Cover
Cover - shares | 6 Months Ended | |
Jun. 30, 2022 | Aug. 05, 2022 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Jun. 30, 2022 | |
Document Transition Report | false | |
Entity File Number | 001-38832 | |
Entity Registrant Name | SURGALIGN HOLDINGS, INC. | |
Entity Incorporation, State or Country Code | DE | |
Entity Tax Identification Number | 83-2540607 | |
Entity Address, Address Line One | 520 Lake Cook Road | |
Entity Address, Address Line Two | Suite 315 | |
Entity Address, City or Town | Deerfield | |
Entity Address, State or Province | IL | |
Entity Address, Postal Zip Code | 60015 | |
City Area Code | 224 | |
Local Phone Number | 303-4651 | |
Title of 12(b) Security | common stock, $0.001 par value | |
Trading Symbol | SRGA | |
Security Exchange Name | NASDAQ | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Accelerated Filer | |
Entity Small Business | false | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding | 6,746,501 | |
Amendment Flag | false | |
Document Fiscal Year Focus | 2022 | |
Document Fiscal Period Focus | Q2 | |
Entity Central Index Key | 0001760173 | |
Current Fiscal Year End Date | --12-31 |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Current Assets: | ||
Cash and cash equivalents | $ 29,344 | $ 51,287 |
Accounts receivable - less allowances of $8,941 at June 30, 2022 and $9,272 at December 31, 2021 | 20,502 | 19,197 |
Inventories - current | 25,334 | 26,204 |
Prepaid and other current assets | 11,622 | 9,984 |
Total current assets | 86,802 | 106,672 |
Non-current inventories | 11,734 | 10,212 |
Property and equipment - net | 1,321 | 945 |
Other assets - net | 5,840 | 5,970 |
Total assets | 105,697 | 123,799 |
Current Liabilities: | ||
Accounts payable | 10,557 | 10,204 |
Current portion of acquisition contingency - Holo | 9,042 | 25,585 |
Accrued expenses | 17,214 | 17,769 |
Accrued income taxes | 434 | 484 |
Total current liabilities | 37,247 | 54,042 |
Acquisition contingencies - Holo | 22,393 | 26,343 |
Warrant liability | 1,554 | 12,013 |
Notes payable - related party | 10,087 | 9,982 |
Other long-term liabilities | 3,575 | 3,176 |
Total liabilities | 74,856 | 105,556 |
Commitments and contingencies (Note 18) | ||
Mezzanine equity | 10,006 | 10,006 |
Stockholders' equity: | ||
Common stock, $.001 par value: 300,000,000 shares authorized; 6,667,505 and 4,887,982 shares issued and outstanding, as of June 30, 2022 and December 31, 2021, respectively | 7 | 5 |
Additional paid-in capital | 604,252 | 585,517 |
Accumulated other comprehensive loss | (2,242) | (1,820) |
Accumulated deficit | (575,274) | (569,613) |
Less treasury stock, 61,668 and 51,448 shares, as of June 30, 2022 and December 31, 2021, respectively, at cost | (5,908) | (5,852) |
Total stockholders' equity | 20,835 | 8,237 |
Total liabilities, mezzanine equity and stockholders' equity | $ 105,697 | $ 123,799 |
Condensed Consolidated Balanc_2
Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Statement of Financial Position [Abstract] | ||
Accounts receivable allowances | $ 8,941 | $ 9,272 |
Common stock, par value (in dollars per share) | $ 0.001 | $ 0.001 |
Common stock, shares authorized (in shares) | 300,000,000 | 300,000,000 |
Common stock, shares issued (in shares) | 6,667,505 | 4,887,982 |
Common stock, shares outstanding (in shares) | 6,667,505 | 4,887,982 |
Treasury stock (in shares) | 61,668 | 51,448 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Comprehensive Loss - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Income Statement [Abstract] | ||||
Revenues | $ 20,623 | $ 24,834 | $ 41,228 | $ 48,125 |
Cost of goods sold | 6,414 | 7,229 | 12,824 | 13,467 |
Gross profit | 14,209 | 17,605 | 28,404 | 34,658 |
Operating Expenses: | ||||
General and administrative | 24,289 | 25,541 | 49,606 | 51,701 |
Research and development | 4,082 | 3,183 | 8,530 | 6,059 |
Gain on acquisition contingency | (1,990) | (2,236) | (10,493) | (2,287) |
Asset impairment and abandonments | 996 | 2,206 | 1,935 | 4,382 |
Transaction and integration expenses | 222 | 2,188 | 1,138 | 2,510 |
Total operating expenses | 27,599 | 30,882 | 50,716 | 62,365 |
Operating loss | (13,390) | (13,277) | (22,312) | (27,707) |
Other expense (income) - net | ||||
Other expense (income) - net | 22 | (101) | 49 | (105) |
Interest expense | 252 | 0 | 504 | 0 |
Foreign exchange loss (gain) | 1,056 | (95) | 1,409 | 450 |
Change in fair value of warrant liability | (9,124) | (2,523) | (18,867) | (2,523) |
Total other (income) - net | (7,794) | (2,719) | (16,905) | (2,178) |
(Loss) before income tax provision | (5,596) | (10,558) | (5,407) | (25,529) |
Income tax provision | 92 | 81 | 254 | 300 |
Net (loss) from operations | (5,688) | (10,639) | (5,661) | (25,829) |
Discontinued Operations (Note 3) | ||||
(Loss) from operations of discontinued operations | 0 | (6,316) | 0 | (6,316) |
Income tax (benefit) | 0 | (763) | 0 | (763) |
Net income (loss) from discontinued operations | 0 | (5,553) | 0 | (5,553) |
Net loss | (5,688) | (16,192) | (5,661) | (31,382) |
Net income applicable to noncontrolling interests | 0 | 0 | 0 | 0 |
Net income | (5,688) | (16,192) | (5,661) | (31,382) |
Other comprehensive income (loss) | ||||
Unrealized foreign currency translation (gain) loss | (313) | 35 | (422) | (36) |
Total other comprehensive (loss) | $ (5,375) | $ (16,227) | $ (5,239) | $ (31,346) |
Net loss from operations per share - basic (in dollars per share) | $ (0.86) | $ (2.79) | $ (0.92) | $ (7.29) |
Net income (loss) from discontinued operations per common share - basic (in dollars per share) | 0 | (1.46) | 0 | (1.57) |
Net loss per share applicable to Surgalign Holdings, Inc.- basic (in dollars per share) | (0.86) | (4.25) | (0.92) | (8.86) |
Net loss from operations per share - diluted (in dollars per share) | (0.86) | (2.79) | (0.92) | (7.29) |
Net income (loss) from discontinued operations per common share - diluted (in dollars per share) | 0 | (1.46) | 0 | (1.57) |
Net loss per share applicable to Surgalign Holdings, Inc.- diluted (in dollars per share) | $ (0.86) | $ (4.25) | $ (0.92) | $ (8.86) |
Weighted average basic shares (in shares) | 6,640,405 | 3,808,475 | 6,174,273 | 3,542,497 |
Weighted average diluted shares (in shares) | 6,640,405 | 3,808,475 | 6,174,273 | 3,542,497 |
Condensed Consolidated Statem_2
Condensed Consolidated Statement of Stockholders' Equity - USD ($) $ in Thousands | Total | Total | Common Stock | Additional Paid-In Capital | Accumulated Other Comprehensive Loss | Accumulated Deficit | Treasury Stock |
Beginning Balance at Dec. 31, 2020 | $ 24,170 | $ 3 | $ 517,201 | $ (2,416) | $ (484,962) | $ (5,656) | |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net income (loss) | (15,190) | (15,190) | |||||
Foreign currency translation adjustment | 71 | 71 | |||||
Share offering | 36,484 | 1 | 36,483 | ||||
Exercise of common stock options | 23 | 23 | |||||
Stock-based compensation | 936 | 936 | |||||
Purchase of treasury stock | (110) | (110) | |||||
Ending Balance at Mar. 31, 2021 | 46,384 | 4 | 554,643 | (2,345) | (500,152) | (5,766) | |
Beginning Balance at Dec. 31, 2020 | 24,170 | 3 | 517,201 | (2,416) | (484,962) | (5,656) | |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net income (loss) | $ (31,382) | ||||||
Ending Balance at Jun. 30, 2021 | 52,812 | 5 | 577,320 | (2,380) | (516,344) | (5,789) | |
Beginning Balance at Mar. 31, 2021 | 46,384 | 4 | 554,643 | (2,345) | (500,152) | (5,766) | |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net income (loss) | (16,192) | (16,192) | (16,192) | ||||
Foreign currency translation adjustment | (35) | (35) | |||||
Share offering | 21,044 | 1 | 21,043 | ||||
Equity instruments issued in connection with the Holo acquisition | 221 | 221 | |||||
Stock-based compensation | 1,413 | 1,413 | |||||
Purchase of treasury stock | (23) | (23) | |||||
Ending Balance at Jun. 30, 2021 | 52,812 | 5 | 577,320 | (2,380) | (516,344) | (5,789) | |
Beginning Balance at Dec. 31, 2021 | 8,237 | 5 | 585,517 | (1,820) | (569,613) | (5,852) | |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net income (loss) | 27 | 27 | |||||
Foreign currency translation adjustment | (109) | (109) | |||||
Share offering | 8,488 | 1 | 8,487 | ||||
Prefunded warrant execution | 1,749 | 1,749 | |||||
Equity instruments issued in connection with the Holo acquisition | 5,919 | 1 | 5,918 | ||||
Stock-based compensation | 1,374 | 1,374 | |||||
Purchase of treasury stock | (5) | (5) | |||||
Ending Balance at Mar. 31, 2022 | 25,680 | 7 | 603,045 | (1,929) | (569,586) | (5,857) | |
Mezzanine equity, beginning balance at Dec. 31, 2021 | 10,006 | ||||||
Mezzanine equity, ending balance at Mar. 31, 2022 | 10,006 | ||||||
Beginning Balance at Dec. 31, 2021 | 8,237 | 5 | 585,517 | (1,820) | (569,613) | (5,852) | |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net income (loss) | (5,661) | ||||||
Ending Balance at Jun. 30, 2022 | 20,835 | 7 | 604,252 | (2,242) | (575,274) | (5,908) | |
Mezzanine equity, beginning balance at Dec. 31, 2021 | 10,006 | ||||||
Mezzanine equity, ending balance at Jun. 30, 2022 | 10,006 | ||||||
Beginning Balance at Mar. 31, 2022 | 25,680 | 7 | 603,045 | (1,929) | (569,586) | (5,857) | |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | |||||||
Net income (loss) | (5,688) | (5,688) | (5,688) | ||||
Foreign currency translation adjustment | (313) | (313) | |||||
Stock-based compensation | 971 | 971 | |||||
Purchase of stock in the ESPP Plan | 186 | 186 | |||||
Purchase of treasury stock | (51) | (51) | |||||
Other | 50 | 50 | |||||
Ending Balance at Jun. 30, 2022 | $ 20,835 | $ 7 | $ 604,252 | $ (2,242) | $ (575,274) | $ (5,908) | |
Mezzanine equity, beginning balance at Mar. 31, 2022 | 10,006 | ||||||
Mezzanine equity, ending balance at Jun. 30, 2022 | $ 10,006 |
Condensed Consolidated Statem_3
Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2022 | Jun. 30, 2021 | |
Cash flows from operating activities: | ||
Net loss | $ (5,661) | $ (31,382) |
Adjustments to reconcile net income (loss) to net cash used in operating activities: | ||
Depreciation and amortization expense | 1,180 | 1,153 |
Provision for bad debts and product returns | 700 | 2,439 |
Investor fee | 916 | 0 |
Change in fair value of warrant liability | (18,867) | (2,523) |
Provision for inventory write-downs | 3,804 | 4,367 |
Insurance proceeds related to operating activities | 0 | (1,993) |
Income taxes payable | 0 | (13,326) |
Stock-based compensation | 2,299 | 2,349 |
Asset impairment and abandonments | 1,935 | 4,382 |
Gain on acquisition contingency | (10,493) | (2,287) |
Loss on sale of discontinued operations | 0 | 6,316 |
Bargain purchase gain | 0 | (90) |
Other | (3) | (33) |
Change in assets and liabilities: | ||
Accounts receivable | (2,082) | (3,777) |
Inventories | (4,767) | (9,111) |
Accounts payable | 446 | (3,818) |
Accrued expenses | (7,025) | 23,605 |
Right-of-use asset and lease liability | 223 | (3,165) |
Other operating assets and liabilities | 4,986 | (19,253) |
Net cash used in operating activities | (32,409) | (46,147) |
Cash flows from investing activities: | ||
Payments for OEM working capital adjustment | 0 | (5,430) |
Purchases of property and equipment | (3,034) | (4,952) |
Business acquisitions, net of cash acquired | 0 | (330) |
Patent and acquired intangible asset costs | (184) | (311) |
Net cash used in investing activities | (3,218) | (11,023) |
Cash flows from financing activities: | ||
Share offering proceeds including prefunded warrant exercised, net | 17,729 | 82,326 |
Proceeds from exercise of common stock options | 0 | 23 |
Proceeds from Employee Stock Purchase Program (ESPP) | 186 | 0 |
Payment of Holo Milestones - contingent consideration | (4,081) | 0 |
Payments for treasury stock | (56) | (133) |
Net cash provided by financing activities | 13,778 | 82,216 |
Effect of exchange rate changes on cash and cash equivalents | (94) | 249 |
Net (decrease) increase in cash and cash equivalents | (21,943) | 25,295 |
Cash and cash equivalents, beginning of period | 51,287 | 43,962 |
Cash and cash equivalents, end of period | 29,344 | 69,257 |
Supplemental cash flow disclosure: | ||
Net income tax payments, net of refunds | 1,548 | 15,481 |
Non-cash acquisition of property and equipment | 189 | 629 |
Prompt | ||
Non-cash common stock issuance | 0 | 221 |
Holo Surgical Inc | ||
Non-cash common stock issuance | $ 5,919 | $ 0 |
Business
Business | 6 Months Ended |
Jun. 30, 2022 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Business | Business Surgalign Holdings, Inc. (the “Company”), is a global medical technology company focused on elevating the standard of care by driving the evolution of digital health. We have a broad portfolio of spinal hardware implants, including solutions for fusion procedures in the lumbar, thoracic, and cervical spine, motion preservation solutions for the lumbar spine, and a minimally invasive surgical implant system for fusion of the sacroiliac joint. We also have a portfolio of advanced and traditional orthobiologics, or biomaterials, products. We currently market and sell products to hospitals, ambulatory surgery centers, and healthcare providers in the United States and in 50 countries worldwide. W e are developing an artificial intelligence (“AI”) and augmented reality ( “ AR ” ) technology platform called HOLO™ AI, a powerful suite of AI software technology which connects the continuum of care from the pre-op and clinical stage through post-op care, and is designed to achieve better surgical outcomes, reduce complications, and improve patient satisfaction. We believe HOLO AI is one of the most advanced AI technologies with applications beyond the spine and operating room. Our HOLO Portal™ surgical guidance system, a component of our HOLO AI technology platform, is designed to automatically recognize, identify, and segment patient anatomy to autonomously assist the surgeon throughout the surgical procedure. This proprietary AI-based platform is an intelligent anatomical mapping technology designed to assist surgeons by allowing them to remain in safe anatomical zones, and to enhance surgical performance. We plan to leverage our HOLO AI platform to improve patient outcomes and drive adoption of our spinal hardware implants and biomaterials products. We are developing a pipeline of new innovative technologies that we plan to integrate with our HOLO AI platform. We are headquartered in Deerfield, Illinois, with commercial, innovation and design centers in San Diego, CA; Wurmlingen, Germany; Poznan, Poland; and Warsaw, Poland. The Company operates one reportable segment: Spine. Reverse Stock Split On May 10, 2022, the stockholders of the Company approved the proposal to authorize the Company’s Board of Directors (the “Board”) to amend the Company’s Amended and Restated Certificate of Incorporation to affect a reverse stock split of the Company’s common stock (the “Reverse Stock Split”). Following Board approval on May 11, 2022, the Reverse Stock Split became effective on May 16, 2022 at a 1-for-30 ratio. The Reverse Stock Split did not modify any rights or preferences of the shares of the Company’s common stock. Proportionate adjustments were made to the exercise prices and the number of shares underlying the Company’s outstanding equity awards, as applicable, and warrants, as well as to the number of shares issued and issuable under the Company’s equity incentive plans. The Reverse Stock Split did not affect the number of authorized shares of common stock or the par value of the common stock. Effective this quarter, all per share amounts, and references to common shares and common share amounts have been retroactively restated for all periods presented. Acquisition of equity interest in INN On December 30, 2021, we completed a Stock Purchase Agreement (“Purchase Agreement”) to acquire 42% of Inteneural Networks Inc. (“INN”) for a non-exclusive license to use INN's AI technology for autonomously segmenting and identifying neural structures in medical images and helping identify possible pathological states to advance our digital health strategy. INN is a private technology company that is developing technology that harnesses machine learning (“ML”) and AI to autonomously and accurately identify and segment neural structures in medical images and integrate specific reference information regarding possible pathological states to physicians caring for patients. As consideration for the 42% stake in INN, we paid total consideration of $20.0 million which consisted of $5.0 million in cash, 227,359 shares of our common stock with a fair value of $4.9 million and issued unsecured promissory notes to the Sellers in an aggregate principal amount of $10.6 million with a fair value of $10.1 million on date of acquisition. As part of the transaction and subject to certain contingencies, the Company must purchase up to 100% of the equity of INN in three 19.3% tranches for $19.3 million each when the Company achieves three additional clinical, regulatory, and revenue milestones. Prompt Prototypes LLC Acquisition On April 30, 2021, The Company, entered into an Asset Purchase Agreement with Prompt Prototypes LLC (“Prompt”), a California limited liability company, and Peter Kopley, an individual residing in the State of California (the “Sellers”). The Company purchased the assets of Prompt to expand its research and development capabilities and create the capacity to produce certain medical prototypes. Pursuant to the terms of the Agreement, the Company purchased specific assets and assumed certain liabilities of Prompt for a purchase price of $1.1 million. At the closing, the Company paid $0.3 million of cash and issued restricted shares with an aggregate fair market value of $0.2 million to the Seller. The remaining $0.6 million of the purchase price will be paid contingent on Mr. Kopley’s continued employment with the Company, in the form of cash and restricted shares in two equal amounts on the 18th and 36th month anniversary of the closing date. These payments are considered future compensation. OEM Disposition On July 20, 2020, pursuant to the Equity Purchase Agreement dated as of January 13, 2020 (as amended from time to time, the “OEM Purchase Agreement”), by and between the Company and Ardi Bidco Ltd. (the “Buyer”), the Company completed the sale of its former original equipment manufacturing business, and business related to processing donated human musculoskeletal and other tissue and bovine and porcine animal tissue in producing allograft and xenograft implants using BioCleanse ® , Tutoplast ® and Cancelle ® SP sterilization processes (collectively, the “OEM Businesses”) to Buyer and its affiliates for a purchase price of $440.0 million of cash, subject to certain adjustments (the “Transactions”). More specifically, pursuant to the terms of the OEM Purchase Agreement, the Company sold to the Buyer and its affiliates all of the issued and outstanding shares of RTI OEM, LLC (which, prior to the Transactions, was converted to a corporation and changed its name to “RTI Surgical, Inc.”), RTI Surgical, LLC (which, prior to the Transactions, was converted to a corporation and changed its name to “Pioneer Surgical Technology, Inc.”), Tutogen Medical, Inc. and Tutogen Medical GmbH. The Transactions were previously described in the Proxy Statement filed by the Company with the SEC on June 18, 2020. Subsequent to the Transactions, the Company changed its name to Surgalign Holdings, Inc, operating through its primary subsidiary, Surgalign Spine Technologies, Inc. Where obvious and appropriate from the context, references herein to Surgalign or the Company refer to the Company excluding the disposed OEM Businesses. COVID-19 The COVID-19 pandemic continues to impact our business results of operations and financial condition. Although vaccines have been made available, it remains uncertain when our business will return to normal operations. The full extent to which the COVID-19 pandemic will impact the Company’s business moving forward depends on future developments that are highly uncertain and cannot be accurately predicted. While market conditions have improved, many government agencies in conjunction with hospitals and healthcare systems continue to defer, reduce or suspend elective surgical procedures due to COVID-19. We have seen and may continue to see a significant reduction in procedural volumes as hospital systems and/or patients elect to defer spine surgery procedures and navigate the uncertainties of COVID-19. Despite the impact COVID-19 has had on our business, we have continued to invest in our digital health strategy, invest in our teams, improve operating processes through building strong foundations, and taken steps to position ourselves for long-term success by improving patient outcomes while maintaining adequate cash levels. Liquidity As supply chain issues continue, COVID-19 evolves, and inflation persists, all factors may materially and adversely affect our revenues, financial condition, profitability, and cash flows for an indeterminate period of time. Going Concern The accompanying condensed consolidated financial statements of the Company have been prepared assuming the Company will continue as a going concern and in accordance with generally accepted accounting principles in the United States of America. The going concern basis of presentation assumes that we will continue in operation one year after the date these financial statements are issued, and we will be able to realize our assets and discharge our liabilities and commitments in the normal course of business. As of June 30, 2022, the Company had cash and cash equivalent of $29.3 million and an accumulated deficit of $575.3 million. For the three and six months ended June 30, 2022, the company had a loss from continuing operations of $5.7 million and $5.7 million, and a net loss applicable to Surgalign Holdings, Inc. of $5.7 million and $5.7 million, respectively. The Company has incurred losses from operations in the previous two fiscal years and did not generate positive cash flows from operations in fiscal year 2021 or for the six months ended June 30, 2022. The Company expects net operating losses for the full year 2022 as it works to commercialize its HOLO Portal Surgical Guidance System and further develop its AI Platform and spinal device product lines. On February 15, 2022, we issued and sold in an underwritten public offering 1,285,507 shares of common stock and 163,768 of pre-funded warrants to purchase common stock with gross proceeds of $20.0 million at an effective offering price of $13.8000 and $13.7970 per share respectively. In addition, the Company issued warrants to purchase up to an aggregate of 1,086,956 shares of common stock at a strike price of $18.0000 that are exercisable over the next five years. Also in connection with the offering, the Company issued placement agent warrants to purchase an aggregate of up to 86,956 shares of common stock at a strike price of $17.2500 per share that are exercisable over the next five years. Finally, the Company granted the underwriters the option for a period of 30 days from February 15, 2022 to purchase up to 217,391 additional shares of the Company’s common stock at the public offering price of $13.7970 per share and/or warrants to purchase up to 163,043 shares of the Company’s common stock at a public offering price of $0.0030 per warrant. The Underwriters did not exercise the option to purchase the common shares from the Company, but they did exercise the option to purchase the warrants which have not been converted to common shares as of June 30, 2022. We received net proceeds of $17.7 million from the offering. On June 14, 2021, we issued and sold in a registered direct offering an aggregate of 966,183 shares of our common stock and investor warrants to purchase up to an aggregate of 966,183 shares at a strike price of $51.7500. The Company, also in connection with the direct offering, issued placement agent warrants to purchase an aggregate of up to 57,971 shares of our common stock at a strike price of $64.6875 per share. We received net proceeds of $45.8 million from the offering after deducting investor fees of $4.2 million. On February 1, 2021, we closed a public offering and sold a total 956,666 shares of our common stock at a price of $45.0000 per share, less the underwriter discounts and commissions. We received gross proceeds of $40.5 million from the offering after deducting the underwriting discounts and commission of $4.0 million. The Company is projecting it will continue to generate significant negative operating cash flows over the next 12-months and beyond. In management’s evaluation of the going concern conclusion we considered the following: i) supply chain and labor issues, continued COVID-19 uncertainties, inflation and recent market volatility; ii) negative cash flows that are projected over the next 12-month period; iii) potential milestone payments related to the Holo Surgical Inc. (“Holo Surgical”) and INN acquisitions should any of the milestones be achieved; iv) seller notes with a fair value amount of $10.1 million due to the seller of INN on December 31, 2024; and v) various supplier minimum requirements. The Company’s operating plan for the next 12-month period also includes continued investments in its product pipeline including both within digital health and hardware and biologics, which will necessitate additional financing. In addition to these efforts the Company will need continued capital and cash flows to fund the future operations through 2022 and beyond. The Company’s ability to raise additional capital may be adversely impacted by potential worsening global economic and geopolitical conditions and the recent disruptions to, and volatility in, financial markets in the United States and worldwide. If cash resources are insufficient to satisfy the Company’s on-going cash requirements through 2022, the Company will be required to scale back operations, reduce research and development expenses, and postpone, as well as suspend capital expenditures, in order to preserve liquidity. No assurance can be given that any future financing will be available or, if available, that it will be on terms that are satisfactory to the Company. Even if the Company is able to obtain additional financing, it may contain undue restrictions on our operations, in the case of debt financing, or cause substantial dilution for our stockholders, in the case of equity financing. In consideration of the inherent risks and uncertainties and the Company’s forecasted negative cash flows as described above, management has concluded that substantial doubt exists with respect to the Company’s ability to continue as a going concern within one year after the date the condensed consolidated financial statements are issued. Management continually evaluates plans to raise additional debt and/or equity financing and will attempt to curtail discretionary expenditures in the future, if necessary; however, in consideration of the risks and uncertainties mentioned, such plans cannot be considered probable of occurring at this time. The recoverability of a major portion of the recorded asset amounts shown in the Company’s accompanying condensed consolidated balance sheets is dependent upon continued operations of the Company, which in turn is dependent upon the Company’s ability to meet its funding requirements on a continuous basis to maintain existing financing to succeed in its future operations. The Company’s condensed consolidated financial statements do not include any adjustment relating to the recoverability and classification of recorded asset amounts and classification of liabilities that might be necessary should the Company be unable to continue in existence. |
Basis of Presentation
Basis of Presentation | 6 Months Ended |
Jun. 30, 2022 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Basis of Presentation | Basis of Presentation The accompanying condensed consolidated financial statements include all adjustments, consisting of normal recurring accruals, which the Company considers necessary for a fair presentation of the results of operations for the periods shown. The condensed consolidated financial statements have been prepared in accordance with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X, and, therefore, do not include all information and footnotes necessary for a fair presentation of the condensed consolidated financial position, results of operations, comprehensive loss and cash flows in conformity with accounting principles generally accepted in the United States of America (“GAAP”). The preparation of our condensed consolidated financial statements in accordance with GAAP often requires us to make estimates and judgments that affect reported amounts. These estimates and judgments are based on historical experience and assumptions that we believe to be reasonable under the circumstances. Assumptions and judgments based on historical experience may provide reported results, which differ from actual results; however, these assumptions and judgments historically have not varied significantly from actual experience, and we therefore do not expect them to vary significantly in the future. All intercompany balances and transactions have been eliminated in consolidation. The results of operations for any interim period are not necessarily indicative of the results to be expected for the full year. The Company includes acquisition, disposal, integration and separation related costs, which are predominantly composed of legal, consulting, and advisor fee expenses, within the “Transaction and integration expense” line on the condensed consolidated statements of comprehensive loss. The condensed consolidated financial statements include the accounts of the Company and its wholly owned subsidiaries, Surgalign Spine Technologies, Inc., Paradigm Spine, LLC (“Paradigm”), Pioneer Surgical Technology, Inc. (“Pioneer Surgical”), Holo Surgical Inc. (“Holo Surgical”), and Prompt Prototypes, LLC (“Prompt”). The operating results of the disposed OEM Businesses have been reported as discontinued operations in the condensed consolidated financial statements in the prior comparative periods. The Company consolidates the accounts of INN, a 42% owned subsidiary as control was achieved through means other than voting rights ( “ variable interest entities ” or “ VIE ” ) as the Company is deemed to be the primary beneficiary of INN. For further information on the Company’s significant accounting policies, refer to the consolidated financial statements and notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2021 filed with the Securities and Exchange Commission (“SEC”) on March 15, 2022 . Accounting Standards Issued But Not Yet Adopted To date, there have been no recent accounting pronouncements not yet effective that have a material, or potentially material, impact to our consolidated financial statements. Significant New Accounting Policies There are no new accounting policies effective that have a material impact on the financial statements. Reclassification in the Condensed Consolidated Financial Statements |
Discontinued Operations
Discontinued Operations | 6 Months Ended |
Jun. 30, 2022 | |
Discontinued Operations and Disposal Groups [Abstract] | |
Discontinued Operations | Discontinued Operations In connection with the Transactions, on July 20, 2020, the Company completed the disposition of its OEM Businesses. Accordingly, the OEM Businesses are reported as discontinued operations in accordance with ASC 205-20, Discontinued Operations (“ASC 205-20”). The results of operations from the OEM Businesses are classified as discontinued operations in the condensed consolidated statements of comprehensive loss. There were no assets or liabilities of the OEM Businesses as of June 30, 2022 or December 31, 2021 due to the transaction occurring on July 20, 2020. Applicable amounts in prior years have been recast to conform to this discontinued operations presentation. The following table presents the financial results of the discontinued operations: Three Months Ended Six Months Ended 2022 2021 2022 2021 Major classes of line items constituting net income (loss) from discontinued operations Revenues $ — $ — $ — $ — Costs of processing and distribution — — — — Gross profit — — — — Expenses: General and administrative — — — — Severance and restructuring costs — — — — Transaction and integration expenses — — — — Total expenses — — — — Operating (loss) income — — — — Other expense – net: OEM working capital adjustment — 6,316 — 6,316 Interest expense — — — — Derivative loss — — — — Loss on extinguishment of debt — — — — Foreign exchange loss (gain) — — — — Total other expense – net — 6,316 — 6,316 Loss from discontinued operations — (6,316) — (6,316) Gain on sale of net assets of discontinued operations — — — — Income (loss) from discontinued operations before income tax provision (benefit) — (6,316) — (6,316) Income tax provision (benefit) — (763) — (763) Net income (loss) from discontinued operations $ — $ (5,553) $ — $ (5,553) In accordance with ASC 205-20, only expenses specifically identifiable and related to a business to be disposed may be presented in discontinued operations. As such, the general and administrative expenses in discontinued operations include corporate costs incurred directly to solely support the Company’s OEM Businesses. The Company applied the “Intraperiod Tax Allocation” rules under ASC 740, Income Taxes (“ASC 740”), which requires the allocation of an entity’s total annual income tax provision among continuing operations and, in the Company’s case, discontinued operations. On December 1, 2020, pursuant to the OEM Purchase Agreement, the Company received a notice from the Buyer indicating that a post-closing adjustment in an amount of up to $14.0 million may be owed in respect of the working capital adjustment paid at closing. O n June 3, 2021, the firm engaged to resolve the dispute issued a binding, non-appealable resolution whereby it was determined the Company was liable for $5.8 million of the disputed amount, which was finalized and paid during the second quarter of 2021. The final settlement was expensed under “Income (loss) from operations of discontinued operations” in our condensed consolidated statements of comprehensive loss. Total operating and investing cash flows of discontinued operations for the six months ended June 30, 2022 and 2021 is comprised of the following, which excludes the effect of income taxes: Six Months Ended Six Months Ended June 30, June 30, Significant operating non-cash reconciliation items: Depreciation and amortization $ — $ — Provision for bad debt and products returns $ — $ — Revenue recognized due to change in deferred revenue $ — $ — Deferred income tax provision $ — $ — Stock-based compensation $ — $ — Gain on sale of discontinued assets, net $ — $ — Loss on extinguishment of debt $ — $ — Amortizations of debt issuance costs $ — $ — Amortizations of debt discount $ — $ — Significant investing items: Payments for OEM working capital adjustment $ — $ (5,430) Purchases of property and equipment $ — $ — Patent and acquired intangible asset costs $ — $ — Proceeds from sale of OEM Business $ — $ — |
Leases
Leases | 6 Months Ended |
Jun. 30, 2022 | |
Leases [Abstract] | |
Leases | Leases The Company’s leases are classified as operating leases that include office space, automobiles, and copiers. The Company does not have any finance leases and the Company’s operating leases do not have any residual value guarantees, restrictions, or covenants. As of June 30, 2022 the only lease that has yet to commence is for our San Diego Design Center, which is expected to open in the second half of 2022. Therefore, no lease obligation or right-of-use (“ROU”) asset has been recorded as of June 30, 2022. All other obligations associated with the lease are reflected as of June 30, 2022. The Company’s leases have remaining lease terms of 1 to 8 years, some of which include options to extend or terminate the leases. The option to extend is only included in the lease term if the Company is reasonably certain of exercising that option. Operating lease ROU assets are presented within “Other assets-net” on the condensed consolidated balance sheets. The current portion of operating lease liabilities are presented within “Accrued expenses,” and the non-current portion of operating lease liabilities are presented within “Other long-term liabilities” on the condensed consolidated balance sheets. The Company’s lease agreements do not provide a readily determinable implicit rate nor is it available to the Company from its lessors. Instead, the Company estimates its incremental borrowing rate based on information available at lease commencement in order to discount lease payments to present value. Short-term leases with an initial term of 12 months or less are not recorded on the consolidated balance sheet. A subset of the Company’s automobile and copier leases contain variable payments. The variable lease payments for such automobile leases are based on actual mileage incurred at the standard contractual rate. The variable lease payments for such copier leases are based on actual copies incurred at the standard contractual rate. The variable lease costs for all leases are immaterial. The components of operating lease expense were as follows: For the Three Months Ended For the Six Months Ended 2022 2021 2022 2021 Operating lease cost $ 119 $ 195 $ 244 $ 378 Short-term operating lease cost 221 112 442 149 Total operating lease cost $ 340 $ 307 $ 686 $ 527 Supplemental cash flow information related to operating leases was as follows: For the Three Months Ended For the Six Months Ended 2022 2021 2022 2021 Cash paid for amounts included in the measurement of lease liabilities $ 339 $ 332 $ 686 $ 576 ROU assets obtained in exchange for lease obligations — 80 — 80 Supplemental balance sheet information related to operating leases was as follows: Balance Sheet Classification Balance at June 30, 2022 Balance at December 31, 2021 Assets: Right-of-use assets Other assets – net $ 768 $ 876 Liabilities: Current Accrued expenses $ 283 $ 294 Noncurrent Other long-term liabilities 843 947 Total operating lease liabilities $ 1,126 $ 1,241 The weighted-average remaining lease terms and discount rates were as follows: For the Six Months Ended 2022 2021 Weighted-average remaining lease term (years) 6.0 5.8 Weighted-average discount rate 5.1 % 5.0 % As of June 30, 2022, maturities of operating lease liabilities were as follows: Balance at June 30, 2022 (remaining) $ 264 2023 212 2024 172 2025 160 2026 159 2027 and beyond 358 Total future minimum lease payments 1,325 Less imputed interest (199) Total $ 1,126 |
Revenue from Contracts with Cus
Revenue from Contracts with Customers | 6 Months Ended |
Jun. 30, 2022 | |
Revenue from Contract with Customer [Abstract] | |
Revenue from Contracts with Customers | Revenue from Contracts with Customers The Company recognizes revenue upon transfer of control of promised products in an amount that reflects the consideration it expects to receive in exchange for those products. The Company typically transfers control at a point in time upon shipment or delivery of the implants for direct sales, or upon implantation for sales of consigned inventory. The customer is able to direct the use of and obtain substantially all of the benefits from the implant at the time the implant is shipped, delivered, or implanted, based on the terms of the contract. Disaggregation of Revenue The Company’s entire revenue for the three and six months ended June 30, 2022 and 2021 was recognized at a point in time. The following table represents total revenue by geographical region for the three and six months ended June 30, 2022 and 2021, respectively: For the Three Months Ended For the Six Months Ended 2022 2021 2022 2021 Revenues: Domestic $ 17,215 $ 20,726 $ 34,299 $ 40,574 International 3,408 4,108 6,929 7,551 Total revenues from contracts with customers $ 20,623 $ 24,834 $ 41,228 $ 48,125 |
Business Combinations
Business Combinations | 6 Months Ended |
Jun. 30, 2022 | |
Business Combination and Asset Acquisition [Abstract] | |
Business Combinations | Business Combinations Inteneural Networks Inc. On December 30, 2021, the Company entered into a Stock Purchase Agreement with Dearborn Capital Management LLC, and Neva, LLC, a Delaware limited liability company (collectively the sellers of INN), that are owned by Krzysztof Siemionow, MD, PhD (“Siemionow”), Pawel Lewicki, PhD (“Lewicki”) respectively, to acquire a 42% equity interest in the issued and outstanding shares of INN for a non-exclusive right to use their proprietary technology. Lewicki served as a member of the Board of Directors (the “Board”). INN is a medical high-tech company, specializing in AI and big data learning analysis of brain imaging. INN has a proprietary AI technology that autonomously segments and identifies neural structures in medical images and helps identify possible pathological states. This technology has potential future applications in neurosurgery as well as a wide variety of potential disorders, including dementia, autism, tumors, aneurysm, stroke, and neurovascular structures using magnetic resonance imaging and computed tomography platforms. The Company believes the transaction has the following benefits: i) the integration of INN’s ML and AI technologies positions the Company as a leader in intelligent digital health; ii) bringing INN’s intercranial capabilities to the HOLO TM AI platform, the Company can expand the applicability of HOLO AI technology into significant segments beyond spine, in particular neurosurgery; iii) the synergies in the research and development and eventual commercial functions should provide for a particularly efficient integration of INN’s technology and talent; and iv) the transaction materially contributes to the Company’s mission to improve patient's lives through better outcomes. As consideration for the 42% ownership we paid $20.0 million which consisted of $5.0 million in cash, issuance to the Sellers of 227,359 shares of our common stock, par value of $0.001, which had a fair value of $4.9 million and issuance of unsecured promissory notes to the Sellers in fair value of the principal in the amount of $10.1 million. In exchange for 42% equity interest the Company is able to use the proprietary AI technology as a nonexclusive licensee. As part of the transaction, the Company must purchase up to 100% of the equity of INN if the three additional clinical, regulatory, and revenue milestones are met. With each additional closing, the Company will acquire an additional 19.3% equity within INN for an additional $19.3 million in cash payment for each milestone. These milestones have not been achieved as of June 30, 2022. Management has determined that the Company has obtained control through means other than voting rights as the Company is deemed to be the primary beneficiary and is the most closely associated decision maker under ASC 810, Consolidation. Based on this the Company has considered INN to be a VIE and was fully consolidated into the condensed consolidated financial statements as of June 30, 2022 . INN does not have any assets or liabilities as of June 30, 2022 and December 31, 2021 . Additionally, there was no income statement activity within INN for the three and six months ended June 30, 2022 and 2021. The Company further determined that substantially all of the fair value of INN was concentrated in the acquired in-process research and development (“IPR&D”) asset in accordance with ASC 805, Business Combination and therefore accounted for this as an asset acquisition. The total consideration of the asset acquisition was determined to be $72.3 million, which consisted of cash consideration of $5.0 million, $4.9 million of fair value of shares issued to the seller, $10.1 million of seller notes issued to the sellers, direct and incremental expenses of $0.4 million incurred for the INN acquisition, $10.3 million in forward contracts related to the three potential milestone payments and $41.7 million in noncontrolling interest related to the 58% equity interest not purchased. As the forward contracts are redeemable upon a future event (FDA approval) it is determined that this event is not probable under the accounting guidance. As a result, the forward contracts are not remeasured to fair value for the three and six months ended June 30, 2022. The total purchase price paid in the INN acquisition has been allocated to the net assets acquired based on the relative fair value as the completion of the acquisition, primarily including the IPR&D related to INN’s development of their AI technology that autonomously segments neural structures and other intangible assets for assembled workforce. The neuro networks and segmentation has not yet reached technological feasibility and has no alternative use; thus, the purchased IPR&D was expensed immediately to the acquisition during the fourth quarter, resulting in a one-time charge of $72.1 million recognized in the asset acquisition expense line on the consolidated statement of comprehensive loss for the year ended December 31, 2021. Additionally, the intangible asset related to the assembled workforce, in the amount of $0.2 million was immediately impaired together with other intangible assets during the fourth quarter of 2021 due to the Company’s negative projected cash flows. The Company recorded noncontrolling interest of $52.0 million which is comprised of $41.7 million related to the investment in INN and $10.3 million related to the embedded forward contracts as of the transaction date. Management determined that because the IPR&D asset was immediately expensed it did not have technological feasibility. As a result of the transaction, the company recorded a $72.1 million loss within the Consolidated Statements of Comprehensive Loss during the fourth quarter for the year ended December 31, 2021 . This loss had a net impact of $30.2 million to Surgalign, and $41.9 million impact to INN. Prompt Prototypes Acquisition On April 30, 2021, the Company, entered into an Asset Purchase Agreement (the “Agreement”) with Prompt Prototypes LLC (“Prompt”), a California limited liability company, and Peter Kopley, an individual residing in the State of California (the “Sellers”). The Company purchased the assets of Prompt to expand its research and development capabilities and create the capacity to produce certain medical prototypes. Pursuant to the terms of the Agreement, the Company purchased specific assets and assumed certain liabilities of Prompt for a purchase price of $1.1 million. At the closing, the Company paid $0.3 million of cash and issued restricted shares with an aggregate fair market value of $0.2 million to the sellers. The remaining $0.6 million of the purchase price will be paid to Mr. Kopley, contingent on the continued employment with the Company, in the form of cash and restricted shares in two equal amounts on the 18 th and 36 th month anniversary of the closing date. These payments are considered future compensation. The following table summarizes the fair value of the identifiable assets acquired and liabilities assumed from the acquisition of Prompt as of April 30, 2021 (in thousands): Inventories $ 140 Right-of-use assets 78 Property and equipment 528 Operating lease liabilities (78) Deferred tax liability (28) Net assets acquired $ 640 Bargain purchase gain (90) Total purchase price $ 550 Based on the final purchase price, the fair value of the assets acquired and liabilities assumed exceeded the purchase price consideration resulting in a bargain purchase gain of $0.1 million and was recorded in “Other (income) expense – net” during the three and six month period ended June 30, 2021. The bargain purchase was primarily driven by the potential future compensation expense in lieu of an increased purchase price. |
Stock-Based Compensation
Stock-Based Compensation | 6 Months Ended |
Jun. 30, 2022 | |
Share-Based Payment Arrangement [Abstract] | |
Stock-Based Compensation | Stock-Based Compensation The following tables summarize our stock option and stock grant awards by plan: For the six months ended June 30, 2022: Plan Stock Options Restricted Stock Awards Restricted Stock Units Total 2021 Incentive Inducement Plan — — 116,948 116,948 2021 Incentive Compensation Plan — — 4,277 4,277 Total — — 121,225 121,225 For the six months ended June 30, 2021: Plan Stock Options Restricted Stock Awards Restricted Stock Units Total 2021 Incentive Inducement Plan 14,066 — 7,490 21,556 2021 Incentive Compensation Plan 3,803 — 148,173 151,976 2018 Incentive Compensation Plan 8,005 4,920 — 12,925 Total 25,874 4,920 155,663 186,457 The Company recognized stock-based compensation as follows: For the Three Months Ended For the Six Months Ended 2022 2021 2022 2021 Stock-based compensation: Costs of goods sold $ — $ — $ — $ 21 General and administrative 852 1,344 2,123 2,233 Research and development 73 69 176 95 Total $ 925 $ 1,413 $ 2,299 $ 2,349 The expense in the table above represents stock-based compensation for outstanding awards, and related expenses for the Company’s employee stock purchase program. For the three and six months ended June 30, 2022 and June 30, 2021, the Company incurred no stock-based compensation expense related to the disposed OEM Business. |
Net Loss Per Common Share
Net Loss Per Common Share | 6 Months Ended |
Jun. 30, 2022 | |
Earnings Per Share [Abstract] | |
Net Loss Per Common Share | Net Loss Per Common Share A reconciliation of the number of shares of common stock used in the calculation of basic and diluted net income per common share is presented below: For the Three Months Ended For the Six Months Ended 2022 2021 2022 2021 Weighted average basic shares 6,640,405 3,808,475 6,174,273 3,542,497 For the three and six months ended June 30, 2022 and 2021, the Company has recorded a net loss from operations. As a result, the Company has excluded all potential dilutive shares from the computation of the diluted net loss per common share to avoid the anti-dilutive effect. The following table includes the number of potential dilutive shares that were excluded due to the anti-dilutive effect: For the Three Months Ended For the Six Months Ended 2022 2021 2022 2021 Stock Options — 4,389 — 17,903 Restricted Stock Units and Restricted Stock Awards 210,909 38,366 158,645 43,128 Total 210,909 42,755 158,645 61,031 For the three months ended June 30, 2022 and 2021, the company excluded 90,109 and 174,158, respectively, of issued stock options in the computation of diluted net loss per share, and for the six months ended June 30, 2022 and 2021, the Company excluded 103,982 and 155,466, respectively, of issued stock options in the computation of diluted net loss per common share because their exercise price exceeded the average market price during the respective periods. The Company’s outstanding warrants were also excluded from the computation of diluted net loss per common share as they were considered “out-of-the-money” as of June 30, 2022. |
Inventories
Inventories | 6 Months Ended |
Jun. 30, 2022 | |
Inventory Disclosure [Abstract] | |
Inventories | Inventories The inventory balances as of June 30, 2022 and December 31, 2021 consist entirely of finished goods. The Company values its inventories at the lower of net realizable value or cost using first-in, first-out (“FIFO”). For the three months ended June 30, 2022 and 2021, the Company had inventory write-downs of $0.8 million and $1.6 million, respectively, and for the six months ended June 30, 2022 and 2021, the Company had inventory write-downs of $3.8 million and $4.4 million, respectively, relating primarily to excess quantities and obsolescence (“E&O”) of inventories. The E&O write-downs are included in the cost of goods sold on the condensed consolidated statements of comprehensive loss. |
Prepaid and Other Current Asset
Prepaid and Other Current Assets | 6 Months Ended |
Jun. 30, 2022 | |
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract] | |
Prepaid and Other Current Assets | Prepaid and Other Current Assets Prepaid and other current assets are as follows: June 30, December 31, Income tax receivable $ 2,320 $ 4,116 Leasehold improvement reimbursement 3,468 — Prepaid expenses 1,655 2,553 Payroll tax receivable 1,423 — OEM safety stock receivable 1,000 1,000 Insurance recovery receivable — 1,500 Other receivables 1,756 815 $ 11,622 $ 9,984 |
Property and Equipment
Property and Equipment | 6 Months Ended |
Jun. 30, 2022 | |
Property, Plant and Equipment [Abstract] | |
Property and Equipment | Property and Equipment The net book value of property and equipment after accumulated depreciation and all impairment is as follows: June 30, 2022 December 31, 2021 Processing equipment $ 298 $ 346 Surgical instruments 481 489 Office equipment, furniture and fixtures 8 15 Computer equipment and software 154 44 Construction in process 380 51 $ 1,321 $ 945 For the three months ended June 30, 2022 and 2021, the Company recorded depreciation expense in connection with property and equipment of $0.6 million and $0.6 million, respectively. For the six months ended June 30, 2022 and 2021, the Company recorded depreciation expense in connection with property and equipment of $1.1 million and $1.1 million, respectively. The Company uses the straight-line method of depreciation. For the three months ended June 30, 2022 and 2021, the Company recorded asset impairment and abandonment charges of $1.0 million and $2.2 million, respectively. For the six months ended June 30, 2022 and 2021, the Company recorded asset impairment and abandonment charges of $1.9 million and $4.4 million, respectively. The fair value of property and equipment was measured utilizing an orderly liquidation value of each of the underlying assets. For the three months ended June 30, 2022 and 2021, the Company capitalized a total of $0.0 million and $0.8 million of internal software expense related to the implementation of a new Enterprise Resource Planning (“ERP”) system. For the six months ended June 30, 2022 and 2021, the Company capitalized a total of $0.0 million and $1.1 million of internal software expense related to the implementation of a new ERP system. The ERP system was implemented in January 2022 and related capitalized expenses were transferred from “Construction in process” to “Comput er equipment and software” to coincide with implementation. Impairment of the ERP costs was $0.0 million and $0.8 million for the three months ended June 30, 2022 and 2021, respectively. Impairment of the ERP costs was $0.0 million and $1.1 million for the six months ended June 30, 2022 and 2021, respectively. The impairment charges were triggered by continued negative operating cash flows. For the three months ended June 30, 2022 and 2021, the Company expensed $0.1 million and $0.0 million, respectively, related to the ERP implementation. For the six months ended June 30, 2022 and 2021, the Company expensed $0.7 million and $0.1 million respectively, related to the ERP implementation. These non-capitalizable expenses are recorded in the “General, and administrative” line on the condensed consolidated statements of comprehensive loss. |
Warrants
Warrants | 6 Months Ended |
Jun. 30, 2022 | |
Warrants and Rights Note Disclosure [Abstract] | |
Warrants | Warrants On February 15, 2022, we issued and sold in an underwritten public offering 1,285,507 shares of common stock and 163,768 of pre-funded warrants to purchase common stock with gross proceeds of $20.0 million at an effective offering price of $13.8000 and $13.7970 per share respectively. In addition, the Company issued warrants to purchase up to an aggregate of 1,086,956 shares of common stock at a strike price of $18.0000 that are exercisable over the next five years. Also in connection with the offering, the Company issued placement agent warrants to purchase an aggregate of up to 86,956 shares of common stock at a strike price of $17.2500 per share that are exercisable over the next five years. Finally, the Company granted the underwriters the option for a period of 30 days from February 15, 2022 to purchase up to 217,391 additional shares of our common stock at the public offering price of $13.7970 per share and/or warrants to purchase up to 163,043 shares of the Company’s common stock at a public offering price of $0.0030 per warrant. The Underwriters did not exercise the option to purchase the common shares from the Company, but they did exercise the option to purchase the warrants which have not been converted to common shares as of June 30, 2022. We received net proceeds of $17.7 million from the offering. The Company incurred issuance costs related to the offering of $2.3 million which has been allocated between the value of the warrant liability and the amounts recorded within the Statement of Shareholders Equity. Fees allocated to the warrant liabilities were $0.9 million and is reflected in the “Transaction and integration expenses” line in the condensed consolidated statement of loss. The remaining $1.4 million is allocated to common shares and is reflected in “Additional Paid-In Capital” and “Common Stock” sections of the Company’s condensed consolidated balance sheets On June 14, 2021, the Company issued and sold in a registered direct offering priced at-the-market an aggregate of 966,183 shares of its common stock and warrants exercisable for an aggregate of 966,183 shares of Company common stock, at a combined purchase price of $51.7500 per share. The warrants have an exercise price equal to $51.7500 per share, are exercisable immediately upon issuance and will expire three years from the issuance date. The net proceeds from the direct offering, after deducting investor and management fees, were $45.8 million. Upon any exercise of the offering warrants issued in the offering for cash, the Company agreed to pay the placement agent a total cash fee equal to 7.0% of the aggregate gross proceeds from the exercise of the offering warrants and a management fee equal to 1.0% of the aggregate gross proceeds from the exercise of the offering warrants. The Company, also in connection with the direct The Company accounts for its warrants in accordance with ASC 815-40, “Derivatives and Hedging—Contracts in Entity’s Own Equity” (“ASC 815”), under which the warrants did not meet the criteria for equity classification and thus were recorded as liabilities. Since the warrants met the definition of a derivative in accordance with ASC 815, these warrants were measured at fair value at inception and will be remeasured at each reporting date in accordance with ASC 820, Fair Value Measurement |
Fair Value Information
Fair Value Information | 6 Months Ended |
Jun. 30, 2022 | |
Fair Value Disclosures [Abstract] | |
Fair Value Information | Fair Value Information Fair value is defined as the price that would be received upon the sale of an asset or paid to transfer a liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value maximize the use of observable inputs and minimize the use of unobservable inputs. The fair value hierarchy defines a three-level valuation hierarchy for classification and disclosure of fair value measurements as follows: Level 1 – Quoted prices in active markets for identical assets or liabilities. Level 2 – Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. Level 3 – Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. Acquisition Contingencies Changes in the fair value of contingent consideration are recorded in the “Gain on acquisition contingency” line in the condensed consolidated statement of loss . Significant changes in unobservable inputs, mainly the probability of success and projected cash flows, could result in material changes to the contingent consideration liability. Holo Surgical On September 29, 2020, the Company entered into a Stock Purchase Agreement (the “Holo Purchase Agreement”), with Roboticine, Inc, a Delaware corporation (the “Seller”), Holo Surgical S.A., a Polish joint-stock company (“Holo S.A.”), Pawel Lewicki, PhD (“Lewicki”), and Krzysztof Siemionow, MD, PhD (“Siemionow”), which provides for the Company to acquire all of the issued and outstanding equity interests in Holo Surgical Inc., a Delaware corporation and a wholly owned subsidiary of the Seller (“Holo Surgical”). The Seller, Holo S.A., Lewicki and Siemionow are together referred to herein as the “Seller Group Members.” The Acquisition was closed on October 23, 2020. As consideration for the Holo Surgical acquisition, the Company paid to the Seller $30.0 million in cash and issued to the Seller 208,333 shares of common stock, par value $0.001 of the Company (“Common Stock”). In addition, the Seller is entitled to receive contingent consideration from the Company valued in an aggregate amount of up to $83.0 million, to be paid through the issuance of Common Stock or the payment of cash, contingent upon and following the achievement of certain regulatory, commercial and utilization milestones by specified time periods occurring up to the sixth (6 th ) anniversary of the closing. T he contingent consideration is evaluated quarterly, or more frequently, if circumstances dictate. Changes in the fair value of contingent consideration are recorded in the “Gain on acquisition contingency” line item in the condensed consolidated statements of comprehensive loss. Significant changes in unobservable inputs, mainly the probability of success and cash flows projected, could result in material changes to the contingent consideration liabilities. The Purchase Agreement provides that the Company will issue Common Stock to satisfy any contingent consideration payable to the Seller, until the total number of shares of Common Stock issued to the Seller pursuant to the Purchase Agreement (including the 208,333 shares of Common Stock issued at closing) is equal to 496,666 shares of Common Stock. Following the attainment of that limitation, the post-closing contingent payments would be payable in cash. The number of shares of Common Stock issued as contingent consideration with respect to the achievement of a post-closing milestone, if any, will be calculated based on the volume weighted average price of the Common Stock for the five (5) day trading period commencing on the opening of trading on the third trading day following the achievement of the applicable milestone. On January 12, 2022, the Company entered into a Second Amendment to the Stock Purchase Agreement with the sellers of Holo Surgical to amend one of the regulatory milestones beyond December 31, 2021. This regulatory milestone was subsequently achieved on January 14, 2022 when the Company received 510(k) clearance for its HOLO Portal ™ surgical guidance system. Upon achievement of this milestone the Company issued 288,333 in common stock at a value of $5.9 million, and also paid the sellers $4.1 million in cash for a total payment for achieving the milestone of $10.0 million pursuant to the terms of the agreement (the “Holo Milestone Payments”). The Company determined the fair value of the Holo Milestone Payments to be the present value of each future payment amount estimated using a probability weighted model, driven by the probability of success factor and expected payment date. The probability of success factor was used in the fair value calculation to reflect inherent regulatory, development and commercial risk of the Holo Milestone Payments. More specifically, the probability of expected achievement of the specific milestones, including risks associated with the uncertainty regarding the achievement and payment of milestones; obtaining regulatory approvals in the United States and Europe; the development of new features used with the product; the adaption of the new technology by surgeons; and the placement of the devices within the field. This fair value measurement is based on significant unobservable inputs in the market and thus represents a Level 3 measurement within the fair value hierarchy. Inputs used in estimating the fair value of the contingent consideration for Holo Surgical as of June 30, 2022 and December 31, 2021, are summarized below: Fair Value at June 30, 2022 Valuation Technique Unobservable Inputs Ranges $31,435 Earn-Out Valuation Probability of success factor 0% - 95% Discount rates 2.51% - 16.54% Fair Value at December 31, 2021 Valuation Technique Unobservable Inputs Ranges $51,928 Earn-Out Valuation Probability of success factor 0% - 90% Discount rates 0.06% - 11.60% The following table provides a reconciliation of contingent consideration measured at fair value using significant unobservable inputs (Level 3) as of June 30, 2022 and December 31, 2021 : June 30, December 31, Beginning balance as of January 1 $ 51,928 $ 56,515 Gain on acquisition contingency (10,493) (4,587) Milestone payments (10,000) — Ending balance as of June 30 $ 31,435 $ 51,928 Paradigm On March 8, 2019, the Company acquired Paradigm, which included a contingent liability related to the revenue based earnout (“Paradigm Earnout”) of $72.2 million. The fair value of the contingent liability was measured using Level 3 inputs. Unobservable inputs for the probability-weighted model included weighted average cost of capital and company specific projected revenue and costs. During 2019 management reduced the contingency consideration to $0.0 million due to a revision in the milestone inputs and recorded a gain of $72.2 million which was recognized during 2019. There are no amounts recorded as contingent consideration as of June 30, 2022 and December 31, 2021 as management has determined that the milestones will not be met. The last milestones will expire on December 31, 2022. Property and Equipment, Intangibles and Other Assets As of June 30, 2022, and December 31, 2021, respectively, property and equipment with a carrying amount of $2.9 million and $12.0 million were written down to their estimated fair value of $1.3 million and $0.9 million using Level 3 inputs. The Level 3 fair value was measured based on orderly liquidation value and is evaluated on a quarterly basis. Unobservable inputs for the orderly liquidation value included replacement costs, physical deterioration estimates and market sales data for comparable assets. Definite-lived intangible and other assets subject to amortization were impaired and written down to their estimated fair values in 2022 and 2021. Fair value is measured as of the impairment date using Level 3 inputs. Definite-lived intangible assets and other assets’ fair value was measured based on the income approach and orderly liquidation value, respectively. Due to the Company’s forecasted cash flow being negative, any intangible assets acquired during the period were immediately impaired. Unobservable inputs for the orderly liquidation value included replacement costs, physical deterioration estimates and market sales data for comparable assets. Unobservable inputs for the income approach included forecasted cash flows generated from use of the definite-lived intangible assets. As a result of impairments recognized, the following table summarizes the post impairment fair values of the corresponding assets subject to fair value measured using Level 3 inputs as of June 30, 2022 and December 31, 2021: Fair value June 30, December 31, Property and equipment – net $ 1,321 $ 945 Definite-lived intangible assets – net — — Other assets – net 5,840 5,970 $ 7,161 $ 6,915 Property and equipment was impaired and written down to their estimated fair values during the six months ended June 30, 2022 and 2021. Other intangible assets and other assets were impaired and written down to their estimated fair values during the six months ended June 30, 2022 and 2021. The following table summarizes the corresponding impairment charge during the three and six months ended June 30, 2022 and 2021: For the Three Months Ended For the Six Months Ended Impairment 2022 2021 2022 2021 Property and equipment – net $ 784 $ 2,012 $ 1,573 $ 3,791 Definite-lived intangible assets – net 100 150 201 311 Other assets – net 112 44 161 280 $ 996 $ 2,206 $ 1,935 $ 4,382 During the three and six months ended June 30, 2022 and 2021, the Company concluded, through its ASC 360 impairment testing of long-lived assets classified as held and used, that factors existed indicating that finite-lived intangible assets were impaired. The factors considered by management include a history of net losses and negative cash flows in each of those periods to be able to support the assets. The Company tested the carrying amounts of the property and equipment, definite lived intangibles, and other assets for impairment. As a result, we recorded an impairment charge of $1.0 million and $2.2 million for the three months ended June 30, 2022, and an impairment charge of $1.9 million and $4.4 million for the six months ended June 30, 2022 and 2021 recorded within the “Asset impairment and abandonments” line item on the condensed consolidated statement of loss . Warrant Liability Warrants are accounted for as liabilities in accordance with ASC 815-40 and are presented within “Warrant liability” in the Company’s condensed consolidated balance sheets. The following table presents information about the Company’s liabilities that are measured at fair value: Level June 30, 2022 December 31, 2021 Warrant liability 3 $ 1,554 $ 12,013 June 14, 2021 Warrants The table presented below is a summary of changes in the fair value of the Company’s Level 3 valuation for the June 14, 2021 warrant liability for the six months ended June 30, 2022: Warrant Liability December 31, 2021 $ 12,013 Change in fair value of warrant liability (11,848) June 30, 2022 $ 165 The warrant liability is revalued each reporting period with the change in fair value recorded in the accompanying condensed consolidated statements of comprehensive loss until the warrants are exercised or expire. The fair value of the warrant liability is estimated using the Black-Scholes Option Pricing Model using the following valuation inputs: June 30, December 31, Stock price $ 3.41 $ 21.60 Risk-free interest rate 2.91 % 0.84 % Dividend yield 0.00 % 0.00 % Volatility 100.00 % 130.00 % February 15, 2022 Warrants The table presented below is a summary of changes in the fair value of the Company’s Level 3 valuation for the February 15, 2022 warrant liability for the six months ended June 30, 2022, there were no warrants issued as of June 30, 2021: Warrant Liability December 31, 2021 $ — Fair value of warrants on date of issuance 10,157 Execution of prefunded warrants (1,749) Change in fair value of warrant liability (7,019) June 30, 2022 $ 1,389 The warrant liability is revalued each reporting period with the change in fair value recorded in the accompanying condensed consolidated statements of comprehensive loss until the warrants are exercised or expire. The fair value of the warrant liability is estimated using the Black-Scholes Option Pricing Model using the following valuation inputs: June 30, Stock price $ 3.41 Risk-free interest rate 3.01 % Dividend yield 0.00 % Volatility 80.00 % |
Accrued Expenses
Accrued Expenses | 6 Months Ended |
Jun. 30, 2022 | |
Payables and Accruals [Abstract] | |
Accrued Expenses | Accrued Expenses Accrued expenses are as follows: June 30, December 31, Accrued compensation $ 5,531 $ 5,258 Accrued distributor commissions 3,819 2,957 Accrued securities class action settlement — 1,500 Other 7,864 8,054 Total accrued expenses $ 17,214 $ 17,769 |
Other Long-term Liabilities
Other Long-term Liabilities | 6 Months Ended |
Jun. 30, 2022 | |
Other Liabilities, Noncurrent [Abstract] | |
Other Long-term Liabilities | Other Long-term Liabilities Other long-term liabilities are as follows: June 30, 2022 December 31, 2021 Acquisition contingencies $ 22,393 $ 26,343 Warrant Liability 1,554 12,013 Lease obligations 843 947 Other 2,732 2,229 Total other long-term liabilities $ 27,522 $ 41,532 |
Income Taxes
Income Taxes | 6 Months Ended |
Jun. 30, 2022 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | Income Taxes The Company evaluates the need for deferred tax asset valuation allowances based on a more likely than not standard. The ability to realize deferred tax assets depends on the ability to generate sufficient taxable income within the carryback or carryforward periods provided for in the tax law for each applicable tax jurisdiction. The Company has evaluated all evidence, both positive and negative, and maintains a valuation allowance on deferred tax assets in the United States as well as most foreign jurisdictions as of June 30, 2022. For the three months ended June 30, 2022 and 2021, the Company recorded income tax provision of $0.1 million and $0.1 million, respectively in continuing operations. The June 30, 2022 three-month income tax provision was primarily a result of non-U.S. income tax expense and interest accrued on uncertain tax positions. The June 30, 2021 three-month income tax provision was primarily a result of the impact of uncertain tax position interest accrual. For the six months ended June 30, 2022 and 2021, the Company recorded income tax provision of $0.3 million and $0.3 million, respectively. The June 30, 2022 six-month income tax provision was primarily a result of federal tax notices received, non-U.S. income tax expense, and interest accrued on uncertain tax positions. The June 30, 2021 six-month income tax provision was primarily a result of federal interest liability as a result of timing of payments and impact of uncertain tax position interest accrual. |
Debt
Debt | 6 Months Ended |
Jun. 30, 2022 | |
Debt Disclosure [Abstract] | |
Debt | Debt On December 30, 2021, the Company issued $10.6 million aggregate principal amount of unsecured seller notes (“Seller Notes”) recorded at $10.1 million and $10.0 million as of June 30, 2022 and December 31, 2021 respectively. All principal and accrued interest due and payable on the earlier of December 30, 2024, or the date upon which a change in control occurs. Interest is paid in kind and capitalized into the principal amount of the Seller Notes on each anniversary of the issuance date at a rate of 6.8% per year. For the three months ended June 30, 2022 management accrued $0.1 million in interest expense and accredited $0.2 million related to the seller notes for a total interest expense of $0.3 million. For the six months ended June 30, 2022 management accrued $0.1 million in interest expense and accredited $0.4 million related to the seller notes for a total interest expense of $0.5 million. In the event of default, as defined in the agreement, any and all of the indebtedness may be immediately declared due and payable, and the interest would accrue at a 4.0% higher rate. There is no prepayment penalty or covenants related to the fixed rate notes. The Seller Notes were issued as deferred consideration in connection with the INN Purchase Agreement discussed at Note 1, Note 6, and Note 21. Debt issuance costs were immaterial and were included within the overall costs of the acquisition of INN. The following table summarizes the debt recorded on the condensed consolidated balance sheet: Carrying Value (In thousands) June 30, 2022 December 31, 2021 Seller Notes-P. Lewicki $ 5,306 $ 5,306 Seller Notes-K. Siemionow 5,306 5,306 Less: accretion of acquisition adjustment (525) (630) Total Seller Notes – related party 10,087 9,982 Current portion of seller notes — — Total long-term seller notes, excluding current portion $ 10,087 $ 9,982 The fair value of the Seller Notes is $10.0 million at June 30, 2022 and December 31, 2021, respectively. The Company has determined that the Seller Notes is a level 2 financial instrument as there are other unobservable inputs. As of June 30, 2022, the future maturities of long-term debt, excluding deferred financing costs, accrued interest and debt discount, were as follows: Future Maturities of Long-Term Debt 2022 $ — 2023 — 2024 10,612 2025 — 2026 — Thereafter — Total $ 10,612 |
Commitments and Contingencies
Commitments and Contingencies | 6 Months Ended |
Jun. 30, 2022 | |
Commitments and Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | Commitments and Contingencies Acquisition of Paradigm – On March 8, 2019, pursuant to a Master Transaction Agreement, the Company acquired Paradigm in a cash and stock transaction valued at up to $300.0 million consisting of $150.0 million of cash, plus potential future milestone payments. Paradigm’s primary product is the Coflex ® Interlaminar Stabilization ® device, a minimally invasive motion preserving stabilization implant that is FDA approved for the treatment of moderate to severe lumbar spinal stenosis in conjunction with decompression. Under the terms of the agreement, the Company paid $100.0 million in cash and issued 357,653 shares of the Company’s common stock. The shares of Company common stock issued on March 8, 2019, were valued based on the volume weighted average closing trading price for the five revenue earnout consideration. The first potential earnout payment of $20.0 million was based on revenues achieved during any twelve-month period ending on December 31, 2020. As the revenue milestone was not achieved, there was no consideration due with respect to the first earnout period and the Company has no further liability with respect thereto. The last milestone is based on a probability weighted model and, the Company estimates a contingent liability related to the revenue based earnout of zero utilizing a Monte-Carlo simulation model. A Monte-Carlo simulation is an analytical method used to estimate fair value by performing a large number of simulations or trial runs and thereby determining a value based on the possible outcomes. Accounted for as a liability to be revalued at each reporting period, the fair value of the contingent liability was measured using Level 3 inputs, which includes weighted average cost of capital and projected revenues and costs. There are no amounts recorded as contingent consideration as of June 30, 2022 and December 31, 2021 as management has determined that the milestones will not be met. The last milestones will expire on December 31, 2022. Aziyo – On August 1, 2018, the Company and Aziyo Biologics, Inc. (“Aziyo”) entered into a Distribution Agreement which was subsequently amended on December 3, 2018, and November 15, 2020 (the “Distribution Agreement”). Pursuant to the Distribution Agreement, the Company has exclusive distribution rights to certain biologic implants manufactured by Aziyo and marketed under the ViBone trade name (“ViBone”). The Distribution Agreement provides for minimum purchases of ViBone implants on an annual basis through calendar 2025. For calendar years 2019-2021, if the minimum purchase obligations for a particular year are not fulfilled, the Distribution Agreement provides various options for the Company to satisfy such obligations (“Shortfall Obligations”) in subsequent years, including a combination of payments and/or providing purchase orders for the shortfall amount in a given year. If a purchase order is submitted, the contract does not provide that it needs to be satisfied during the following year (i.e., the Company can satisfy the orders over multiple years and until the minimum is achieved). For calendar years 2022 and beyond, if the Company does not satisfy the minimum purchase obligations specified in the Distribution Agreement, the Company can continue to market the ViBone implants on a non-exclusive basis without any Shortfall Obligations. In January 2021 and 2022, the Company issued purchase orders to Aziyo for $12.4 million and $14.2 million respectively related to the shortfalls in each of the years. Acquisition of Holo Surgical – As part of the Holo Surgical acquisition, the Company issued contingent consideration which would be payable to the sellers upon the achievement of certain regulatory, commercial, and utilization milestones by specified time periods. On January 14, 2022 the Company received 510(k) clearance for the HOLO Portal TM surgical guidance system. Upon achievement of this milestone the Company issued 288,333 in common stock at a value of $5.9 million and also paid the sellers $4.1 million in cash for a total payment for achieving the milestone of $10.0 million pursuant to the terms of the agreement. The fair value of the liability was $31.4 million as of June 30, 2022 with $9.0 million classified as current liabilities within “ Current portion of accrued acquisition contingency – Holo” while $22.4 million was classified as “ Acquisition contingencies – Holo .” The fair value of the liability was $51.9 million on December 31, 2021 with $25.6 million classified as current liabilities within “ Current portion of accrued acquisition contingency – Holo” while $26.3 million classified as “ Acquisition contingencies – Holo .” The change in the fair value of the liability of $10.5 million since December 31, 2021 was recognized in the gain on acquisition contingency line of the condensed consolidated statements of comprehensive loss. Manufacturing Agreements with Former OEM Affiliates – In connection with the closing of the OEM Transaction, on July 20, 2020 the Company entered into three manufacturing and distribution agreements with affiliates of Montague Private Equity: (i) a Manufacture and Distribution Agreement (the “Hardware MDA”) with Pioneer Surgical Technology, Inc. (“Pioneer”) pursuant to which Pioneer would manufacture certain hardware implants for the Company; (ii) a Processing and Distribution Agreement with RTI Surgical, Inc. (“RTI”), an affiliate of Pioneer, pursuant to which RTI would process certain biologic implants for the Company (the “PDA”); and (iii) a Manufacture and Distribution Agreement (“NanOss”) pursuant to which Pioneer would manufacture certain synthetic implants for the Company (the “NanOss MDA”), and together with the Hardware MDA and the PDA, the “OEM Distribution Agreements.” The original OEM Distribution Agreements contain aggregate minimum performance obligations for each of the first three years of the agreements as follows: • Year 1: $24.2 million • Year 2: $25.8 million • Year 3: $27.2 million On August 5, 2022 , the Company amended the OEM distribution agreement to reduce the Contract Year 3 minimum to $17.9 million. The amendments also release the Company of any obligation to cure any purchase shortfall in Contract Year 2 and thus the Company has not recorded any liability as it relates to this contract year. Also on August 5, 2022, the Company entered into a letter agreement relating to the Design and Development Agreement, which contained a provision whereby the Company would pay Pioneer a minimum of $1.7 million for direct labor costs and certain services with respect to maintaining design history files in each of the first two years under the Design and Development Agreement. The letter agreement stated that the Company owes Pioneer $2.1 million for the shortfall in Contract Year 1 and Year 2. The Company has agreed to pay the amount and has recorded the liability in “Accrued expenses” on the condensed consolidated balance sheets as of June 30, 2022. San Diego Lease – On March 12, 2021, the Company entered into a Lease (the “Lease”) with SNH Medical Office Properties Trust, a Maryland real estate investment trust (the “Landlord”), to house the Company’s offices, lab and innovation space (the “Building”) in San Diego, California. The initial term of the Lease is twelve years, with one extension option for a period of seven years. Under the terms of the Lease, the Company will lease an aggregate of approximately 94,457 rentable square feet of a building located at 3030 Science Park Road, San Diego, California (the “Premises”). The Landlord agreed to make improvements after the execution of the leases, after which occupancy is expected to be delivered to the Company. Aggregate payments towards base rent for the Premises over the term of the lease will be approximately $64.6 million, including 13 months of rent abatement. The Company will recognize the lease assets and liabilities when the Landlord makes the underlying asset available to the Company and as such no amounts were accrued as of June 30, 2022. Concurrent with the Company’s execution of the Lease, as a security deposit, the Company delivered to the Landlord a payment in the amount of $2.5 million which is recorded within “Other assets – net” in our condensed consolidated balance sheets. In addition, the Company maintains a prepaid reimbursement balance of $3.5 million which is recorded within “Prepaid and other current assets” in our condensed consolidated balance sheets. |
Legal Actions
Legal Actions | 6 Months Ended |
Jun. 30, 2022 | |
Commitments and Contingencies Disclosure [Abstract] | |
Legal Actions | Legal Actions The Company is, from time to time, involved in litigation relating to claims arising out of its operations in the ordinary course of business. Based on the information currently available to the Company, including the availability of coverage under its insurance policies, except as described below and in Note 20 the Company does not believe that any of these claims that were outstanding as of June 30, 2022 will have a material adverse impact on its financial position or results of operations. The Company’s accounting policy is to accrue for legal costs as they are incurred. Coloplast — RTI Surgical, Inc., as a predecessor to the Company, is presently named as co-defendant along with other companies in a small percentage of the transvaginal surgical mesh (“TSM”) mass tort claims being brought in various state and federal courts. The TSM litigation has as its catalyst various Public Health Notifications issued by the FDA with respect to the placement of certain TSM implants that were the subject of 510(k) regulatory clearance prior to their distribution. The Company does not process or otherwise manufacture for distribution in the U.S. any implants that were the subject of these FDA Public Health Notifications. The Company denies any allegations against it and intends to continue to vigorously defend itself. In addition to claims made directly against the Company, Coloplast, a distributor of TSM’s and certain allografts processed and private labeled for them under a contract with the Company, has also been named as a defendant in individual TSM cases in various federal and state courts. Coloplast requested that the Company indemnify or defend Coloplast in those claims which allege injuries caused by the Company’s allograft implants, and on April 24, 2014, Coloplast sued RTI Surgical, Inc. in the Fourth Judicial District of Minnesota for declaratory relief and breach of contract. On December 11, 2014, Coloplast entered into a settlement agreement with RTI Surgical, Inc. and Tutogen Medical, Inc. (the “Company Parties”) resulting in dismissal of the case. Under the terms of the settlement agreement, the Company Parties are responsible for the defense and indemnification of two categories of present and future claims: (1) tissue only (where Coloplast is solely the distributor of Company processed allograft tissue and no Coloplast-manufactured or distributed synthetic mesh is identified) (“Tissue Only Claims”), and (2) tissue plus non-Coloplast synthetic mesh (“Tissue-Non-Coloplast Claims”) (the Tissue Only Claims and the Tissue-Non-Coloplast Claims being collectively referred to as “Indemnified Claims”). As of June 30, 2022, there are a cumulative total of 1,026 Indemnified Claims for which the Company Parties are providing defense and indemnification. In connection with the transactions, liabilities related to these claims remained a liability retained by the Company. The defense and indemnification of these cases are covered under the Company’s insurance policy subject to a reservation of rights by the insurer. Based on the current information available to the Company, the impact that current or any future TSM litigation may have on the Company cannot be reasonably estimated. LifeNet — On June 27, 2018, LifeNet Health, Inc. (“LifeNet”) filed a patent infringement lawsuit in the United States District Court for the Middle District of Florida (since moved to the Northern District of Florida) claiming infringement of five of its patents by the Company’s predecessor RTI Surgical, Inc. The suit requests damages, enhanced damages, reimbursement of costs and expenses, reasonable attorney fees, and an injunction. The asserted patents are expired. On April 7, 2019, the Court granted the Company’s request to stay the lawsuit pending the U.S. Patent Trial and Appeal Board’s (“PTAB”) decision whether to institute review of the patentability of LifeNet’s patents. On August 12, 2019 the PTAB instituted review of three LifeNet patents, and on September 3, 2019 the PTAB instituted review of the remaining two. On August 4, 2020 and August 26, 2020, the PTAB issued final written decisions finding that certain claims were shown to be unpatentable and others not. Neither party appealed the PTAB’s decisions with respect to the three LifeNet patents on which the PTAB instituted review on August 12, 2019. With respect to the remaining two LifeNet patents, Surgalign filed Notices of Appeal with the Federal Circuit on October 27, 2020 and LifeNet filed a Notice of Cross-appeal on November 9, 2020. The Federal Circuit issued its written opinion regarding Surgalign’s Appeal and LifeNet’s Cross-appeal on April 11, 2022, affirming in-part, reversing in-part, and remanding one issue to the PTAB. In connection with the transactions, liabilities related to these claims remained a liability retained by the Company. The Company continues to believe the suit is without merit and will vigorously defend its position. Based on the current information available to the Company, the impact that current or any future litigation may have on the Company cannot be reasonably estimated. Securities Class Action— The Company’s Investigation (as defined below) resulted in stockholder litigation against the Company and certain former officers of the Company in the United States District Court for the Northern District of Illinois (the “Court”) on March 23, 2020 asserting claims under Sections 10(b) and 20(a) of the Securities Exchange Act of 1934 (the “Exchange Act”) . On June 30, 2021, the parties to the Lowry Action conducted a mediation session and on July 27, 2021, a binding term sheet settling the Lowry Action was entered into whereby the defendants agreed to pay $10.5 million (inclusive of attorneys’ fees and administrative costs) in exchange for the dismissal with prejudice of all claims. On September 22, 2021, the court granted preliminary approval to the settlement, and the amount was paid by the Company’s insurers under its Directors’ and Officers’ insurance policies. The Court entered an order approving the settlement on January 26, 2022 and no amounts were outstanding on June 30, 2022 . The matter is now concluded. Derivative Lawsuits —Three derivative lawsuits have also been filed on behalf of the Company, naming it as a nominal defendant, and demanding a jury trial. On June 5, 2020, David Summers filed a shareholder derivative lawsuit (the “Summers Action”) against certain current and former directors and officers of the Company (as well as the Company as a nominal defendant), in the United States District Court for the Northern District of Illinois asserting statutory claims under Sections 10(b), 14(a), and 20(a) of the Exchange Act, as well as common law claims for breach of fiduciary duty, unjust enrichment and corporate waste. Thereafter, two similar shareholder derivative lawsuits asserting many of the same claims were filed in the same court against the same current and former directors and officers of the Company (as well as the Company as a nominal defendant), as well as a books and records demand under Section 220 of the Delaware General Corporate Law (the “Books and Records Demand”). The three derivative lawsuits have been consolidated into the first-filed Summers Action (together with the Books and Records Demand, the “Derivative Actions”). On September 6, 2020, the court entered an order staying the Summers Action pending resolution of the motions to dismiss in the Lowry Action. On September 30, 2021, the court granted preliminary approval of a proposed settlement of the Derivative Actions (the “Derivative Actions Settlement”). Pursuant to the Derivative Actions Settlement, the Company has agreed to adopt or revise certain corporate governance policies and procedures, and the Company’s insurers agreed to pay $1.5 million to plaintiffs’ counsel. Based on this a corresponding receivable and liability of $1.5 million was recorded within “Prepaid and other current assets,” and “Accrued expenses” on the consolidated balance sheets as of December 31, 2021. The settlement amount was paid by the Company’s insurers under its Directors’ and Officers’ insurance policies in January 2022 in the amount of $1.5 million. On January 24, 2022, the court gave final approval to the Derivative Actions Settlement. The matter is now concluded and no amounts were outstanding at June 30, 2022 . GPV I FIZN and StartVenture Poland Sp. z.o.o. ASI SKA – The Company is presently named as a co-defendant along with other companies and individuals, including Dr. Siemionow and Dr. Lewicki, our former Chief Medical Officer and former Director respectively, by former stockholders of Holo Surgical, S.A. (“Holo SA”), individually and/or collectively, for common law fraud, constructive fraud, fraudulent inducement, conspiracy to defraud, and unjust enrichment, unlawful taking and conversion based on illegal and fraudulent actions related to (i) the sale of shares in Holo Surgical, Inc. to Roboticine, (ii) the purchase of Plaintiffs’ ownership interests in Holo SA by Roboticine, and (iii) the subsequent sale of Holo Surgical, Inc. to the Company. The Company does not believe that any of the claims relate to its action with regards to the negotiations nor the purchase of Holo SA and on May 27, 2022, moved to dismiss. |
Regulatory Actions
Regulatory Actions | 6 Months Ended |
Jun. 30, 2022 | |
Regulatory Actions [Abstract] | |
Regulatory Actions | Regulatory Actions SEC Investigation — As previously disclosed in the Company’s Current Report on Form 8-K filed with the SEC on March 16, 2020, and the Form 10-K filed with the SEC on June 8, 2020, the Audit Committee of the Board of Directors, with the assistance of independent legal and forensic accounting advisors, conducted an internal investigation of matters relating to the Company’s revenue recognition practices for certain contractual arrangements, primarily with customers of the Company’s formerly-owned OEM Businesses, including the accounting treatment, financial reporting and internal controls related to such arrangements (the “Investigation”). The Investigation also examined transactions to understand the practices related to manual journal entries for accrual and reserve accounts. As a result of the Investigation, the Audit Committee concluded that the Company would restate its previously issued audited financial statements for fiscal years 2018, 2017, and 2016, selected financial data for fiscal years 2015 and 2014, the condensed consolidated financial statements for the quarterly periods within these years commencing with the first quarter of 2016, as well as the condensed consolidated financial statements for the quarterly periods within the 2019 fiscal year. |
Related Party Transactions
Related Party Transactions | 6 Months Ended |
Jun. 30, 2022 | |
Related Party Transactions [Abstract] | |
Related Party Transactions | Related Party Transactions The Company’s related parties include: i) a person who is or was (since the beginning of the last fiscal year for which the Company has filed a Form 10-K and proxy statement, even if he or she does not presently serve in that role) an executive officer, director or nominee for election as a director; ii) greater than five percent beneficial owner of the Company’s common stock; or iii) immediate family member of any of the foregoing. The Company has not entered into any related party transactions in 2022. The following transactions were determined to be related parties at the time of the transaction: The Holo Surgical Acquisition As discussed in Note 6, on September 29, 2020, the Company entered into the Holo Purchase Agreement, pursuant to which, among other things, the Company consummated the Acquisition on October 23, 2020. As consideration for the Acquisition, the Company paid to Seller $30.0 million in cash and issued to Seller 208,333 shares of its common stock with a fair value of $12.3 million. In addition, the Seller will be entitled to receive contingent consideration from the Company valued at $50.6 million as of October 23, 2020, which must be first paid in shares of our common stock (in an amount up to 288,333 shares) and then paid in cash thereafter, contingent upon and following the achievement of certain regulatory, commercial and utilization milestones by specified time periods occurring up to the sixth (6th) anniversary of the Closing Date. Dr. Pawel Lewicki was appointed to the Company’s board of directors on November 23, 2020 and served through May 10, 2022. Dr. Pawel Lewicki indirectly owned approximately 57.5% of the outstanding ownership interests in the Seller prior to the acquisition being executed. INN Acquisition On December 30, 2021, we executed the INN Purchase Agreement with the related party Sellers, Siemionow, the former Chief Medical Officer of the Company, and Dr. Lewicki, who own the remaining 58% of INN evenly. See Note 1 , Note 6, and Note 17 for further discussion on amounts outstanding to them. |
Subsequent Events
Subsequent Events | 6 Months Ended |
Jun. 30, 2022 | |
Subsequent Events [Abstract] | |
Subsequent Events | Subsequent Events The Company evaluated subsequent events as of the issuance date of the condensed consolidated financial statements as defined by FASB ASC 855, Subsequent Events. |
Basis of Presentation (Policies
Basis of Presentation (Policies) | 6 Months Ended |
Jun. 30, 2022 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Basis of Presentation | Basis of Presentation The accompanying condensed consolidated financial statements include all adjustments, consisting of normal recurring accruals, which the Company considers necessary for a fair presentation of the results of operations for the periods shown. The condensed consolidated financial statements have been prepared in accordance with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X, and, therefore, do not include all information and footnotes necessary for a fair presentation of the condensed consolidated financial position, results of operations, comprehensive loss and cash flows in conformity with accounting principles generally accepted in the United States of America (“GAAP”). The preparation of our condensed consolidated financial statements in accordance with GAAP often requires us to make estimates and judgments that affect reported amounts. These estimates and judgments are based on historical experience and assumptions that we believe to be reasonable under the circumstances. Assumptions and judgments based on historical experience may provide reported results, which differ from actual results; however, these assumptions and judgments historically have not varied significantly from actual experience, and we therefore do not expect them to vary significantly in the future. All intercompany balances and transactions have been eliminated in consolidation. The results of operations for any interim period are not necessarily indicative of the results to be expected for the full year. The Company includes acquisition, disposal, integration and separation related costs, which are predominantly composed of legal, consulting, and advisor fee expenses, within the “Transaction and integration expense” line on the condensed consolidated statements of comprehensive loss. The condensed consolidated financial statements include the accounts of the Company and its wholly owned subsidiaries, Surgalign Spine Technologies, Inc., Paradigm Spine, LLC (“Paradigm”), Pioneer Surgical Technology, Inc. (“Pioneer Surgical”), Holo Surgical Inc. (“Holo Surgical”), and Prompt Prototypes, LLC (“Prompt”). The operating results of the disposed OEM Businesses have been reported as discontinued operations in the condensed consolidated financial statements in the prior comparative periods. The Company consolidates the accounts of INN, a 42% owned subsidiary as control was achieved through means other than voting rights ( “ variable interest entities ” or “ VIE ” |
Accounting Standards Issued But Not Yet Adopted and Significant New Accounting Policies | Accounting Standards Issued But Not Yet Adopted To date, there have been no recent accounting pronouncements not yet effective that have a material, or potentially material, impact to our consolidated financial statements. Significant New Accounting Policies |
Discontinued Operations (Tables
Discontinued Operations (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Discontinued Operations and Disposal Groups [Abstract] | |
Schedule of Financial Results and Operating and Investing Cash Flows of Discontinued Operations | The following table presents the financial results of the discontinued operations: Three Months Ended Six Months Ended 2022 2021 2022 2021 Major classes of line items constituting net income (loss) from discontinued operations Revenues $ — $ — $ — $ — Costs of processing and distribution — — — — Gross profit — — — — Expenses: General and administrative — — — — Severance and restructuring costs — — — — Transaction and integration expenses — — — — Total expenses — — — — Operating (loss) income — — — — Other expense – net: OEM working capital adjustment — 6,316 — 6,316 Interest expense — — — — Derivative loss — — — — Loss on extinguishment of debt — — — — Foreign exchange loss (gain) — — — — Total other expense – net — 6,316 — 6,316 Loss from discontinued operations — (6,316) — (6,316) Gain on sale of net assets of discontinued operations — — — — Income (loss) from discontinued operations before income tax provision (benefit) — (6,316) — (6,316) Income tax provision (benefit) — (763) — (763) Net income (loss) from discontinued operations $ — $ (5,553) $ — $ (5,553) Total operating and investing cash flows of discontinued operations for the six months ended June 30, 2022 and 2021 is comprised of the following, which excludes the effect of income taxes: Six Months Ended Six Months Ended June 30, June 30, Significant operating non-cash reconciliation items: Depreciation and amortization $ — $ — Provision for bad debt and products returns $ — $ — Revenue recognized due to change in deferred revenue $ — $ — Deferred income tax provision $ — $ — Stock-based compensation $ — $ — Gain on sale of discontinued assets, net $ — $ — Loss on extinguishment of debt $ — $ — Amortizations of debt issuance costs $ — $ — Amortizations of debt discount $ — $ — Significant investing items: Payments for OEM working capital adjustment $ — $ (5,430) Purchases of property and equipment $ — $ — Patent and acquired intangible asset costs $ — $ — Proceeds from sale of OEM Business $ — $ — |
Leases (Tables)
Leases (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Leases [Abstract] | |
Schedule of Components of Operating Lease Expense | The components of operating lease expense were as follows: For the Three Months Ended For the Six Months Ended 2022 2021 2022 2021 Operating lease cost $ 119 $ 195 $ 244 $ 378 Short-term operating lease cost 221 112 442 149 Total operating lease cost $ 340 $ 307 $ 686 $ 527 Supplemental cash flow information related to operating leases was as follows: For the Three Months Ended For the Six Months Ended 2022 2021 2022 2021 Cash paid for amounts included in the measurement of lease liabilities $ 339 $ 332 $ 686 $ 576 ROU assets obtained in exchange for lease obligations — 80 — 80 |
Schedule of Supplemental Balance Sheet Information Related to Operating Leases | Supplemental balance sheet information related to operating leases was as follows: Balance Sheet Classification Balance at June 30, 2022 Balance at December 31, 2021 Assets: Right-of-use assets Other assets – net $ 768 $ 876 Liabilities: Current Accrued expenses $ 283 $ 294 Noncurrent Other long-term liabilities 843 947 Total operating lease liabilities $ 1,126 $ 1,241 |
Schedule of Weighted-Average Remaining Lease Terms and Discount Rates | The weighted-average remaining lease terms and discount rates were as follows: For the Six Months Ended 2022 2021 Weighted-average remaining lease term (years) 6.0 5.8 Weighted-average discount rate 5.1 % 5.0 % |
Schedule of Maturities of Operating Lease Liabilities | As of June 30, 2022, maturities of operating lease liabilities were as follows: Balance at June 30, 2022 (remaining) $ 264 2023 212 2024 172 2025 160 2026 159 2027 and beyond 358 Total future minimum lease payments 1,325 Less imputed interest (199) Total $ 1,126 |
Revenue from Contracts with C_2
Revenue from Contracts with Customers (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Revenue from Contract with Customer [Abstract] | |
Schedule of Total Revenue by Geographical Region | The Company’s entire revenue for the three and six months ended June 30, 2022 and 2021 was recognized at a point in time. The following table represents total revenue by geographical region for the three and six months ended June 30, 2022 and 2021, respectively: For the Three Months Ended For the Six Months Ended 2022 2021 2022 2021 Revenues: Domestic $ 17,215 $ 20,726 $ 34,299 $ 40,574 International 3,408 4,108 6,929 7,551 Total revenues from contracts with customers $ 20,623 $ 24,834 $ 41,228 $ 48,125 |
Business Combinations (Tables)
Business Combinations (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Business Combination and Asset Acquisition [Abstract] | |
Schedule of Fair Value of Identifiable Assets Acquired and Liabilities Assumed | The following table summarizes the fair value of the identifiable assets acquired and liabilities assumed from the acquisition of Prompt as of April 30, 2021 (in thousands): Inventories $ 140 Right-of-use assets 78 Property and equipment 528 Operating lease liabilities (78) Deferred tax liability (28) Net assets acquired $ 640 Bargain purchase gain (90) Total purchase price $ 550 |
Stock-Based Compensation (Table
Stock-Based Compensation (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Share-Based Payment Arrangement [Abstract] | |
Schedule of Stock Option And Stock Grant Awards By Plan | The following tables summarize our stock option and stock grant awards by plan: For the six months ended June 30, 2022: Plan Stock Options Restricted Stock Awards Restricted Stock Units Total 2021 Incentive Inducement Plan — — 116,948 116,948 2021 Incentive Compensation Plan — — 4,277 4,277 Total — — 121,225 121,225 For the six months ended June 30, 2021: Plan Stock Options Restricted Stock Awards Restricted Stock Units Total 2021 Incentive Inducement Plan 14,066 — 7,490 21,556 2021 Incentive Compensation Plan 3,803 — 148,173 151,976 2018 Incentive Compensation Plan 8,005 4,920 — 12,925 Total 25,874 4,920 155,663 186,457 |
Schedule of Stock-Based Compensation Recognized | The Company recognized stock-based compensation as follows: For the Three Months Ended For the Six Months Ended 2022 2021 2022 2021 Stock-based compensation: Costs of goods sold $ — $ — $ — $ 21 General and administrative 852 1,344 2,123 2,233 Research and development 73 69 176 95 Total $ 925 $ 1,413 $ 2,299 $ 2,349 |
Net Loss Per Common Share (Tabl
Net Loss Per Common Share (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Earnings Per Share [Abstract] | |
Schedule of Common Stock used in Calculation of Basic and Diluted Earnings Per Share | A reconciliation of the number of shares of common stock used in the calculation of basic and diluted net income per common share is presented below: For the Three Months Ended For the Six Months Ended 2022 2021 2022 2021 Weighted average basic shares 6,640,405 3,808,475 6,174,273 3,542,497 |
Schedule of Number of Potential Dilutive Shares that Excluded Due to Anti-dilutive Effect | The following table includes the number of potential dilutive shares that were excluded due to the anti-dilutive effect: For the Three Months Ended For the Six Months Ended 2022 2021 2022 2021 Stock Options — 4,389 — 17,903 Restricted Stock Units and Restricted Stock Awards 210,909 38,366 158,645 43,128 Total 210,909 42,755 158,645 61,031 |
Prepaid and Other Current Ass_2
Prepaid and Other Current Assets (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract] | |
Schedule of Prepaid and Other Current Assets | Prepaid and other current assets are as follows: June 30, December 31, Income tax receivable $ 2,320 $ 4,116 Leasehold improvement reimbursement 3,468 — Prepaid expenses 1,655 2,553 Payroll tax receivable 1,423 — OEM safety stock receivable 1,000 1,000 Insurance recovery receivable — 1,500 Other receivables 1,756 815 $ 11,622 $ 9,984 |
Property and Equipment (Tables)
Property and Equipment (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Property, Plant and Equipment [Abstract] | |
Schedule of Property and Equipment | The net book value of property and equipment after accumulated depreciation and all impairment is as follows: June 30, 2022 December 31, 2021 Processing equipment $ 298 $ 346 Surgical instruments 481 489 Office equipment, furniture and fixtures 8 15 Computer equipment and software 154 44 Construction in process 380 51 $ 1,321 $ 945 |
Fair Value Information (Tables)
Fair Value Information (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Fair Value Disclosures [Abstract] | |
Schedule of Fair Value of Warrant Liability Valuation Inputs | Inputs used in estimating the fair value of the contingent consideration for Holo Surgical as of June 30, 2022 and December 31, 2021, are summarized below: Fair Value at June 30, 2022 Valuation Technique Unobservable Inputs Ranges $31,435 Earn-Out Valuation Probability of success factor 0% - 95% Discount rates 2.51% - 16.54% Fair Value at December 31, 2021 Valuation Technique Unobservable Inputs Ranges $51,928 Earn-Out Valuation Probability of success factor 0% - 90% Discount rates 0.06% - 11.60% The warrant liability is revalued each reporting period with the change in fair value recorded in the accompanying condensed consolidated statements of comprehensive loss until the warrants are exercised or expire. The fair value of the warrant liability is estimated using the Black-Scholes Option Pricing Model using the following valuation inputs: June 30, December 31, Stock price $ 3.41 $ 21.60 Risk-free interest rate 2.91 % 0.84 % Dividend yield 0.00 % 0.00 % Volatility 100.00 % 130.00 % The warrant liability is revalued each reporting period with the change in fair value recorded in the accompanying condensed consolidated statements of comprehensive loss until the warrants are exercised or expire. The fair value of the warrant liability is estimated using the Black-Scholes Option Pricing Model using the following valuation inputs: June 30, Stock price $ 3.41 Risk-free interest rate 3.01 % Dividend yield 0.00 % Volatility 80.00 % |
Schedule of Reconciliation of Acquisition Contingencies | The following table provides a reconciliation of contingent consideration measured at fair value using significant unobservable inputs (Level 3) as of June 30, 2022 and December 31, 2021 : June 30, December 31, Beginning balance as of January 1 $ 51,928 $ 56,515 Gain on acquisition contingency (10,493) (4,587) Milestone payments (10,000) — Ending balance as of June 30 $ 31,435 $ 51,928 |
Schedule of Fair Value Assets Subject to Fair Value Measured Using Level 3 Inputs | As a result of impairments recognized, the following table summarizes the post impairment fair values of the corresponding assets subject to fair value measured using Level 3 inputs as of June 30, 2022 and December 31, 2021: Fair value June 30, December 31, Property and equipment – net $ 1,321 $ 945 Definite-lived intangible assets – net — — Other assets – net 5,840 5,970 $ 7,161 $ 6,915 |
Schedule of Impairments of Assets Subject to Fair Value Measured Using Level 3 Inputs | The following table summarizes the corresponding impairment charge during the three and six months ended June 30, 2022 and 2021: For the Three Months Ended For the Six Months Ended Impairment 2022 2021 2022 2021 Property and equipment – net $ 784 $ 2,012 $ 1,573 $ 3,791 Definite-lived intangible assets – net 100 150 201 311 Other assets – net 112 44 161 280 $ 996 $ 2,206 $ 1,935 $ 4,382 |
Schedule of Liabilities Measured at Fair Value on Recurring Basis | The following table presents information about the Company’s liabilities that are measured at fair value: Level June 30, 2022 December 31, 2021 Warrant liability 3 $ 1,554 $ 12,013 |
Schedule of Changes in Fair Value of Level 3 Valuation for the Warrant Lability | The table presented below is a summary of changes in the fair value of the Company’s Level 3 valuation for the June 14, 2021 warrant liability for the six months ended June 30, 2022: Warrant Liability December 31, 2021 $ 12,013 Change in fair value of warrant liability (11,848) June 30, 2022 $ 165 The table presented below is a summary of changes in the fair value of the Company’s Level 3 valuation for the February 15, 2022 warrant liability for the six months ended June 30, 2022, there were no warrants issued as of June 30, 2021: Warrant Liability December 31, 2021 $ — Fair value of warrants on date of issuance 10,157 Execution of prefunded warrants (1,749) Change in fair value of warrant liability (7,019) June 30, 2022 $ 1,389 |
Accrued Expenses (Tables)
Accrued Expenses (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Payables and Accruals [Abstract] | |
Schedule of Accrued Expenses | Accrued expenses are as follows: June 30, December 31, Accrued compensation $ 5,531 $ 5,258 Accrued distributor commissions 3,819 2,957 Accrued securities class action settlement — 1,500 Other 7,864 8,054 Total accrued expenses $ 17,214 $ 17,769 |
Other Long-term Liabilities (Ta
Other Long-term Liabilities (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Other Liabilities, Noncurrent [Abstract] | |
Schedule of Other Long-term Liabilities | Other long-term liabilities are as follows: June 30, 2022 December 31, 2021 Acquisition contingencies $ 22,393 $ 26,343 Warrant Liability 1,554 12,013 Lease obligations 843 947 Other 2,732 2,229 Total other long-term liabilities $ 27,522 $ 41,532 |
Debt (Tables)
Debt (Tables) | 6 Months Ended |
Jun. 30, 2022 | |
Debt Disclosure [Abstract] | |
Schedule of Long-term Debt Instruments | Carrying Value (In thousands) June 30, 2022 December 31, 2021 Seller Notes-P. Lewicki $ 5,306 $ 5,306 Seller Notes-K. Siemionow 5,306 5,306 Less: accretion of acquisition adjustment (525) (630) Total Seller Notes – related party 10,087 9,982 Current portion of seller notes — — Total long-term seller notes, excluding current portion $ 10,087 $ 9,982 |
Schedule of Maturities of Long-term Debt | As of June 30, 2022, the future maturities of long-term debt, excluding deferred financing costs, accrued interest and debt discount, were as follows: Future Maturities of Long-Term Debt 2022 $ — 2023 — 2024 10,612 2025 — 2026 — Thereafter — Total $ 10,612 |
Business (Details)
Business (Details) $ / shares in Units, $ in Thousands | 3 Months Ended | 6 Months Ended | |||||||||||||
May 16, 2022 | Feb. 15, 2022 USD ($) $ / shares shares | Dec. 30, 2021 USD ($) | Dec. 30, 2021 USD ($) shares | Dec. 30, 2021 USD ($) tranche | Dec. 30, 2021 USD ($) payment | Jun. 14, 2021 USD ($) $ / shares shares | Apr. 30, 2021 USD ($) payment | Feb. 01, 2021 USD ($) $ / shares shares | Jun. 30, 2022 USD ($) country | Dec. 31, 2021 USD ($) | Jun. 30, 2021 USD ($) | Jun. 30, 2022 USD ($) country segment | Jun. 30, 2021 USD ($) | Jul. 20, 2020 USD ($) | |
Business [Line Items] | |||||||||||||||
Countries in which we market and sell (more than) | country | 50 | 50 | |||||||||||||
Number of reportable segments | segment | 1 | ||||||||||||||
Stock split conversion ratio | 0.03333 | ||||||||||||||
Cash consideration | $ 0 | $ 330 | |||||||||||||
Cash and cash equivalents | $ 29,344 | $ 51,287 | 29,344 | ||||||||||||
Accumulated deficit | (575,274) | (569,613) | (575,274) | ||||||||||||
Net loss from continuing operations | (5,700) | (5,700) | |||||||||||||
Net loss | $ (5,688) | $ (16,192) | $ (5,661) | $ (31,382) | |||||||||||
Strike price of warrants (in dollars per share) | $ / shares | $ 51.7500 | ||||||||||||||
Period of warrants exercisable expiration period (in years) | 3 years | ||||||||||||||
Sold | |||||||||||||||
Business [Line Items] | |||||||||||||||
Purchase price | $ 440,000 | ||||||||||||||
Warrants | |||||||||||||||
Business [Line Items] | |||||||||||||||
Period of warrants exercisable expiration period (in years) | 5 years | ||||||||||||||
Placement Agent Warrants | |||||||||||||||
Business [Line Items] | |||||||||||||||
Strike price of warrants (in dollars per share) | $ / shares | $ 64.6875 | ||||||||||||||
Period of warrants exercisable expiration period (in years) | 5 years | ||||||||||||||
Public Offering Warrants | |||||||||||||||
Business [Line Items] | |||||||||||||||
Warrants issued (in shares) | shares | 163,043 | ||||||||||||||
Strike price of warrants (in dollars per share) | $ / shares | $ 0.0030 | ||||||||||||||
Public Offering | |||||||||||||||
Business [Line Items] | |||||||||||||||
Common stock sold (in shares) | shares | 1,285,507 | 956,666 | |||||||||||||
Net proceeds from issuance of common stock | $ 20,000 | ||||||||||||||
Sale of stock price (in dollars per share) | $ / shares | $ 13.8000 | ||||||||||||||
Underwriters option | 30 days | ||||||||||||||
Net proceeds from the direct offering, after deducting investor and management fees | $ 17,700 | $ 45,800 | $ 40,500 | ||||||||||||
Common stock sold (in shares) | shares | 966,183 | ||||||||||||||
Investors fees | $ 4,200 | $ 4,000 | |||||||||||||
Common stock price per share (in dollars per share) | $ / shares | $ 45 | ||||||||||||||
Public Offering | Pre-Funded Warrants | |||||||||||||||
Business [Line Items] | |||||||||||||||
Warrants issued (in shares) | shares | 163,768 | ||||||||||||||
Sale of warrants price (in dollars per share) | $ / shares | $ 13.7970 | ||||||||||||||
Public Offering | Warrants | |||||||||||||||
Business [Line Items] | |||||||||||||||
Warrants issued (in shares) | shares | 966,183 | ||||||||||||||
Strike price of warrants (in dollars per share) | $ / shares | $ 18 | ||||||||||||||
Public Offering | Warrants | Maximum | |||||||||||||||
Business [Line Items] | |||||||||||||||
Warrants issued (in shares) | shares | 1,086,956 | ||||||||||||||
Public Offering | Placement Agent Warrants | |||||||||||||||
Business [Line Items] | |||||||||||||||
Warrants issued (in shares) | shares | 57,971 | ||||||||||||||
Strike price of warrants (in dollars per share) | $ / shares | $ 17.2500 | $ 64.6875 | |||||||||||||
Public Offering | Placement Agent Warrants | Maximum | |||||||||||||||
Business [Line Items] | |||||||||||||||
Warrants issued (in shares) | shares | 86,956 | ||||||||||||||
Public Offering | Invest Warrants | |||||||||||||||
Business [Line Items] | |||||||||||||||
Warrants issued (in shares) | shares | 966,183 | ||||||||||||||
Strike price of warrants (in dollars per share) | $ / shares | $ 51.7500 | ||||||||||||||
Over-Allotment Option | |||||||||||||||
Business [Line Items] | |||||||||||||||
Common stock sold (in shares) | shares | 217,391 | ||||||||||||||
Sale of stock price (in dollars per share) | $ / shares | $ 13.7970 | ||||||||||||||
INN Acquisition | |||||||||||||||
Business [Line Items] | |||||||||||||||
Payments to acquire businesses | $ 20,000 | ||||||||||||||
Cash consideration | 5,000 | ||||||||||||||
Shares issued | 4,900 | ||||||||||||||
Net loss | $ 30,200 | ||||||||||||||
INN Acquisition | Achievement of all milestones | |||||||||||||||
Business [Line Items] | |||||||||||||||
Payments to acquire businesses | 72,300 | ||||||||||||||
Aggregate principal amount | 10,600 | ||||||||||||||
Fair value | $ 10,100 | $ 10,100 | $ 10,100 | $ 10,100 | |||||||||||
Equity interest acquired (up to) | 100% | 100% | 100% | 100% | |||||||||||
Number of payments | 3 | 3 | |||||||||||||
INN Acquisition | Tranche One | |||||||||||||||
Business [Line Items] | |||||||||||||||
Percentage of additional voting interests acquired (as a percent) | 19.30% | 19.30% | 19.30% | 19.30% | |||||||||||
Equity interests issued and issuable | $ 19,300 | ||||||||||||||
INN Acquisition | Tranche Two | |||||||||||||||
Business [Line Items] | |||||||||||||||
Percentage of additional voting interests acquired (as a percent) | 19.30% | 19.30% | 19.30% | 19.30% | |||||||||||
Equity interests issued and issuable | $ 19,300 | ||||||||||||||
INN Acquisition | Tranche Three | |||||||||||||||
Business [Line Items] | |||||||||||||||
Percentage of additional voting interests acquired (as a percent) | 19.30% | 19.30% | 19.30% | 19.30% | |||||||||||
Equity interests issued and issuable | $ 19,300 | ||||||||||||||
INN Acquisition | Common Stock | |||||||||||||||
Business [Line Items] | |||||||||||||||
Shares issuable at closing (in shares) | shares | 227,359 | ||||||||||||||
Prompt | Agreement | |||||||||||||||
Business [Line Items] | |||||||||||||||
Payments to acquire businesses | $ 1,100 | ||||||||||||||
Cash consideration | 300 | ||||||||||||||
Shares issued | 200 | ||||||||||||||
Contingent consideration | $ 600 | ||||||||||||||
Number of payments | payment | 2 | ||||||||||||||
First payment | 18 months | ||||||||||||||
Second payment | 36 months | ||||||||||||||
INN Acquisition | INN Acquisition | |||||||||||||||
Business [Line Items] | |||||||||||||||
Percentage of voting interests acquired (as a percent) | 42% | 42% | 42% | 42% |
Basis of Presentation (Details)
Basis of Presentation (Details) | Dec. 30, 2021 |
INN Acquisition | INN Acquisition | |
Business Combinations [Line Items] | |
Percentage of voting interests acquired (as a percent) | 42% |
Discontinued Operations - Sched
Discontinued Operations - Schedule of Financial Results of Discontinued Operations (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Other expense – net: | ||||
Gain on sale of net assets of discontinued operations | $ 0 | $ (6,316) | ||
(Loss) from operations of discontinued operations | $ 0 | $ (6,316) | 0 | (6,316) |
Income tax provision (benefit) | 0 | (763) | 0 | (763) |
Net income (loss) from discontinued operations | 0 | (5,553) | 0 | (5,553) |
OEM Business | Sold | ||||
Major classes of line items constituting net income (loss) from discontinued operations | ||||
Revenues | 0 | 0 | 0 | 0 |
Costs of processing and distribution | 0 | 0 | 0 | 0 |
Gross profit | 0 | 0 | 0 | 0 |
Expenses: | ||||
General and administrative | 0 | 0 | 0 | 0 |
Severance and restructuring costs | 0 | 0 | 0 | 0 |
Transaction and integration expenses | 0 | 0 | 0 | 0 |
Total expenses | 0 | 0 | 0 | 0 |
Operating (loss) income | 0 | 0 | 0 | 0 |
Other expense – net: | ||||
OEM working capital adjustment | 0 | 6,316 | 0 | 6,316 |
Interest expense | 0 | 0 | 0 | 0 |
Derivative loss | 0 | 0 | 0 | 0 |
Loss on extinguishment of debt | 0 | 0 | 0 | 0 |
Foreign exchange loss (gain) | 0 | 0 | 0 | 0 |
Total other expense – net | 0 | 6,316 | 0 | 6,316 |
Loss from discontinued operations | 0 | (6,316) | 0 | (6,316) |
Gain on sale of net assets of discontinued operations | 0 | 0 | 0 | 0 |
(Loss) from operations of discontinued operations | 0 | (6,316) | 0 | (6,316) |
Income tax provision (benefit) | 0 | (763) | 0 | (763) |
Net income (loss) from discontinued operations | $ 0 | $ (5,553) | $ 0 | $ (5,553) |
Discontinued Operations - Addit
Discontinued Operations - Additional Information (Details) - OEM Business - Sold - USD ($) $ in Millions | 3 Months Ended | ||
Jun. 30, 2021 | Jun. 03, 2021 | Dec. 01, 2020 | |
Income Statement Balance Sheet And Additional Disclosures By Disposal Groups Including Discontinued Operations [Line Items] | |||
Maximum working capital adjustment amount | $ 14 | ||
Liable dispute amount paid | $ 5.8 | ||
Liable amount, remaining in dispute | $ 5.8 |
Discontinued Operations - Sch_2
Discontinued Operations - Schedule of Operating and Investing Cash Flows of Discontinued Operations (Details) - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2022 | Jun. 30, 2021 | |
Significant operating non-cash reconciliation items: | ||
Stock-based compensation | $ 2,299 | $ 2,349 |
Significant investing items: | ||
Payments for OEM working capital adjustment | 0 | (5,430) |
Purchases of property and equipment | (189) | (629) |
Sold | OEM Business | ||
Significant operating non-cash reconciliation items: | ||
Depreciation and amortization | 0 | 0 |
Provision for bad debt and products returns | 0 | 0 |
Revenue recognized due to change in deferred revenue | 0 | 0 |
Deferred income tax provision | 0 | 0 |
Stock-based compensation | 0 | 0 |
Gain on sale of discontinued assets, net | 0 | 0 |
Loss on extinguishment of debt | 0 | 0 |
Amortizations of debt issuance costs | 0 | 0 |
Amortizations of debt discount | 0 | 0 |
Significant investing items: | ||
Payments for OEM working capital adjustment | 0 | (5,430) |
Purchases of property and equipment | 0 | 0 |
Patent and acquired intangible asset costs | 0 | 0 |
Proceeds from sale of OEM Business | $ 0 | $ 0 |
Leases - Additional Information
Leases - Additional Information (Details) | Jun. 30, 2022 |
Minimum | |
Lessee, Lease, Description [Line Items] | |
Remaining lease term (in years) | 1 year |
Maximum | |
Lessee, Lease, Description [Line Items] | |
Remaining lease term (in years) | 8 years |
Leases - Schedule of Operating
Leases - Schedule of Operating Leases (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Leases [Abstract] | ||||
Operating lease cost | $ 119 | $ 195 | $ 244 | $ 378 |
Short-term operating lease cost | 221 | 112 | 442 | 149 |
Total operating lease cost | $ 340 | $ 307 | $ 686 | $ 527 |
Leases - Schedule of Supplement
Leases - Schedule of Supplemental Cash Flow Information Related to Leases (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Leases [Abstract] | ||||
Cash paid for amounts included in the measurement of lease liabilities | $ 339 | $ 332 | $ 686 | $ 576 |
ROU assets obtained in exchange for lease obligations | $ 0 | $ 80 | $ 0 | $ 80 |
Leases - Schedule of Suppleme_2
Leases - Schedule of Supplemental Balance Sheet Information Related to Leases (Details) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Leases [Abstract] | ||
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration] | Other assets - net | Other assets - net |
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration] | Accrued expenses | Accrued expenses |
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration] | Other long-term liabilities | Other long-term liabilities |
Assets: | ||
Right-of-use assets | $ 768 | $ 876 |
Liabilities: | ||
Current | 283 | 294 |
Noncurrent | 843 | 947 |
Total operating lease liabilities | $ 1,126 | $ 1,241 |
Leases - Schedule of Weighted-A
Leases - Schedule of Weighted-Average Remaining Lease Terms and Discount Rates (Details) | Jun. 30, 2022 | Jun. 30, 2021 |
Leases [Abstract] | ||
Weighted-average remaining lease term (years) | 6 years | 5 years 9 months 18 days |
Weighted-average discount rate | 5.10% | 5% |
Leases - Schedule of Maturities
Leases - Schedule of Maturities of Operating Lease Liabilities (Details) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Leases [Abstract] | ||
2022 (remaining) | $ 264 | |
2023 | 212 | |
2024 | 172 | |
2025 | 160 | |
2026 | 159 | |
2027 and beyond | 358 | |
Total future minimum lease payments | 1,325 | |
Less imputed interest | (199) | |
Total operating lease liabilities | $ 1,126 | $ 1,241 |
Revenue from Contracts with C_3
Revenue from Contracts with Customers - Schedule of Total Revenue by Geographical Region (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Disaggregation Of Revenue [Line Items] | ||||
Total revenues from contracts with customers | $ 20,623 | $ 24,834 | $ 41,228 | $ 48,125 |
Point In Time | ||||
Disaggregation Of Revenue [Line Items] | ||||
Total revenues from contracts with customers | 20,623 | 24,834 | 41,228 | 48,125 |
Point In Time | Domestic | ||||
Disaggregation Of Revenue [Line Items] | ||||
Total revenues from contracts with customers | 17,215 | 20,726 | 34,299 | 40,574 |
Point In Time | International | ||||
Disaggregation Of Revenue [Line Items] | ||||
Total revenues from contracts with customers | $ 3,408 | $ 4,108 | $ 6,929 | $ 7,551 |
Business Combinations - Inteneu
Business Combinations - Inteneural Networks Inc. (Details) $ / shares in Units, $ in Thousands | 3 Months Ended | 6 Months Ended | 12 Months Ended | |||||||
Dec. 30, 2021 USD ($) $ / shares | Dec. 30, 2021 USD ($) $ / shares shares | Dec. 30, 2021 USD ($) tranche $ / shares | Dec. 30, 2021 USD ($) payment $ / shares | Jun. 30, 2022 USD ($) $ / shares | Dec. 31, 2021 USD ($) $ / shares | Jun. 30, 2021 USD ($) | Jun. 30, 2022 USD ($) $ / shares | Jun. 30, 2021 USD ($) | Dec. 31, 2021 USD ($) $ / shares | |
Business Combinations [Line Items] | ||||||||||
Cash consideration | $ 0 | $ 330 | ||||||||
Common stock, par value (in dollars per share) | $ / shares | $ 0.001 | $ 0.001 | $ 0.001 | $ 0.001 | ||||||
Net loss | $ (5,688) | $ (16,192) | $ (5,661) | (31,382) | ||||||
Net loss applicable to noncontrolling interests | $ 0 | $ 0 | $ 0 | $ 0 | ||||||
INN Acquisition | ||||||||||
Business Combinations [Line Items] | ||||||||||
Payments to acquire businesses | $ 20,000 | |||||||||
Cash consideration | 5,000 | |||||||||
Shares issued | 4,900 | |||||||||
Direct and incremental costs | 400 | $ 400 | $ 400 | $ 400 | ||||||
Acquisition of additional voting interests | 41,700 | |||||||||
Acquisition related costs | $ 72,100 | |||||||||
Fair value of noncontrolling interests | 52,000 | 52,000 | 52,000 | 52,000 | ||||||
Net loss | 30,200 | |||||||||
Net loss applicable to noncontrolling interests | $ 41,900 | |||||||||
INN Acquisition | Assembled Workforce | ||||||||||
Business Combinations [Line Items] | ||||||||||
Acquisition related costs | $ 200 | |||||||||
INN Acquisition | Achievement of all milestones | ||||||||||
Business Combinations [Line Items] | ||||||||||
Payments to acquire businesses | 72,300 | |||||||||
Fair value | $ 10,100 | $ 10,100 | $ 10,100 | $ 10,100 | ||||||
Equity interest acquired (up to) | 100% | 100% | 100% | 100% | ||||||
Number of payments | 3 | 3 | ||||||||
Revenue based earnout consideration | $ 10,300 | $ 10,300 | $ 10,300 | $ 10,300 | ||||||
INN Acquisition | Tranche One | ||||||||||
Business Combinations [Line Items] | ||||||||||
Percentage of additional voting interests acquired (as a percent) | 19.30% | 19.30% | 19.30% | 19.30% | ||||||
Equity interests issued and issuable | $ 19,300 | |||||||||
INN Acquisition | Tranche Two | ||||||||||
Business Combinations [Line Items] | ||||||||||
Percentage of additional voting interests acquired (as a percent) | 19.30% | 19.30% | 19.30% | 19.30% | ||||||
Equity interests issued and issuable | $ 19,300 | |||||||||
INN Acquisition | Tranche Three | ||||||||||
Business Combinations [Line Items] | ||||||||||
Percentage of additional voting interests acquired (as a percent) | 19.30% | 19.30% | 19.30% | 19.30% | ||||||
Equity interests issued and issuable | $ 19,300 | |||||||||
INN Acquisition | Common Stock | ||||||||||
Business Combinations [Line Items] | ||||||||||
Shares issuable at closing (in shares) | shares | 227,359 | |||||||||
Common stock, par value (in dollars per share) | $ / shares | $ 0.001 | $ 0.001 | $ 0.001 | $ 0.001 | ||||||
INN Acquisition | INN Acquisition | ||||||||||
Business Combinations [Line Items] | ||||||||||
Percentage of voting interests acquired (as a percent) | 42% | 42% | 42% | 42% | ||||||
Ownership percentage by noncontrolling owners (as a percent) | 58% | 58% | 58% | 58% |
Business Combinations - Prompt
Business Combinations - Prompt Prototypes Acquisition (Details) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Apr. 30, 2021 USD ($) payment | Jun. 30, 2021 USD ($) | Jun. 30, 2022 USD ($) | Jun. 30, 2021 USD ($) | |
Business Combinations [Line Items] | ||||
Cash consideration | $ 0 | $ 330 | ||
Prompt | ||||
Business Combinations [Line Items] | ||||
Second payment | 36 months | |||
Prompt | Agreement | ||||
Business Combinations [Line Items] | ||||
Payments to acquire businesses | $ 1,100 | |||
Cash consideration | 300 | |||
Shares issued | 200 | |||
Contingent consideration | $ 600 | |||
Number of payments | payment | 2 | |||
First payment | 18 months | |||
Bargain purchase gain | $ 100 | $ 100 |
Business Combinations - Schedul
Business Combinations - Schedule of Fair Value of Identifiable Assets Acquired and Liabilities Assumed (Details) - Prompt - Agreement $ in Thousands | Apr. 30, 2021 USD ($) |
Business Combinations [Line Items] | |
Inventories | $ 140 |
Right-of-use assets | 78 |
Property and equipment | 528 |
Operating lease liabilities | (78) |
Deferred tax liability | (28) |
Net assets acquired | 640 |
Bargain purchase gain | (90) |
Total purchase price | $ 550 |
Stock-Based Compensation - Sche
Stock-Based Compensation - Schedule of Stock Option And Stock Grant Awards By Plan (Details) - shares | 6 Months Ended | |
Jun. 30, 2022 | Jun. 30, 2021 | |
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Total, granted (in shares) | 121,225 | 186,457 |
Stock Options | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Stock Options, granted (in shares) | 0 | 25,874 |
Restricted Stock Awards | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Restricted Stock Awards and Units, granted (in shares) | 0 | 4,920 |
Restricted Stock Units | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Restricted Stock Awards and Units, granted (in shares) | 121,225 | 155,663 |
2021 Incentive Inducement Plan | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Total, granted (in shares) | 116,948 | 21,556 |
2021 Incentive Inducement Plan | Stock Options | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Stock Options, granted (in shares) | 0 | 14,066 |
2021 Incentive Inducement Plan | Restricted Stock Awards | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Restricted Stock Awards and Units, granted (in shares) | 0 | 0 |
2021 Incentive Inducement Plan | Restricted Stock Units | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Restricted Stock Awards and Units, granted (in shares) | 116,948 | 7,490 |
2021 Incentive Compensation Plan | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Total, granted (in shares) | 4,277 | 151,976 |
2021 Incentive Compensation Plan | Stock Options | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Stock Options, granted (in shares) | 0 | 3,803 |
2021 Incentive Compensation Plan | Restricted Stock Awards | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Restricted Stock Awards and Units, granted (in shares) | 0 | 0 |
2021 Incentive Compensation Plan | Restricted Stock Units | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Restricted Stock Awards and Units, granted (in shares) | 4,277 | 148,173 |
2018 Incentive Compensation Plan | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Total, granted (in shares) | 12,925 | |
2018 Incentive Compensation Plan | Stock Options | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Stock Options, granted (in shares) | 8,005 | |
2018 Incentive Compensation Plan | Restricted Stock Awards | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Restricted Stock Awards and Units, granted (in shares) | 4,920 | |
2018 Incentive Compensation Plan | Restricted Stock Units | ||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||
Restricted Stock Awards and Units, granted (in shares) | 0 |
Stock-Based Compensation - Stoc
Stock-Based Compensation - Stock-Based Compensation Recognized (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items] | ||||
Stock-based compensation | $ 925 | $ 1,413 | $ 2,299 | $ 2,349 |
Costs of goods sold | ||||
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items] | ||||
Stock-based compensation | 0 | 0 | 0 | 21 |
General and administrative | ||||
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items] | ||||
Stock-based compensation | 852 | 1,344 | 2,123 | 2,233 |
Research and development | ||||
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items] | ||||
Stock-based compensation | $ 73 | $ 69 | $ 176 | $ 95 |
Stock-Based Compensation - Addi
Stock-Based Compensation - Additional Information (Details) - USD ($) | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||||
Stock-based compensation expense | $ 925,000 | $ 1,413,000 | $ 2,299,000 | $ 2,349,000 |
Discontinued Operations | OEM Business | ||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||||
Stock-based compensation expense | $ 0 | $ 0 | $ 0 | $ 0 |
Net Loss Per Common Share - Rec
Net Loss Per Common Share - Reconciliation of Common Stock Used in Calculation of Basic and Diluted Earnings Per Share (Details) - shares | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Earnings Per Share [Abstract] | ||||
Weighted average basic shares (in shares) | 6,640,405 | 3,808,475 | 6,174,273 | 3,542,497 |
Weighted average diluted shares (in shares) | 6,640,405 | 3,808,475 | 6,174,273 | 3,542,497 |
Net Loss Per Common Share - Sch
Net Loss Per Common Share - Schedule of Number of Potential Dilutive Shares that Excluded Due to Anti-dilutive Effect (Details) - shares | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||||
Number of potential dilutive shares excluded due to anti-dilutive effect (in shares) | 210,909 | 42,755 | 158,645 | 61,031 |
Stock Options | ||||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||||
Number of potential dilutive shares excluded due to anti-dilutive effect (in shares) | 0 | 4,389 | 0 | 17,903 |
Restricted Stock Units and Restricted Stock Awards | ||||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||||
Number of potential dilutive shares excluded due to anti-dilutive effect (in shares) | 210,909 | 38,366 | 158,645 | 43,128 |
Net Loss Per Common Share - Add
Net Loss Per Common Share - Additional Information (Details) - shares | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||||
Anti-dilutive stock excluded from the computation of diluted EPS (in shares) | 210,909 | 42,755 | 158,645 | 61,031 |
Stock Options | ||||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||||
Anti-dilutive stock excluded from the computation of diluted EPS (in shares) | 90,109 | 174,158 | 103,982 | 155,466 |
Inventories - Additional Inform
Inventories - Additional Information (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Inventory Disclosure [Abstract] | ||||
Inventory write-downs | $ 800 | $ 1,600 | $ 3,804 | $ 4,367 |
Prepaid and Other Current Ass_3
Prepaid and Other Current Assets - Schedule of Prepaid and Other Current Assets (Details) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract] | ||
Income tax receivable | $ 2,320 | $ 4,116 |
Leasehold improvement reimbursement | 3,468 | 0 |
Prepaid expenses | 1,655 | 2,553 |
Payroll tax receivable | 1,423 | 0 |
OEM safety stock receivable | 1,000 | 1,000 |
Insurance recovery receivable | 0 | 1,500 |
Other receivables | 1,756 | 815 |
Prepaid and other current assets | $ 11,622 | $ 9,984 |
Property and Equipment - Schedu
Property and Equipment - Schedule of Net Book Value of Property and Equipment after Accumulated Depreciation and Impairment (Details) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Property, Plant and Equipment [Line Items] | ||
Property and equipment - net | $ 1,321 | $ 945 |
Processing equipment | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment - net | 298 | 346 |
Surgical instruments | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment - net | 481 | 489 |
Office equipment, furniture and fixtures | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment - net | 8 | 15 |
Computer equipment and software | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment - net | 154 | 44 |
Construction in process | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment - net | $ 380 | $ 51 |
Property and Equipment - Additi
Property and Equipment - Additional Information (Details) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Property, Plant and Equipment [Line Items] | ||||
Depreciation expense | $ 0.6 | $ 0.6 | $ 1.1 | $ 1.1 |
Asset impairment and abandonment charges | 1 | 2.2 | 1.9 | 4.4 |
ERP | ||||
Property, Plant and Equipment [Line Items] | ||||
Asset impairment and abandonment charges | 0 | 0.8 | 0 | 1.1 |
Capitalized cost | 0 | 0.8 | 0 | 1.1 |
ERP implementation expense | 0.1 | 0 | 0.7 | 0.1 |
HOLO Portal Surgical Guidance System. | ||||
Property, Plant and Equipment [Line Items] | ||||
Capitalized cost | $ 0.4 | $ 0 | 0.4 | 0 |
Capitalized compensation expense | $ 0.1 | $ 0 |
Warrants - Additional Informati
Warrants - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions | 6 Months Ended | |||
Feb. 15, 2022 | Jun. 14, 2021 | Feb. 01, 2021 | Jun. 30, 2022 | |
Class Of Warrant Or Right [Line Items] | ||||
Strike price of warrants (in dollars per share) | $ 51.7500 | |||
Period of warrants exercisable expiration period (in years) | 3 years | |||
Percentage of placement agent sash fee equal to gross proceeds from warrants (as a percent) | 7% | |||
Management fee equal to aggregate of gross proceeds of warrants (as a percent) | 1% | |||
Additional Paid-In Capital | ||||
Class Of Warrant Or Right [Line Items] | ||||
Stock issuance costs | $ 1.4 | |||
Common Stock | ||||
Class Of Warrant Or Right [Line Items] | ||||
Stock issuance costs | 1.4 | |||
Warrants | ||||
Class Of Warrant Or Right [Line Items] | ||||
Period of warrants exercisable expiration period (in years) | 5 years | |||
Warrants | Transaction and integration expenses | ||||
Class Of Warrant Or Right [Line Items] | ||||
Warrant issuance costs | 0.9 | |||
Placement Agent Warrants | ||||
Class Of Warrant Or Right [Line Items] | ||||
Strike price of warrants (in dollars per share) | $ 64.6875 | |||
Period of warrants exercisable expiration period (in years) | 5 years | |||
Placement Agent Warrants | Maximum | ||||
Class Of Warrant Or Right [Line Items] | ||||
Number of common stock shares issuable upon conversion of warrants (in shares) | 57,971 | |||
Public Offering Warrants | ||||
Class Of Warrant Or Right [Line Items] | ||||
Warrants issued (in shares) | 163,043 | |||
Strike price of warrants (in dollars per share) | $ 0.0030 | |||
Public Offering | ||||
Class Of Warrant Or Right [Line Items] | ||||
Common stock sold (in shares) | 1,285,507 | 956,666 | ||
Net proceeds from issuance of common stock | $ 20 | |||
Sale of stock price (in dollars per share) | $ 13.8000 | |||
Net proceeds from the direct offering, after deducting investor and management fees | $ 17.7 | $ 45.8 | $ 40.5 | |
Issuance costs | $ 2.3 | |||
Stock issuance costs | $ 4.2 | $ 4 | ||
Common stock sold (in shares) | 966,183 | |||
Common stock price per share (in dollars per share) | $ 45 | |||
Public Offering | Pre-Funded Warrants | ||||
Class Of Warrant Or Right [Line Items] | ||||
Warrants issued (in shares) | 163,768 | |||
Public Offering | Warrants | ||||
Class Of Warrant Or Right [Line Items] | ||||
Warrants issued (in shares) | 966,183 | |||
Strike price of warrants (in dollars per share) | $ 18 | |||
Public Offering | Warrants | Maximum | ||||
Class Of Warrant Or Right [Line Items] | ||||
Warrants issued (in shares) | 1,086,956 | |||
Public Offering | Placement Agent Warrants | ||||
Class Of Warrant Or Right [Line Items] | ||||
Warrants issued (in shares) | 57,971 | |||
Strike price of warrants (in dollars per share) | $ 17.2500 | $ 64.6875 | ||
Public Offering | Placement Agent Warrants | Maximum | ||||
Class Of Warrant Or Right [Line Items] | ||||
Warrants issued (in shares) | 86,956 | |||
Over-Allotment Option | ||||
Class Of Warrant Or Right [Line Items] | ||||
Common stock sold (in shares) | 217,391 | |||
Sale of stock price (in dollars per share) | $ 13.7970 | |||
At-the-Market Offering | ||||
Class Of Warrant Or Right [Line Items] | ||||
Net proceeds from the direct offering, after deducting investor and management fees | $ 45.8 | |||
Common stock sold (in shares) | 966,183 | |||
Common stock price per share (in dollars per share) | $ 51.7500 |
Fair Value Information - Additi
Fair Value Information - Additional Information (Details) - USD ($) | 6 Months Ended | 12 Months Ended | ||||||
Jan. 14, 2022 | Oct. 23, 2020 | Sep. 29, 2020 | Mar. 08, 2019 | Jun. 30, 2022 | Jun. 30, 2021 | Dec. 31, 2019 | Dec. 31, 2021 | |
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||||||||
Cash consideration | $ 0 | $ 330,000 | ||||||
Common stock, par value (in dollars per share) | $ 0.001 | $ 0.001 | ||||||
Property and equipment - net | $ 1,321,000 | $ 945,000 | ||||||
Property And Equipment Written Down To Estimated Fair Value | ||||||||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||||||||
Property and equipment - net | 2,900,000 | 12,000,000 | ||||||
Level 3 | ||||||||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||||||||
Property and equipment – net, Fair Value | 1,321,000 | 945,000 | ||||||
Level 3 | Property And Equipment Written Down To Estimated Fair Value | ||||||||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||||||||
Property and equipment – net, Fair Value | 1,300,000 | 900,000 | ||||||
Holo Surgical Inc | Holo Purchase Agreement | ||||||||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||||||||
Cash consideration | $ 4,100,000 | $ 30,000,000 | $ 30,000,000 | |||||
Shares issuable at closing (in shares) | 208,333 | |||||||
Common stock, par value (in dollars per share) | $ 0.001 | |||||||
Revenue based earnout consideration | $ 83,000,000 | |||||||
Contingent consideration payable closing milestones, term (in years) | 6 years | 6 years | ||||||
Equity interest issued or issuable, number of shares (in shares) | 5,900,000 | |||||||
Trading days (in days) | 5 days | |||||||
Number of contingent consideration shares issued (in shares) | 288,333 | |||||||
Contingent liability | $ 10,000,000 | 31,400,000 | 51,900,000 | |||||
Holo Surgical Inc | Common Stock | Holo Purchase Agreement | ||||||||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||||||||
Shares issuable at closing (in shares) | 208,333 | |||||||
Equity interest issued or issuable, number of shares (in shares) | 496,666 | |||||||
Paradigm Spine Acquisition | ||||||||
Fair Value Balance Sheet Grouping Financial Statement Captions [Line Items] | ||||||||
Cash consideration | $ 100,000,000 | |||||||
Shares issuable at closing (in shares) | 357,653 | |||||||
Revenue based earnout consideration | $ 150,000,000 | |||||||
Trading days (in days) | 5 days | |||||||
Contingent liability | $ 72,200,000 | $ 0 | $ 0 | $ 0 | ||||
Gain on acquisition contingency | $ 72,200,000 |
Fair Value Information - Schedu
Fair Value Information - Schedule of Fair Value Measurement Inputs Valuation Technique (Details) - Holo Surgical Inc - Level 3 $ in Thousands | Jun. 30, 2022 USD ($) | Dec. 31, 2021 USD ($) | Jun. 30, 2021 USD ($) | Dec. 31, 2020 USD ($) |
Achievement of all milestones | ||||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||||
Contingent liability | $ 31,435 | $ 51,928 | $ 51,928 | $ 56,515 |
Earn-Out Valuation | Minimum | Probability of success factor | ||||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||||
Unobservable Inputs | 0 | 0 | ||
Earn-Out Valuation | Minimum | Discount rates | ||||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||||
Unobservable Inputs | 0.0251 | 0.0006 | ||
Earn-Out Valuation | Maximum | Probability of success factor | ||||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||||
Unobservable Inputs | 0.95 | 0.90 | ||
Earn-Out Valuation | Maximum | Discount rates | ||||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||||
Unobservable Inputs | 0.1654 | 0.1160 | ||
Earn-Out Valuation | Achievement of all milestones | ||||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||||
Contingent liability | $ 31,435 | $ 51,928 |
Fair Value Information - Sche_2
Fair Value Information - Schedule of Reconciliation of Acquisition Contingencies (Details) - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2022 | Jun. 30, 2021 | |
Fair Value Disclosures [Abstract] | ||
Gain on acquisition contingency | $ (10,493) | $ (2,287) |
Holo Surgical Inc | Achievement of all milestones | Level 3 | ||
Fair Value Disclosures [Abstract] | ||
Beginning balance as of January 1 | 51,928 | 56,515 |
Gain on acquisition contingency | (10,493) | (4,587) |
Milestone payments | (10,000) | 0 |
Ending balance as of June 30 | $ 31,435 | $ 51,928 |
Fair Value Information - Sche_3
Fair Value Information - Schedule of Fair Value Assets Subject to Fair Value Measured Using Level 3 Inputs (Details) - Level 3 - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Impaired Long Lived Assets Held And Used [Line Items] | ||
Property and equipment – net | $ 1,321 | $ 945 |
Definite-lived intangible assets – net | 0 | 0 |
Other assets – net | 5,840 | 5,970 |
Long lived assets | $ 7,161 | $ 6,915 |
Fair Value Information - Sche_4
Fair Value Information - Schedule of Impairments of Assets Subject to Fair Value Measured Using Level 3 Inputs (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Impaired Long Lived Assets Held And Used [Line Items] | ||||
Asset impairment and abandonment charges | $ 1,000 | $ 2,200 | $ 1,900 | $ 4,400 |
Level 3 | ||||
Impaired Long Lived Assets Held And Used [Line Items] | ||||
Property and equipment – net | 784 | 2,012 | 1,573 | 3,791 |
Definite-lived intangible assets – net | 100 | 150 | 201 | 311 |
Other assets – net | 112 | 44 | 161 | 280 |
Asset impairment and abandonment charges | $ 996 | $ 2,206 | $ 1,935 | $ 4,382 |
Fair Value Information - Sche_5
Fair Value Information - Schedule of Liabilities Measured at Fair Value on Recurring Basis (Details) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Level 3 | Warrant liability | ||
Fair Value Liabilities Measured On Recurring Basis [Line Items] | ||
Warrant liability | $ 1,554 | $ 12,013 |
Fair Value Information - Sche_6
Fair Value Information - Schedule of Changes in Fair Value of Level 3 Valuation for the Warrant Liability (Details) - Level 3 $ in Thousands | 6 Months Ended |
Jun. 30, 2022 USD ($) | |
June 14, 2021 Warrants | |
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward] | |
Beginning balance | $ 12,013 |
Change in fair value of warrant liability | (11,848) |
Ending balance | 165 |
February 15, 2022 Warrants | |
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward] | |
Beginning balance | 0 |
Fair value of warrants on date of issuance | 10,157 |
Execution of prefunded warrants | (1,749) |
Change in fair value of warrant liability | (7,019) |
Ending balance | $ 1,389 |
Fair Value Information - Fair V
Fair Value Information - Fair Value of Warrant Liability Valuation Inputs (Details) - Black-Scholes Option Pricing Model | Jun. 30, 2022 | Dec. 31, 2021 |
Stock price | June 14, 2021 Warrants | ||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||
Measurement inputs | 3.41 | 21.60 |
Stock price | February 15, 2022 Warrants | ||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||
Measurement inputs | 3.41 | |
Risk-free interest rate | June 14, 2021 Warrants | ||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||
Measurement inputs | 0.0291 | 0.0084 |
Risk-free interest rate | February 15, 2022 Warrants | ||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||
Measurement inputs | 0.0301 | |
Dividend yield | June 14, 2021 Warrants | ||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||
Measurement inputs | 0 | 0 |
Dividend yield | February 15, 2022 Warrants | ||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||
Measurement inputs | 0 | |
Volatility | June 14, 2021 Warrants | ||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||
Measurement inputs | 1 | 1.3000 |
Volatility | February 15, 2022 Warrants | ||
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | ||
Measurement inputs | 0.8000 |
Accrued Expenses - Accrued Expe
Accrued Expenses - Accrued Expenses (Details) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Payables and Accruals [Abstract] | ||
Accrued compensation | $ 5,531 | $ 5,258 |
Accrued distributor commissions | 3,819 | 2,957 |
Accrued securities class action settlement | 0 | 1,500 |
Other | 7,864 | 8,054 |
Total accrued expenses | $ 17,214 | $ 17,769 |
Other Long-term Liabilities - S
Other Long-term Liabilities - Schedule of Other Long-term Liabilities (Details) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Other Liabilities, Noncurrent [Abstract] | ||
Acquisition contingencies | $ 22,393 | $ 26,343 |
Warrant Liability | 1,554 | 12,013 |
Lease obligations | 843 | 947 |
Other | 2,732 | 2,229 |
Total other long-term liabilities | $ 27,522 | $ 41,532 |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2021 | Jun. 30, 2022 | Jun. 30, 2021 | |
Income Tax Disclosure [Abstract] | ||||
Income tax provision | $ 92 | $ 81 | $ 254 | $ 300 |
Debt - Additional Information (
Debt - Additional Information (Details) - Seller Notes - Unsecured Debt - USD ($) | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2022 | Jun. 30, 2022 | Dec. 31, 2021 | Dec. 30, 2021 | |
Debt Instrument [Line Items] | ||||
Debt issuance amount | $ 10,600,000 | |||
Contingent liability | $ 10,100,000 | $ 10,100,000 | $ 10,000,000 | |
Stated rate (as a percent) | 6.80% | |||
Accrued interest expense | 100,000 | 100,000 | ||
Amortizations of debt discount | 200,000 | 400,000 | ||
Interest expense | 300,000 | 500,000 | ||
Long -term debt default rate | 4% | |||
Level 2 | ||||
Debt Instrument [Line Items] | ||||
Fair value | $ 10,000,000 | $ 10,000,000 | $ 10,000,000 |
Debt - Schedule of Long-term De
Debt - Schedule of Long-term Debt Instruments (Details) - USD ($) $ in Thousands | Jun. 30, 2022 | Dec. 31, 2021 |
Debt Instrument [Line Items] | ||
Total Seller Notes – related party | $ 10,612 | |
Unsecured Debt | Seller Notes | ||
Debt Instrument [Line Items] | ||
Less: accretion of acquisition adjustment | (525) | $ (630) |
Total Seller Notes – related party | 10,087 | 9,982 |
Current portion of seller notes | 0 | 0 |
Total long-term seller notes, excluding current portion | 10,087 | 9,982 |
Unsecured Debt | Seller Notes | P. Lewicki | ||
Debt Instrument [Line Items] | ||
2021 Fixed Rate Note | 5,306 | 5,306 |
Unsecured Debt | Seller Notes | K. Siemionow | ||
Debt Instrument [Line Items] | ||
2021 Fixed Rate Note | $ 5,306 | $ 5,306 |
Debt - Schedule of Future Matur
Debt - Schedule of Future Maturities of Long-term Debt (Details) $ in Thousands | Jun. 30, 2022 USD ($) |
Debt Disclosure [Abstract] | |
2022 | $ 0 |
2023 | 0 |
2024 | 10,612 |
2025 | 0 |
2026 | 0 |
Thereafter | 0 |
Total Seller Notes – related party | $ 10,612 |
Commitments and Contingencies (
Commitments and Contingencies (Details) | 1 Months Ended | 3 Months Ended | 6 Months Ended | 12 Months Ended | |||||||||||||
Jan. 14, 2022 USD ($) shares | Mar. 12, 2021 USD ($) ft² claim | Oct. 23, 2020 USD ($) shares | Sep. 29, 2020 USD ($) | Mar. 08, 2019 USD ($) shares | Jan. 31, 2022 USD ($) | Jan. 31, 2021 USD ($) | Jun. 30, 2022 USD ($) | Jun. 30, 2021 USD ($) | Jun. 30, 2022 USD ($) | Jun. 30, 2021 USD ($) | Dec. 31, 2020 USD ($) | Aug. 08, 2022 USD ($) | Aug. 05, 2022 USD ($) | Dec. 31, 2021 USD ($) | Jul. 20, 2020 USD ($) agreement | Dec. 31, 2019 USD ($) | |
Commitment And Contingencies [Line Items] | |||||||||||||||||
Cash consideration | $ 0 | $ 330,000 | |||||||||||||||
Current portion of acquisition contingency - Holo | $ 9,042,000 | 9,042,000 | $ 25,585,000 | ||||||||||||||
Change in fair value of liability | (10,493,000) | (2,287,000) | |||||||||||||||
Operating lease cost | 119,000 | $ 195,000 | 244,000 | 378,000 | |||||||||||||
Cash paid for amounts included in the measurement of lease liabilities | 339,000 | $ 332,000 | 686,000 | $ 576,000 | |||||||||||||
Manufacturing and Distribution Agreements with Affiliates of Montague Private Equity | |||||||||||||||||
Commitment And Contingencies [Line Items] | |||||||||||||||||
Number of manufacturing and distribution agreements | agreement | 3 | ||||||||||||||||
Year 1 | $ 24,200,000 | ||||||||||||||||
Year 2 | 25,800,000 | ||||||||||||||||
Year 3 | $ 27,200,000 | ||||||||||||||||
Manufacturing and Distribution Agreements with Affiliates of Montague Private Equity | Subsequent Event | |||||||||||||||||
Commitment And Contingencies [Line Items] | |||||||||||||||||
Year 3 | $ 17,900,000 | ||||||||||||||||
Design and Development Agreement with Pioneer | Subsequent Event | |||||||||||||||||
Commitment And Contingencies [Line Items] | |||||||||||||||||
Year 1 | $ 1,700,000 | ||||||||||||||||
Year 2 | 1,700,000 | ||||||||||||||||
Pioneer shortfall Year 1 and Year 2 | Subsequent Event | |||||||||||||||||
Commitment And Contingencies [Line Items] | |||||||||||||||||
Shortfall | $ 2,100,000 | ||||||||||||||||
San Diego Lease | Premises | |||||||||||||||||
Commitment And Contingencies [Line Items] | |||||||||||||||||
Operating lease term of contract (in years) | 12 years | ||||||||||||||||
Number of lease extension options (in years) | claim | 1 | ||||||||||||||||
Lease extension term (in years) | 7 years | ||||||||||||||||
Lease rentable area (in square feet) | ft² | 94,457 | ||||||||||||||||
Operating lease cost | $ 64,600,000 | ||||||||||||||||
Rent abatement term (in months) | 13 months | ||||||||||||||||
San Diego Lease | Premises | Other assets - net | |||||||||||||||||
Commitment And Contingencies [Line Items] | |||||||||||||||||
Cash paid for amounts included in the measurement of lease liabilities | $ 2,500,000 | ||||||||||||||||
San Diego Lease | Premises | Prepaid and other current assets | |||||||||||||||||
Commitment And Contingencies [Line Items] | |||||||||||||||||
Prepaid reimbursement | $ 3,500,000 | ||||||||||||||||
Paradigm Spine Acquisition | |||||||||||||||||
Commitment And Contingencies [Line Items] | |||||||||||||||||
Total considerations including acquisition contingencies | $ 300,000,000 | ||||||||||||||||
Cash to be paid at closing | 150,000,000 | ||||||||||||||||
Cash consideration | $ 100,000,000 | ||||||||||||||||
Shares issuable at closing (in shares) | shares | 357,653 | ||||||||||||||||
Trading days (in days) | 5 days | ||||||||||||||||
Number of common stock to be issued at closing, value | $ 50,000,000 | ||||||||||||||||
Revenue based earnout consideration | 150,000,000 | ||||||||||||||||
First potential earnout payment | $ 20,000,000 | ||||||||||||||||
Estimated contingent liability | 0 | ||||||||||||||||
Contingent liability | $ 72,200,000 | 0 | 0 | 0 | $ 0 | ||||||||||||
Aziyo Biologics, Inc. | |||||||||||||||||
Commitment And Contingencies [Line Items] | |||||||||||||||||
Shortfall obligation | $ 14,200,000 | $ 12,400,000 | |||||||||||||||
Holo Surgical Inc | Holo Purchase Agreement | |||||||||||||||||
Commitment And Contingencies [Line Items] | |||||||||||||||||
Cash consideration | $ 4,100,000 | $ 30,000,000 | $ 30,000,000 | ||||||||||||||
Shares issuable at closing (in shares) | shares | 208,333 | ||||||||||||||||
Trading days (in days) | 5 days | ||||||||||||||||
Revenue based earnout consideration | $ 83,000,000 | ||||||||||||||||
Contingent liability | $ 10,000,000 | 31,400,000 | 31,400,000 | 51,900,000 | |||||||||||||
Number of contingent consideration shares issued (in shares) | shares | 288,333 | ||||||||||||||||
Equity interest issued or issuable, number of shares (in shares) | shares | 5,900,000 | ||||||||||||||||
Current portion of acquisition contingency - Holo | 9,000,000 | 9,000,000 | 25,600,000 | ||||||||||||||
Contingent liability, included as Acquisition contingencies - Holo | $ 22,400,000 | 22,400,000 | $ 26,300,000 | ||||||||||||||
Change in fair value of liability | $ 10,500,000 |
Legal Actions - Additional Info
Legal Actions - Additional Information (Details) $ in Thousands | 1 Months Ended | ||||||
Jan. 26, 2022 USD ($) | Sep. 30, 2021 USD ($) | Jul. 27, 2018 patent | Jan. 31, 2022 USD ($) | Jun. 30, 2022 USD ($) claim | Dec. 31, 2021 USD ($) | Jun. 02, 2020 claim | |
Loss Contingencies [Line Items] | |||||||
Insurance recovery receivable | $ 0 | $ 1,500 | |||||
Indemnified Claims | |||||||
Loss Contingencies [Line Items] | |||||||
Number of pending claims | claim | 1,026 | ||||||
LifeNet | |||||||
Loss Contingencies [Line Items] | |||||||
Number of patents claims | patent | 5 | ||||||
Securities Class Action | Judicial Ruling | |||||||
Loss Contingencies [Line Items] | |||||||
Litigation settlement paid by insurers | $ 10,500 | ||||||
Derivative Actions | |||||||
Loss Contingencies [Line Items] | |||||||
Number of pending claims | claim | 3 | ||||||
Damages sought value, liability | $ 1,500 | ||||||
Settlement paid by insurers | $ 1,500 | ||||||
Derivative Actions | Prepaid and other current assets | |||||||
Loss Contingencies [Line Items] | |||||||
Insurance recovery receivable | 1,500 | ||||||
Derivative Actions | Accrued expenses | |||||||
Loss Contingencies [Line Items] | |||||||
Liability | $ 1,500 |
Regulatory Actions (Details)
Regulatory Actions (Details) - Subsequent Event - SEC $ in Millions | Aug. 03, 2022 USD ($) |
Public Utilities, General Disclosures [Line Items] | |
Payment of civil penalty | $ 2 |
Recouped compensation expected to receive | $ 0.6 |
Related Party Transactions - Ad
Related Party Transactions - Additional Information (Details) - USD ($) $ in Thousands | 6 Months Ended | ||||||
Jan. 14, 2022 | Dec. 30, 2021 | Oct. 23, 2020 | Sep. 29, 2020 | Jun. 30, 2022 | Jun. 30, 2021 | Dec. 31, 2021 | |
Related Party Transaction [Line Items] | |||||||
Percent of beneficial owner of common stock (as a percent) | 5% | ||||||
Cash consideration | $ 0 | $ 330 | |||||
Holo Surgical Inc | Holo Purchase Agreement | |||||||
Related Party Transaction [Line Items] | |||||||
Cash consideration | $ 4,100 | $ 30,000 | $ 30,000 | ||||
Shares issuable at closing (in shares) | 208,333 | ||||||
Shares issued | $ 12,300 | ||||||
Contingent liability | $ 10,000 | $ 31,400 | $ 51,900 | ||||
Maximum shares to be issued (in shares) | 288,333 | ||||||
Contingent consideration payable closing milestones, term (in years) | 6 years | 6 years | |||||
Holo Surgical Inc | Holo Purchase Agreement | Dr. Pawel Lewicki | |||||||
Related Party Transaction [Line Items] | |||||||
Indirect outstanding ownership (as a percent) | 57.50% | ||||||
Holo Surgical Inc | Holo Purchase Agreement | Achievement of all milestones | |||||||
Related Party Transaction [Line Items] | |||||||
Contingent liability | $ 50,600 | ||||||
INN Acquisition | |||||||
Related Party Transaction [Line Items] | |||||||
Cash consideration | $ 5,000 | ||||||
Shares issued | $ 4,900 | ||||||
INN Acquisition | INN Acquisition | |||||||
Related Party Transaction [Line Items] | |||||||
Ownership percentage by noncontrolling owners (as a percent) | 58% |