Catheter Precision (VTAK) 10-Q 16 Nov 20 2020 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2020	Nov. 11, 2020
Cover [Abstract]
Entity Registrant Name	Ra Medical Systems, Inc.
Entity Central Index Key	0001716621
Document Type	10-Q
Document Period End Date	Sep. 30, 2020
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Title of 12(b) Security	Common Stock, par value $0.0001 per share
Trading Symbol	RMED
Security Exchange Name	NYSE
Entity Filer Category	Non-accelerated Filer
Entity Common Stock, Shares Outstanding		72,982,062
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q3
Entity Emerging Growth Company	true
Entity Small Business	true
Entity Ex transition period	false
Entity Current Reporting Status	Yes
Entity Shell Company	false
Entity File Number	001-38677
Entity Tax Identification Number	38-3661826
Entity Address, Address Line One	2070 Las Palmas Drive
Entity Address, City or Town	Carlsbad
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92011
City Area Code	760
Local Phone Number	804-1648
Document Quarterly Report	true
Document Transition Report	false
Entity Incorporation, State or Country Code	DE
Entity Interactive Data Current	Yes

Condensed Balance Sheets (Unaud

Condensed Balance Sheets (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Current Assets
Cash and cash equivalents	$ 33,646	$ 14,584
Short-term investments		15,993
Accounts receivable, net	475	786
Inventories	2,592	2,777
Prepaid expenses and other current assets	466	1,860
Total current assets	37,179	36,000
Property and equipment, net	3,581	5,050
Operating lease right-of-use-assets	2,574	2,835
Other non-current assets	120	196
TOTAL ASSETS	43,454	44,081
Current Liabilities
Accounts payable	899	1,532
Accrued expenses	4,591	2,642
Current portion of deferred revenue	1,729	2,029
Current portion of equipment financing	306	293
Current portion of promissory note	168
Current portion of operating lease liabilities	346	318
Total current liabilities	8,039	6,814
Deferred revenue	656	1,232
Equipment financing	34	265
Promissory note	1,832
Operating lease liabilities	2,355	2,620
Total liabilities	12,916	10,931
Commitments and contingencies (Note 13)
Stockholders’ Equity
Preferred stock, $0.0001 par value, 10,000,000 authorized at September 30, 2020 and December 31, 2019, respectively; none issued
Common stock, $0.0001 par value, 300,000,000 shares authorized; 72,468,337 and 13,770,349 issued and outstanding at September 30, 2020 and December 31, 2019, respectively	7	1
Additional paid-in capital	173,289	150,280
Accumulated deficit	(142,758)	(117,157)
Accumulated other comprehensive income		26
Total stockholders’ equity	30,538	33,150
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY	$ 43,454	$ 44,081

Condensed Balance Sheets (Una_2

Condensed Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Sep. 30, 2020	Dec. 31, 2019
Statement Of Financial Position [Abstract]
Common stock, par value	$ 0.0001	$ 0.0001
Common stock, shares authorized	300,000,000	300,000,000
Common stock, shares issued	72,468,337	13,770,349
Common stock, shares outstanding	72,468,337	13,770,349
Preferred stock, par value	$ 0.0001	$ 0.0001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares issued	0	0

Condensed Statements of Operati

Condensed Statements of Operations (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Net revenue
Total net revenue	$ 914	$ 1,908	$ 3,188	$ 5,809
Cost of revenue
Total cost of revenue	1,418	2,425	4,169	7,100
Gross loss	(504)	(517)	(981)	(1,291)
Operating expenses
Selling, general and administrative	4,933	15,889	19,114	42,907
Research and development	2,332	1,182	5,580	3,692
Total operating expenses	7,265	17,071	24,694	46,599
Operating loss	(7,769)	(17,588)	(25,675)	(47,890)
Other income (expense), net
Interest income	4	245	128	870
Interest expense	(14)	(72)	(54)	(186)
Total other income (expense), net	(10)	173	74	684
Loss before income tax expense	(7,779)	(17,415)	(25,601)	(47,206)
Income tax expense		3		8
Net loss	$ (7,779)	$ (17,418)	$ (25,601)	$ (47,214)
Basic and diluted net loss per share	$ (0.13)	$ (1.30)	$ (0.79)	$ (3.63)
Basic and diluted weighted average common shares outstanding	59,638	13,370	32,443	13,023
Product Sales [Member]
Net revenue
Total net revenue	$ 183	$ 1,078	$ 923	$ 3,256
Cost of revenue
Total cost of revenue	670	1,518	2,258	4,848
Service and Other [Member]
Net revenue
Total net revenue	731	830	2,265	2,553
Cost of revenue
Total cost of revenue	$ 748	$ 907	$ 1,911	$ 2,252

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Loss (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Statement Of Income And Comprehensive Income [Abstract]
Net loss	$ (7,779)	$ (17,418)	$ (25,601)	$ (47,214)
Other comprehensive (loss) income:
Unrealized (losses) gains related to short-term investments		(13)	(26)	38
Total other comprehensive (loss) income		(13)	(26)	38
Comprehensive loss	$ (7,779)	$ (17,431)	$ (25,627)	$ (47,176)

Condensed Statements of Cash Fl

Condensed Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
CASH FLOWS FROM OPERATING ACTIVITIES:
Net loss			$ (25,601)	$ (47,214)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation	$ 500	$ 400	1,584	1,046
Operating lease right-of-use-assets amortization	100	100	261	245
Provision for doubtful accounts			25	266
Stock-based compensation			3,044	22,154
Loss on disposal of property and equipment			64
Changes in operating assets and liabilities:
Accounts receivable			286	(242)
Inventories			78	(1,774)
Prepaid expenses and other assets			1,437	438
Accounts payable			(633)	(121)
Accrued expenses			1,678	1,577
Deferred revenue			(876)	234
Other liabilities			(237)	(210)
Net cash used in operating activities			(18,890)	(23,601)	$ (33,200)
CASH FLOWS FROM INVESTING ACTIVITIES:
Purchases of available-for-sale securities				(36,461)
Proceeds from maturities of available-for-sale securities			16,000	10,697
Purchases of property and equipment			(72)	(220)
Net cash provided by (used in) investing activities			15,928	(25,984)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of common stock and warrants, net of placement agent fees of $2,113			19,887
Proceeds from issuance of common stock in connection with the exercise of warrants			827
Proceeds from issuance of common stock in connection with the employee stock purchase plan			27	37
Proceeds from promissory note			2,000
Payments on equipment financing			(218)	(255)
Payments of offering costs related to the issuance of common stock and warrants			(499)
Net cash provided by (used in) financing activities			22,024	(218)
NET CHANGE IN CASH AND CASH EQUIVALENTS			19,062	(49,803)
CASH AND CASH EQUIVALENTS, beginning of period			14,584	64,315	64,315
CASH AND CASH EQUIVALENTS, end of period	33,646	$ 14,512	33,646	14,512	$ 14,584
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING AND FINANCING ACTIVITIES:
Unpaid offering costs	$ 281		281
Transfer from inventories to property and equipment for lasers			107	1,299
Unpaid property and equipment included in equipment financing				156
SUPPLEMENTAL CASH FLOW INFORMATION:
Cash payments for interest			$ 23	39
Cash payments for taxes				$ 24

Condensed Statements of Cash _2

Condensed Statements of Cash Flows (Unaudited) (Parenthetical) $ in Thousands	9 Months Ended
	Sep. 30, 2020USD ($)
Statement Of Cash Flows [Abstract]
Common stock and warrants, net of placement agent fees	$ 2,113

Condensed Statements of Stockho

Condensed Statements of Stockholders' Equity (Unaudited) - USD ($) shares in Thousands, $ in Thousands	Total	Cumulative Effect, Period of Adoption, Adjustment	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income (Loss)	Accumulated Deficit	Accumulated DeficitCumulative Effect, Period of Adoption, Adjustment
Adoption of accounting standard (See Note 2)		$ 21					$ 21
Balances at January 1, 2019	$ 66,726		$ 1	$ 126,925		$ (60,200)
Balances at Dec. 31, 2018	$ 66,705		$ 1	126,925		$ (60,221)
Balance (in shares) at Dec. 31, 2018			12,689
AccountingStandardsUpdateExtensibleList	us-gaap:AccountingStandardsUpdate201807Member					us-gaap:AccountingStandardsUpdate201807Member
Common stock issued (in shares)			148
Stock-based compensation	$ 7,745			7,745
Net loss	(14,674)					$ (14,674)
Balances at Mar. 31, 2019	59,797		$ 1	134,670		(74,874)
Balance (in shares) at Mar. 31, 2019			12,837
Balances at Dec. 31, 2018	66,705		$ 1	126,925		(60,221)
Balance (in shares) at Dec. 31, 2018			12,689
Other comprehensive Income (loss)	38
Net loss	(47,214)
Balances at Sep. 30, 2019	41,741		$ 1	149,116	$ 38	(107,414)
Balance (in shares) at Sep. 30, 2019			13,408
Balances at Mar. 31, 2019	59,797		$ 1	134,670		(74,874)
Balance (in shares) at Mar. 31, 2019			12,837
Common stock issued	37			37
Common stock issued (in shares)			384
Stock-based compensation	7,132			7,132
Other comprehensive Income (loss)	51				51
Net loss	(15,122)					(15,122)
Balances at Jun. 30, 2019	51,895		$ 1	141,839	51	(89,996)
Balance (in shares) at Jun. 30, 2019			13,221
Common stock issued (in shares)			187
Stock-based compensation	7,277			7,277
Other comprehensive Income (loss)	(13)				(13)
Net loss	(17,418)					(17,418)
Balances at Sep. 30, 2019	41,741		$ 1	149,116	38	(107,414)
Balance (in shares) at Sep. 30, 2019			13,408
Balances at Dec. 31, 2019	33,150		$ 1	150,280	26	(117,157)
Balance (in shares) at Dec. 31, 2019			13,770
Common stock issued (in shares)			125
Stock-based compensation	1,047			1,047
Other comprehensive Income (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			13,895
Balances at Dec. 31, 2019	33,150		$ 1	150,280	26	(117,157)
Balance (in shares) at Dec. 31, 2019			13,770
Other comprehensive Income (loss)	(26)
Net loss	(25,601)
Balances at Sep. 30, 2020	30,538		$ 7	173,289		(142,758)
Balance (in shares) at Sep. 30, 2020			72,468
Balances at Mar. 31, 2020	26,474		$ 1	151,327	4	(124,858)
Balance (in shares) at Mar. 31, 2020			13,895
Exercise of warrants	827		$ 1	826
Exercise of warrants (in shares)			1,838
Common stock issued pursuant to the vesting of restricted stock units and ESPP	27			27
Common stock issued pursuant to the vesting of restricted stock units and ESPP (in shares)			228
Common stock issued	5,284		$ 2	5,282
Common stock issued (in shares)			22,222
Warrants issued, net	3,464			3,464
Stock-based compensation	1,033			1,033
Other comprehensive Income (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			38,183
Common stock issued	6,341		$ 3	6,338
Common stock issued (in shares)			34,285
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			72,468

Organization and Nature of Oper

Organization and Nature of Operations	9 Months Ended
	Sep. 30, 2020
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Organization and Nature of Operations	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. In July 2018, the Company reincorporated in Delaware. In connection with the Company’s initial public offering (“IPO”), which closed on October 1, 2018, 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. COVID-19 — The global spread of the novel coronavirus (COVID-19) has created significant volatility, uncertainty and economic disruption. The ultimate effects of the COVID-19 on the Company’s business, operations and financial condition are unknown at this time. In the near term, the Company expects that 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 impacts its business will depend on future developments, which are highly uncertain and cannot be predicted, including new information which may emerge concerning the severity of COVID-19 and the actions to contain it or treat its impact, among others. Going Concern — The condensed 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. 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 $142.8 million at September 30, 2020. For the year ended December 31, 2019 and the nine months ended September 30, 2020, the Company used $33.2 million and $18.9 million for operating activities, respectively. As of September 30, 2020, the Company had cash and cash equivalents of $33.6 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 DABRA catheters not being used for the atherectomy clinical trial while it continues its engineering efforts to improve the shelf-life of its catheters. Additional test data will need to be submitted and approved by the FDA prior to resuming commercial shipments of catheters. The Company expects this to be resolved in the first quarter of 2021. The Company also expects the COVID-19 pandemic to have a continued negative impact on its revenue and the timing of enrollment in its atherectomy clinical trial as well as the Company’s ability to secure additional financing in a timely manner or on favorable terms, if at all. Although the Company has bolstered its liquidity resources in 2020, management concluded that the aforementioned conditions, particularly the ongoing uncertainty related to the negative impacts of the COVID-19 pandemic, continue to raise substantial doubt about the Company’s ability to continue as a going concern within 12 months from the date of issuance of the financial statements. Management’s plans to address this uncertainty include raising additional funding, if necessary, through public or private equity or debt financings. However, the Company may not be able to secure such financing in a timely manner or on favorable terms, if at all. Furthermore, if the Company issues equity securities to raise additional funds, its existing stockholders may experience dilution, and the new equity securities may have rights, preferences and privileges senior to those of the Company’s existing stockholders.

Significant Accounting Policies

Significant Accounting Policies	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Note 2—Significant Accounting Policies Interim condensed financial information —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 statement of stockholders’ equity for the periods presented. The results of operations for the three and nine months ended September 30, 2020 are not necessarily indicative of the results to be expected for the year ending December 31, 2020 or for any other future annual or interim period. The balance sheet as of December 31, 2019 included herein was derived from the audited financial statements as of that date. 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 filed with the SEC on March 11, 2020. Use of estimates —The financial statements of the Company have been prepared by management in accordance with accounting principles generally accepted in the United States of America. 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, 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. Product warranty —The Company records estimated product warranty costs at the time of sale. Products are warrantied against defects in material and workmanship when properly used for their intended purpose and appropriately maintained. Accordingly, the Company generally replaces catheters that kink or fail to calibrate. The product warranty liability is determined based on historical information such as past experience, product failure rates or number of units repaired, estimated cost of material and labor. The product warranty liability also includes the estimated costs of a product recall. 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. Inventories —Inventories are stated at the lower of cost (first-in, first-out method) or net realizable value. Cost includes materials, labor and manufacturing overhead related to the purchase and production of inventories. The Company reduces the carrying value of inventories for those items that are potentially excess, obsolete or slow-moving based on changes in customer demand, technological developments or other economic factors. Catheters are manufactured in-house and each catheter is tested at various stages of the manufacturing process for adherence to quality standards. Catheters that do not meet functionality specification at each test point are destroyed and immediately written off, with the expense recorded in cost of revenue in the statement of operations. Once manufactured, completed catheters that pass quality assurance, are sent to a third-party for sterilization and sealed in a sterile container. Upon return from the third-party sterilizer, a sample of catheters from each batch are re-tested. If the sample tests are successful, the batch is accepted into finished goods inventory and if the sample tests are unsuccessful, the entire batch is written off, with the expense recorded in cost of revenue in the statement of operations. Revenue —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 provisions for any form of consideration including partial refund or credit against amounts owed to the Company. Services and other revenue primarily consist of sales of extended warranty and billable services, including repair activity and income from rental of lasers. 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 catheters to the customer which aggregate the majority of the vascular segment revenue. There are no specified minimum purchase commitments for the catheters. 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 warranty with the purchase of its laser systems. Customers can extend the warranty period through the purchase of extended warranty service contracts. Extended warranty service contracts are sold with contract terms ranging from 12 to 60 months and cover periods after the end of the initial 12-month warranty period. The warranty provides the customer with maintenance services in addition to the assurance that the laser product complies with agreed-upon specifications. Therefore, the warranty service is treated as a separate performance obligation from the laser system. Warranty services are a stand-ready obligation, and the Company recognizes revenue on a straight-line basis over the service contract term. Warranty service revenue is included in service and other revenue in the statements of operations. Deferred revenue at December 31, 2019 was $3.3 million. Revenue recognized in each of the three months ended September 30, 2020 and 2019 relating to amounts previously included in deferred revenue was $0.4 million. Revenue recognized in the nine months ended September 30, 2020 and 2019 was $1.7 million and $1.6 million, respectively. The deferred revenue greater than one year will be recognized during the remaining service period through 2024. 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. 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 September 30, 2020 and December 31, 2019, respectively. Rental Income 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 three months ended September 30, 2020 and September 30, 2019 was $0.1 million and $0.2 million, respectively. Rental income from lease arrangements for each of the nine months ended September 30, 2020 and 2019 was $0.4 million and $0.5 million, respectively. Recently Adopted Accounting Pronouncements —In June 2018, the FASB issued ASU 2018-07, Improvements to Nonemployee Share-Based Payment Accounting . ASU 2018-07 expands the scope of Topic 718, Compensation—Stock Compensation , to include share-based payments issued to nonemployees for goods or services. Consequently, the accounting for share-based payments to nonemployees and employees will be substantially aligned. ASU 2018-07 supersedes Subtopic 505-50, Equity—Equity-Based Payments to Non-Employees . The amendments are effective for fiscal years beginning after December 15, 2019. Early adoption is permitted, but no earlier than a company’s adoption date of Topic 606, Revenue from Contracts with Customers. The Company adopted this guidance on January 1, 2020 and there was no impact on the financial statements and related disclosures. 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 In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326)

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2020
Fair Value Disclosures [Abstract]
Fair Value Measurements	Note 3—Fair Value Measurements 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 September 30, 2020 Money market funds $ 18,393 $ 18,393 $ — $ — 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
	Sep. 30, 2020
Inventory Disclosure [Abstract]
Inventories	Inventories consisted of the following (in thousands): September 30, 2020 December 31, 2019 Raw materials $ 2,259 $ 2,300 Work in process 167 215 Finished goods 166 262 Inventories $ 2,592 $ 2,777

Property and Equipment, Net

Property and Equipment, Net	9 Months Ended
	Sep. 30, 2020
Property Plant And Equipment Net [Abstract]
Property and Equipment, Net	Note 5—Property and Equipment, net Property and equipment consisted of the following (in thousands): September 30, 2020 December 31, 2019 Lasers $ 4,694 $ 4,671 Automobiles 1,054 1,109 Machinery and equipment 866 841 Computer hardware and software 357 348 Leasehold improvements 119 119 Furniture and fixtures 48 48 Construction in progress 51 23 Property and equipment, gross 7,189 7,159 Accumulated depreciation (3,608 ) (2,109 ) Property and equipment, net $ 3,581 $ 5,050 Depreciation expense was $0.5 million $0.4 million for the three months ended September 30, 2020 and 2019, respectively and $1.6 million and $1.0 million for the nine months ended September 30, 2020 and 2019, respectively

Accrued Expenses

Accrued Expenses	9 Months Ended
	Sep. 30, 2020
Payables And Accruals [Abstract]
Accrued Expenses	Note 6—Accrued Expenses Accrued expenses consisted of the following (in thousands): September 30, 2020 December 31, 2019 Compensation and related benefits $ 596 $ 1,163 Accrued warranty (Note 7) 227 338 Accrued services 3,768 1,141 Accrued expenses $ 4,591 $ 2,642

Accrued Warranty

Accrued Warranty	9 Months Ended
	Sep. 30, 2020
Product Warranties Disclosures [Abstract]
Accrued Warranty	Note 7—Accrued Warranty Activity in the product warranty accrual is included in accrued expenses above and consists of the following (in thousands): For the Nine Months Ended September 30, 2020 Year Ended December 31, 2019 Balance at beginning of period $ 338 $ 112 Increase in warranty accrual 54 889 Change in liability for pre-existing warranties — (28 ) Claims satisfied (165 ) (635 ) Accrued warranty $ 227 $ 338 Warranty expense was $15,000 and $0.1 million for the three months ended September 30, 2020 and 2019, respectively and $54,000 and $0.9 million for the nine months ended September 30, 2020 and 2019, respectively of catheters, which was initiated in September 2019.

Paycheck Protection Program Pro

Paycheck Protection Program Promissory Note	9 Months Ended
	Sep. 30, 2020
Paycheck Protection Program Promissory Note [Abstract]
Paycheck Protection Program Promissory Note	Note 8—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 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. The Company intends to apply for forgiveness under the provisions of the CARES Act. Forgiveness is subject to the sole approval of the Small Business Administration. Interest expense for the three and nine months ended September 30, 2020 was approximately $5,000 and $8,000, respectively.

Leases

Leases	9 Months Ended
	Sep. 30, 2020
Leases [Abstract]
Leases	Note 9—Leases The Company has two operating leases for office and manufacturing space which requires 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 2021. At September 30, 2020 the weighted average remaining lease term was 7.25 years. The operating leases are included in the balance sheet at the present value of the lease payments at a 7% discount rate using 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, 2020 and 2019, operating lease expense and cash paid for leases were $0.1 million. For each of the nine months ended September 30, 2020 and 2019, operating lease expense $0.4 million. For the nine months ended September 30, 2020 and 2019, cash paid for leases was $0.4 million and $0.3 million, respectively. O The following table presents the lease liabilities within the condensed balance sheet, related to the Company’s operating leases as of September 30, 2020 (in thousands): Years Ending December 31, 2020 (remaining three months) $ 129 2021 528 2022 432 2023 445 2024 459 2025 472 Thereafter 987 Total operating lease payments $ 3,452 Less: imputed interest (751 ) Total operating lease liabilities $ 2,701

Loss per Share

Loss per Share	9 Months Ended
	Sep. 30, 2020
Earnings Per Share [Abstract]
Loss per Share	Note 10—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 restricted stock awards and units using the treasury stock method, along with the effect, if any, from outstanding convertible securities. 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 September 30, 2020 consisted of warrants of 58,625,823, stock options of 3,621,280, restricted stock units of 516,964, restricted stock awards of 125,000 and Employee Stock Purchase Plan shares of 94,296. Anti-dilutive common share equivalents excluded from the computation of diluted net loss per share at September 30, 2019 consisted of stock options of 1,869,127 and restricted stock units of 1,021,977 and Employee Stock Purchase Plan shares of 15,344.

Equity Offerings

Equity Offerings	9 Months Ended
	Sep. 30, 2020
Equity [Abstract]
Equity Offerings	Note 11—Equity Offerings In May 2020, the Company completed a public offering (the “May 2020 Offering”) of an aggregate of 22,222,222 shares of common stock, together with accompanying warrants to purchase up to an aggregate of 22,222,222 shares of common stock, at a public offering price of $0.45 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 $0.45 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 1,555,555 shares of common stock, are immediately exercisable for an exercise price of $0.5625, and expire five years following the date of issuance. 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 1,837,667 shares of common stock in connection with the exercise of warrants issued in the May 2020 Offering. At September 30, 2020, the Company had 20,384,555 In August 2020, the Company completed another public offering (the “August 2020 Offering”) of an aggregate of 34,285,714 shares of common stock, together with accompanying warrants to purchase up to an aggregate of 34,285,714 shares of common stock, at a public offering price of $ 0.35 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 $ 0.35 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 2,399,999 shares of common stock , are immediately exercisable for an exercise price of $ 0.4375 , 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 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 September 30, 2020, the Company had 34,285,714

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2020
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock-Based Compensation	Note 12—Stock-Based Compensation 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, 800,000 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 nine months ended September 30, 2020 there were 450,000 stock options granted with a weighted average exercise price of $1.02 and 125,000 restricted stock awards granted with a grant date fair value of $0.1 million under the 2020 Plan. There are 56,250 exercisable options in the 2020 Plan at September 30, 2020. A summary of the activity and related information of the stock options issued under the 2018 Equity Incentive Plan 2018 Stock Compensation Plan Stock Options Weighted Average Exercise Price Weighted Average Remaining Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding at December 31, 2019 3,139,537 $ 15.50 8.09 $ — Granted 293,220 1.23 Forfeited (261,477 ) 14.56 Outstanding at September 30, 2020 3,171,280 $ 14.26 7.73 $ — Exercisable at September 30, 2020 1,803,297 $ 20.37 6.81 $ — Vested and expected to vest at September 30, 2020 3,171,280 $ 14.26 7.73 $ — A summary of the activity and related information of the restricted stock units issued under the 2018 Plan is presented below: Restricted Stock Units Weighted Average Grant Date Fair Value Outstanding at December 31, 2019 271,472 $ 5.15 Granted 429,359 0.54 Vested and released (166,273 ) 3.70 Forfeited (17,584 ) 4.06 Outstanding at September 30, 2020 516,974 $ 2.14 Stock-based compensation expense recorded in operating expenses was as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Selling, general and administrative $ 771 $ 6,603 $ 2,476 $ 19,286 Research and development 115 254 317 1,440 Stock-based compensation in operating expenses $ 886 $ 6,857 $ 2,793 $ 20,726 Stock-based compensation amounts of $0.1 million and $0.4 million were capitalized to inventory and property and equipment during the three months ended September 30, 2020 and 2019, respectively. Stock-based compensation of $0.3 million and $1.4 million were capitalized to inventory and property and equipment during the nine months ended September 30, 2020 and 2019, respectively. Unrecognized compensation expense for stock options issued as of September 30, 2020 was $2.6 million and is expected to be recognized over a weighted-average period of 1.3 years. Unrecognized compensation expense for the restricted stock units and restricted stock awards as of September 30, 2020 was $0.8 million and is expected to be recognized over a weighted-average period of 2.0 years.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2020
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 13—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., between September 27, 2018 and November 27, 2019, inclusive, in violation of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934. 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 On October 21, 2019, pursuant to the parties’ stipulation, the court stayed the derivative lawsuit until the related class action is resolved 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. Government Investigations As previously announced in the Form 8-K filed on August 12, 2019, the Audit Committee of the Company’s Board of Directors (the “Audit Committee”) conducted an investigation of certain allegations raised by a former employee. The Company announced the Audit Committee’s findings in the Form 8-K filed on October 31, 2019. 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. As also previously announced, the Company voluntarily contacted the Securities and Exchange Commission’s (the “SEC”) 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 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. In October 2019, the U.S. Department of Justice, or DOJ, served the Company with a Civil Investigative Demand (“CID”) seeking information with respect to a False Claims Act investigation concerning whether the Company fraudulently obtained 510(k) marketing clearance for the Company’s devices marketed under the trade name DABRA, whether the Company marketed and promoted DABRA devices for unapproved uses that were not covered by federal healthcare programs, and whether the Company paid improper remuneration to physicians and other healthcare providers in violation of the Anti-Kickback Statute, 42 U.S.C. §1320a-7b. The Company believes as many as 13 states are participating in the DOJ’s False Claims Act investigation. active and ongoing The Company is unable to predict the ultimate outcome and has accrued $2.7 million at September 30, 2020 related to this contingency. It is reasonably possible that the estimated amount will change. 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) (the “Pennsylvania Case”), requesting declaratory relief that: (1) Strata and Mr. Geiger are not liable for tortious interference, defamation, libel, or unfair competition based on an e-mail by Mr. Geiger to an investment bank (the “Geiger Email”); (2) Strata and Mr. Geiger made no actionable statements about the Company to such investment bank; (3) the Company cannot enforce the 2011 settlement and release agreement between the Company and PhotoMedex, Inc. (“Settlement Agreement”) against Strata; and (4) that any dispute regarding the Geiger Email does not relate to the Settlement Agreement. The action filed by Strata and Mr. Geiger does not request any monetary damages. 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 (the “California Case”)) alleging (1) breach of the Settlement Agreement, (2) intentional interference in contractual relations, (3) intentional interference in prospective economic relations, and (4) trade libel. In the California Case, the Company alleges, among other things, that the statements in the Geiger Email regarding alleged patent infringement constitute a breach of the Settlement Agreement, that the Strata Parties employed deceptive practices designed to delay the Company’s initial public offering and reduce the amount of capital raised by the Company, and that statements in the Geiger Email regarding patent infringement, off label promotion and reimbursement constitute trade libel. 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 separation agreement and release of claims, contrary to the terms of his Severance Agreement. Mr. Irwin claims that he was willing to sign the Company’s standard separation agreement and release of claims. Based on this allegation, Mr. Irwin is claiming nonpayment of wages, penalties for nonpayment of wages, failure to provide wage statements, breach of contract, and breach of implied covenant of good faith and fair dealing. The Company believes that Mr. Irwin’s allegations lack merit, and plans to vigorously defend the action.

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2020
Segment Reporting [Abstract]
Segment Information	Note 14—Segment Information The Company has organized its business into two operating segments based on the product specialties: the vascular segment and the dermatology segment. In deciding how to allocate resources and assess performance, the Company’s chief operating decision maker regularly evaluates the sales and gross profit of these segments. Amounts included within selling, general and administrative expense and research and development expense are general to the Company and not specific to a particular segment; therefore, these amounts are not evaluated by the Company’s chief operating decision maker on a segmented basis. The following tables summarize segment performance (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Vascular $ 68 $ 226 $ 259 $ 1,121 Dermatology 846 1,682 2,929 4,688 Net revenue $ 914 $ 1,908 $ 3,188 $ 5,809 Vascular $ 515 $ 920 $ 1,593 $ 3,510 Dermatology 903 1,505 2,576 3,590 Cost of revenue $ 1,418 $ 2,425 $ 4,169 $ 7,100 Vascular $ (447 ) $ (694 ) $ (1,334 ) $ (2,389 ) Dermatology (57 ) 177 353 1,098 Gross loss $ (504 ) $ (517 ) $ (981 ) $ (1,291 ) Generally, all assets are common assets, except for lasers placed with customers, which are a subset of property and equipment. The net book value of the lasers in the vascular segment was $2.0 million and $2.6 million as of September 30, 2020 and December 31, 2019, respectively. The net book value of the lasers in the dermatology segment was $0.7 million and $0.9 million as of September 30, 2020 and December 31, 2019, respectively. No sales to an individual customer or country other than the United States accounted for more than 10% of revenue for the three and nine Sales to one individual customer and country accounted for 13% of revenue in the three months ended September 30, . No sales to an individual customer or country other than the United States accounted for more than 10% of net revenue for the nine months ended September 30, 2019. Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 United States $ 905 $ 1,618 $ 2,972 $ 5,219 All other countries 9 290 216 590 Net revenue $ 914 $ 1,908 $ 3,188 $ 5,809

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2020
Subsequent Events [Abstract]
Subsequent Events	Note 15—Subsequent Events Stock-Based Compensation On October 12, 2020, the Company’s shareholders approved an amendment to the Company’s 2018 Equity Incentive Plan to increase the number of shares of common stock reserved thereunder by 9,000,000 shares. On October 12, 2020, 500,000 shares of restricted stock awards were granted under the 2018 Equity Incentive Plan, to the independent members of the Board of Directors, in connection with their annual grant. On November 5, 2020, the Board of Directors approved 3.35 million restricted stock awards and 3.35 million performance stock awards to be granted to employees. The restricted stock awards vest and become non-forfeitable over three years. The performance stock awards vest and become non-forfeitable over three years if certain corporate goals are achieved by the initial vesting date. Reverse Stock Split On November 10, 2020, the Company’s shareholders approved an amendment to our Amended and Restated Certificate of Incorporation to effect a reverse stock split of the Company’s outstanding shares of common stock at a stock split ratio of between 1-for-25 and 1-for-75, inclusive, which ratio will be selected at the sole discretion of our Board of Directors. To effect the reverse stock split, the Board of Directors must approve the actual split ratio within the range and file the amendment with the Secretary of State of the State of Delaware.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2020
Accounting Policies [Abstract]
Interim Consolidated Financial Information	Interim condensed financial information —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 statement of stockholders’ equity for the periods presented. The results of operations for the three and nine months ended September 30, 2020 are not necessarily indicative of the results to be expected for the year ending December 31, 2020 or for any other future annual or interim period. The balance sheet as of December 31, 2019 included herein was derived from the audited financial statements as of that date. 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 filed with the SEC on March 11, 2020.
Use of Estimates	Use of estimates —The financial statements of the Company have been prepared by management in accordance with accounting principles generally accepted in the United States of America. 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, 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 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.
Product Warranty	Product warranty —The Company records estimated product warranty costs at the time of sale. Products are warrantied against defects in material and workmanship when properly used for their intended purpose and appropriately maintained. Accordingly, the Company generally replaces catheters that kink or fail to calibrate. The product warranty liability is determined based on historical information such as past experience, product failure rates or number of units repaired, estimated cost of material and labor. The product warranty liability also includes the estimated costs of a product recall. 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.
Inventories	Inventories —Inventories are stated at the lower of cost (first-in, first-out method) or net realizable value. Cost includes materials, labor and manufacturing overhead related to the purchase and production of inventories. The Company reduces the carrying value of inventories for those items that are potentially excess, obsolete or slow-moving based on changes in customer demand, technological developments or other economic factors. Catheters are manufactured in-house and each catheter is tested at various stages of the manufacturing process for adherence to quality standards. Catheters that do not meet functionality specification at each test point are destroyed and immediately written off, with the expense recorded in cost of revenue in the statement of operations. Once manufactured, completed catheters that pass quality assurance, are sent to a third-party for sterilization and sealed in a sterile container. Upon return from the third-party sterilizer, a sample of catheters from each batch are re-tested. If the sample tests are successful, the batch is accepted into finished goods inventory and if the sample tests are unsuccessful, the entire batch is written off, with the expense recorded in cost of revenue in the statement of operations.
Revenue	Revenue —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 provisions for any form of consideration including partial refund or credit against amounts owed to the Company. Services and other revenue primarily consist of sales of extended warranty and billable services, including repair activity and income from rental of lasers. 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 catheters to the customer which aggregate the majority of the vascular segment revenue. There are no specified minimum purchase commitments for the catheters. 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 warranty with the purchase of its laser systems. Customers can extend the warranty period through the purchase of extended warranty service contracts. Extended warranty service contracts are sold with contract terms ranging from 12 to 60 months and cover periods after the end of the initial 12-month warranty period. The warranty provides the customer with maintenance services in addition to the assurance that the laser product complies with agreed-upon specifications. Therefore, the warranty service is treated as a separate performance obligation from the laser system. Warranty services are a stand-ready obligation, and the Company recognizes revenue on a straight-line basis over the service contract term. Warranty service revenue is included in service and other revenue in the statements of operations. Deferred revenue at December 31, 2019 was $3.3 million. Revenue recognized in each of the three months ended September 30, 2020 and 2019 relating to amounts previously included in deferred revenue was $0.4 million. Revenue recognized in the nine months ended September 30, 2020 and 2019 was $1.7 million and $1.6 million, respectively. The deferred revenue greater than one year will be recognized during the remaining service period through 2024. 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. 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 September 30, 2020 and December 31, 2019, respectively. Rental Income 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 three months ended September 30, 2020 and September 30, 2019 was $0.1 million and $0.2 million, respectively. Rental income from lease arrangements for each of the nine months ended September 30, 2020 and 2019 was $0.4 million and $0.5 million, respectively.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements —In June 2018, the FASB issued ASU 2018-07, Improvements to Nonemployee Share-Based Payment Accounting . ASU 2018-07 expands the scope of Topic 718, Compensation—Stock Compensation , to include share-based payments issued to nonemployees for goods or services. Consequently, the accounting for share-based payments to nonemployees and employees will be substantially aligned. ASU 2018-07 supersedes Subtopic 505-50, Equity—Equity-Based Payments to Non-Employees . The amendments are effective for fiscal years beginning after December 15, 2019. Early adoption is permitted, but no earlier than a company’s adoption date of Topic 606, Revenue from Contracts with Customers. The Company adopted this guidance on January 1, 2020 and there was no impact on the financial statements and related disclosures. 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 In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (Topic 326)

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2020
Fair Value Disclosures [Abstract]
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 September 30, 2020 Money market funds $ 18,393 $ 18,393 $ — $ — 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
	Sep. 30, 2020
Inventory Disclosure [Abstract]
Schedule of Inventories	Inventories consisted of the following (in thousands): September 30, 2020 December 31, 2019 Raw materials $ 2,259 $ 2,300 Work in process 167 215 Finished goods 166 262 Inventories $ 2,592 $ 2,777

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	9 Months Ended
	Sep. 30, 2020
Property Plant And Equipment Net [Abstract]
Schedule of Property and Equipment	Property and equipment consisted of the following (in thousands): September 30, 2020 December 31, 2019 Lasers $ 4,694 $ 4,671 Automobiles 1,054 1,109 Machinery and equipment 866 841 Computer hardware and software 357 348 Leasehold improvements 119 119 Furniture and fixtures 48 48 Construction in progress 51 23 Property and equipment, gross 7,189 7,159 Accumulated depreciation (3,608 ) (2,109 ) Property and equipment, net $ 3,581 $ 5,050

Accrued Expenses (Tables)

Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2020
Payables And Accruals [Abstract]
Schedule of Accrued Expenses	Accrued expenses consisted of the following (in thousands): September 30, 2020 December 31, 2019 Compensation and related benefits $ 596 $ 1,163 Accrued warranty (Note 7) 227 338 Accrued services 3,768 1,141 Accrued expenses $ 4,591 $ 2,642

Accrued Warranty (Tables)

Accrued Warranty (Tables)	9 Months Ended
	Sep. 30, 2020
Product Warranties Disclosures [Abstract]
Schedule Product Warranty Accrual Included in Accrued Expenses	Activity in the product warranty accrual is included in accrued expenses above and consists of the following (in thousands): For the Nine Months Ended September 30, 2020 Year Ended December 31, 2019 Balance at beginning of period $ 338 $ 112 Increase in warranty accrual 54 889 Change in liability for pre-existing warranties — (28 ) Claims satisfied (165 ) (635 ) Accrued warranty $ 227 $ 338

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2020
Leases [Abstract]
Schedule of Operating Lease Maturities	The following table presents the lease liabilities within the condensed balance sheet, related to the Company’s operating leases as of September 30, 2020 (in thousands): Years Ending December 31, 2020 (remaining three months) $ 129 2021 528 2022 432 2023 445 2024 459 2025 472 Thereafter 987 Total operating lease payments $ 3,452 Less: imputed interest (751 ) Total operating lease liabilities $ 2,701

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2020
Schedule of Restricted Stock Units Activity	A summary of the activity and related information of the restricted stock units issued under the 2018 Plan is presented below: Restricted Stock Units Weighted Average Grant Date Fair Value Outstanding at December 31, 2019 271,472 $ 5.15 Granted 429,359 0.54 Vested and released (166,273 ) 3.70 Forfeited (17,584 ) 4.06 Outstanding at September 30, 2020 516,974 $ 2.14
Stock Options [Member]
Schedule of Options Activity	A summary of the activity and related information of the stock options issued under the 2018 Equity Incentive Plan 2018 Stock Compensation Plan Stock Options Weighted Average Exercise Price Weighted Average Remaining Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding at December 31, 2019 3,139,537 $ 15.50 8.09 $ — Granted 293,220 1.23 Forfeited (261,477 ) 14.56 Outstanding at September 30, 2020 3,171,280 $ 14.26 7.73 $ — Exercisable at September 30, 2020 1,803,297 $ 20.37 6.81 $ — Vested and expected to vest at September 30, 2020 3,171,280 $ 14.26 7.73 $ —
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 September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Selling, general and administrative $ 771 $ 6,603 $ 2,476 $ 19,286 Research and development 115 254 317 1,440 Stock-based compensation in operating expenses $ 886 $ 6,857 $ 2,793 $ 20,726

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2020
Segment Reporting [Abstract]
Schedule of Segment Performance	The following tables summarize segment performance (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Vascular $ 68 $ 226 $ 259 $ 1,121 Dermatology 846 1,682 2,929 4,688 Net revenue $ 914 $ 1,908 $ 3,188 $ 5,809 Vascular $ 515 $ 920 $ 1,593 $ 3,510 Dermatology 903 1,505 2,576 3,590 Cost of revenue $ 1,418 $ 2,425 $ 4,169 $ 7,100 Vascular $ (447 ) $ (694 ) $ (1,334 ) $ (2,389 ) Dermatology (57 ) 177 353 1,098 Gross loss $ (504 ) $ (517 ) $ (981 ) $ (1,291 )
Schedule of Net Revenue Classified by Major Geographical Areas	Net revenue, classified by the major geographic areas in which our customers are located, was as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 United States $ 905 $ 1,618 $ 2,972 $ 5,219 All other countries 9 290 216 590 Net revenue $ 914 $ 1,908 $ 3,188 $ 5,809

Organization and Nature of Op_2

Organization and Nature of Operations - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended		12 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Common stock, par value	$ 0.0001		$ 0.0001
Common stock, shares authorized	300,000,000		300,000,000
Preferred stock, par value	$ 0.0001		$ 0.0001
Preferred stock, shares authorized	10,000,000		10,000,000
Accumulated deficit	$ 142,758		$ 117,157
Net cash used in operating activities	18,890	$ 23,601	33,200
Cash and cash equivalents	$ 33,646		$ 14,584

Significant Accounting Polici_3

Significant Accounting Policies - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019
Deferred revenue					$ 3.3
Deferred revenue, recognized	$ 0.4	$ 0.4	$ 1.7	$ 1.6
Remaining service period to recognize deferred revenue, description			2024
Capitalized contract cost, net	0.2		$ 0.2		$ 0.4
Laser revenue	$ 0.1	$ 0.2	$ 0.4	$ 0.5
Minimum [Member]
Regular warranty service contracts term			12 months
Maximum [Member]
Extended warranty service contracts term			60 months
Capitalized contract cost amortization period			1 year

Fair Value Measurements - Summa

Fair Value Measurements - Summary of Hierarchy for Assets Measured at Fair Value on a Recurring Basis (Detail) - Fair Value, Measurements, Recurring [Member] - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
US Government Agencies Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total Fair Value		$ 1,000
US Government Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total Fair Value		14,993
Quoted Market Prices for Identical Assets (Level 1) [Member] | US Government Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total Fair Value		14,993
Other Observable Inputs (Level 2) [Member] | US Government Agencies Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total Fair Value		1,000
Money market Funds [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total Fair Value	$ 18,393	13,219
Money market Funds [Member] | Quoted Market Prices for Identical Assets (Level 1) [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total Fair Value	$ 18,393	$ 13,219

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Inventory Disclosure [Abstract]
Raw materials	$ 2,259	$ 2,300
Work in process	167	215
Finished goods	166	262
Inventories	$ 2,592	$ 2,777

Property and Equipment, Net - S

Property and Equipment, Net - Schedule of Property and Equipment (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 7,189	$ 7,159
Accumulated depreciation	(3,608)	(2,109)
Property and equipment, net	3,581	5,050
Lasers [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	4,694	4,671
Machinery And Equipment [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	866	841
Automobiles [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	1,054	1,109
Computer Hardware And Software [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	357	348
Leasehold Improvements [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	119	119
Furniture And Fixtures [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	48	48
Construction In Progress [Member]
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 51	$ 23

Property and Equipment, Net - A

Property and Equipment, Net - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Property Plant And Equipment [Abstract]
Depreciation	$ 500	$ 400	$ 1,584	$ 1,046

Accrued Expenses - Schedule of

Accrued Expenses - Schedule of Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019	Dec. 31, 2018
Payables And Accruals [Abstract]
Compensation and related benefits	$ 596	$ 1,163
Accrued warranty (Note 7)	227	338	$ 112
Accrued services	3,768	1,141
Accrued expenses	$ 4,591	$ 2,642

Accrued Warranty - Schedule Pro

Accrued Warranty - Schedule Product Warranty Accrual Included in Accrued Expenses (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2020	Dec. 31, 2019
Product Warranties Disclosures [Abstract]
Balance at beginning of period, Accrued warranty	$ 338	$ 112
Increase in warranty accrual	54	889
Change in liability for pre-existing warranties		(28)
Claims satisfied	(165)	(635)
Balance at ending of period, Accrued warranty	$ 227	$ 338

Accrued Warranty - Additional I

Accrued Warranty - Additional Information (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019	Dec. 31, 2018
Product Warranty Liability [Line Items]
Warranty expense	$ 15,000	$ 100,000	$ 54,000	$ 900,000
Accrued warranty (Note 7)	227,000		227,000		$ 338,000	$ 112,000
Catheters [Member] | Product Recall [Member]
Product Warranty Liability [Line Items]
Accrued warranty (Note 7)	$ 100,000		$ 100,000		$ 200,000

Paycheck Protection Program P_2

Paycheck Protection Program Promissory Note - Additional Information (Details) - USD ($)	1 Months Ended	3 Months Ended		9 Months Ended
	May 31, 2020	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Interest expense		$ 14,000	$ 72,000	$ 54,000	$ 186,000
PPP Promissory Note [Member] | CARES Act [Member]
Paycheck protection program, amount	$ 2,000,000
Interest rate	1.00%
Payments due, beginning date	Nov. 1, 2020
Payments due, ending date	May 3, 2022
Interest expense		$ 5,000		$ 8,000
Deferral period for all loans				10 months
Debt instrument, description				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.
PPP Promissory Note [Member] | CARES Act [Member] | Minimum [Member]
Extended maturity period				2 years
PPP Promissory Note [Member] | CARES Act [Member] | Maximum [Member]
Extended maturity period				5 years

Leases - Additional Information

Leases - Additional Information (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020USD ($)Lease	Sep. 30, 2019USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2019USD ($)
Operating Leased Assets [Line Items]
Number of leases | Lease	2
Operating lease, discount rate	7.00%		7.00%
Operating lease, weighted average remaining lease term	7 years 3 months		7 years 3 months
Operating lease expense	$ 100	$ 100	$ 400	$ 400
Operating lease , cash payment	100	100	400	300
Operating lease right-of-use-assets amortization	$ 100	$ 100	$ 261	$ 245
Office Building [Member]
Operating Leased Assets [Line Items]
Lease expiration period	2027
Manufacturing Facility [Member]
Operating Leased Assets [Line Items]
Lease expiration period	2021

Leases - Lease Liabilities Rela

Leases - Lease Liabilities Related to Operating Leases Presented within Condensed Balance Sheet (Details) $ in Thousands	Sep. 30, 2020USD ($)
Leases [Abstract]
2020 (remaining three months)	$ 129
2021	528
2022	432
2023	445
2024	459
2025	472
Thereafter	987
Total operating lease payments	3,452
Less: imputed interest	(751)
Total operating lease liabilities	$ 2,701

Loss per Share - Additional Inf

Loss per Share - Additional Information (Details) - USD ($)	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Loss allocated to participating securities	$ 0
Stock Options [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive common share equivalents excluded from computation of diluted net loss per share	3,621,280	1,869,127
Warrants [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive common share equivalents excluded from computation of diluted net loss per share	58,625,823
Restricted Stock Units (RSUs) [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive common share equivalents excluded from computation of diluted net loss per share	516,964	1,021,977
Restricted Stock Awards (RSAs) [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive common share equivalents excluded from computation of diluted net loss per share	125,000
Employee Stock Purchase Plan [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive common share equivalents excluded from computation of diluted net loss per share	94,296	15,344

Equity Offerings - Additional I

Equity Offerings - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	1 Months Ended
	Aug. 31, 2020	Jun. 30, 2020	May 31, 2020	Sep. 30, 2020	May 22, 2020	Dec. 31, 2019
Class Of Stock [Line Items]
Common stock, shares authorized				300,000,000		300,000,000
Common stock, par value				$ 0.0001		$ 0.0001
Stock issued during period shares warrants Exercised		1,837,667
May 2020 Offering [Member]
Class Of Stock [Line Items]
Common stock, shares authorized			22,222,222
Warrants issued price per share					$ 0.45
Proceeds from issuance of common stock			$ 8.7
Other offering expenses			1.3
Valuation of warrants			$ 3.5
Volatility rate			59.86%
Risk-free interest rate			0.34%
Expected dividend yield			0.00%
Expected terms (In Years)			2 years 6 months
Common stocvk reserve for issuance				20,384,555
May 2020 Offering [Member] | Warrant [Member]
Class Of Stock [Line Items]
Common stock, par value			$ 0.45
Equity offering description			Each share of common stock was sold in the offering with one warrant to purchase one share of common stock.
Warrants issued price per share			$ 0.45
Warrants expire period			5 years
May 2020 Offering [Member] | Maximum [Member] | Warrant [Member]
Class Of Stock [Line Items]
Warrants issued during period			22,222,222
May 2020 Offering [Member] | Placement Agent Warrants [Member]
Class Of Stock [Line Items]
Common stocvk reserve for issuance				1,555,555
May 2020 Offering [Member] | Placement Agent Warrants [Member] | Warrant [Member]
Class Of Stock [Line Items]
Warrants issued price per share			$ 0.5625
common stock expire period			5 years
May 2020 Offering [Member] | Placement Agent Warrants [Member] | Maximum [Member] | Warrant [Member]
Class Of Stock [Line Items]
Placement agent warrants issued			1,555,555
May 2020 Offering [Member] | Offering [Member]
Class Of Stock [Line Items]
Warrants issued price per share					$ 0.5625
August 2020 Offering [Member]
Class Of Stock [Line Items]
Common stock, shares authorized	34,285,714
Warrants issued price per share	$ 0.35
Proceeds from issuance of common stock	$ 10.4
Valuation of warrants	$ 4
Volatility rate	59.72%
Risk-free interest rate	0.17%
Expected dividend yield	0.00%
Expected terms (In Years)	2 years 6 months
Common stocvk reserve for issuance				34,285,714
August 2020 Offering [Member] | Warrant [Member]
Class Of Stock [Line Items]
Common stock, par value	$ 0.35
Equity offering description	Each share of common stock was sold in the offering with one warrant to purchase one share of common stock.
Warrants issued price per share	$ 0.35
Warrants expire period	5 years
August 2020 Offering [Member] | Maximum [Member] | Warrant [Member]
Class Of Stock [Line Items]
Warrants issued during period	34,285,714
August 2020 Offering [Member] | Placement Agent Warrants [Member]
Class Of Stock [Line Items]
Common stocvk reserve for issuance				2,399,999
August 2020 Offering [Member] | Placement Agent Warrants [Member] | Warrant [Member]
Class Of Stock [Line Items]
Warrants issued price per share	$ 0.4375
common stock expire period	5 years
August 2020 Offering [Member] | Placement Agent Warrants [Member] | Maximum [Member] | Warrant [Member]
Class Of Stock [Line Items]
Placement agent warrants issued	2,399,999
August 2020 Offering [Member] | Offering [Member]
Class Of Stock [Line Items]
Warrants issued price per share	$ 0.4375

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019	Dec. 31, 2019	Mar. 31, 2020
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Stock-based compensation			$ 3,044	$ 22,154
Weighted Average Remaining Life (in years)			1 year 3 months 18 days
Stock Options [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares granted under the plan			293,220
Weighted average exercise price of stock options			$ 1.23
Number of shares exercisable under the plan	1,803,297		1,803,297
Stock-based compensation	$ 100	$ 400	$ 300	$ 1,400
Unrecognized compensation expense for stock options issued	2,600		$ 2,600
Weighted Average Remaining Life (in years)			7 years 8 months 23 days		8 years 1 month 2 days
Restricted Stock Units (RSUs) [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
2020 Inducement Equity Incentive Plan (the "2020 plan") [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stocvk reserve for issuance						800,000
Number of shares granted under the plan			450,000
Weighted average exercise price of stock options			$ 1.02
Number of shares exercisable under the plan	56,250		56,250
2020 Inducement Equity Incentive Plan (the "2020 plan") [Member] | Restricted Stock Awards (RSAs) [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Restricted stock awards granted			125,000
Restricted stock awards with grant date fair value			$ 100

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Options Activity (Details) - $ / shares	9 Months Ended	12 Months Ended
	Sep. 30, 2020	Dec. 31, 2019
Weighted Average Remaining Life (in years)
Weighted Average Remaining Life (in years)	1 year 3 months 18 days
Stock Options [Member]
Options outstanding
Beginning balance	3,139,537
Granted	293,220
Forfeited	(261,477)
Ending balance	3,171,280	3,139,537
Exercisable at the end of the period	1,803,297
Vested and expected to vest at the end of the period	3,171,280
Weighted Average Remaining Life (in years)
Weighted Average Remaining Life (in years)	7 years 8 months 23 days	8 years 1 month 2 days
Exercisable at the end of the period	6 years 9 months 22 days
Vested and expected to vest at the end of the period	7 years 8 months 23 days
Weighted Average Exercise Price
Beginning balance	$ 15.50
Granted	1.23
Forfeited	14.56
Ending balance	14.26	$ 15.50
Exercisable at the end of the period	20.37
Vested and expected to vest at the end of the period	$ 14.26

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of Restricted Stock Units Activity (Details) - Restricted Stock Units (RSUs) [Member]	9 Months Ended
	Sep. 30, 2020$ / sharesshares
Restricted Stock Units
Beginning balance | shares	271,472
Granted | shares	429,359
Vested and released | shares	(166,273)
Forfeited | shares	(17,584)
Ending balance | shares	516,974
Weighted Average Grant Date Fair Value
Beginning balance | $ / shares	$ 5.15
Granted | $ / shares	0.54
Vested and released | $ / shares	3.70
Forfeited | $ / shares	4.06
Ending balance | $ / shares	$ 2.14

Stock-Based Compensation - Sc_3

Stock-Based Compensation - Schedule of Stock-based Compensation Expense Recorded in Operating Expenses (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation in operating expenses	$ 886	$ 6,857	$ 2,793	$ 20,726
Selling, General and Administrative [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation in operating expenses	771	6,603	2,476	19,286
Research and Development [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation in operating expenses	$ 115	$ 254	$ 317	$ 1,440

Commitments and Contingencies (

Commitments and Contingencies (Details) - USD ($)	1 Months Ended	9 Months Ended
	Oct. 31, 2019	Sep. 30, 2020
Commitments And Contingencies Disclosure [Abstract]
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
Estimate range of possible outcome		$ 2,700,000

Segment Reporting - Additional

Segment Reporting - Additional Information (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020USD ($)	Sep. 30, 2019	Sep. 30, 2020USD ($)Segment	Sep. 30, 2019	Dec. 31, 2019USD ($)
Segment Reporting Information [Line Items]
Number of operating segments | Segment			2
Property and equipment, net	$ 3,581		$ 3,581		$ 5,050
Revenue from Contract with Customer Benchmark [Member] | Customer Concentration Risk [Member]
Segment Reporting Information [Line Items]
Concentration risk, percentage	10.00%	13.00%	10.00%	10.00%
Vascular [Member]
Segment Reporting Information [Line Items]
Property and equipment, net	$ 2,000		$ 2,000		2,600
Dermatology [Member]
Segment Reporting Information [Line Items]
Property and equipment, net	$ 700		$ 700		$ 900

Segment Reporting - Summary of

Segment Reporting - Summary of Segment Performance (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Segment Reporting Information [Line Items]
Net revenue	$ 914	$ 1,908	$ 3,188	$ 5,809
Cost of revenue	1,418	2,425	4,169	7,100
Gross profit (loss)	(504)	(517)	(981)	(1,291)
Vascular [Member]
Segment Reporting Information [Line Items]
Net revenue	68	226	259	1,121
Cost of revenue	515	920	1,593	3,510
Gross profit (loss)	(447)	(694)	(1,334)	(2,389)
Dermatology [Member]
Segment Reporting Information [Line Items]
Net revenue	846	1,682	2,929	4,688
Cost of revenue	903	1,505	2,576	3,590
Gross profit (loss)	$ (57)	$ 177	$ 353	$ 1,098

Segment Reporting - Summary o_2

Segment Reporting - Summary of Net Revenue Classified by Major Geographic Areas (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Revenues From External Customers And Long Lived Assets [Line Items]
Net revenue	$ 914	$ 1,908	$ 3,188	$ 5,809
United States [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net revenue	905	1,618	2,972	5,219
All other countries [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net revenue	$ 9	$ 290	$ 216	$ 590

Subsequent Events - Additional

Subsequent Events - Additional Information (Details) - Subsequent Event [Member]	Nov. 10, 2020	Nov. 05, 2020shares	Oct. 12, 2020shares
Subsequent Event [Line Items]
Reverse stock split ratio	On November 10, 2020, the Company’s shareholders approved an amendment to our Amended and Restated Certificate of Incorporation to effect a reverse stock split of the Company’s outstanding shares of common stock at a stock split ratio of between 1-for-25 and 1-for-75, inclusive, which ratio will be selected at the sole discretion of our Board of Directors.
Maximum [Member]
Subsequent Event [Line Items]
Stock split ratio	0.04
Minimum [Member]
Subsequent Event [Line Items]
Stock split ratio	0.013
Employees [Member] | Restricted Stock Award [Member]
Subsequent Event [Line Items]
Granted		3,350,000
Award Vesting Period		3 years
Employees [Member] | Performance Stock Award [Member]
Subsequent Event [Line Items]
Granted		3,350,000
Award Vesting Period		3 years
2018 Equity Incentive Plan [Member]
Subsequent Event [Line Items]
Common stocvk reserve for issuance			9,000,000
2018 Equity Incentive Plan [Member] | Director [Member]
Subsequent Event [Line Items]
Restricted stock awards granted			500,000