short-term Investments - Additional Information (Detail) | 12 Months Ended |
Dec. 31, 2019 | |
Maximum [Member] | |
Marketable Securities [Line Items] | |
Debt securities maturity period | 1 year |
Inventories (Details)
Inventories (Details) - USD ($) $ in Thousands | Sep. 30, 2021 | Dec. 31, 2020 | Dec. 31, 2019 |
Inventory Disclosure [Abstract] | |||
Raw materials | $ 884 | $ 547 | $ 977 |
Work in process | 60 | 270 | 215 |
Finished goods | 53 | 60 | 100 |
Total inventories | $ 997 | $ 877 | $ 1,292 |
Property and Equipment - Schedu
Property and Equipment - Schedule of Property and Equipment (Details) - USD ($) $ in Thousands | Sep. 30, 2021 | Dec. 31, 2020 | Dec. 31, 2019 |
Property Plant And Equipment [Line Items] | |||
Property and equipment, gross | $ 4,754 | $ 5,653 | $ 5,763 |
Accumulated depreciation | (2,724) | (3,126) | (1,619) |
Total property and equipment, net | 2,030 | 2,527 | 4,144 |
Lasers | |||
Property Plant And Equipment [Line Items] | |||
Property and equipment, gross | 3,151 | 3,194 | 3,307 |
Machinery and Equipment | |||
Property Plant And Equipment [Line Items] | |||
Property and equipment, gross | 812 | 834 | 809 |
Computer Hardware and Software | |||
Property Plant And Equipment [Line Items] | |||
Property and equipment, gross | 353 | 353 | 348 |
Construction in Progress | |||
Property Plant And Equipment [Line Items] | |||
Property and equipment, gross | 209 | 51 | 23 |
Leasehold Improvements | |||
Property Plant And Equipment [Line Items] | |||
Property and equipment, gross | 119 | 119 | 119 |
Automobiles | |||
Property Plant And Equipment [Line Items] | |||
Property and equipment, gross | 62 | 1,054 | 1,109 |
Furniture and Fixtures | |||
Property Plant And Equipment [Line Items] | |||
Property and equipment, gross | $ 48 | $ 48 | $ 48 |
Property and Equipment - Additi
Property and Equipment - Additional Information (Details) - USD ($) $ in Millions | 3 Months Ended | 9 Months Ended | 12 Months Ended | |||
Sep. 30, 2021 | Sep. 30, 2020 | Sep. 30, 2021 | Sep. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | |
Property Plant And Equipment [Line Items] | ||||||
Depreciation expense | $ 0.2 | $ 0.4 | $ 0.7 | $ 1.3 | $ 1.6 | $ 1 |
Automobiles | Selling, General and Administrative Expenses [Member] | ||||||
Property Plant And Equipment [Line Items] | ||||||
Gain on Sale of Property and Equipment | $ 0.5 |
Accrued Expenses - Schedule of
Accrued Expenses - Schedule of Accrued Expenses (Details) - USD ($) $ in Thousands | Sep. 30, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 |
Payables and Accruals [Abstract] | ||||
Accrued legal expenses | $ 1,393 | $ 957 | ||
Compensation and related benefits | 496 | 2,479 | $ 985 | |
Accrued warranty | 195 | 204 | 234 | $ 50 |
Other accrued expenses | 548 | 507 | ||
Accrued Services | 1,464 | 1,141 | ||
Total accrued expenses | $ 2,632 | $ 4,147 | $ 2,360 |
Accrued Warranty - Schedule of
Accrued Warranty - Schedule of Warranty Accrual Included in Accrued Expenses (Details) - USD ($) $ in Thousands | 9 Months Ended | 12 Months Ended | |
Sep. 30, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Product Warranties Disclosures [Abstract] | |||
Balance at beginning of period, Accrued warranty | $ 204 | $ 234 | $ 50 |
Increase in warranty accrual | 19 | 709 | |
Change in liability for pre-existing warranties | 4 | (28) | |
Claims satisfied | (9) | (53) | (497) |
Balance at ending of period, Accrued warranty | $ 195 | $ 204 | $ 234 |
Accrued Warranty - Additional I
Accrued Warranty - Additional Information (Details) - USD ($) $ in Thousands | Sep. 30, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 |
Product Warranty Liability [Line Items] | ||||
Accrued warranty | $ 195 | $ 204 | $ 234 | $ 50 |
Previously Reported [Member] | ||||
Product Warranty Liability [Line Items] | ||||
Accrued warranty | 19 | 700 | ||
Catheters [Member] | Product Recall [Member] | ||||
Product Warranty Liability [Line Items] | ||||
Accrued warranty | $ 100 | $ 100 | $ 200 |
Paycheck Protection Program P_2
Paycheck Protection Program Promissory Note - Additional Information (Details) - USD ($) | 1 Months Ended | 3 Months Ended | 9 Months Ended | 12 Months Ended | |||
May 31, 2020 | Sep. 30, 2021 | Sep. 30, 2020 | Sep. 30, 2021 | Sep. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | |
Gain on extinguishment of promissory note | $ 2,023,000 | ||||||
Interest expense | $ 41,000 | $ 71,000 | |||||
Promissory Note | Corona Virus Aid Relief Economic Security Act | |||||||
Paycheck protection program, amount | $ 2,000,000 | ||||||
Interest rate | 1.00% | ||||||
Payments due, beginning date | Nov. 1, 2020 | ||||||
Payments due, ending date | 2022-05 | ||||||
Payments due, ending date | May 3, 2022 | ||||||
Gain on extinguishment of promissory note | 2,000,000 | ||||||
Interest expense | $ 0 | $ 5,000 | $ 10,000 | $ 8,000 | $ 13,000 | ||
Deferral period for all loans | 10 months | ||||||
Debt instrument, description | payments would have been due beginning August 2021, and the principal amount, along with unpaid interest, would have been due in May 2022. The principal and interest could be forgiven if the proceeds were used for forgivable purposes as defined by the terms in the PPP Promissory Note. | payments are due beginning August 2021 and the principal amount along with unpaid interest is due in May 2022. The Company has requested from its lender an extension of the loan maturity from two years to five years as permitted under the PPPFA. The principal and interest may be forgiven if the proceeds are used for forgivable purposes as defined by the terms in the PPP Promissory Note, and the Company believes it has used the proceeds from the PPP Promissory Note for forgivable purposes as defined by the terms of the PPP Promissory Note. | |||||
Promissory Note | Corona Virus Aid Relief Economic Security Act | Minimum [Member] | |||||||
Extended maturity period | 2 years | ||||||
Promissory Note | Corona Virus Aid Relief Economic Security Act | Maximum [Member] | |||||||
Extended maturity period | 5 years |
Leases - Additional Information
Leases - Additional Information (Details) $ in Thousands | 3 Months Ended | 9 Months Ended | 12 Months Ended | ||||
Sep. 30, 2021USD ($) | Sep. 30, 2020USD ($) | Sep. 30, 2021USD ($)Lease | Sep. 30, 2020USD ($) | Dec. 31, 2020USD ($)Lease | Dec. 31, 2019USD ($) | Jan. 01, 2019USD ($) | |
Operating Leased Assets [Line Items] | |||||||
Number of leases | Lease | 2 | 2 | |||||
Operating lease, discount rate | 7.00% | 7.00% | 7.00% | ||||
Operating lease, weighted average remaining lease term | 6 years 3 months 18 days | 6 years 3 months 18 days | 7 years | ||||
Operating lease expense | $ 100 | $ 100 | $ 400 | $ 400 | $ 500 | $ 500 | |
Operating lease , cash payment | 100 | 100 | 400 | 400 | 500 | 500 | |
Amortization for operating lease right-of-use-assets | 100 | $ 100 | 300 | $ 300 | 400 | 300 | |
Operating lease right-of-use assets | 2,205 | 2,205 | 2,484 | $ 2,835 | |||
Operating lease, liability | $ 2,355 | $ 2,355 | $ 2,620 | ||||
Accounting Standards Update 2016-02 [Member] | |||||||
Operating Leased Assets [Line Items] | |||||||
Operating lease right-of-use assets | $ 3,200 | ||||||
Operating lease, liability | $ 3,200 | ||||||
Office Building [Member] | |||||||
Operating Leased Assets [Line Items] | |||||||
Lease expiration period | 2027 | 2027 | |||||
Manufacturing Facility [Member] | |||||||
Operating Leased Assets [Line Items] | |||||||
Lease expiration period | 2021 | ||||||
Lease expiration period month and year | 2021-12 |
Leases - Schedule of Maturities
Leases - Schedule of Maturities of Operating Lease Liabilities (Details) - USD ($) $ in Thousands | Sep. 30, 2021 | Dec. 31, 2020 |
Leases [Abstract] | ||
2021 (remaining three months) | $ 132 | |
2021 - 2022 | 432 | $ 528 |
2022 - 2023 | 445 | 432 |
2023 - 2024 | 459 | 445 |
2024 - 2025 | 472 | 459 |
2025 - 2026 | 486 | 472 |
Thereafter | 501 | 987 |
Total operating lease payments | 2,927 | 3,323 |
Less: imputed interest | (572) | (703) |
Total operating lease liabilities | $ 2,355 | $ 2,620 |
Net Loss per Share - Additional
Net Loss per Share - Additional Information (Details) - USD ($) | 9 Months Ended | 12 Months Ended | ||
Sep. 30, 2021 | Sep. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | |
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||||
Loss allocated to participating securities | $ 0 | $ 0 | ||
Stock Options [Member] | ||||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||||
Anti-dilutive share equivalents excluded from computation of diluted net loss per share | 126,998 | 144,851 | 142,171 | 125,579 |
Warrants [Member] | ||||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||||
Anti-dilutive share equivalents excluded from computation of diluted net loss per share | 2,419,280 | 2,345,033 | 2,345,033 | |
Restricted Stock Units (RSUs) [Member] | ||||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||||
Anti-dilutive share equivalents excluded from computation of diluted net loss per share | 45,832 | 20,678 | 33,548 | 10,864 |
Restricted Stock Awards (RSAs) [Member] | ||||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||||
Anti-dilutive share equivalents excluded from computation of diluted net loss per share | 312,380 | 5,000 | 290,536 | |
Employee Stock Purchase Plan [Member] | ||||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||||
Anti-dilutive share equivalents excluded from computation of diluted net loss per share | 10,462 | 3,772 | 3,200 | 2,473 |
Equipment Financing - Additiona
Equipment Financing - Additional Information (Details) - Automobile Loan [Member] $ in Thousands | 12 Months Ended | ||
Dec. 31, 2020USD ($) | Dec. 31, 2019USD ($) | Dec. 31, 2018agreementAutomobile | |
Debt Instrument [Line Items] | |||
Number of loan agreements | agreement | 4 | ||
Interest expense | $ 28,000 | $ 48,000 | |
Number of automobiles financed | Automobile | 25 | ||
Weighted average interest rate | 6.50% | ||
Debt instrument outstanding balance | $ 300 | ||
Debt instruments maturity year | 2021 | ||
Debt instrument maturity date | Mar. 31, 2021 |
Equity Offerings - Additional I
Equity Offerings - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions | Feb. 28, 2021 | Aug. 31, 2021 | Jun. 30, 2021 | Sep. 30, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Jul. 14, 2018 | Jul. 13, 2018 |
Class Of Stock [Line Items] | ||||||||
Common stock, shares authorized | 300,000,000 | 300,000,000 | 300,000,000 | 25,000,000 | 10,000,000 | |||
Common stock, par value | $ 0.0001 | $ 0.0001 | $ 0.0001 | $ 0.0001 | ||||
ATM Offering | ||||||||
Class Of Stock [Line Items] | ||||||||
Common stock, shares authorized | 35,768 | 1,139,306 | 2,582,019 | |||||
Common stock, par value | $ 8.39 | $ 4 | $ 4.29 | |||||
Proceeds from issuance of common stock | $ 0.3 | $ 4.4 | $ 10.6 | |||||
Offering fees and other expenses | $ 0.2 |
Stockholders' Equity - Addition
Stockholders' Equity - Additional Information (Details) - USD ($) | 1 Months Ended | |||||||
Aug. 31, 2020 | Jun. 30, 2020 | May 31, 2020 | Sep. 30, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Jul. 14, 2018 | Jul. 13, 2018 | |
Class of Stock [Line Items] | ||||||||
Common stock, shares authorized | 300,000,000 | 300,000,000 | 300,000,000 | 25,000,000 | 10,000,000 | |||
Preferred stock, shares outstanding | 0 | 0 | ||||||
Stock issued during period shares warrants Exercised | 73,506 | |||||||
Common stock, par value | $ 0.0001 | $ 0.0001 | $ 0.0001 | $ 0.0001 | ||||
May 2020 Offering [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Common stock, shares authorized | 888,888 | |||||||
Proceeds from issuance of common stock | $ 8,700,000 | |||||||
Common stock reserve for issuance | 815,382 | |||||||
Expected terms (In Years) | 2 years 6 months | |||||||
Offering fees and other expenses | $ 1,300 | |||||||
Valuation of warrants | $ 3,500,000 | |||||||
Volatility rate | 59.86% | |||||||
Risk-free interest rate | 0.34% | |||||||
Expected dividend yield | 0.00% | |||||||
May 2020 Offering [Member] | Placement Agent Warrants [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Common stock reserve for issuance | 62,222 | |||||||
May 2020 Offering [Member] | Warrant [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Warrants issued price per share | $ 11.25 | |||||||
Equity offering description | Each share of common stock was sold in the offering with one warrant to purchase one share of common stock | |||||||
Warrants expire period | 5 years | |||||||
Common stock, par value | $ 11.25 | |||||||
May 2020 Offering [Member] | Warrant [Member] | Placement Agent Warrants [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Warrants issued price per share | $ 14.0625 | |||||||
Common stock expire period | 5 years | |||||||
May 2020 Offering [Member] | Warrant [Member] | Maximum [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Warrants issued during period | $ 888,888,000 | |||||||
May 2020 Offering [Member] | Warrant [Member] | Maximum [Member] | Placement Agent Warrants [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Placement agent warrants issued | 62,222 | |||||||
August 2020 Offering [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Common stock, shares authorized | 1,371,429 | |||||||
Warrants issued price per share | $ 8.75 | |||||||
Proceeds from issuance of common stock | $ 10,400,000 | |||||||
Common stock reserve for issuance | 1,371,429 | |||||||
Expected terms (In Years) | 2 years 6 months | |||||||
Offering fees and other expenses | $ 1,600,000 | |||||||
Valuation of warrants | $ 4,000,000 | |||||||
Volatility rate | 59.72% | |||||||
Risk-free interest rate | 0.17% | |||||||
Expected dividend yield | 0.00% | |||||||
August 2020 Offering [Member] | Placement Agent Warrants [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Common stock reserve for issuance | 96,000 | |||||||
August 2020 Offering [Member] | Offering [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Warrants issued price per share | $ 10.9375 | |||||||
Equity offering description | Each share of common stock was sold in the offering with one warrant to purchase one share of common stock. | |||||||
August 2020 Offering [Member] | Warrant [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Warrants issued price per share | $ 8.75 | |||||||
Warrants expire period | 5 years | |||||||
Common stock, par value | $ 8.75 | |||||||
August 2020 Offering [Member] | Warrant [Member] | Placement Agent Warrants [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Warrants issued price per share | $ 10.9375 | |||||||
Common stock expire period | 5 years | |||||||
August 2020 Offering [Member] | Warrant [Member] | Maximum [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Warrants issued price per share | $ 1,371,429 | |||||||
August 2020 Offering [Member] | Warrant [Member] | Maximum [Member] | Placement Agent Warrants [Member] | ||||||||
Class of Stock [Line Items] | ||||||||
Placement agent warrants issued | 96,000 |
Stock-Based Compensation - Sche
Stock-Based Compensation - Schedule of Options Activity (Details) - $ / shares | 9 Months Ended | 12 Months Ended | ||
Sep. 30, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Weighted Average Remaining Life (in years) | ||||
Weighted Average Remaining Life (in years) | 1 year 10 months 24 days | |||
Stock Options [Member] | ||||
Options outstanding | ||||
Beginning balance | 124,171 | 125,579 | 76,804 | |
Forfeited | (15,173) | (13,137) | (12,079) | |
Number of shares granted under the plan | 11,729 | 60,854 | ||
Ending balance | 108,998 | 124,171 | 125,579 | 76,804 |
Exercisable at the end of the period | 95,096 | 84,376 | ||
Vested and expected to vest at the end of the period | 108,998 | 124,171 | ||
Weighted Average Remaining Life (in years) | ||||
Weighted Average Remaining Life (in years) | 4 years 9 months 25 days | 6 years 5 months 1 day | 9 years 5 months 4 days | 9 years 5 months 4 days |
Exercisable at the end of the period | 4 years 3 months 25 days | 5 years 10 months 20 days | ||
Vested and expected to vest at the end of the period | 4 years 9 months 18 days | 6 years 5 months 1 day | ||
Weighted Average Exercise Price | ||||
Beginning balance | $ 363.31 | $ 387.50 | $ 714.75 | |
Weighted average exercise price of stock options | 30.69 | 30.50 | ||
Forfeited | 87.28 | 297.57 | 670.25 | |
Ending balance | 401.74 | 363.31 | $ 387.50 | $ 714.75 |
Exercisable at the end of the period | 455.95 | 466.78 | ||
Vested and expected to vest at the end of the period | $ 401.74 | $ 363.31 | ||
Stock Option Activity Two Thousand Twenty Equity Incentive Plan [Member] | ||||
Options outstanding | ||||
Beginning balance | 18,000 | |||
Ending balance | 18,000 | 18,000 | ||
Exercisable at the end of the period | 6,750 | |||
Vested and expected to vest at the end of the period | 18,000 | |||
Weighted Average Remaining Life (in years) | ||||
Weighted Average Remaining Life (in years) | 8 years 6 months | 9 years 2 months 26 days | ||
Exercisable at the end of the period | 8 years 6 months | |||
Vested and expected to vest at the end of the period | 8 years 6 months | |||
Weighted Average Exercise Price | ||||
Beginning balance | $ 25.50 | |||
Ending balance | 25.50 | $ 25.50 | ||
Exercisable at the end of the period | 25.50 | |||
Vested and expected to vest at the end of the period | $ 25.50 |
Stock-Based Compensation - Sc_2
Stock-Based Compensation - Schedule of Restricted Stock Units Activity (Details) - Restricted Stock Units (RSUs) [Member] - $ / shares | 9 Months Ended | 12 Months Ended | |
Sep. 30, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Restricted Stock Units | |||
Beginning balance | 33,548 | 10,864 | 59,767 |
Granted | 29,614 | 32,019 | 12,010 |
Vested and released | (7,906) | (48,269) | |
Vested | (1,845) | ||
Forfeited | (15,485) | (1,429) | (12,644) |
Ending balance | 45,832 | 33,548 | 10,864 |
Weighted Average Grant Date Fair Value | |||
Beginning balance | $ 21.93 | $ 128.82 | $ 672.75 |
Granted | 3.99 | $ 10.82 | $ 98.75 |
Vested and released | 114.55 | 698.25 | |
Vested | 64.80 | ||
Forfeited | 14.67 | $ 101.79 | $ 497.75 |
Ending balance | $ 11.06 | $ 21.93 | $ 128.82 |
Stock-Based Compensation - Sc_3
Stock-Based Compensation - Schedule of Restricted Stock Awards Activity (Details) - Restricted Stock Awards (RSAs) [Member] - $ / shares | 9 Months Ended | 12 Months Ended |
Sep. 30, 2021 | Dec. 31, 2020 | |
Restricted Stock Units | ||
Beginning balance | 286,161 | |
Granted | 286,161 | |
Ending balance | 286,161 | |
Beginning balance | $ 4.77 | |
Granted | $ 4.77 | |
Ending balance | $ 4.77 | |
Two Thousand Eighteen Restricted Stock Plan | ||
Restricted Stock Units | ||
Beginning balance | 286,161 | |
Granted | 103,939 | |
Vested | (31,388) | |
Forfeited | (50,082) | |
Ending balance | 308,630 | 286,161 |
Beginning balance | $ 4.77 | |
Granted | 4.82 | |
Vested | 6.96 | |
Forfeited | 5.10 | |
Ending balance | $ 4.51 | $ 4.77 |
Two Thousand Twenty Restricted Stock Plan | ||
Restricted Stock Units | ||
Beginning balance | 4,375 | |
Vested | (625) | |
Ending balance | 3,750 | 4,375 |
Beginning balance | $ 25.50 | |
Vested | 25.50 | |
Ending balance | $ 25.50 | $ 25.50 |
Stock-Based Compensation - Sc_4
Stock-Based Compensation - Schedule of Stock-based Compensation Expense Recorded in Operating Expenses (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | 12 Months Ended | |||
Sep. 30, 2021 | Sep. 30, 2020 | Sep. 30, 2021 | Sep. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | |
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items] | ||||||
Stock-based compensation in operating expenses | $ 105 | $ 872 | $ 1,802 | $ 2,741 | $ 3,679 | $ 17,678 |
Selling, General And Administrative [Member] | ||||||
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items] | ||||||
Stock-based compensation in operating expenses | 78 | 757 | 1,551 | 2,424 | 3,235 | 16,141 |
Research And Development [Member] | ||||||
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items] | ||||||
Stock-based compensation in operating expenses | $ 27 | $ 115 | $ 251 | $ 317 | $ 444 | $ 1,537 |
Stock-Based Compensation - Sc_5
Stock-Based Compensation - Schedule of Fair Value of Options Using the Black Scholes Option Pricing Model and Weighted Average Assumptions Used (Details) - Stock Options [Member] | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
2018 Plan [Member] | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Risk free interest rate | 1.30% | 1.60% |
Volatility rate | 58.96% | 59.26% |
Expected dividend yield | 0.00% | 0.00% |
Expected life (in years) | 5 years 9 months 18 days | 5 years 10 months 24 days |
2020 Plan [Member] | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Risk free interest rate | 0.50% | |
Volatility rate | 58.33% | |
Expected dividend yield | 0.00% | |
Expected life (in years) | 6 years 3 months 18 days |
Stock-Based Compensation - Addi
Stock-Based Compensation - Additional Information (Details) - USD ($) | Jun. 04, 2018 | Sep. 30, 2018 | Sep. 30, 2021 | Sep. 30, 2020 | Sep. 30, 2021 | Sep. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | Mar. 13, 2020 | Jun. 08, 2018 |
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Stock-based compensation | $ 1,967,000 | $ 3,044,000 | $ 4,082,000 | $ 23,543,000 | |||||||
Weighted Average Remaining Life (in years) | 1 year 10 months 24 days | ||||||||||
2018 Stock Compensation Plan [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Common stock reserve for issuance | 132,000 | 132,000 | 65,285 | ||||||||
Maximum annual increase of outstanding stock reserved for future issuance, Percentage | 5.00% | ||||||||||
Number of shares available for grant under the plan | 110,329 | ||||||||||
2020 Inducement Equity Incentive Plan (the "2020 plan") [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Common stock reserve for issuance | 32,000 | ||||||||||
Number of shares granted under the plan | 18,000 | ||||||||||
Weighted average exercise price of stock options | $ 25.50 | ||||||||||
Number of shares exercisable under the plan | 3,375 | ||||||||||
2018 Employee Stock Purchase Plan (ESPP) [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Common stock reserve for issuance | 11,870 | ||||||||||
Maximum annual increase of outstanding stock reserved for future issuance, Percentage | 1.25% | ||||||||||
Number of shares available for grant under the plan | 19,463 | ||||||||||
Common stock discount rate | 85.00% | ||||||||||
Shares issued under employee stock purchase plan, Shares | 5,278 | 368 | |||||||||
Shares issued under employee stock purchase plan, Value | $ 42,000,000 | $ 37,000,000 | |||||||||
Stock Options [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Stock-based compensation | $ 5,000,000 | $ 48,000,000 | $ 100 | $ 100 | 200,000 | $ 1,000,000 | |||||
Unrecognized compensation expense for stock options issued | $ 400 | $ 400 | $ 1,800,000 | ||||||||
Weighted Average Remaining Life (in years) | 4 years 9 months 25 days | 6 years 5 months 1 day | 9 years 5 months 4 days | 9 years 5 months 4 days | |||||||
Weighted-average recognized period | 1 year 2 months 12 days | ||||||||||
Number of shares granted under the plan | 11,729 | 60,854 | |||||||||
Weighted average exercise price of stock options | $ 30.69 | $ 30.50 | |||||||||
Number of shares exercisable under the plan | 95,096 | 95,096 | 84,376 | ||||||||
Stock Options [Member] | 2018 Stock Compensation Plan [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Authorized replacement equity awards of stock options and restricted stock units | 76,076 | ||||||||||
Share-based compensation arrangement by share-based payment award, Award vesting rights | generally vest 33% on the first anniversary of the grant date with the balance vesting monthly over the remaining two years | ||||||||||
Share based compensation awards expiration date | Jan. 31, 2020 | ||||||||||
Stock Options [Member] | 2018 Stock Compensation Plan [Member] | First Anniversary [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Stock options granted under the 2018 Plan vesting percentage | 33.00% | 25.00% | |||||||||
Stock Options [Member] | 2018 Stock Compensation Plan [Member] | Second Anniversary [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Stock options granted under the 2018 Plan vesting percentage | 25.00% | ||||||||||
Stock Options [Member] | 2018 Stock Compensation Plan [Member] | Third Anniversary [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Stock options granted under the 2018 Plan vesting percentage | 25.00% | ||||||||||
Stock Options [Member] | 2018 Stock Compensation Plan [Member] | Forth Anniversary [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Stock options granted under the 2018 Plan vesting percentage | 25.00% | ||||||||||
Restricted Stock Units (RSUs) [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Unrecognized compensation expense for stock options issued | $ 300 | $ 300 | $ 600,000 | ||||||||
Weighted-average recognized period | 2 years | 1 year 10 months 24 days | |||||||||
Restricted Stock Units (RSUs) [Member] | 2018 Stock Compensation Plan [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Authorized replacement equity awards of stock options and restricted stock units | 53,633 | ||||||||||
Restricted Stock Awards (RSAs) [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Unrecognized compensation expense for stock options issued | $ 800 | $ 800 | |||||||||
Weighted-average recognized period | 2 years 4 months 24 days | ||||||||||
Restricted Stock Awards (RSAs) [Member] | 2020 Inducement Equity Incentive Plan (the "2020 plan") [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Restricted stock awards granted | 5,000 | ||||||||||
Restricted stock awards with grant date fair value | $ 100,000 | ||||||||||
Restricted Stock [Member] | |||||||||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||||||||||
Unrecognized compensation expense for stock options issued | $ 1,400,000 | ||||||||||
Weighted-average recognized period | 2 years 9 months 18 days |
Income Taxes - Reconciliation o
Income Taxes - Reconciliation of Differences between United States Statutory Federal Income Tax Rate and Effective Tax Rate (Details) | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Income Tax Disclosure [Abstract] | ||
Tax computed at the federal statutory rate | 21.00% | 21.00% |
State income taxes, net of federal benefits | 5.10% | 1.90% |
Nondeductible expenses | (0.10%) | (0.40%) |
Stock-based compensation | (2.20%) | (9.50%) |
Deferred tax adjustments | (57.00%) | |
Change in valuation allowance | 33.20% | (13.00%) |
Income Taxes - Summary of Feder
Income Taxes - Summary of Federal and State Income Tax Provision (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Current | ||
State | $ 7 | $ 15 |
Current federal and state income tax expense | 7 | 15 |
Deferred | ||
Income tax expense | $ 7 | $ 15 |
Income Taxes - Significant Comp
Income Taxes - Significant Components of Deferred Tax Assets (Liabilities) (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Deferred Tax Assets: | ||
Net operating loss carryforwards | $ 3,720 | $ 16,096 |
Operating lease liabilities | 691 | 766 |
Other accruals | 101 | 61 |
Accrued compensation | 448 | |
Reserves | 299 | 301 |
Deferred revenue | 642 | 850 |
Intangible assets | 32 | 253 |
Stock-based compensation | 4,910 | 4,821 |
Total gross deferred tax assets | 10,843 | 23,148 |
Deferred Tax Liabilities: | ||
Property and equipment | (805) | (1,026) |
Operating lease right-of-use assets | (655) | (739) |
Other | (61) | (92) |
Total gross deferred tax liabilities | (1,521) | (1,857) |
Valuation allowance | $ (9,322) | $ (21,291) |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Details) | 12 Months Ended |
Dec. 31, 2020USD ($) | |
Operating Loss Carryforwards [Line Items] | |
Net operating loss carryforwards expiration year | 2032 |
Deferred tax expense impact | $ 20,800,000 |
Unrecognized tax benefits | 0 |
Anticipated amount of unrecognized tax benefits significantly increase or decrease in next 12 months | 0 |
Unrecognized tax benefits accrued interest and penalties | $ 0 |
Income tax examination years under examination | 2016 and later |
Federal [Member] | |
Operating Loss Carryforwards [Line Items] | |
Net operating loss carryforwards | $ 14,300,000 |
State [Member] | |
Operating Loss Carryforwards [Line Items] | |
Net operating loss carryforwards | $ 13,400,000 |
Commitments and Contingencies -
Commitments and Contingencies - Additional Information (Details) - USD ($) | Nov. 12, 2021 | Jan. 19, 2021 | Dec. 28, 2020 | Jan. 31, 2019 | Sep. 30, 2021 | Sep. 30, 2020 | Sep. 30, 2021 | Sep. 30, 2020 | Dec. 31, 2020 | Dec. 31, 2019 |
Loss Contingencies [Line Items] | ||||||||||
Total net revenues | $ 5,000 | $ 68,000 | $ 17,000 | $ 259,000 | $ 259,000 | $ 1,273,000 | ||||
Audit committee findings | The primary investigative findings were: (i) the DABRA catheter frequently failed to calibrate and occasionally overheated, posing a risk of injury to physicians and patients; (ii) the Company’s explanations regarding its fourth quarter 2018 and first quarter 2019 sales created a risk of confusion because they did not explicitly reference inconsistent DABRA catheter performance and catheter failures; (iii) the Company failed to timely make at least two Medical Device Reports, or MDRs, to the FDA; (iv) the Company, out of a concern for the DABRA catheters’ performance, engaged in systematic efforts to replace product held by customers, which constituted product recalls, but were not documented as such, (v) the Company lack documentation of sufficient detail and specificity to support certain payments to physicians, ostensibly for training and consulting services, and as to three physicians did not accurately reflect the purpose and nature of approximately $300,000 of payments, which could be perceived as an improper attempt to obtain business or to gain special advantage, (vi) while the indication for use in the 510(k) clearance the Company obtained for the DABRA system is not for atherectomy, the Company’s salespeople were instructed to characterize DABRA as performing atherectomy and to encourage doctors to seek reimbursement using atherectomy codes, (vii) the Company’s determinations to direct potentially valuable benefits and opportunities to doctors were informed in part by sales prospects, and (viii) the Company received complaints regarding regulatory or compliance concerns that, because they implicated executive officers, should have been brought to the attention of the Board or the Audit Committee, but were not. | |||||||||
Payments to physicians that lack documentation of sufficient detail | $ 300,000 | |||||||||
Retirement benefits, description | In January 2019, the Company established a defined contribution plan under Section 401(k) of the Internal Revenue Code (“401(k) Plan”) that the Company administers for participating employees’ contributions. | |||||||||
Defined contribution plan, description | All full-time employees are eligible under the 401(k) Plan. The Company will make contributions, based on a match of 100% of each employee’s contribution up to 3% and 50% of contributions between 3% and 5%, with the match-eligible contribution being limited to 4% of the employee’s eligible compensation. | |||||||||
Loss contingency, payments | $ 2,700,000 | |||||||||
Settlement accrued expenses | $ 300,000 | |||||||||
Employer matching contribution, maximum (percentage) | 50.00% | |||||||||
Defined benefit contribution plan expense | 300,000 | $ 300,000 | ||||||||
First Anniversary [Member] | ||||||||||
Loss Contingencies [Line Items] | ||||||||||
Maximum contribution per employee (percentage) | 3.00% | |||||||||
Employer matching contribution, maximum (percentage) | 100.00% | |||||||||
Third Anniversary [Member] | ||||||||||
Loss Contingencies [Line Items] | ||||||||||
Maximum contribution per employee (percentage) | 4.00% | |||||||||
Maximum [Member] | Second Anniversary [Member] | ||||||||||
Loss Contingencies [Line Items] | ||||||||||
Maximum contribution per employee (percentage) | 5.00% | |||||||||
Minimum [Member] | Second Anniversary [Member] | ||||||||||
Loss Contingencies [Line Items] | ||||||||||
Maximum contribution per employee (percentage) | 3.00% | |||||||||
Settlement Agreement [Member] | ||||||||||
Loss Contingencies [Line Items] | ||||||||||
Settlement amount , year 2021 | $ 500,000 | |||||||||
Settlement year one | 2021 | |||||||||
Settlement amount , year 2022 | $ 750,000 | |||||||||
Settlement year two | 2022 | |||||||||
Settlement amount , year 2023 | $ 1,000,000 | |||||||||
Settlement year three | 2023 | |||||||||
Settlement amount , year 2024 | $ 1,250,000 | |||||||||
Settlement year four | 2024 | |||||||||
Business acquisition, settlement amount | $ 5,000,000 | |||||||||
Business acquisition additional settlement percentage | 4.00% | |||||||||
Business acquisition, transaction costs | $ 100,000,000 | |||||||||
Business acquisition change In control payments | 28,000,000 | |||||||||
Settlement claim | 56,000,000 | |||||||||
Settlement expense | 200,000 | |||||||||
Litigation settlement amount, current | 2,400,000 | |||||||||
Litigation settlement, remaining amount | $ 100,000 | |||||||||
Allegations description | (a) paid illegal remuneration to certain physicians to induce them to use the DABRA laser system in violation of the federal anti-kickback statute and (b) marketed the DABRA laser system for off-label use in atherectomy procedures despite product performance issues causing calibration and overheating problems, which posed a risk to physicians and patients (the “Covered Conduct”). | |||||||||
Settlement Agreement [Member] | Maximum [Member] | ||||||||||
Loss Contingencies [Line Items] | ||||||||||
Total net revenues | 10,000,000 | |||||||||
Business acquisition change In control payments | 28,000,000 | |||||||||
Litigation settlement amount | $ 2,500,000 | |||||||||
Settlement Agreement [Member] | Minimum [Member] | ||||||||||
Loss Contingencies [Line Items] | ||||||||||
Business acquisition, transaction costs | $ 100,000,000 | |||||||||
Integrity Agreement [Member] | ||||||||||
Loss Contingencies [Line Items] | ||||||||||
Agreement term | 5 years | |||||||||
Subsequent Event | ||||||||||
Loss Contingencies [Line Items] | ||||||||||
Settlement provided for a payment to plaintiff class | $ 265,000 | |||||||||
Securities Litigation | Subsequent Event | ||||||||||
Loss Contingencies [Line Items] | ||||||||||
Settlement provided for a payment to plaintiff class | $ 10,000,000 | |||||||||
Expected amount contribute to settlement | $ 1,000,000 |
Net Revenue by Geography - Sche
Net Revenue by Geography - Schedule of Net Revenue, Classified by the Major Geographic Areas (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Revenues from External Customers and Long-Lived Assets [Line Items] | ||
Revenues | $ 259 | $ 1,273 |
United States | ||
Revenues from External Customers and Long-Lived Assets [Line Items] | ||
Revenues | 259 | 1,273 |
All other countries | ||
Revenues from External Customers and Long-Lived Assets [Line Items] | ||
Revenues |