Merit Medical Systems (MMSI) 10-Q 9 Nov 17 2017 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2017	Oct. 31, 2017
Document Information [Abstract]
Entity Registrant Name	MERIT MEDICAL SYSTEMS INC
Entity Central Index Key	856,982
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Document Type	10-Q
Document Period End Date	Sep. 30, 2017
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	Q3
Amendment Flag	false
Entity Common Stock, Shares Outstanding		50,198,833
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
CURRENT ASSETS:
Cash and cash equivalents	$ 23,362	$ 19,171
Trade receivables — net of allowance for uncollectible accounts — 2017 — $1,547 and 2016 — $1,587	101,394	80,521
Employee receivables	147	198
Other receivables	5,900	5,445
Inventories	145,598	120,695
Prepaid expenses and other assets	20,581	6,226
Prepaid income taxes	2,792	2,525
Deferred income tax assets	0	8,219
Income tax refund receivables	91	423
Total current assets	299,865	243,423
PROPERTY AND EQUIPMENT:
Land and land improvements	19,804	19,379
Buildings	144,084	139,119
Manufacturing equipment	193,061	178,110
Furniture and fixtures	49,035	43,433
Leasehold improvements	31,345	30,413
Construction-in-progress	34,625	28,180
Total property and equipment	471,954	438,634
Less accumulated depreciation	(181,672)	(162,061)
Property and equipment — net	290,282	276,573
OTHER ASSETS:
Goodwill	234,043	211,927
Deferred income tax assets	2,046	171
Other assets	32,412	28,012
Total other assets	497,004	422,807
TOTAL	1,087,151	942,803
CURRENT LIABILITIES:
Trade payables	32,291	30,619
Accrued expenses	56,508	44,947
Current portion of long-term debt	16,962	10,000
Advances from employees	542	572
Income taxes payable	1,435	2,193
Total current liabilities	107,738	88,331
LONG-TERM DEBT	260,978	314,373
DEFERRED INCOME TAX LIABILITIES	23,764	25,981
LIABILITIES RELATED TO UNRECOGNIZED TAX BENEFITS	438	438
DEFERRED COMPENSATION PAYABLE	10,319	9,211
DEFERRED CREDITS	2,439	2,550
OTHER LONG-TERM OBLIGATIONS	14,659	3,730
Total liabilities	420,335	444,614
COMMITMENTS AND CONTINGENCIES (Notes 5, 9, 10 and 13)
STOCKHOLDERS’ EQUITY:
Preferred stock — 5,000 shares authorized as of September 30, 2017 and December 31, 2016; no shares issued
Common stock, no par value; shares authorized — 100,000; issued and outstanding as of September 30, 2017 - 50,194 and December 31, 2016 - 44,645	351,321	206,186
Retained earnings	314,602	293,885
Accumulated other comprehensive income (loss)	893	(1,882)
Total stockholders’ equity	666,816	498,189
TOTAL	1,087,151	942,803
Developed technology — net of accumulated amortization — 2017 — $67,320 and 2016 — $52,843
OTHER ASSETS:
Intangible Assets	172,796	135,358
Other — net of accumulated amortization — 2017 — $34,985 and 2016 — $30,048
OTHER ASSETS:
Intangible Assets	$ 55,707	$ 47,339

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
CURRENT ASSETS:
Trade receivables, allowances	$ 1,547	$ 1,587
STOCKHOLDERS’ EQUITY:
Preferred stock shares authorized (in shares)	5,000,000	5,000,000
Preferred stock shares issued (in shares)	0	0
Common stock par value (in USD per share)
Common stock shares authorized (in shares)	100,000,000	100,000,000
Common stock shares issued (in shares)	50,194,000	44,645,000
Common stock shares outstanding (in shares)	50,194,000	44,645,000
Developed technology — net of accumulated amortization — 2017 — $67,320 and 2016 — $52,843
OTHER ASSETS:
Intangibles, accumulated amortization	$ 67,320	$ 52,843
Other
OTHER ASSETS:
Intangibles, accumulated amortization	$ 34,985	$ 30,048

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Income Statement [Abstract]
NET SALES	$ 179,337	$ 156,975	$ 536,955	$ 446,123
COST OF SALES	98,823	89,160	296,358	251,354
GROSS PROFIT	80,514	67,815	240,597	194,769
OPERATING EXPENSES:
Selling, general and administrative	54,716	53,198	169,896	138,556
Research and development	12,838	11,424	38,676	33,440
Contingent consideration (benefit) expense	20	(94)	39	99
Acquired in-process research and development	12,061	300	12,136	400
Total operating expenses	79,635	64,828	220,747	172,495
INCOME FROM OPERATIONS	879	2,987	19,850	22,274
OTHER INCOME (EXPENSE):
Interest income	94	29	266	55
Interest expense	(1,590)	(3,022)	(5,935)	(6,120)
Gain on bargain purchase	(778)	0	10,796	0
Other income (expense) — net	(810)	1	(376)	(445)
Other income (expense) — net	(3,084)	(2,992)	4,751	(6,510)
INCOME (LOSS) BEFORE INCOME TAXES	(2,205)	(5)	24,601	15,764
INCOME TAX EXPENSE (BENEFIT)	1,400	(978)	3,900	3,100
NET INCOME (LOSS)	$ (3,569)	$ 973	$ 20,717	$ 12,615
EARNINGS PER COMMON SHARE:
Basic (in dollars per share)	$ (0.07)	$ 0.02	$ 0.43	$ 0.28
Diluted (in dollars per share)	$ (0.07)	$ 0.02	$ 0.42	$ 0.28
AVERAGE COMMON SHARES:
Basic (in shares)	50,150	44,447	48,332	44,346
Diluted (in shares)	51,599	45,000	49,555	44,763

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Statement of Comprehensive Income [Abstract]
Net income	$ (3,569)	$ 973	$ 20,717	$ 12,615
Other comprehensive income (loss):
Cash flow hedges	(144)	(103)	166	(984)
Less income tax benefit (expense)	56	40	(64)	383
Foreign currency translation adjustment	721	454	2,925	1,259
Less income tax benefit (expense)	0	0	(252)	(210)
Total other comprehensive income	633	391	2,775	448
Total comprehensive income (loss)	$ (2,936)	$ 1,364	$ 23,492	$ 13,063

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 20,717,000	$ 12,615,000
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	39,388,000	31,594,000
Gain on bargain purchase	(10,796,000)	0
Losses on sales and/or abandonment of property and equipment	219,000	102,000
Write-off of patents and intangible assets	86,000	90,000
Acquired in-process research and development	12,136,000	400,000
Fair value changes in contingent liabilities/assets	0	99,000
Amortization of deferred credits	(111,000)	(128,000)
Amortization of long-term debt issuance costs	514,000	779,000
Deferred income taxes	(290,000)	187,000
Excess tax benefits from stock-based compensation	0	(527,000)
Stock-based compensation expense	2,883,000	1,913,000
Changes in operating assets and liabilities, net of effects from acquisitions:
Trade receivables	(10,963,000)	(5,166,000)
Employee receivables	54,000	42,000
Other receivables	(503,000)	3,385,000
Inventories	(9,922,000)	220,000
Prepaid expenses and other assets	(1,587,000)	(452,000)
Prepaid income taxes	(231,000)	(63,000)
Income tax refund receivables	280,000	514,000
Other assets	(2,992,000)	(1,591,000)
Trade payables	(876,000)	(9,018,000)
Accrued expenses	4,514,000	1,693,000
Advances from employees	(44,000)	(50,000)
Income taxes payable	(764,000)	(183,000)
Liabilities related to unrecognized tax benefits	0	(366,000)
Deferred compensation payable	1,107,000	500,000
Other long-term obligations	574,000	(251,000)
Total adjustments	22,676,000	23,723,000
Net cash provided by operating activities	43,393,000	36,338,000
Capital expenditures for:
Property and equipment	(29,522,000)	(26,492,000)
Intangible assets	(1,927,000)	(1,594,000)
Proceeds from sale of cost method investment	0	1,089,000
Proceeds from the sale of property and equipment	9,000	5,000
Cash paid in acquisitions, net of cash acquired	(103,500,000)	(119,808,000)
Net cash used in investing activities	(134,940,000)	(146,800,000)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of common stock	143,069,000	4,422,000
Payment of offering costs related to issuance of common stock	(816,000)	0
Proceeds from issuance of long-term debt	151,462,000	203,478,000
Payments on long-term debt	(197,962,000)	(82,658,000)
Excess tax benefits from stock-based compensation	0	527,000
Long-term debt issuance costs	0	(1,948,000)
Contingent payments related to acquisitions	(45,000)	(199,000)
Payment of taxes related to an exchange of common stock	0	(86,000)
Net cash provided by financing activities	95,708,000	123,536,000
EFFECT OF EXCHANGE RATES ON CASH	30,000	67,000
NET INCREASE IN CASH AND CASH EQUIVALENTS	4,191,000	13,141,000
CASH AND CASH EQUIVALENTS:
Beginning of period	19,171,000	4,177,000
End of period	23,362,000	17,318,000
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION
Interest (net of capitalized interest of $371 and $337, respectively)	5,953,000	6,223,000
Income taxes	4,029,000	2,237,000
SUPPLEMENTAL DISCLOSURES OF NON-CASH INVESTING AND FINANCING ACTIVITIES
Property and equipment purchases in accounts payable	1,394,000	2,709,000
Acquisition purchases in accrued expenses and other long-term obligations	12,000,000	293,000
Contingent receivable in exchange for sale of cost method investment	0	711,000
Merit common stock surrendered (0 and 14 shares, respectively) in exchange for exercise of stock options	$ 0	$ 346,000

CONSOLIDATED STATEMENTS OF CAS7

CONSOLIDATED STATEMENTS OF CASH FLOWS (Parenthetical) - USD ($) shares in Thousands, $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Net capitalized interest	$ 371	$ 337
Common Stock
Company's common stock surrendered in exchange for the exercise of stock options (in shares)	0	14

Basis of Presentation

Basis of Presentation	9 Months Ended
	Sep. 30, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Summary of Significant Accounting Policies	Basis of Presentation. The interim consolidated financial statements of Merit Medical Systems, Inc. ("Merit," "we" or "us") for the three and nine-month periods ended September 30, 2017 and 2016 are not audited. Our consolidated financial statements are prepared in accordance with the requirements for unaudited interim periods and, consequently, do not include all disclosures required to be made in conformity with accounting principles generally accepted in the United States of America ("U.S. GAAP"). In the opinion of our management, the accompanying consolidated financial statements contain all adjustments, consisting of normal recurring accruals, necessary for a fair presentation of our financial position as of September 30, 2017 and December 31, 2016 , and our results of operations and cash flows for the three and nine-month periods ended September 30, 2017 and 2016 . The results of operations for the three and nine-month periods ended September 30, 2017 and 2016 are not necessarily indicative of the results for a full-year period. These interim consolidated financial statements should be read in conjunction with the financial statements included in our Annual Report on Form 10-K (the "2016 Form 10-K") for the year ended December 31, 2016 , which was filed with the Securities and Exchange Commission (the "SEC") on March 1, 2017.

Inventories

Inventories	9 Months Ended
	Sep. 30, 2017
Inventory Disclosure [Abstract]
Inventories	Inventories. Inventories at September 30, 2017 and December 31, 2016 consisted of the following (in thousands): September 30, December 31, 2017 2016 Finished goods $ 80,708 $ 63,852 Work-in-process 18,162 11,008 Raw materials 46,728 45,835 Total $ 145,598 $ 120,695

Stock Based Compensation

Stock Based Compensation	9 Months Ended
	Sep. 30, 2017
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Employee Stock Purchase Plan Stock Options and Warrants	Stock-Based Compensation . Stock-based compensation expense before income tax expense for the three and nine-month periods ended September 30, 2017 and 2016 , consisted of the following (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Cost of goods sold $ 189 $ 105 $ 453 $ 369 Research and development 110 51 262 147 Selling, general, and administrative 893 347 2,168 1,397 Stock-based compensation expense before taxes $ 1,192 $ 503 $ 2,883 $ 1,913 As of September 30, 2017 , the total remaining unrecognized compensation cost related to non-vested stock options, net of expected forfeitures, was approximately $16.3 million and is expected to be recognized over a weighted average period of 3.66 years. During the three and nine-month periods ended September 30, 2017 , we granted stock-based awards representing 20,000 and approximately 1.3 million shares of our common stock, respectively. During the three and nine-month periods ended September 30, 2016 , we granted stock-based awards representing 21,000 and 805,375 shares of our common stock, respectively. We use the Black-Scholes methodology to value the stock-based compensation expense for options. In applying the Black-Scholes methodology to the options granted during the nine-month periods ended September 30, 2017 and 2016 , the fair value of our stock-based awards granted was estimated using the following assumptions for the periods indicated below: Nine Months Ended September 30, 2017 2016 Risk-free interest rate 1.77% - 1.83% 1.15% - 1.40% Expected option life 5.0 years 5.0 years Expected dividend yield —% —% Expected price volatility 33.81% - 34.07% 36.30% - 37.06% For the purpose of the foregoing analysis, the average risk-free interest rate is determined using the U.S. Treasury rate in effect as of the date of grant, based on the expected term of the stock option. We determine the expected term of the stock options using the historical exercise behavior of employees. The expected price volatility was determined using a weighted average of daily historical volatility of our stock price over the corresponding expected option life and implied volatility based on recent trends of the daily historical volatility. For options with a vesting period, compensation expense is recognized on a straight-line basis over the service period, which corresponds to the vesting period.

Earnings Per Common Share (EPS)

Earnings Per Common Share (EPS)	9 Months Ended
	Sep. 30, 2017
Earnings Per Share, Basic and Diluted [Abstract]
Earnings Per Common Share (EPS)	Earnings Per Common Share (EPS). The computation of weighted average shares outstanding and the basic and diluted earnings per common share for the following periods consisted of the following (in thousands, except per share amounts): Three Months Nine Months Net Income Shares Per Share Amount Net Income Shares Per Share Amount Period ended September 30, 2017: Basic EPS $ (3,569 ) 50,150 $ (0.07 ) $ 20,717 48,332 $ 0.43 Effect of dilutive stock options and warrants 1,449 1,223 Diluted EPS $ (3,569 ) 51,599 $ (0.07 ) $ 20,717 49,555 $ 0.42 Stock options excluded from the calculation of common stock equivalents as the impact was anti-dilutive 200 434 Period ended September 30, 2016: Basic EPS $ 973 44,447 $ 0.02 $ 12,615 44,346 $ 0.28 Effect of dilutive stock options and warrants 553 417 Diluted EPS $ 973 45,000 $ 0.02 $ 12,615 44,763 $ 0.28 Stock options excluded from the calculation of common stock equivalents as the impact was anti-dilutive 408 864

Acquisitions

Acquisitions	9 Months Ended
	Sep. 30, 2017
Business Combinations [Abstract]
Acquisitions	. On September 1, 2017, we entered into a share purchase agreement with IntelliMedical Technologies Pty Ltd ("IntelliMedical") to acquire the intellectual property rights associated with a steerable guidewire system. We made an initial payment of approximately $11.9 million in September 2017, and we are obligated to pay up to an additional $15 million Australian dollars if certain milestones set forth in the agreement are reached. We are also required to pay royalties equal to 6% of net sales, commencing upon the first commercial sale of the product and throughout the term of the applicable patents. We accounted for this transaction as an asset purchase. The initial payment has been included in the accompanying consolidated statements of income as acquired in-process research and development expense for the three and nine-month periods ended September 30, 2017, because both technological feasibility of the underlying research and development project had not yet been reached and such technology had no identified future alternative use as of the date of acquisition. On August 4, 2017 we entered into intellectual property and asset purchase agreements with Laurane Medical S.A.S. ("Laurane") and its shareholders to acquire inventories and the intellectual property rights associated with Laurane's manual bone biopsy devices, manual bone marrow needles and muscle biopsy kits for an aggregate purchase price of $16.5 million . We also recorded a contingent consideration liability of $5.5 million related to royalties potentially payable to Laurane's shareholders pursuant to the terms of the intellectual property purchase agreement. We accounted for this acquisition as a business combination. The following table summarizes the aggregate purchase price (including contingent royalty payment liabilities) allocated to the assets acquired from Laurane (in thousands): Preliminary Allocation Net Assets Acquired Inventories $ 579 Intangibles Developed technology 14,920 Customer list 120 Goodwill 6,381 Total net assets acquired $ 22,000 We are amortizing the developed technology intangible asset over 12 years and the customer list on an accelerated basis over one year. The total weighted-average amortization period for these acquired intangible assets is 11.9 years. The sales and results of operations related to the acquisition have been included in our cardiovascular segment since the acquisition date and were not material. Acquisition-related costs associated with the Laurane acquisition, which are included in selling, general and administrative expenses in the accompanying consolidated statements of income, were not material. On July 3, 2017, we entered into an asset purchase agreement with Osseon LLC (“Osseon”) to acquire substantially all the assets related to Osseon’s vertebral augmentation products. We accounted for this acquisition as a business combination. The purchase price for the business was approximately $6.8 million . Acquisition-related costs associated with the Osseon acquisition, which are included in selling, general and administrative expenses in the accompanying consolidated statements of income, were not material. The results of operations related to this acquisition have been included in our cardiovascular segment since the acquisition date. During the three and nine-month periods ended September 30, 2017, our net sales of Osseon products were approximately $442,000 . It is not practical to separately report the earnings related to the Osseon acquisition, as we cannot split out sales costs related solely to the products we acquired from Osseon, principally because our sales representatives sell multiple products (including the products we acquired from Osseon) in our cardiovascular business segment. The following table summarizes the preliminary purchase price allocated to the net assets acquired (in thousands): Preliminary Allocation Net Assets Acquired Inventories $ 1,023 Property and equipment 58 Intangibles Developed technology 5,400 Customer list 200 Goodwill 159 Total net assets acquired $ 6,840 With respect to the Osseon assets, we are amortizing developed technology over nine years and customer lists on an accelerated basis over eight years. The total weighted-average amortization period for these acquired intangible assets is approximately 9.0 years. On July 1, 2017, we entered into an exclusive license agreement with Pleuratech ApS ("Pleuratech") to acquire the rights to manufacture and sell the KatGuide chest tube insertion tool. As of September 30, 2017, we had paid $2.0 million in connection with this agreement. We are obligated to pay an additional $5.0 million if certain milestones set forth in the license agreement are met. We are also required to pay royalties equal to 6% of net sales throughout the term of the license agreement. We accounted for this transaction as an asset purchase. We recorded the amount paid upon closing as a license agreement intangible asset, which we intend to amortize over 15 years . On June 16, 2017, we entered into an asset purchase agreement with Lazarus Medical Technologies, LLC to acquire the patent rights and other intellectual property related to the Repositionable Chest Tube TM and related devices. As of September 30, 2017, we had paid $570,000 in connection with this agreement. We are also obligated to pay an additional $750,000 if certain milestones set forth in the purchase agreement are reached. We are also required to pay royalties equal to 6.0% of net sales throughout the term of the purchase agreement. We accounted for this transaction as an asset purchase. We recorded the amount paid upon closing as a license agreement intangible asset, which we intend to amortize over 15 years . On May 23, 2017, we paid $2.5 million to acquire 182,000 shares of preferred stock of Fusion Medical, Inc. ("Fusion"), a developer of medical devices designed primarily for clot removal. The shares of preferred stock we acquired, which represent an ownership interest of approximately 19.5% , have been accounted for as an equity method investment of $2.5 million reflected within other assets in the accompanying consolidated balance sheets because we may be deemed to exercise significant influence over the operations of Fusion. On May 19, 2017, we entered into a business purchase agreement, termination agreement, distribution agreement and a supply agreement with Sugan Co, Ltd. ("Sugan"), a Japanese medical device distributor. Pursuant to these agreements, we terminated our former distributor agreement with Sugan and acquired the customer list Sugan used in the distribution of our products in Japan. The consideration attributed to the customer list was approximately $1.1 million , which is payable on or before December 31, 2017. The purchase price is recorded as a customer list intangible asset and the amount due to Sugan is recorded in accrued expenses within the accompanying consolidated balance sheets. We intend to amortize the customer list intangible asset on an accelerated basis over five years . In addition, we granted to Sugan the right to continue to distribute a limited number of our products, related to fluid administration, through December 31, 2021 and to manufacture and sell to Sugan certain contrast injector products during a term of four years, subject to extensions. On May 1, 2017, we entered into an agreement and plan of merger with Vascular Access Technologies, Inc. ("VAT"), pursuant to which we acquired the SAFECVAD™ device. We accounted for this acquisition as a business combination. The purchase price for the business was $5.0 million . We also recorded $4.9 million of contingent consideration related to royalties potentially payable to VAT pursuant to the merger agreement. The following table summarizes the preliminary purchase price allocated to the net assets acquired and liabilities assumed (in thousands): Preliminary Allocation Adjustments (1) Revised Preliminary Allocation Net Assets Acquired Intangibles Developed technology $ 7,800 $ — $ 7,800 In-process technology 850 250 1,100 Goodwill 4,323 (153 ) 4,170 Deferred tax liabilities (3,073 ) (97 ) (3,170 ) Total net assets acquired $ 9,900 $ — $ 9,900 (1) Amounts represent adjustments to the preliminary purchase price allocation first presented in our Quarterly Report on Form 10-Q for the quarter ended June 30, 2017 resulting from our ongoing activities, including reassessment of the assets acquired and liabilities assumed, with respect to finalizing our purchase price allocation for this acquisition. We are amortizing the developed technology intangible asset over 15 years . The sales and results of operations related to the acquisition have been included in our cardiovascular segment since the acquisition date and were not material. Acquisition-related costs associated with the VAT acquisition, which are included in selling, general and administrative expenses in the accompanying consolidated statements of income, were not material. On January 31, 2017, we signed a purchase agreement with Argon Medical Devices, Inc. ("Argon") to acquire Argon’s critical care division, including a manufacturing facility in Singapore, the related commercial operations in Europe and Japan, and certain inventories and intellectual property rights within the United States. We made an initial payment of approximately $10.9 million and received a subsequent reduction to the purchase price of approximately $797,000 related to a working capital adjustment according to the terms of the purchase agreement. We accounted for the acquisition as a business combination. Acquisition-related costs associated with the acquisition of the Argon critical care division during the three and nine-month periods ended September 30, 2017 , which are included in selling, general and administrative expenses in the accompanying consolidated statements of income, were approximately $90,000 and $2.5 million , respectively. The results of operations related to this acquisition have been included in our cardiovascular segment since the acquisition date. During the three and nine-month periods ended September 30, 2017 , our net sales of Argon products were approximately $11.0 million and $30.0 million , respectively. It is not practical to separately report the earnings related to the Argon acquisition, as we cannot split out sales costs related solely to the products we acquired from Argon, principally because our sales representatives sell multiple products (including the products we acquired from Argon) in our cardiovascular business segment. The assets and liabilities in the initial purchase price allocation for the Argon acquisition are stated at fair value based on estimates of fair value using available information and making assumptions our management believes are reasonable. The following table summarizes the preliminary purchase price allocated to the net tangible and intangible assets acquired and liabilities assumed (in thousands), adjusted as of September 30, 2017: Preliminary Allocation Adjustments (2) Revised Preliminary Allocation Assets Acquired Cash and cash equivalents $ 1,436 $ — $ 1,436 Trade receivables 8,351 — 8,351 Inventories 12,217 (995 ) 11,222 Prepaid expenses and other assets 1,275 — 1,275 Property and equipment 2,667 (348 ) 2,319 Deferred tax assets 184 19 203 Intangibles Developed technology 2,600 (400 ) 2,200 Customer lists 1,300 200 1,500 Trademarks 1,500 (600 ) 900 Total assets acquired 31,530 (2,124 ) 29,406 Liabilities Assumed Trade payables (2,306 ) (109 ) (2,415 ) Accrued expenses (5,083 ) — (5,083 ) Income taxes payable (2 ) — (2 ) Deferred income tax liabilities (999 ) (11 ) (1,010 ) Total liabilities assumed (8,390 ) (120 ) (8,510 ) Total net assets acquired 23,140 (2,244 ) 20,896 Gain on bargain purchase (1) (12,243 ) 1,447 (10,796 ) Total purchase price $ 10,897 $ (797 ) $ 10,100 (1) The total fair value of the net assets acquired from Argon exceeded the purchase price, resulting in a gain on bargain purchase which was recorded within other income (expense) in our consolidated statements of income, and includes a negative adjustment of $778,000 in the three-month period ended September 30, 2017 (in addition to the negative adjustment of $669,000 in the three-month period ended June 30, 2017). We believe the reason for the provisional gain on bargain purchase was a result of the divestiture of a non-strategic, slow-growth critical care business for Argon. It is our understanding that the divestiture allows Argon to focus on its higher growth interventional portfolio. (2) Amounts represent adjustments to the preliminary purchase price allocation first presented in our March 31, 2017 Form 10-Q resulting from our ongoing activities, including reassessment of the assets acquired and liabilities assumed, with respect to finalizing our purchase price allocation for this acquisition. With respect to the Argon assets, we are amortizing developed technology over seven years and customer lists on an accelerated basis over five years. While U.S. trademarks can be renewed indefinitely, we currently estimate that we will generate cash flow from the acquired trademarks for a period of five years from the acquisition date. The total weighted-average amortization period for these acquired intangible assets is 6.0 years . Given the timing of this acquisition, which closed during the first quarter of 2017, as well as the complexity of the acquisition, the entire purchase price allocation disclosed herein (as well as the gain on bargain purchase) is considered provisional at this time and is subject to adjustment to reflect information obtained about factors and circumstances that existed as of the acquisition date that if known would have affected the measurement of the amounts recognized as of that date. We continue to assess whether we have fully identified all the assets acquired and the liabilities assumed. Consequently, the measurement period remains open. On January 31, 2017, we acquired substantially all the assets, including intellectual property covered by approximately 40 patents and pending applications, and assumed certain liabilities, of Catheter Connections, Inc. (“Catheter Connections”), in exchange for payment of $38.0 million . Catheter Connections, based in Salt Lake City, Utah, developed and marketed the DualCap® System, an innovative family of disinfecting products designed to protect patients from intravenous infections resulting from infusion therapy. We accounted for this acquisition as a business combination. Acquisition-related costs associated with the Catheter Connections acquisition during the three and nine-month periods ended September 30, 2017 , which are included in selling, general and administrative expenses in the accompanying consolidated statements of income, were approximately $31,000 and $482,000 , respectively. The results of operations related to this acquisition have been included in our cardiovascular segment since the acquisition date. During the three and nine-month periods ended September 30, 2017 , our net sales of the products acquired from Catheter Connections were approximately $2.7 million and $7.0 million , respectively. It is not practical to separately report the earnings related to the products acquired from Catheter Connections, as we cannot split out sales costs related solely to those products, principally because our sales representatives sell multiple products (including the DualCap System) in the cardiovascular business segment. The purchase price was preliminarily allocated as follows (in thousands): Preliminary Allocation Adjustments (1) Revised Preliminary Allocation Assets Acquired Trade receivables $ 952 $ 7 $ 959 Inventories 2,244 (87 ) 2,157 Prepaid expenses and other assets 181 (96 ) 85 Property and equipment 1,472 — 1,472 Intangibles Developed technology 22,900 (1,800 ) 21,100 Customer lists 100 600 700 Trademarks 2,900 — 2,900 Goodwill 7,612 1,376 8,988 Total assets acquired 38,361 — 38,361 Liabilities Assumed Trade payables (338 ) — (338 ) Accrued expenses (23 ) — (23 ) Total liabilities assumed (361 ) — (361 ) Net assets acquired $ 38,000 $ — $ 38,000 (1) Amounts represent adjustments to the preliminary purchase price first presented in our Quarterly Report on Form 10-Q for the Quarter Ended March 31, 2017, resulting from our ongoing activities with respect to finalizing our purchase price allocation for this acquisition. The larger adjustments primarily relate to the valuation of the acquired intangible assets. We are amortizing the Catheter Connections developed technology asset over 12 years, the related trademarks over 10 years, and the associated customer list over eight years. We have estimated the weighted average life of the intangible Catheter Connections assets acquired to be approximately 11.7 years . On July 6, 2016, we acquired all the issued and outstanding shares of DFINE Inc. ("DFINE"). The DFINE acquisition added a line of vertebral augmentation products for the treatment of vertebral compression fractures as well as medical devices used to treat metastatic spine tumors. We made an initial payment of $97.5 million to certain DFINE stockholders on July 6, 2016 and paid approximately $578,000 related to a net working capital adjustment subject to review by Merit and the preferred stockholders of DFINE. We accounted for the acquisition as a business combination. In the three-month period ended December 31, 2016, we negotiated the final net working capital adjustment, resulting in a reduction to the purchase price of approximately $1.1 million . As a result, we recorded measurement period adjustments to reduce inventories by approximately $89,000 , reduce property and equipment by approximately $109,000 , reduce goodwill by approximately $1.2 million , reduce accrued expenses by approximately $407,000 and increase the associated deferred tax liabilities by approximately $113,000 . The measurement period for this acquisition is closed. Under U.S. GAAP, measurement period adjustments are recognized on a prospective basis in the period of change, instead of restating prior periods. There was no material impact to reported earnings in connection with these measurement period adjustments. Acquisition-related costs associated with the DFINE acquisition during the year ended December 31, 2016, which were included in selling, general and administrative expenses in the consolidated statements of income included in the 2016 Form 10-K, were approximately $1.6 million . The results of operations related to this acquisition have been included in our cardiovascular segment since the acquisition date. During the year ended December 31, 2016, our net sales of DFINE products were approximately $13.5 million . It is not practical to separately report the earnings related to the DFINE acquisition, as we cannot split out sales costs related solely to the DFINE products, principally because our sales representatives sell multiple products (including DFINE products) in the cardiovascular business segment. The purchase price was allocated to the net tangible and intangible assets acquired and liabilities assumed, based on estimated fair values, as follows (in thousands): Assets Acquired Trade receivables $ 4,054 Other receivables 6 Inventories 8,585 Prepaid expenses 630 Property and equipment 1,630 Other long-term assets 145 Intangibles Developed technology 67,600 Customer lists 2,400 Trademarks 4,400 Goodwill 24,818 Total assets acquired 114,268 Liabilities Assumed Trade payables (1,790 ) Accrued expenses (5,298 ) Deferred income tax liabilities - current (701 ) Deferred income tax liabilities - noncurrent (10,844 ) Total liabilities assumed (18,633 ) Net assets acquired, net of cash received of $1,327 $ 95,635 With respect to the DFINE assets, we are amortizing developed technology over 15 years and customer lists on an accelerated basis over nine years. While U.S. trademarks can be renewed indefinitely, we currently estimate that we will generate cash flow from the acquired trademarks for a period of 15 years from the acquisition date. The total weighted-average amortization period for these acquired intangible assets is 14.8 years . On February 4, 2016, we purchased the HeRO® Graft device and other related assets from CryoLife, Inc., a developer of medical devices based in Kennesaw, Georgia ("CryoLife"). The HeRO Graft is a fully subcutaneous vascular access system intended for use in maintaining long-term vascular access for chronic hemodialysis patients who have failing fistulas, grafts or are catheter dependent due to a central venous blockage. The purchase price was $18.5 million , which was paid in full during 2016. We accounted for this acquisition as a business combination. The purchase price was allocated as follows (in thousands): Assets Acquired Inventories $ 2,455 Property and equipment 290 Intangibles Developed technology 12,100 Trademarks 700 Customers Lists 400 Goodwill 2,555 Total assets acquired $ 18,500 We are amortizing the developed HeRO Graft technology asset over ten years, the related trademarks over 5.5 years, and the associated customer lists over 12 years. We have estimated the weighted average life of the intangible HeRO Graft assets acquired to be approximately 9.8 years. Acquisition-related costs related to the HeRO Graft device and other related assets during the year ended December 31, 2016, which were included in selling, general and administrative expenses in the consolidated statements of income included in the 2016 Form 10-K, were not material. The results of operations related to this acquisition have been included in our cardiovascular segment since the acquisition date. During the year ended December 31, 2016, our net sales of the products acquired from CryoLife were approximately $7.1 million . It is not practical to separately report the earnings related to the products acquired from CryoLife, as we cannot split out sales costs related solely to those products, principally because our sales representatives sell multiple products (including the HeRO Graft device) in the cardiovascular business segment. The following table summarizes our consolidated results of operations for the three-month period ended September 30, 2016 and the nine-month periods ended September 30, 2017 and 2016, as well as unaudited pro forma consolidated results of operations as though the DFINE acquisition had occurred on January 1, 2015 and the acquisition of the Argon critical care division had occurred on January 1, 2016 (in thousands, except per share amounts): Three Months Ended Nine Months Ended Nine Months Ended September 30, 2016 September 30, 2017 September 30, 2016 As Reported Pro Forma As Reported Pro Forma As Reported Pro Forma Net Sales $ 156,975 $ 167,321 $ 536,955 $ 539,715 $ 446,123 $ 494,589 Net Income 973 1,174 20,717 10,047 12,615 16,454 Earnings per common share: Basic $ 0.02 $ 0.03 $ 0.43 $ 0.21 $ 0.28 $ 0.37 Diluted $ 0.02 $ 0.03 $ 0.42 $ 0.20 $ 0.28 $ 0.37 * The pro forma results for the three-month period ended September 30, 2017 are not included in the table above because the operating and financial results for the DFINE and Argon critical care division acquisitions were included in our consolidated statements of income for this period. The unaudited pro forma information set forth above is for informational purposes only and includes adjustments related to the step-up of acquired inventories, amortization expense of acquired intangible assets, interest expense on long-term debt and changes in the timing of the recognition of the gain on bargain purchase. The pro forma information should not be considered indicative of actual results that would have been achieved if the DFINE acquisition had occurred on January 1, 2015 and the acquisition of the Argon critical care division had occurred on January 1, 2016, or results that may be obtained in any future period. The pro forma consolidated results of operations do not include the Laurane, Osseon, VAT, Catheter Connections or HeRO Graft acquisitions as we do not deem the pro forma effect of these transactions to be material.

Segment Reporting

Segment Reporting	9 Months Ended
	Sep. 30, 2017
Segment Reporting [Abstract]
Segment Reporting and Foreign Operations	Segment Reporting. We report our operations in two operating segments: cardiovascular and endoscopy. Our cardiovascular segment consists of cardiology and radiology medical device products which assist in diagnosing and treating coronary artery disease, peripheral vascular disease and other non-vascular diseases and includes embolotherapeutic, cardiac rhythm management ("CRM"), electrophysiology ("EP"), and interventional oncology and spine devices. Our endoscopy segment consists of gastroenterology and pulmonology medical device products which assist in the palliative treatment of expanding esophageal, tracheobronchial and biliary strictures caused by malignant tumors. We evaluate the performance of our operating segments based on operating income. Financial information relating to our reportable operating segments and reconciliations to the consolidated totals for the three and nine-month periods ended September 30, 2017 and 2016 , are as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Net Sales (1) Cardiovascular $ 172,723 $ 150,503 $ 517,140 $ 428,571 Endoscopy 6,614 6,472 19,815 17,552 Total net sales 179,337 156,975 536,955 446,123 Operating Income (Loss) (1) Cardiovascular (1,207 ) 1,858 14,239 19,385 Endoscopy 2,086 1,129 5,611 2,889 Total operating income 879 2,987 19,850 22,274 (1) Net sales and operating income have been adjusted from earlier reported year-to-date amounts for 2017 and 2016 to reflect changes in product classifications between our operating segments, which were made to be consistent with updates in the management of our product portfolios in the third quarter of 2017.

Recent Accounting Pronouncement

Recent Accounting Pronouncements (Notes)	9 Months Ended
	Sep. 30, 2017
Accounting Changes and Error Corrections [Abstract]
Description of New Accounting Pronouncements Not yet Adopted	New Financial Accounting Standards . Recently Adopted In January 2017, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standards Update (“ASU”) No. 2017-04, Intangibles - Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment , which eliminates the requirement to determine the fair value of individual assets and liabilities of a reporting unit to measure goodwill impairment. Under these amendments, goodwill impairment testing will be performed by comparing the fair value of the reporting unit with its carrying amount and recognizing an impairment charge for the amount by which the carrying amount exceeds the reporting unit’s fair value. We adopted ASU 2017-04 effective January 1, 2017 on a prospective basis, and it did not have a material impact on our consolidated financial statements for the nine months ended September 30, 2017. In January 2017, the FASB issued ASU No. 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business , which provides guidance to entities to assist with evaluating when a set of transferred assets and activities is a business and provides a screen to determine when a set is not a business. Under the new guidance, when substantially all the fair value of gross assets acquired (or disposed of) is concentrated in a single identifiable asset, or group of similar assets, the assets acquired would not represent a business. Also, to be considered a business, an acquisition would have to include an input and a substantive process that together significantly contribute to the ability to produce outputs. We adopted ASU 2017-01 effective January 1, 2017 on a prospective basis. The implementation of ASU 2017-01 did not have a material impact on our consolidated financial statements for the nine months ended September 30, 2017. In March 2016, the FASB issued ASU No. 2016-09, Compensation - Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting , which requires companies to record excess tax benefits and deficiencies in income rather than the current requirement to record them through equity. ASU 2016-09 also allows companies the option to recognize forfeitures of share-based awards when they occur rather than the previous requirement to make an estimate upon the grant of the awards. We adopted ASU 2016-09 effective January 1, 2017 on a prospective basis and, as such, no prior periods were adjusted. In accordance with the new standard and prospectively since the date we adopted ASU 2016-09, excess tax benefits from stock-based compensation are reported as an income tax benefit in our consolidated statements of income (see Note 8). In November 2015, the FASB issued ASU No. 2015-17, Income Taxes (Topic 740): Balance Sheet Classification of Deferred Taxes , which requires all deferred tax assets and deferred tax liabilities to be presented as noncurrent within a classified balance sheet. We adopted ASU 2015-17 effective January 1, 2017 on a prospective basis and did not reclassify presentation of prior year balances. The adoption of this standard did not have a material impact on our consolidated financial statements for the nine months ended September 30, 2017. In July 2015, the FASB issued ASU No. 2015-11, Simplifying the Measurement of Inventory . ASU 2015-11 requires that inventory be measured at the lower of cost or net realizable value. Net realizable value is the estimated selling price in the ordinary course of business, less reasonably predictable costs of completion, disposal, and transportation. Inventory measured using last-in, first-out or the retail inventory method are excluded from the scope of ASU 2015-11, which is effective for fiscal years beginning after December 15, 2016, and interim periods within those fiscal years. The implementation of ASU 2015-11 did not have a material impact on our consolidated financial statements for the nine months ended September 30, 2017. Not Yet Adopted In August 2017, the FASB issued ASU 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities , which expands and refines hedge accounting for both financial and non-financial risk components, aligns the recognition and presentation of the effects of hedging instruments and hedge items in the financial statements, and includes certain targeted improvements to ease the application of current guidance related to the assessment of hedge effectiveness. ASU 2017-12 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. Early adoption is permitted. We are currently evaluating the anticipated impact of adopting ASU 2017-12 on our consolidated financial statements. In October 2016, the FASB issued ASU No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other than Inventory , which requires the recognition of the income tax consequences of an intra-entity transfer of an asset, other than inventory, when the transfer occurs. ASU 2016-16 will be effective for us on January 1, 2018. We do not presently anticipate that the adoption of ASU 2016-16 will have a material impact on our consolidated financial statements. In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments , which addresses eight specific cash flow issues with the objective of reducing the existing diversity in practice in how certain cash receipts and cash payments are presented and classified in the statement of cash flows. ASU 2016-15 will be effective for us on January 1, 2018 with early adoption permitted. We do not presently anticipate that the adoption of ASU 2016-15 will have a material impact on our consolidated financial statements. In February 2016, the FASB issued ASU No. 2016-02, Leases , which eliminates the current tests for lease classification under U.S. GAAP and requires lessees to recognize the right-of-use assets and related lease liabilities on the balance sheet for all leases greater than one year in duration. ASU 2016-02 is effective for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years. Early adoption of ASU 2016-02 is permitted. ASU 2016-02 provides that lessees (for capital and operating leases) and lessors (for sales-type, direct financing, and operating leases) must apply a modified retrospective transition approach for leases existing at, or entered into after, the beginning of the earliest comparative period presented in the financial statements. The modified retrospective approach would not require any transition accounting for leases that expired before the earliest comparative period presented. Lessees and lessors may not apply a full retrospective transition approach. We are assessing the impact that ASU 2016-02 is anticipated to have on our consolidated financial statements. We currently expect that most of our operating lease commitments will be subject to the new standard and recognized as lease liabilities and right-of-use assets upon our adoption of ASU 2016-02. In January 2016, the FASB issued ASU No. 2016-01, Financial Instruments - Overall: Recognition and Measurement of Financial Assets and Financial Liabilities, which amends the guidance regarding the classification and measurement of financial instruments. Changes to the current guidance primarily affect the accounting for equity investments, financial liabilities under the fair value option, and the presentation and disclosure requirements for financial instruments. In addition, ASU 2016-01 clarifies guidance related to the valuation allowance assessment when recognizing deferred tax assets resulting from unrealized losses on available-for-sale debt securities. ASU 2016-01 will be effective for us on January 1, 2018. Early adoption is not permitted except for the provision to record fair value changes for financial liabilities under the fair value option resulting from instrument-specific credit risk in other comprehensive income. Upon adoption of ASU 2016-01, an entity should apply the amendments by means of a cumulative-effect adjustment to the balance sheet at the beginning of the first reporting period in which the guidance is effective. We do not presently anticipate that the adoption of ASU 2016-01 will have a material impact on our financial statements. In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606) , to update the financial reporting requirements for revenue recognition. Topic 606 outlines a single comprehensive model for entities to use in accounting for revenue arising from contracts with customers and supersedes most current revenue recognition guidance, including industry-specific guidance. The guidance is based on the principle that an entity should recognize revenue to depict the transfer of goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. The guidance also requires additional disclosure about the nature, amount, timing and uncertainty of revenue and cash flows arising from customer contracts, including significant judgments and changes in judgments and assets recognized from costs incurred to fulfill a contract. This guidance is effective for us beginning on January 1, 2018, and entities have the option of using either a full retrospective or a modified retrospective approach for the adoption of the new standard. We expect to adopt this standard using the modified retrospective approach beginning in 2018. We have substantially completed our impact assessment of implementing this guidance. We have evaluated each of the five steps in Topic 606, which are as follows: 1) Identify the contract with the customer; 2) Identify the performance obligations in the contract; 3) Determine the transaction price; 4) Allocate the transaction price to the performance obligations; and 5) Recognize revenue when (or as) performance obligations are satisfied. Our preliminary conclusion is that we expect to identify similar performance obligations under ASC Topic 606 as compared with deliverables and separate units of account previously identified. The Company does not expect revenue to be affected materially in any period due to the adoption of ASC Topic 606 because the Company believes it would have sufficient information to conclude that the transaction price was fixed or determinable under current GAAP and would have recorded revenue upon shipment or delivery under either ASC Topic 605 or ASC Topic 606. Additionally, the Company does not expect cost of sales (product) to be affected materially in any period due to the adoption of Topic 606. We continue to evaluate the impact that this new standard will have on our Original Equipment Manufacturing arrangements. There are also certain considerations related to accounting policies, business processes and internal control over financial reporting that are associated with implementing Topic 606. We are currently evaluating our policies, processes, and control framework for revenue recognition and identifying any changes that may need to be made in response to the new guidance. Disclosure requirements under the new guidance in Topic 606 have been significantly expanded in comparison to the disclosure requirements under the current guidance, including disclosures related to disaggregation of revenue into appropriate categories, performance obligations, the judgments made in revenue recognition determinations, adjustments to revenue which relate to activities from previous quarters or years, any significant reversals of revenue, and costs to obtain or fulfill contracts. Designing and implementing the appropriate controls over gathering and reporting the information required under Topic 606 is currently in process, and we anticipate it will be completed prior to January 1, 2018.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2017
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes. Our provision for income taxes for the three months ended September 30, 2017 was a tax expense of approximately $1.4 million compared to a tax benefit of $978,000 for the corresponding period of 2016. The increase in the income tax expense for the third quarter of 2017 compared to the third quarter of 2016 was primarily due to the discrete tax impact of the in-process research and development charge attributable to the IntelliMedical acquisition completed in the third quarter of 2017, which was not deductible for tax purposes. Our provision for income taxes for the nine months ended September 30, 2017 and 2016 was a tax expense of approximately $3.9 million and approximately $3.1 million , respectively, which resulted in an effective tax rate of 15.8% and 20.0% , respectively. The decrease in the effective income tax rate for the nine-month period ended September 30, 2017, when compared to the corresponding period of 2016, was primarily related to a discrete tax benefit related to share-based payment awards due to application of ASC Update 2016-09 and a nontaxable gain on the bargain purchase relating to our acquisition of the critical care division of Argon.

Revolving Credit Facility and L

Revolving Credit Facility and Long-Term Debt	9 Months Ended
	Sep. 30, 2017
Debt Disclosure [Abstract]
Revolving Credit Facility and Long-Term Debt	Revolving Credit Facility and Long-term Debt. Our outstanding debt obligations as of September 30, 2017 and December 31, 2016 , consisted of the following (in thousands): September 30, 2017 December 31, 2016 2016 Term loan $ 87,500 $ 145,000 2016 Revolving credit loans 184,000 180,000 2017 Debt facility 6,962 — Less debt issuance costs (522 ) (627 ) Total debt 277,940 324,373 Less current portion 16,962 10,000 Long-term portion $ 260,978 $ 314,373 2017 Debt Facility On February 23, 2017, we entered into a loan agreement with HSBC Bank USA, National Association ("HSBC Bank") whereby HSBC Bank agreed to provide us with a loan in the amount of approximately $7.0 million . The loan matures on February 1, 2018, with an extension available at our option, subject to certain conditions. The loan agreement bears interest at the three-month London Inter-Bank Offered Rate (“LIBOR”) plus 1.0% , which resets quarterly. The loan is secured by assets equal to the currently outstanding loan balance. The loan contains covenants, representations and warranties and other terms customary for loans of this nature. As of September 30, 2017 , our interest rate on the loan was a variable rate of 2.32% . 2016 Term Loan and Revolving Credit Loans On July 6, 2016, we entered into a Second Amended and Restated Credit Agreement (as amended to date, the “Second Amended Credit Agreement”), with Wells Fargo Bank, National Association, as administrative agent, swingline lender and a lender, and Wells Fargo Securities, LLC, as sole lead arranger and sole bookrunner. In addition to Wells Fargo Bank, National Association, Bank of America, N.A., U.S. Bank, National Association, and HSBC Bank, are parties to the Second Amended Credit Agreement as lenders. The Second Amended Credit Agreement amends and restates in its entirety our previously outstanding Amended and Restated Credit Agreement and all amendments thereto. The Second Amended Credit Agreement was amended on September 28, 2016 to allow for a new revolving credit loan to our wholly-owned subsidiary and on March 20, 2017 to allow flexibility in how we apply net proceeds received from equity issuances to prepay outstanding indebtedness. The Second Amended Credit Agreement provides for a term loan of $150 million and a revolving credit commitment up to an aggregate amount of $275 million , which includes a reserve of $25 million to make swingline loans from time to time. The term loan is payable in quarterly installments in the amounts provided in the Second Amended Credit Agreement until the maturity date of July 6, 2021, at which time the term and revolving credit loans, together with accrued interest thereon, will be due and payable. At any time prior to the maturity date, we may repay any amounts owing under all revolving credit loans, term loans, and all swingline loans in whole or in part, subject to certain minimum thresholds, without premium or penalty, other than breakage costs. Revolving credit loans denominated in dollars and term loans made under the Second Amended Credit Agreement bear interest, at our election, at either a Base Rate or Eurocurrency Base Rate (as such terms are defined in the Second Amended Credit Agreement) plus the applicable margin, which increases as our Consolidated Total Leverage Ratio (as defined in the Second Amended Credit Agreement) increases. Revolving credit loans denominated in an Alternative Currency (as defined in the Second Amended Credit Agreement) bear interest at the Eurocurrency rate plus the applicable margin. Swingline loans bear interest at the base rate plus the applicable margin. Upon an event of default, the interest rate may be increased by 2.0% . The revolving credit commitment will also carry a commitment fee of 0.15% to 0.40% per annum on the unused portion. The Second Amended Credit Agreement is collateralized by substantially all our assets. The Second Amended Credit Agreement contains covenants, representations and warranties and other terms customary for loans of this nature. The Second Amended Credit Agreement requires that we maintain certain financial covenants, as follows: Covenant Requirement Consolidated Total Leverage Ratio (1) July 1, 2017 through December 31, 2017 3.75 to 1.0 January 1, 2018 through March 31, 2018 3.5 to 1.0 April 1, 2018 and thereafter 3.25 to 1.0 Consolidated EBITDA (2) 1.25 to 1.0 Consolidated Net Income (3) $0 Facility Capital Expenditures (4) $30 million (1) Maximum Consolidated Total Leverage Ratio (as defined in the Second Amended Credit Agreement) as of any fiscal quarter end. (2) Minimum ratio of Consolidated EBITDA (as defined in the Second Amended Credit Agreement and adjusted for certain expenditures) to Consolidated Fixed Charges (as defined in the Second Amended Credit Agreement) for any period of four consecutive fiscal quarters. (3) Minimum level of Consolidated Net Income (as defined in the Second Amended Credit Agreement) for consecutive periods, and subject to certain adjustments. (4) Maximum level of the aggregate amount of all Facility Capital Expenditures (as defined in the Second Amended Credit Agreement) in any fiscal year. Additionally, the Second Amended Credit Agreement contains customary events of default and affirmative and negative covenants for transactions of this type. As of September 30, 2017 , we believe we were in compliance with all covenants set forth in the Second Amended Credit Agreement. As of September 30, 2017 , we had outstanding borrowings of approximately $271.5 million under the Second Amended Credit Agreement, with available borrowings of approximately $91.0 million , based on the leverage ratio required pursuant to the Second Amended Credit Agreement. Our interest rate as of September 30, 2017 was a fixed rate of 2.23% on $126.3 million and a fixed rate of 2.37% on $48.8 million as a result of interest rate swaps (see Note 10), a variable floating rate of 2.49% on $84.5 million and a variable floating rate of 2.49% on $12.0 million . Our interest rate as of December 31, 2016 was a fixed rate of 2.98% on $130.0 million and 3.12% on $45.0 million as a result of interest rate swaps and a variable floating rate of 2.77% on $150.0 million . Future Payments Future minimum principal payments on our long-term debt as of September 30, 2017 , are as follows (in thousands): Years Ending Future Minimum December 31 Principal Payments Remaining 2017 2,500 2018 19,462 2019 15,000 2020 17,500 2021 224,000 Total future minimum principal payments $ 278,462

Derivatives

Derivatives	9 Months Ended
	Sep. 30, 2017
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivatives	Derivatives General. Our earnings and cash flows are subject to fluctuations due to changes in interest rates and foreign currency exchange rates, and we seek to mitigate a portion of these risks by entering into derivative contracts. The derivatives we use are interest rate swaps and foreign currency forward contracts. We recognize derivatives as either assets or liabilities at fair value in the accompanying consolidated balance sheets, regardless of whether or not hedge accounting is applied. We report cash flows arising from our hedging instruments consistent with the classification of cash flows from the underlying hedged items. Accordingly, cash flows associated with our derivative programs are classified as operating activities in the accompanying consolidated statements of cash flows. We formally document, designate and assess the effectiveness of transactions that receive hedge accounting initially and on an ongoing basis. Changes in the fair value of derivatives that qualify for hedge accounting treatment are recorded, net of applicable taxes, in accumulated other comprehensive income (loss), a component of stockholders’ equity in the accompanying consolidated balance sheets. For the ineffective portions of qualifying hedges, the change in fair value is recorded through earnings in the period of change. Changes in the fair value of derivatives not designated as hedging instruments are recorded in earnings throughout the term of the derivative. Interest Rate Risk. A portion of our debt bears interest at variable interest rates and, therefore, we are subject to variability in the cash paid for interest expense. In order to mitigate a portion of this risk, we use a hedging strategy to reduce the variability of cash flows in the interest payments associated with a portion of the variable-rate debt outstanding under our Second Amended Credit Agreement that is solely due to changes in the benchmark interest rate. Derivatives Designated as Cash Flow Hedges On December 19, 2012, we entered into a pay-fixed, receive-variable interest rate swap having an initial notional amount of $150 million with Wells Fargo to fix the one-month LIBOR rate at 0.98% . The variable portion of the interest rate swap is tied to the one-month LIBOR rate (the benchmark interest rate). The interest rates under both the interest rate swap and the underlying debt reset, the swap is settled with the counterparty, and interest is paid on a monthly basis. The notional amount of the interest rate swap is reduced quarterly by 50% of the minimum principal payment due under the terms of our Second Amended Credit Agreement. The interest rate swap is scheduled to expire on December 19, 2017. On August 5, 2016, we entered into a pay-fixed, receive-variable interest rate swap having an initial notional amount of $42.5 million with Wells Fargo to fix the one-month LIBOR rate at 1.12% . The variable portion of the interest rate swap is tied to the one-month LIBOR rate (the benchmark interest rate). On a monthly basis, the interest rates under both the interest rate swap and the underlying debt reset, the swap is settled with the counterparty, and interest is paid. The notional amount of the interest rate swap increases quarterly by an amount equal to the decrease of the hedge entered into on December 19, 2012, up to the amount of $175.0 million . The interest rate swap is scheduled to expire on July 6, 2021. At September 30, 2017 and December 31, 2016 , our interest rate swaps qualified as cash flow hedges. The fair value of our interest rate swaps at September 30, 2017 was an asset of approximately $4.4 million , which was partially offset by approximately $1.7 million in deferred taxes. The fair value of our interest rate swaps at December 31, 2016 was an asset of approximately $5.0 million , which was partially offset by approximately $1.9 million in deferred taxes. Foreign Currency Risk . We operate on a global basis and are exposed to the risk that our financial condition, results of operations, and cash flows could be adversely affected by changes in foreign currency exchange rates. To reduce the potential effects of foreign currency exchange rate movements on net earnings, we enter into derivative financial instruments in the form of foreign currency exchange forward contracts with major financial institutions. Our policy is to enter into foreign currency derivative contracts with maturities of up to two years. We are primarily exposed to foreign currency exchange rate risk with respect to transactions and balances denominated in Euros, British Pounds, Chinese Yuan Renminbi, Mexican Pesos, Brazilian Reals, Australian Dollars, Hong Kong Dollars, Swiss Francs, Swedish Krona, Canadian Dollars, Singapore Dollars, Japanese Yen, Korean Won, and Danish Krone. Our consolidated financial statements are denominated in, and our principal currency is, the U.S. Dollar. We do not use derivative financial instruments for trading or speculative purposes. We are not subject to any credit risk contingent features related to our derivative contracts, and counterparty risk is managed by allocating derivative contracts among several major financial institutions. Derivatives Designated as Cash Flow Hedges For derivative instruments that are designated and qualify as cash flow hedges, the effective portion of the gain or loss on the derivative instrument is reported as a component of other comprehensive income (loss) and reclassified into earnings in the same line item associated with the forecasted transaction and in the same period or periods during which the hedged transaction affects earnings. The remaining gain or loss on the derivative instrument in excess of the cumulative change in the present value of future cash flows of the hedged item, if any (i.e., the ineffective portion) or hedge components excluded from the assessment of effectiveness, are recognized in earnings during the current period. We enter into forward contracts on various foreign currencies to manage the risk associated with forecasted exchange rates which impact revenues, cost of sales, and operating expenses in various international markets. The objective of the hedges is to reduce the variability of cash flows associated with the forecasted purchase or sale of the associated foreign currencies. We enter into approximately 100 foreign currency cash flow hedges every month. As of September 30, 2017, we had entered into foreign currency forward contracts, which qualified as cash flow hedges, with the following notional amounts (in thousands and in local currencies): Currency Symbol Forward Notional Amount Euro EUR 5,555 Swiss Franc CHF 1,088 Danish Krone DKK 7,775 British Pound GBP 2,550 Mexican Peso MXN 64,425 Swedish Krona SEK 10,805 Derivatives Not Designated as Cash Flow Hedges We forecast our net exposure in various receivables and payables to fluctuations in the value of various currencies, and we enter into foreign currency forward contracts to mitigate that exposure. We enter into approximately 20 foreign currency fair value hedges every month. As of September 30, 2017 , we had entered into foreign currency forward contracts related to those balance sheet accounts with the following notional amounts (in thousands and in local currencies): Currency Symbol Forward Notional Amount Euro EUR 21,801 British Pound GBP 1,128 Chinese Yuan Renminbi CNY 39,954 Mexican Peso MXN 17,537 Brazilian Real BRL 8,500 Australian Dollar AUD 4,599 Hong Kong Dollar HKD 11,000 Swiss Franc CHF 278 Swedish Krona SEK 6,007 Canadian Dollar CAD 1,968 Singapore Dollar SGD 3,585 Japanese Yen JPY 178,500 South Korean Won KRW 1,800,000 Balance Sheet Presentation of Derivatives. As of September 30, 2017 and December 31, 2016, all derivatives, both those designated as hedging instruments and those that were not designated as hedging instruments, were recorded gross at fair value on our consolidated balance sheets. We are not subject to any master netting agreements. The fair value of derivative instruments on a gross basis is as follows (in thousands): Fair Value Balance Sheet Location September 30, 2017 December 31, 2016 Derivatives designated as hedging instruments Assets Interest rate swaps Prepaid expenses and other assets (current) $ 79 $ — Interest rate swaps Other assets (long-term) 4,309 4,991 Foreign currency forward contracts Prepaid expenses and other assets (current) 646 116 Foreign currency forward contracts Other assets (long-term) 158 18 (Liabilities) Foreign currency forward contracts Accrued expenses (current) $ (286 ) $ (275 ) Foreign currency forward contracts Other long-term obligations (96 ) (18 ) Derivatives not designated as hedging instruments Assets Foreign currency forward contracts Prepaid expenses and other assets (current) $ 485 $ 220 (Liabilities) Foreign currency forward contracts Accrued expenses (current) (210 ) (171 ) Income Statement Presentation of Derivatives Derivatives Designated as Cash Flow Hedges Derivative instruments designated as cash flow hedges had the following effects, before income taxes, on other comprehensive income and net earnings in our consolidated statements of income, consolidated statements of comprehensive income and consolidated balance sheets (in thousands): Amount of Gain/(Loss) recognized in OCI Amount of Gain/(Loss) reclassified from AOCI Three Months Ended September 30, Three Months Ended September 30, 2017 2016 2017 2016 Derivative instrument Location in Statements of Income Interest rate swaps $ 1 $ (256 ) Interest expense $ 96 $ (153 ) Foreign currency forward contracts 100 — Revenue (101 ) — Cost of goods sold 250 — Amount of Gain/(Loss) recognized in OCI Amount of Gain/(Loss) reclassified from AOCI Nine Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Derivative instrument Location in Statements of Income Interest rate swaps $ (611 ) $ (1,503 ) Interest expense $ (8 ) $ (519 ) Foreign currency forward contracts 841 — Revenue (141 ) — Cost of goods sold 213 — The net amount recognized in earnings during the three and nine-month periods ended September 30, 2017 and 2016 due to ineffectiveness and amounts excluded from the assessment of hedge effectiveness were not significant. As of September 30, 2017, approximately $461,000 , or $282,000 after taxes, was expected to be reclassified from accumulated other comprehensive income to earnings in revenue and cost of sales over the succeeding twelve months. As of September 30, 2017, approximately $ 624,000 , or $381,000 after taxes, was expected to be reclassified from accumulated other comprehensive income to earnings in interest expense over the succeeding twelve months. Derivatives Not Designated as Hedging Instruments The following gains/(losses) from these derivative instruments were recognized in our consolidated statements of income for the periods presented (in thousands): Three months ended September 30, Nine months ended September 30, 2017 2016 2017 2016 Derivative Instrument Location in Statements of Income Foreign currency forward contracts Other income (expense) $ (1,459 ) $ (76 ) $ (4,150 ) $ (222 ) See Note 11 for more information about our derivatives.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2017
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements. Our financial assets and (liabilities) carried at fair value measured on a recurring basis as of September 30, 2017 and December 31, 2016 , consisted of the following (in thousands): Fair Value Measurements Using Total Fair Quoted prices in Significant other Significant Value at active markets observable inputs unobservable inputs Description September 30, 2017 (Level 1) (Level 2) (Level 3) Interest rate contracts (1) $ 4,388 $ — $ 4,388 $ — Foreign currency contract assets, current and long-term (2) $ 1,289 $ — $ 1,289 $ — Foreign currency contract liabilities, current and long-term (3) $ (592 ) $ — $ (592 ) $ — Fair Value Measurements Using Total Fair Quoted prices in Significant other Significant Value at active markets observable inputs unobservable inputs Description December 31, 2016 (Level 1) (Level 2) (Level 3) Interest rate contracts (1) $ 4,991 $ — $ 4,991 $ — Foreign currency contract assets, current and long-term (2) $ 354 $ — $ 354 $ — Foreign currency contract liabilities, current and long-term (3) $ (464 ) $ — $ (464 ) $ — (1) The fair value of the interest rate contracts is determined using Level 2 fair value inputs and is recorded as prepaid expenses and other assets (current) and other assets (long-term) in the consolidated balance sheets. (2) The fair value of the foreign currency contract assets (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as prepaid expenses and other assets (current) and other assets (long-term) in the consolidated balance sheets. (3) The fair value of the foreign currency contract liabilities (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as accrued expenses (current) and other long-term obligations in the consolidated balance sheets. Certain of our business combinations involve the potential for the payment of future contingent consideration, generally based on a percentage of future product sales or upon attaining specified future revenue milestones. See Note 5 for further information regarding these acquisitions. The contingent consideration liability is re-measured at the estimated fair value each reporting period with the change in fair value recognized within operating expenses in the accompanying consolidated statements of income. We measure the initial liability and re-measure the liability on a recurring basis using Level 3 inputs as defined under authoritative guidance for fair value measurements. Changes in the fair value of our contingent consideration liability during the three and nine-month periods ended September 30, 2017 and 2016 , consisted of the following (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Beginning balance $ 5,572 $ 898 $ 683 $ 1,024 Contingent consideration liability recorded as the result of acquisitions (see Note 5) 5,500 — 10,400 — Fair value adjustments recorded to income during the period 20 (193 ) 39 (136 ) Contingent payments made (15 ) (16 ) (45 ) (199 ) Ending balance $ 11,077 $ 689 $ 11,077 $ 689 The recurring Level 3 measurement of our contingent consideration liabilities and contingent receivable includes the following significant unobservable inputs at September 30, 2017 and December 31, 2016 (amounts in thousands): Contingent consideration asset or liability Fair value at September 30, 2017 Valuation technique Unobservable inputs Range Revenue-based payments $ 11,077 Discounted cash flow Discount rate 9.9% - 15% contingent liability Probability of milestone payment 100% Projected year of payments 2017-2037 Contingent receivable $ 528 Discounted cash flow Discount rate 10% asset Probability of milestone payment 57% Projected year of payments 2017-2019 Contingent consideration asset or liability Fair value at December 31, 2016 Valuation technique Unobservable inputs Range Revenue-based payments $ 683 Discounted cash flow Discount rate 9.9% - 15% contingent liability Probability of milestone payment 100% Projected year of payments 2017-2028 Contingent receivable $ 528 Discounted cash flow Discount rate 10% asset Probability of milestone payment 57% Projected year of payments 2017-2019 The contingent consideration liabilities and contingent receivable are re-measured to fair value each reporting period using projected revenues, discount rates, probabilities of payment, and projected payment dates. Projected contingent payment amounts are discounted back to the current period using a discounted cash flow model. Projected revenues are based on our most recent internal operational budgets and long-range strategic plans. An increase (decrease) in either the discount rate or the time to payment, in isolation, may result in a significantly lower (higher) fair value measurement. A decrease in the probability of any milestone payment may result in lower fair value measurements. Our determination of the fair value of the contingent consideration liabilities and contingent receivable could change in future periods based upon our ongoing evaluation of these significant unobservable inputs. We record any such change in fair value to operating expenses in our consolidated statements of income. As of September 30, 2017, approximately $10.8 million was included in other long-term obligations and $243,000 was included in accrued expenses in our consolidated balance sheet. As of December 31, 2016, approximately $595,000 was included in other long-term obligations and $88,000 was included in accrued expenses in our consolidated balance sheet. The cash paid to settle the contingent consideration liability recognized at fair value as of the acquisition date (including measurement-period adjustments) has been reflected as a cash outflow from financing activities in the accompanying consolidated statements of cash flows. During the three and nine-month periods ended September 30, 2017, we had losses of approximately $67,000 , and $86,000 , respectively, compared to losses of approximately $0 and $90,000 for the three and nine-month periods ended September 30, 2016, respectively, related to the measurement of non-financial assets at fair value on a nonrecurring basis subsequent to their initial recognition. The carrying amount of cash and cash equivalents, trade receivables, and trade payables approximate fair value because of the immediate, short-term maturity of these financial instruments. The carrying amount of long-term debt approximates fair value, as determined by borrowing rates estimated to be available to us for debt with similar terms and conditions. The fair value of assets and liabilities whose carrying value approximates fair value is determined using Level 2 inputs, with the exception of cash and cash equivalents, which are Level 1 inputs.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and Intangible Assets. The changes in the carrying amount of goodwill for the nine-month period ended September 30, 2017 were as follows (in thousands): 2017 Goodwill balance at January 1 $ 211,927 Effect of foreign exchange 2,418 Additions as the result of acquisitions 19,698 Goodwill balance at September 30 $ 234,043 As of September 30, 2017 , we had recorded approximately $8.3 million of accumulated goodwill impairment charges. The goodwill balances as of September 30, 2017 and December 31, 2016 , were related to our cardiovascular segment. Other intangible assets at September 30, 2017 and December 31, 2016 , consisted of the following (in thousands): September 30, 2017 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Patents $ 15,972 $ (3,586 ) $ 12,386 Distribution agreements 6,626 (4,248 ) 2,378 License agreements 23,804 (4,387 ) 19,417 Trademarks 16,220 (4,342 ) 11,878 Covenants not to compete 1,028 (961 ) 67 Customer lists 25,942 (17,461 ) 8,481 In-process technology 1,100 — 1,100 Total $ 90,692 $ (34,985 ) $ 55,707 December 31, 2016 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Patents $ 14,130 $ (3,165 ) $ 10,965 Distribution agreements 6,626 (3,527 ) 3,099 License agreements 20,695 (3,422 ) 17,273 Trademarks 12,380 (3,330 ) 9,050 Covenants not to compete 1,028 (936 ) 92 Customer lists 22,261 (15,401 ) 6,860 Royalty agreements 267 (267 ) — Total $ 77,387 $ (30,048 ) $ 47,339 Aggregate amortization expense for the three and nine-month periods ended September 30, 2017 was approximately $7.0 million and $19.4 million , respectively. For the three and nine-month periods ended September 30, 2016, aggregate amortization expense was approximately $5.7 million and $13.6 million , respectively. Estimated amortization expense for the developed technology and other intangible assets for the next five years consists of the following as of September 30, 2017 (in thousands): Year Ending December 31 Remaining 2017 $ 6,745 2018 26,152 2019 25,678 2020 24,524 2021 18,013

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2017
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies. In the ordinary course of business, we are involved in various claims and litigation matters. These claims and litigation matters may include actions involving product liability, intellectual property, contractual, and employment matters. We do not believe that any such actions are likely to be, individually or in the aggregate, material to our business, financial condition, results of operations or liquidity. However, in the event of unexpected further developments, it is possible that the ultimate resolution of these matters, or other similar matters, if unfavorable, may be materially adverse to our business, financial condition, results of operations or liquidity. Legal costs for these matters such as outside counsel fees and expenses are charged to expense in the period incurred. In October 2016, we received a subpoena from the U.S. Department of Justice seeking information on certain of our marketing and promotional practices. We are in the process of responding to the subpoena, which we anticipate will continue during 2017. We have incurred, and anticipate that we will continue to incur, substantial costs in connection with the matter. We incurred approximately $2.1 million and $10.6 million of expenses for the three and nine-month periods ended September 30, 2017 , respectively, responding to the pending subpoena from the U.S. Department of Justice. We expect that these expenses will be in a similar range in subsequent periods and may potentially be higher, depending on the progress of the investigation and other factors beyond our control. The investigation is ongoing and at this stage we are unable to predict its scope, duration or outcome. Investigations such as this may result in the imposition of, among other things, significant damages, injunctions, fines or civil or criminal claims or penalties against our company or individuals. In the event of unexpected further developments, it is possible that the ultimate resolution of any of the foregoing matters, or other similar matters, if resolved in a manner unfavorable to us, may be materially adverse to our business, financial condition, results of operations or liquidity. Legal costs for these matters, such as outside counsel fees and expenses, are charged to expense in the period incurred.

Issuance of Common Stock

Issuance of Common Stock	9 Months Ended
	Sep. 30, 2017
Equity [Abstract]
Issuance of Common Stock	Issuance of Common Stock . On March 28, 2017, we closed a public offering of 5,175,000 shares of common stock and received proceeds of approximately $136.6 million , which is net of approximately $8.8 million in underwriting discounts and commissions and approximately $816,000 in other direct cost incurred and paid by us in connection with this equity offering. The net proceeds from the offering were used primarily to repay outstanding indebtedness under our Second Amended Credit Agreement (including our term loan and revolving credit loans).

Subsequent Events

Subsequent Events	9 Months Ended
	Sep. 30, 2017
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events . We have evaluated whether any subsequent events have occurred from September 30, 2017 to the time of filing of this report that would require disclosure in the consolidated financial statements. We note the following event below: On October 2, 2017, we entered into a share purchase agreement with ITL Healthcare Pty Ltd, a custom procedure pack business located in Melbourne, Australia. The transaction was financed with a combination of cash and existing credit facilities, which totaled approximately $11.3 million . We are currently evaluating the accounting treatment of this purchase, as well as performing the valuation of the assets acquired and the related purchase price allocation.

Basis of Presentation (Policies

Basis of Presentation (Policies)	9 Months Ended
	Sep. 30, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Principles of Consolidation	The interim consolidated financial statements of Merit Medical Systems, Inc. ("Merit," "we" or "us") for the three and nine-month periods ended September 30, 2017 and 2016 are not audited. Our consolidated financial statements are prepared in accordance with the requirements for unaudited interim periods and, consequently, do not include all disclosures required to be made in conformity with accounting principles generally accepted in the United States of America ("U.S. GAAP"). In the opinion of our management, the accompanying consolidated financial statements contain all adjustments, consisting of normal recurring accruals, necessary for a fair presentation of our financial position as of September 30, 2017 and December 31, 2016 , and our results of operations and cash flows for the three and nine-month periods ended September 30, 2017 and 2016 . The results of operations for the three and nine-month periods ended September 30, 2017 and 2016 are not necessarily indicative of the results for a full-year period. These interim consolidated financial statements should be read in conjunction with the financial statements included in our Annual Report on Form 10-K (the "2016 Form 10-K") for the year ended December 31, 2016 , which was filed with the Securities and Exchange Commission (the "SEC") on March 1, 2017.
New Accounting Pronouncements	Financial Accounting Standards . Recently Adopted In January 2017, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standards Update (“ASU”) No. 2017-04, Intangibles - Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment , which eliminates the requirement to determine the fair value of individual assets and liabilities of a reporting unit to measure goodwill impairment. Under these amendments, goodwill impairment testing will be performed by comparing the fair value of the reporting unit with its carrying amount and recognizing an impairment charge for the amount by which the carrying amount exceeds the reporting unit’s fair value. We adopted ASU 2017-04 effective January 1, 2017 on a prospective basis, and it did not have a material impact on our consolidated financial statements for the nine months ended September 30, 2017. In January 2017, the FASB issued ASU No. 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business , which provides guidance to entities to assist with evaluating when a set of transferred assets and activities is a business and provides a screen to determine when a set is not a business. Under the new guidance, when substantially all the fair value of gross assets acquired (or disposed of) is concentrated in a single identifiable asset, or group of similar assets, the assets acquired would not represent a business. Also, to be considered a business, an acquisition would have to include an input and a substantive process that together significantly contribute to the ability to produce outputs. We adopted ASU 2017-01 effective January 1, 2017 on a prospective basis. The implementation of ASU 2017-01 did not have a material impact on our consolidated financial statements for the nine months ended September 30, 2017. In March 2016, the FASB issued ASU No. 2016-09, Compensation - Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting , which requires companies to record excess tax benefits and deficiencies in income rather than the current requirement to record them through equity. ASU 2016-09 also allows companies the option to recognize forfeitures of share-based awards when they occur rather than the previous requirement to make an estimate upon the grant of the awards. We adopted ASU 2016-09 effective January 1, 2017 on a prospective basis and, as such, no prior periods were adjusted. In accordance with the new standard and prospectively since the date we adopted ASU 2016-09, excess tax benefits from stock-based compensation are reported as an income tax benefit in our consolidated statements of income (see Note 8). In November 2015, the FASB issued ASU No. 2015-17, Income Taxes (Topic 740): Balance Sheet Classification of Deferred Taxes , which requires all deferred tax assets and deferred tax liabilities to be presented as noncurrent within a classified balance sheet. We adopted ASU 2015-17 effective January 1, 2017 on a prospective basis and did not reclassify presentation of prior year balances. The adoption of this standard did not have a material impact on our consolidated financial statements for the nine months ended September 30, 2017. In July 2015, the FASB issued ASU No. 2015-11, Simplifying the Measurement of Inventory . ASU 2015-11 requires that inventory be measured at the lower of cost or net realizable value. Net realizable value is the estimated selling price in the ordinary course of business, less reasonably predictable costs of completion, disposal, and transportation. Inventory measured using last-in, first-out or the retail inventory method are excluded from the scope of ASU 2015-11, which is effective for fiscal years beginning after December 15, 2016, and interim periods within those fiscal years. The implementation of ASU 2015-11 did not have a material impact on our consolidated financial statements for the nine months ended September 30, 2017. Not Yet Adopted In August 2017, the FASB issued ASU 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities , which expands and refines hedge accounting for both financial and non-financial risk components, aligns the recognition and presentation of the effects of hedging instruments and hedge items in the financial statements, and includes certain targeted improvements to ease the application of current guidance related to the assessment of hedge effectiveness. ASU 2017-12 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. Early adoption is permitted. We are currently evaluating the anticipated impact of adopting ASU 2017-12 on our consolidated financial statements. In October 2016, the FASB issued ASU No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other than Inventory , which requires the recognition of the income tax consequences of an intra-entity transfer of an asset, other than inventory, when the transfer occurs. ASU 2016-16 will be effective for us on January 1, 2018. We do not presently anticipate that the adoption of ASU 2016-16 will have a material impact on our consolidated financial statements. In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments , which addresses eight specific cash flow issues with the objective of reducing the existing diversity in practice in how certain cash receipts and cash payments are presented and classified in the statement of cash flows. ASU 2016-15 will be effective for us on January 1, 2018 with early adoption permitted. We do not presently anticipate that the adoption of ASU 2016-15 will have a material impact on our consolidated financial statements. In February 2016, the FASB issued ASU No. 2016-02, Leases , which eliminates the current tests for lease classification under U.S. GAAP and requires lessees to recognize the right-of-use assets and related lease liabilities on the balance sheet for all leases greater than one year in duration. ASU 2016-02 is effective for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years. Early adoption of ASU 2016-02 is permitted. ASU 2016-02 provides that lessees (for capital and operating leases) and lessors (for sales-type, direct financing, and operating leases) must apply a modified retrospective transition approach for leases existing at, or entered into after, the beginning of the earliest comparative period presented in the financial statements. The modified retrospective approach would not require any transition accounting for leases that expired before the earliest comparative period presented. Lessees and lessors may not apply a full retrospective transition approach. We are assessing the impact that ASU 2016-02 is anticipated to have on our consolidated financial statements. We currently expect that most of our operating lease commitments will be subject to the new standard and recognized as lease liabilities and right-of-use assets upon our adoption of ASU 2016-02. In January 2016, the FASB issued ASU No. 2016-01, Financial Instruments - Overall: Recognition and Measurement of Financial Assets and Financial Liabilities, which amends the guidance regarding the classification and measurement of financial instruments. Changes to the current guidance primarily affect the accounting for equity investments, financial liabilities under the fair value option, and the presentation and disclosure requirements for financial instruments. In addition, ASU 2016-01 clarifies guidance related to the valuation allowance assessment when recognizing deferred tax assets resulting from unrealized losses on available-for-sale debt securities. ASU 2016-01 will be effective for us on January 1, 2018. Early adoption is not permitted except for the provision to record fair value changes for financial liabilities under the fair value option resulting from instrument-specific credit risk in other comprehensive income. Upon adoption of ASU 2016-01, an entity should apply the amendments by means of a cumulative-effect adjustment to the balance sheet at the beginning of the first reporting period in which the guidance is effective. We do not presently anticipate that the adoption of ASU 2016-01 will have a material impact on our financial statements. In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606) , to update the financial reporting requirements for revenue recognition. Topic 606 outlines a single comprehensive model for entities to use in accounting for revenue arising from contracts with customers and supersedes most current revenue recognition guidance, including industry-specific guidance. The guidance is based on the principle that an entity should recognize revenue to depict the transfer of goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. The guidance also requires additional disclosure about the nature, amount, timing and uncertainty of revenue and cash flows arising from customer contracts, including significant judgments and changes in judgments and assets recognized from costs incurred to fulfill a contract. This guidance is effective for us beginning on January 1, 2018, and entities have the option of using either a full retrospective or a modified retrospective approach for the adoption of the new standard. We expect to adopt this standard using the modified retrospective approach beginning in 2018. We have substantially completed our impact assessment of implementing this guidance. We have evaluated each of the five steps in Topic 606, which are as follows: 1) Identify the contract with the customer; 2) Identify the performance obligations in the contract; 3) Determine the transaction price; 4) Allocate the transaction price to the performance obligations; and 5) Recognize revenue when (or as) performance obligations are satisfied. Our preliminary conclusion is that we expect to identify similar performance obligations under ASC Topic 606 as compared with deliverables and separate units of account previously identified. The Company does not expect revenue to be affected materially in any period due to the adoption of ASC Topic 606 because the Company believes it would have sufficient information to conclude that the transaction price was fixed or determinable under current GAAP and would have recorded revenue upon shipment or delivery under either ASC Topic 605 or ASC Topic 606. Additionally, the Company does not expect cost of sales (product) to be affected materially in any period due to the adoption of Topic 606. We continue to evaluate the impact that this new standard will have on our Original Equipment Manufacturing arrangements. There are also certain considerations related to accounting policies, business processes and internal control over financial reporting that are associated with implementing Topic 606. We are currently evaluating our policies, processes, and control framework for revenue recognition and identifying any changes that may need to be made in response to the new guidance. Disclosure requirements under the new guidance in Topic 606 have been significantly expanded in comparison to the disclosure requirements under the current guidance, including disclosures related to disaggregation of revenue into appropriate categories, performance obligations, the judgments made in revenue recognition determinations, adjustments to revenue which relate to activities from previous quarters or years, any significant reversals of revenue, and costs to obtain or fulfill contracts. Designing and implementing the appropriate controls over gathering and reporting the information required under Topic 606 is currently in process, and we anticipate it will be completed prior to January 1, 2018.
Derivatives	General. Our earnings and cash flows are subject to fluctuations due to changes in interest rates and foreign currency exchange rates, and we seek to mitigate a portion of these risks by entering into derivative contracts. The derivatives we use are interest rate swaps and foreign currency forward contracts. We recognize derivatives as either assets or liabilities at fair value in the accompanying consolidated balance sheets, regardless of whether or not hedge accounting is applied. We report cash flows arising from our hedging instruments consistent with the classification of cash flows from the underlying hedged items. Accordingly, cash flows associated with our derivative programs are classified as operating activities in the accompanying consolidated statements of cash flows. We formally document, designate and assess the effectiveness of transactions that receive hedge accounting initially and on an ongoing basis. Changes in the fair value of derivatives that qualify for hedge accounting treatment are recorded, net of applicable taxes, in accumulated other comprehensive income (loss), a component of stockholders’ equity in the accompanying consolidated balance sheets. For the ineffective portions of qualifying hedges, the change in fair value is recorded through earnings in the period of change. Changes in the fair value of derivatives not designated as hedging instruments are recorded in earnings throughout the term of the derivative. Interest Rate Risk. A portion of our debt bears interest at variable interest rates and, therefore, we are subject to variability in the cash paid for interest expense. In order to mitigate a portion of this risk, we use a hedging strategy to reduce the variability of cash flows in the interest payments associated with a portion of the variable-rate debt outstanding under our Second Amended Credit Agreement that is solely due to changes in the benchmark interest rate. Derivatives Designated as Cash Flow Hedges On December 19, 2012, we entered into a pay-fixed, receive-variable interest rate swap having an initial notional amount of $150 million with Wells Fargo to fix the one-month LIBOR rate at 0.98% . The variable portion of the interest rate swap is tied to the one-month LIBOR rate (the benchmark interest rate). The interest rates under both the interest rate swap and the underlying debt reset, the swap is settled with the counterparty, and interest is paid on a monthly basis. The notional amount of the interest rate swap is reduced quarterly by 50% of the minimum principal payment due under the terms of our Second Amended Credit Agreement. The interest rate swap is scheduled to expire on December 19, 2017. On August 5, 2016, we entered into a pay-fixed, receive-variable interest rate swap having an initial notional amount of $42.5 million with Wells Fargo to fix the one-month LIBOR rate at 1.12% . The variable portion of the interest rate swap is tied to the one-month LIBOR rate (the benchmark interest rate). On a monthly basis, the interest rates under both the interest rate swap and the underlying debt reset, the swap is settled with the counterparty, and interest is paid. The notional amount of the interest rate swap increases quarterly by an amount equal to the decrease of the hedge entered into on December 19, 2012, up to the amount of $175.0 million . The interest rate swap is scheduled to expire on July 6, 2021. At September 30, 2017 and December 31, 2016 , our interest rate swaps qualified as cash flow hedges. The fair value of our interest rate swaps at September 30, 2017 was an asset of approximately $4.4 million , which was partially offset by approximately $1.7 million in deferred taxes. The fair value of our interest rate swaps at December 31, 2016 was an asset of approximately $5.0 million , which was partially offset by approximately $1.9 million in deferred taxes. Foreign Currency Risk . We operate on a global basis and are exposed to the risk that our financial condition, results of operations, and cash flows could be adversely affected by changes in foreign currency exchange rates. To reduce the potential effects of foreign currency exchange rate movements on net earnings, we enter into derivative financial instruments in the form of foreign currency exchange forward contracts with major financial institutions. Our policy is to enter into foreign currency derivative contracts with maturities of up to two years. We are primarily exposed to foreign currency exchange rate risk with respect to transactions and balances denominated in Euros, British Pounds, Chinese Yuan Renminbi, Mexican Pesos, Brazilian Reals, Australian Dollars, Hong Kong Dollars, Swiss Francs, Swedish Krona, Canadian Dollars, Singapore Dollars, Japanese Yen, Korean Won, and Danish Krone. Our consolidated financial statements are denominated in, and our principal currency is, the U.S. Dollar. We do not use derivative financial instruments for trading or speculative purposes. We are not subject to any credit risk contingent features related to our derivative contracts, and counterparty risk is managed by allocating derivative contracts among several major financial institutions. Derivatives Designated as Cash Flow Hedges For derivative instruments that are designated and qualify as cash flow hedges, the effective portion of the gain or loss on the derivative instrument is reported as a component of other comprehensive income (loss) and reclassified into earnings in the same line item associated with the forecasted transaction and in the same period or periods during which the hedged transaction affects earnings. The remaining gain or loss on the derivative instrument in excess of the cumulative change in the present value of future cash flows of the hedged item, if any (i.e., the ineffective portion) or hedge components excluded from the assessment of effectiveness, are recognized in earnings during the current period. We enter into forward contracts on various foreign currencies to manage the risk associated with forecasted exchange rates which impact revenues, cost of sales, and operating expenses in various international markets. The objective of the hedges is to reduce the variability of cash flows associated with the forecasted purchase or sale of the associated foreign currencies.

Inventories (Tables)

Inventories (Tables)	9 Months Ended
	Sep. 30, 2017
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventories at September 30, 2017 and December 31, 2016 consisted of the following (in thousands): September 30, December 31, 2017 2016 Finished goods $ 80,708 $ 63,852 Work-in-process 18,162 11,008 Raw materials 46,728 45,835 Total $ 145,598 $ 120,695

Stock Based Compensation (Table

Stock Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2017
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Schedule of Employee Service Share-based Compensation, Allocation of Recognized Period Costs	Stock-based compensation expense before income tax expense for the three and nine-month periods ended September 30, 2017 and 2016 , consisted of the following (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Cost of goods sold $ 189 $ 105 $ 453 $ 369 Research and development 110 51 262 147 Selling, general, and administrative 893 347 2,168 1,397 Stock-based compensation expense before taxes $ 1,192 $ 503 $ 2,883 $ 1,913
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions	In applying the Black-Scholes methodology to the options granted during the nine-month periods ended September 30, 2017 and 2016 , the fair value of our stock-based awards granted was estimated using the following assumptions for the periods indicated below: Nine Months Ended September 30, 2017 2016 Risk-free interest rate 1.77% - 1.83% 1.15% - 1.40% Expected option life 5.0 years 5.0 years Expected dividend yield —% —% Expected price volatility 33.81% - 34.07% 36.30% - 37.06%

Earnings Per Common Share (EP26

Earnings Per Common Share (EPS) (Tables)	9 Months Ended
	Sep. 30, 2017
Earnings Per Share, Basic and Diluted [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	The computation of weighted average shares outstanding and the basic and diluted earnings per common share for the following periods consisted of the following (in thousands, except per share amounts): Three Months Nine Months Net Income Shares Per Share Amount Net Income Shares Per Share Amount Period ended September 30, 2017: Basic EPS $ (3,569 ) 50,150 $ (0.07 ) $ 20,717 48,332 $ 0.43 Effect of dilutive stock options and warrants 1,449 1,223 Diluted EPS $ (3,569 ) 51,599 $ (0.07 ) $ 20,717 49,555 $ 0.42 Stock options excluded from the calculation of common stock equivalents as the impact was anti-dilutive 200 434 Period ended September 30, 2016: Basic EPS $ 973 44,447 $ 0.02 $ 12,615 44,346 $ 0.28 Effect of dilutive stock options and warrants 553 417 Diluted EPS $ 973 45,000 $ 0.02 $ 12,615 44,763 $ 0.28 Stock options excluded from the calculation of common stock equivalents as the impact was anti-dilutive 408 864

Acquisitions (Tables)

Acquisitions (Tables)	9 Months Ended
	Sep. 30, 2017
Business Combinations [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The purchase price was allocated as follows (in thousands): Assets Acquired Inventories $ 2,455 Property and equipment 290 Intangibles Developed technology 12,100 Trademarks 700 Customers Lists 400 Goodwill 2,555 Total assets acquired $ 18,500 The purchase price was preliminarily allocated as follows (in thousands): Preliminary Allocation Adjustments (1) Revised Preliminary Allocation Assets Acquired Trade receivables $ 952 $ 7 $ 959 Inventories 2,244 (87 ) 2,157 Prepaid expenses and other assets 181 (96 ) 85 Property and equipment 1,472 — 1,472 Intangibles Developed technology 22,900 (1,800 ) 21,100 Customer lists 100 600 700 Trademarks 2,900 — 2,900 Goodwill 7,612 1,376 8,988 Total assets acquired 38,361 — 38,361 Liabilities Assumed Trade payables (338 ) — (338 ) Accrued expenses (23 ) — (23 ) Total liabilities assumed (361 ) — (361 ) Net assets acquired $ 38,000 $ — $ 38,000 (1) Amounts represent adjustments to the preliminary purchase price first presented in our Quarterly Report on Form 10-Q for the Quarter Ended March 31, 2017, resulting from our ongoing activities with respect to finalizing our purchase price allocation for this acquisition. The larger adjustments primarily relate to the valuation of the acquired intangible assets. The following table summarizes the preliminary purchase price allocated to the net tangible and intangible assets acquired and liabilities assumed (in thousands), adjusted as of September 30, 2017: Preliminary Allocation Adjustments (2) Revised Preliminary Allocation Assets Acquired Cash and cash equivalents $ 1,436 $ — $ 1,436 Trade receivables 8,351 — 8,351 Inventories 12,217 (995 ) 11,222 Prepaid expenses and other assets 1,275 — 1,275 Property and equipment 2,667 (348 ) 2,319 Deferred tax assets 184 19 203 Intangibles Developed technology 2,600 (400 ) 2,200 Customer lists 1,300 200 1,500 Trademarks 1,500 (600 ) 900 Total assets acquired 31,530 (2,124 ) 29,406 Liabilities Assumed Trade payables (2,306 ) (109 ) (2,415 ) Accrued expenses (5,083 ) — (5,083 ) Income taxes payable (2 ) — (2 ) Deferred income tax liabilities (999 ) (11 ) (1,010 ) Total liabilities assumed (8,390 ) (120 ) (8,510 ) Total net assets acquired 23,140 (2,244 ) 20,896 Gain on bargain purchase (1) (12,243 ) 1,447 (10,796 ) Total purchase price $ 10,897 $ (797 ) $ 10,100 (1) The total fair value of the net assets acquired from Argon exceeded the purchase price, resulting in a gain on bargain purchase which was recorded within other income (expense) in our consolidated statements of income, and includes a negative adjustment of $778,000 in the three-month period ended September 30, 2017 (in addition to the negative adjustment of $669,000 in the three-month period ended June 30, 2017). We believe the reason for the provisional gain on bargain purchase was a result of the divestiture of a non-strategic, slow-growth critical care business for Argon. It is our understanding that the divestiture allows Argon to focus on its higher growth interventional portfolio. (2) Amounts represent adjustments to the preliminary purchase price allocation first presented in our March 31, 2017 Form 10-Q resulting from our ongoing activities, including reassessment of the assets acquired and liabilities assumed, with respect to finalizing our purchase price allocation for this acquisition. We accounted for this acquisition as a business combination. The following table summarizes the aggregate purchase price (including contingent royalty payment liabilities) allocated to the assets acquired from Laurane (in thousands): Preliminary Allocation Net Assets Acquired Inventories $ 579 Intangibles Developed technology 14,920 Customer list 120 Goodwill 6,381 Total net assets acquired $ 22,000 The following table summarizes the preliminary purchase price allocated to the net assets acquired and liabilities assumed (in thousands): Preliminary Allocation Adjustments (1) Revised Preliminary Allocation Net Assets Acquired Intangibles Developed technology $ 7,800 $ — $ 7,800 In-process technology 850 250 1,100 Goodwill 4,323 (153 ) 4,170 Deferred tax liabilities (3,073 ) (97 ) (3,170 ) Total net assets acquired $ 9,900 $ — $ 9,900 (1) Amounts represent adjustments to the preliminary purchase price allocation first presented in our Quarterly Report on Form 10-Q for the quarter ended June 30, 2017 resulting from our ongoing activities, including reassessment of the assets acquired and liabilities assumed, with respect to finalizing our purchase price allocation for this acquisition. The purchase price was allocated to the net tangible and intangible assets acquired and liabilities assumed, based on estimated fair values, as follows (in thousands): Assets Acquired Trade receivables $ 4,054 Other receivables 6 Inventories 8,585 Prepaid expenses 630 Property and equipment 1,630 Other long-term assets 145 Intangibles Developed technology 67,600 Customer lists 2,400 Trademarks 4,400 Goodwill 24,818 Total assets acquired 114,268 Liabilities Assumed Trade payables (1,790 ) Accrued expenses (5,298 ) Deferred income tax liabilities - current (701 ) Deferred income tax liabilities - noncurrent (10,844 ) Total liabilities assumed (18,633 ) Net assets acquired, net of cash received of $1,327 $ 95,635 The following table summarizes the preliminary purchase price allocated to the net assets acquired (in thousands): Preliminary Allocation Net Assets Acquired Inventories $ 1,023 Property and equipment 58 Intangibles Developed technology 5,400 Customer list 200 Goodwill 159 Total net assets acquired $ 6,840
Business Acquisition, Pro Forma Information	The following table summarizes our consolidated results of operations for the three-month period ended September 30, 2016 and the nine-month periods ended September 30, 2017 and 2016, as well as unaudited pro forma consolidated results of operations as though the DFINE acquisition had occurred on January 1, 2015 and the acquisition of the Argon critical care division had occurred on January 1, 2016 (in thousands, except per share amounts): Three Months Ended Nine Months Ended Nine Months Ended September 30, 2016 September 30, 2017 September 30, 2016 As Reported Pro Forma As Reported Pro Forma As Reported Pro Forma Net Sales $ 156,975 $ 167,321 $ 536,955 $ 539,715 $ 446,123 $ 494,589 Net Income 973 1,174 20,717 10,047 12,615 16,454 Earnings per common share: Basic $ 0.02 $ 0.03 $ 0.43 $ 0.21 $ 0.28 $ 0.37 Diluted $ 0.02 $ 0.03 $ 0.42 $ 0.20 $ 0.28 $ 0.37 * The pro forma results for the three-month period ended September 30, 2017 are not included in the table above because the operating and financial results for the DFINE and Argon critical care division acquisitions were included in our consolidated statements of income for this period.

Segment Reporting (Tables)

Segment Reporting (Tables)	9 Months Ended
	Sep. 30, 2017
Segment Reporting [Abstract]
Schedule of Segment Reporting Information, by Segment	Financial information relating to our reportable operating segments and reconciliations to the consolidated totals for the three and nine-month periods ended September 30, 2017 and 2016 , are as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Net Sales (1) Cardiovascular $ 172,723 $ 150,503 $ 517,140 $ 428,571 Endoscopy 6,614 6,472 19,815 17,552 Total net sales 179,337 156,975 536,955 446,123 Operating Income (Loss) (1) Cardiovascular (1,207 ) 1,858 14,239 19,385 Endoscopy 2,086 1,129 5,611 2,889 Total operating income 879 2,987 19,850 22,274

Revolving Credit Facility and29

Revolving Credit Facility and Long-Term Debt (Tables)	9 Months Ended
	Sep. 30, 2017
Debt Disclosure [Abstract]
Schedule of Long-term Debt Instruments	Our outstanding debt obligations as of September 30, 2017 and December 31, 2016 , consisted of the following (in thousands): September 30, 2017 December 31, 2016 2016 Term loan $ 87,500 $ 145,000 2016 Revolving credit loans 184,000 180,000 2017 Debt facility 6,962 — Less debt issuance costs (522 ) (627 ) Total debt 277,940 324,373 Less current portion 16,962 10,000 Long-term portion $ 260,978 $ 314,373
Schedule of Long-term Debt Covenants	The Second Amended Credit Agreement requires that we maintain certain financial covenants, as follows: Covenant Requirement Consolidated Total Leverage Ratio (1) July 1, 2017 through December 31, 2017 3.75 to 1.0 January 1, 2018 through March 31, 2018 3.5 to 1.0 April 1, 2018 and thereafter 3.25 to 1.0 Consolidated EBITDA (2) 1.25 to 1.0 Consolidated Net Income (3) $0 Facility Capital Expenditures (4) $30 million (1) Maximum Consolidated Total Leverage Ratio (as defined in the Second Amended Credit Agreement) as of any fiscal quarter end. (2) Minimum ratio of Consolidated EBITDA (as defined in the Second Amended Credit Agreement and adjusted for certain expenditures) to Consolidated Fixed Charges (as defined in the Second Amended Credit Agreement) for any period of four consecutive fiscal quarters. (3) Minimum level of Consolidated Net Income (as defined in the Second Amended Credit Agreement) for consecutive periods, and subject to certain adjustments. (4) Maximum level of the aggregate amount of all Facility Capital Expenditures (as defined in the Second Amended Credit Agreement) in any fiscal year.
Schedule of Maturities of Long-term Debt	Future minimum principal payments on our long-term debt as of September 30, 2017 , are as follows (in thousands): Years Ending Future Minimum December 31 Principal Payments Remaining 2017 2,500 2018 19,462 2019 15,000 2020 17,500 2021 224,000 Total future minimum principal payments $ 278,462

Derivatives (Tables)

Derivatives (Tables)	9 Months Ended
	Sep. 30, 2017
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Notional Amounts of Outstanding Derivative Positions	We forecast our net exposure in various receivables and payables to fluctuations in the value of various currencies, and we enter into foreign currency forward contracts to mitigate that exposure. We enter into approximately 20 foreign currency fair value hedges every month. As of September 30, 2017 , we had entered into foreign currency forward contracts related to those balance sheet accounts with the following notional amounts (in thousands and in local currencies): Currency Symbol Forward Notional Amount Euro EUR 21,801 British Pound GBP 1,128 Chinese Yuan Renminbi CNY 39,954 Mexican Peso MXN 17,537 Brazilian Real BRL 8,500 Australian Dollar AUD 4,599 Hong Kong Dollar HKD 11,000 Swiss Franc CHF 278 Swedish Krona SEK 6,007 Canadian Dollar CAD 1,968 Singapore Dollar SGD 3,585 Japanese Yen JPY 178,500 South Korean Won KRW 1,800,000 We enter into approximately 100 foreign currency cash flow hedges every month. As of September 30, 2017, we had entered into foreign currency forward contracts, which qualified as cash flow hedges, with the following notional amounts (in thousands and in local currencies): Currency Symbol Forward Notional Amount Euro EUR 5,555 Swiss Franc CHF 1,088 Danish Krone DKK 7,775 British Pound GBP 2,550 Mexican Peso MXN 64,425 Swedish Krona SEK 10,805
Schedule of Derivative Instruments in Statement of Financial Position, Fair Value	The fair value of derivative instruments on a gross basis is as follows (in thousands): Fair Value Balance Sheet Location September 30, 2017 December 31, 2016 Derivatives designated as hedging instruments Assets Interest rate swaps Prepaid expenses and other assets (current) $ 79 $ — Interest rate swaps Other assets (long-term) 4,309 4,991 Foreign currency forward contracts Prepaid expenses and other assets (current) 646 116 Foreign currency forward contracts Other assets (long-term) 158 18 (Liabilities) Foreign currency forward contracts Accrued expenses (current) $ (286 ) $ (275 ) Foreign currency forward contracts Other long-term obligations (96 ) (18 ) Derivatives not designated as hedging instruments Assets Foreign currency forward contracts Prepaid expenses and other assets (current) $ 485 $ 220 (Liabilities) Foreign currency forward contracts Accrued expenses (current) (210 ) (171 )
Schedule of Cash Flow Hedges Included in Accumulated Other Comprehensive Income (Loss)	Derivative instruments designated as cash flow hedges had the following effects, before income taxes, on other comprehensive income and net earnings in our consolidated statements of income, consolidated statements of comprehensive income and consolidated balance sheets (in thousands): Amount of Gain/(Loss) recognized in OCI Amount of Gain/(Loss) reclassified from AOCI Three Months Ended September 30, Three Months Ended September 30, 2017 2016 2017 2016 Derivative instrument Location in Statements of Income Interest rate swaps $ 1 $ (256 ) Interest expense $ 96 $ (153 ) Foreign currency forward contracts 100 — Revenue (101 ) — Cost of goods sold 250 —
Derivative Instruments, Gain (Loss)	The following gains/(losses) from these derivative instruments were recognized in our consolidated statements of income for the periods presented (in thousands): Three months ended September 30, Nine months ended September 30, 2017 2016 2017 2016 Derivative Instrument Location in Statements of Income Foreign currency forward contracts Other income (expense) $ (1,459 ) $ (76 ) $ (4,150 ) $ (222 )

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2017
Fair Value Disclosures [Abstract]
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis	Our financial assets and (liabilities) carried at fair value measured on a recurring basis as of September 30, 2017 and December 31, 2016 , consisted of the following (in thousands): Fair Value Measurements Using Total Fair Quoted prices in Significant other Significant Value at active markets observable inputs unobservable inputs Description September 30, 2017 (Level 1) (Level 2) (Level 3) Interest rate contracts (1) $ 4,388 $ — $ 4,388 $ — Foreign currency contract assets, current and long-term (2) $ 1,289 $ — $ 1,289 $ — Foreign currency contract liabilities, current and long-term (3) $ (592 ) $ — $ (592 ) $ — Fair Value Measurements Using Total Fair Quoted prices in Significant other Significant Value at active markets observable inputs unobservable inputs Description December 31, 2016 (Level 1) (Level 2) (Level 3) Interest rate contracts (1) $ 4,991 $ — $ 4,991 $ — Foreign currency contract assets, current and long-term (2) $ 354 $ — $ 354 $ — Foreign currency contract liabilities, current and long-term (3) $ (464 ) $ — $ (464 ) $ — (1) The fair value of the interest rate contracts is determined using Level 2 fair value inputs and is recorded as prepaid expenses and other assets (current) and other assets (long-term) in the consolidated balance sheets. (2) The fair value of the foreign currency contract assets (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as prepaid expenses and other assets (current) and other assets (long-term) in the consolidated balance sheets. (3) The fair value of the foreign currency contract liabilities (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as accrued expenses (current) and other long-term obligations in the consolidated balance sheets.
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation	Changes in the fair value of our contingent consideration liability during the three and nine-month periods ended September 30, 2017 and 2016 , consisted of the following (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Beginning balance $ 5,572 $ 898 $ 683 $ 1,024 Contingent consideration liability recorded as the result of acquisitions (see Note 5) 5,500 — 10,400 — Fair value adjustments recorded to income during the period 20 (193 ) 39 (136 ) Contingent payments made (15 ) (16 ) (45 ) (199 ) Ending balance $ 11,077 $ 689 $ 11,077 $ 689
Fair Value Inputs, Liabilities, Quantitative Information	The recurring Level 3 measurement of our contingent consideration liabilities and contingent receivable includes the following significant unobservable inputs at September 30, 2017 and December 31, 2016 (amounts in thousands): Contingent consideration asset or liability Fair value at September 30, 2017 Valuation technique Unobservable inputs Range Revenue-based payments $ 11,077 Discounted cash flow Discount rate 9.9% - 15% contingent liability Probability of milestone payment 100% Projected year of payments 2017-2037 Contingent receivable $ 528 Discounted cash flow Discount rate 10% asset Probability of milestone payment 57% Projected year of payments 2017-2019 Contingent consideration asset or liability Fair value at December 31, 2016 Valuation technique Unobservable inputs Range Revenue-based payments $ 683 Discounted cash flow Discount rate 9.9% - 15% contingent liability Probability of milestone payment 100% Projected year of payments 2017-2028 Contingent receivable $ 528 Discounted cash flow Discount rate 10% asset Probability of milestone payment 57% Projected year of payments 2017-2019

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Changes in carrying amount of goodwill	The changes in the carrying amount of goodwill for the nine-month period ended September 30, 2017 were as follows (in thousands): 2017 Goodwill balance at January 1 $ 211,927 Effect of foreign exchange 2,418 Additions as the result of acquisitions 19,698 Goodwill balance at September 30 $ 234,043
Other intangible assets	Other intangible assets at September 30, 2017 and December 31, 2016 , consisted of the following (in thousands): September 30, 2017 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Patents $ 15,972 $ (3,586 ) $ 12,386 Distribution agreements 6,626 (4,248 ) 2,378 License agreements 23,804 (4,387 ) 19,417 Trademarks 16,220 (4,342 ) 11,878 Covenants not to compete 1,028 (961 ) 67 Customer lists 25,942 (17,461 ) 8,481 In-process technology 1,100 — 1,100 Total $ 90,692 $ (34,985 ) $ 55,707 December 31, 2016 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Patents $ 14,130 $ (3,165 ) $ 10,965 Distribution agreements 6,626 (3,527 ) 3,099 License agreements 20,695 (3,422 ) 17,273 Trademarks 12,380 (3,330 ) 9,050 Covenants not to compete 1,028 (936 ) 92 Customer lists 22,261 (15,401 ) 6,860 Royalty agreements 267 (267 ) — Total $ 77,387 $ (30,048 ) $ 47,339
Estimated amortization expense	Estimated amortization expense for the developed technology and other intangible assets for the next five years consists of the following as of September 30, 2017 (in thousands): Year Ending December 31 Remaining 2017 $ 6,745 2018 26,152 2019 25,678 2020 24,524 2021 18,013

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Inventory Disclosure [Abstract]
Finished goods	$ 80,708	$ 63,852
Work-in-process	18,162	11,008
Raw materials	46,728	45,835
Total	$ 145,598	$ 120,695

Stock Based Compensation - Narr

Stock Based Compensation - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Compensation cost not yet recognized	$ 16.3		$ 16.3
Compensation cost not yet recognized, period of recognition			3 years 7 months 28 days
Options granted in period (in shares)	20,000	21,000	1,300,000	805,375

Stock Based Compensation - Allo

Stock Based Compensation - Allocation of Recognized Period Costs (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	$ 1,192	$ 503	$ 2,883	$ 1,913
Cost of goods sold
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	189	105	453	369
Research and development
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	110	51	262	147
Selling, general, and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	$ 893	$ 347	$ 2,168	$ 1,397

Stock Based Compensation - Fair

Stock Based Compensation - Fair Value Calculation Assumptions (Details)	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected option life	5 years	5 years
Expected dividend yield	0.00%	0.00%
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate	1.77%	1.15%
Expected price volatility	33.81%	36.30%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate	1.83%	1.40%
Expected price volatility	34.07%	37.06%

Earnings Per Common Share (EP37

Earnings Per Common Share (EPS) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Earnings Per Share, Basic and Diluted [Abstract]
Net income, basic	$ (3,569)	$ 973	$ 20,717	$ 12,615
Basic (in shares)	50,150	44,447	48,332	44,346
Basic (in dollars per share)	$ (0.07)	$ 0.02	$ 0.43	$ 0.28
Effect of dilutive stock options and warrants (in shares)	1,449	553	1,223	417
Net income, diluted	$ (3,569)	$ 973	$ 20,717	$ 12,615
Diluted (in shares)	51,599	45,000	49,555	44,763
Diluted (in dollars per share)	$ (0.07)	$ 0.02	$ 0.42	$ 0.28
Antidilutive securities excluded from EPS (in shares)	200	408	434	864

Acquisitions - Narrative (Detai

Acquisitions - Narrative (Details) - USD ($)

Sep. 01, 2017

Aug. 04, 2017

Jul. 03, 2017

Jul. 01, 2017

Jun. 16, 2017

May 23, 2017

May 19, 2017

May 01, 2017

Jan. 31, 2017

Jul. 06, 2016

Feb. 04, 2016

Sep. 30, 2017

Dec. 31, 2016

Sep. 30, 2017

Sep. 30, 2016

Dec. 31, 2016

Dec. 31, 2017

Business Acquisition [Line Items]

Payments to acquire intangible assets

$ 1,927,000

$ 1,594,000

Goodwill acquired

19,698,000

Laurane Medical S.A.S.

Business Acquisition [Line Items]

Total purchase price

$ 16,500,000

Contingent consideration

$ 5,500,000

Weighted average useful life

11 years 11 months

Osseon LLC

Business Acquisition [Line Items]

Total purchase price

$ 6,800,000

Net sales related to acquisition

$ 442,000

442,000

Weighted average useful life

8 years 11 months 15 days

Fusion Medical, Inc.

Business Acquisition [Line Items]

Total purchase price

$ 2,500,000

Ownership interest (percent)

19.50%

Equity Method Investments

$ 2,500,000

Fusion Medical, Inc. | Preferred Stock

Business Acquisition [Line Items]

Shares acquired

182,000

Vascular Access Technologies, Inc.

Business Acquisition [Line Items]

Total purchase price

$ 5,000,000

Contingent consideration

$ 4,900,000

Argon Medical Devices, Inc.

Business Acquisition [Line Items]

Total purchase price

$ 10,100,000

Net sales related to acquisition

11,000,000

30,000,000

Weighted average useful life

5 years 11 months 15 days

Reduction of purchase price

$ (797,000)

Argon Medical Devices, Inc. | Preliminary Allocation

Business Acquisition [Line Items]

Total purchase price

10,897,000

Catheter Connections, Inc.

Business Acquisition [Line Items]

Total purchase price

$ 38,000,000

Net sales related to acquisition

2,700,000

7,000,000

Weighted average useful life

11 years 8 months

DFINE, Inc.

Business Acquisition [Line Items]

Total purchase price

$ 97,500,000

Net sales related to acquisition

$ 13,500,000

Weighted average useful life

14 years 10 months

Consideration paid related to net working capital adjustment

$ 578,000

Reduction of purchase price

$ 1,100,000

Measurement period adjustment, reduction in inventories

89,000

Measurement period adjustment, reduction in property and equipment

109,000

Measurement period adjustment, reduction in goodwill

1,200,000

Measurement period adjustment, reduction in accrued expenses

407,000

Measurement period adjustment, increase in deferred tax liabilities

(113,000)

HeRO®Graft

Business Acquisition [Line Items]

Total purchase price

$ 18,500,000

Weighted average useful life

9 years 9 months 25 days

Income since acquisition date

7,100,000

Developed Technology Rights

Business Acquisition [Line Items]

Intangible Assets

172,796,000

$ 135,358,000

172,796,000

135,358,000

Developed Technology Rights | Laurane Medical S.A.S.

Business Acquisition [Line Items]

Useful life

12 years

Developed Technology Rights | Osseon LLC

Business Acquisition [Line Items]

Useful life

9 years

Developed Technology Rights | Vascular Access Technologies, Inc.

Business Acquisition [Line Items]

Useful life

15 years

Developed Technology Rights | Argon Medical Devices, Inc.

Business Acquisition [Line Items]

Useful life

7 years

Developed Technology Rights | Catheter Connections, Inc.

Business Acquisition [Line Items]

Useful life

12 years

Developed Technology Rights | DFINE, Inc.

Business Acquisition [Line Items]

Useful life

15 years

Developed Technology Rights | HeRO®Graft

Business Acquisition [Line Items]

Useful life

10 years

Customer lists

Business Acquisition [Line Items]

Intangible Assets

8,481,000

8,481,000

6,860,000

Customer lists | Laurane Medical S.A.S.

Business Acquisition [Line Items]

Useful life

1 year

Customer lists | Osseon LLC

Business Acquisition [Line Items]

Useful life

8 years

Customer lists | Sugan Co, Ltd.

Business Acquisition [Line Items]

Useful life

5 years

Customer lists | Sugan Co, Ltd. | Scenario, Forecast

Business Acquisition [Line Items]

Consideration Payable

$ 1,100,000

Customer lists | Argon Medical Devices, Inc.

Business Acquisition [Line Items]

Useful life

5 years

Customer lists | Catheter Connections, Inc.

Business Acquisition [Line Items]

Useful life

8 years

Customer lists | DFINE, Inc.

Business Acquisition [Line Items]

Useful life

9 years

Customer lists | HeRO®Graft

Business Acquisition [Line Items]

Useful life

12 years

License agreements

Business Acquisition [Line Items]

Payment obligation for certain milestones

$ 15,000,000

$ 5,000,000

Current Royalty Rate

6.00%

6.00%

Useful life

15 years

Payments to acquire intangible assets

$ 11,900,000

2,000,000

Intangible Assets

19,417,000

19,417,000

17,273,000

Patent rights and other intellectual property

Business Acquisition [Line Items]

Payment obligation for certain milestones

$ 750,000

Current Royalty Rate

6.00%

Useful life

15 years

Payments to acquire intangible assets

570,000

Trademarks

Business Acquisition [Line Items]

Intangible Assets

11,878,000

11,878,000

$ 9,050,000

Trademarks | Argon Medical Devices, Inc.

Business Acquisition [Line Items]

Useful life

5 years

Trademarks | Catheter Connections, Inc.

Business Acquisition [Line Items]

Useful life

10 years

Trademarks | DFINE, Inc.

Business Acquisition [Line Items]

Useful life

15 years

Trademarks | HeRO®Graft

Business Acquisition [Line Items]

Useful life

5 years 6 months

Cardiovascular Segment | Argon Medical Devices, Inc.

Business Acquisition [Line Items]

Acquisition-related costs

90,000

2,500,000

Cardiovascular Segment | Catheter Connections, Inc.

Business Acquisition [Line Items]

Acquisition-related costs

$ 0

$ 482,000

Cardiovascular Segment | DFINE, Inc.

Business Acquisition [Line Items]

Acquisition-related costs

$ 1,600,000

Acquisitions - Purchase Price A

Acquisitions - Purchase Price Allocation (Laurane Medical S.A.S.) (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Aug. 04, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Goodwill	$ 234,043		$ 211,927
Laurane Medical S.A.S.
Business Acquisition [Line Items]
Inventories		$ 579
Goodwill		6,381
Total assets acquired		22,000
Developed Technology Rights | Laurane Medical S.A.S.
Business Acquisition [Line Items]
Intangibles		14,920
Customer lists | Laurane Medical S.A.S.
Business Acquisition [Line Items]
Intangibles		$ 120

Acquisitions - Purchase Price40

Acquisitions - Purchase Price Allocation (Osseon LLC) (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Jul. 03, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Goodwill	$ 234,043		$ 211,927
Osseon LLC
Business Acquisition [Line Items]
Inventories		$ 1,023
Property and equipment		58
Goodwill		159
Total assets acquired		6,840
Developed Technology Rights | Osseon LLC
Business Acquisition [Line Items]
Intangibles		5,400
Customer lists | Osseon LLC
Business Acquisition [Line Items]
Intangibles		$ 200

Acquisitions - Purchase Price41

Acquisitions - Purchase Price Allocation (Vascular Access Technologies, Inc.) (Details) - USD ($) $ in Thousands	Sep. 30, 2017	May 01, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Goodwill	$ 234,043		$ 211,927
Vascular Access Technologies, Inc.
Business Acquisition [Line Items]
Goodwill		$ 4,170
Deferred tax liabilities		(3,170)
Total assets acquired		9,900
Preliminary Allocation | Vascular Access Technologies, Inc.
Business Acquisition [Line Items]
Goodwill		4,323
Deferred tax liabilities		(3,073)
Total assets acquired		9,900
Adjustment | Vascular Access Technologies, Inc.
Business Acquisition [Line Items]
Goodwill		(153)
Deferred tax liabilities		(97)
Total assets acquired		0
Developed Technology Rights | Vascular Access Technologies, Inc.
Business Acquisition [Line Items]
Intangibles		7,800
Developed Technology Rights | Preliminary Allocation | Vascular Access Technologies, Inc.
Business Acquisition [Line Items]
Intangibles		7,800
Developed Technology Rights | Adjustment | Vascular Access Technologies, Inc.
Business Acquisition [Line Items]
Intangibles		0
In-process technology | Vascular Access Technologies, Inc.
Business Acquisition [Line Items]
Intangibles		1,100
In-process technology | Preliminary Allocation | Vascular Access Technologies, Inc.
Business Acquisition [Line Items]
Intangibles		850
In-process technology | Adjustment | Vascular Access Technologies, Inc.
Business Acquisition [Line Items]
Intangibles		$ 250

Acquisitions - Purchase Price42

Acquisitions - Purchase Price Allocation (Argon Medical Devices, Inc.) (Details) - USD ($) $ in Thousands	Jan. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Business Acquisition [Line Items]
Gain on bargain purchase		$ 778		$ 0	$ (10,796)	$ 0
Argon Medical Devices, Inc.
Business Acquisition [Line Items]
Cash and cash equivalents		1,436			1,436
Trade receivables		8,351			8,351
Inventories		11,222			11,222
Prepaid expenses		1,275			1,275
Property and equipment		2,319			2,319
Deferred tax assets		203			203
Total assets acquired		29,406			29,406
Trade payables		(2,415)			(2,415)
Accrued expenses		(5,083)			(5,083)
Income taxes payable		(2)			(2)
Deferred income tax liabilities - noncurrent		(1,010)			(1,010)
Total liabilities assumed		(8,510)			(8,510)
Total net assets acquired		20,896			20,896
Gain on bargain purchase					(10,796)
Total purchase price	$ 10,100
Provisional gain on bargain purchase		778	$ 669
Preliminary Allocation | Argon Medical Devices, Inc.
Business Acquisition [Line Items]
Cash and cash equivalents		1,436			1,436
Trade receivables		8,351			8,351
Inventories		12,217			12,217
Prepaid expenses		1,275			1,275
Property and equipment		2,667			2,667
Deferred tax assets		184			184
Total assets acquired		31,530			31,530
Trade payables		(2,306)			(2,306)
Accrued expenses		(5,083)			(5,083)
Income taxes payable		(2)			(2)
Deferred income tax liabilities - noncurrent		(999)			(999)
Total liabilities assumed		(8,390)			(8,390)
Total net assets acquired		23,140			23,140
Gain on bargain purchase					(12,243)
Total purchase price	10,897
Adjustment | Argon Medical Devices, Inc.
Business Acquisition [Line Items]
Cash and cash equivalents		0			0
Trade receivables		0			0
Inventories		(995)			(995)
Prepaid expenses		0			0
Property and equipment		(348)			(348)
Deferred tax assets		19			19
Total assets acquired		(2,124)			(2,124)
Trade payables		(109)			(109)
Accrued expenses		0			0
Income taxes payable		0			0
Deferred income tax liabilities - noncurrent		(11)			(11)
Total liabilities assumed		(120)			(120)
Total net assets acquired		(2,244)			(2,244)
Gain on bargain purchase					1,447
Total purchase price	$ (797)
Developed Technology Rights | Argon Medical Devices, Inc.
Business Acquisition [Line Items]
Intangibles		2,200			2,200
Developed Technology Rights | Preliminary Allocation | Argon Medical Devices, Inc.
Business Acquisition [Line Items]
Intangibles		2,600			2,600
Developed Technology Rights | Adjustment | Argon Medical Devices, Inc.
Business Acquisition [Line Items]
Intangibles		(400)			(400)
Customer lists | Argon Medical Devices, Inc.
Business Acquisition [Line Items]
Intangibles		1,500			1,500
Customer lists | Preliminary Allocation | Argon Medical Devices, Inc.
Business Acquisition [Line Items]
Intangibles		1,300			1,300
Customer lists | Adjustment | Argon Medical Devices, Inc.
Business Acquisition [Line Items]
Intangibles		200			200
Trademarks | Argon Medical Devices, Inc.
Business Acquisition [Line Items]
Intangibles		900			900
Trademarks | Preliminary Allocation | Argon Medical Devices, Inc.
Business Acquisition [Line Items]
Intangibles		1,500			1,500
Trademarks | Adjustment | Argon Medical Devices, Inc.
Business Acquisition [Line Items]
Intangibles		$ (600)			$ (600)

Acquisitions - Purchase Price43

Acquisitions - Purchase Price Allocation (Catheter Connections, Inc.) (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Goodwill	$ 234,043	$ 211,927
Catheter Connections, Inc.
Business Acquisition [Line Items]
Trade receivables	959
Inventories	2,157
Prepaid expenses	85
Property and equipment	1,472
Goodwill	8,988
Total assets acquired	38,361
Trade payables	(338)
Accrued expenses	(23)
Total liabilities assumed	(361)
Net assets acquired, net of cash received of $1,327	38,000
Preliminary Allocation | Catheter Connections, Inc.
Business Acquisition [Line Items]
Trade receivables	952
Inventories	2,244
Prepaid expenses	181
Property and equipment	1,472
Goodwill	7,612
Total assets acquired	38,361
Trade payables	(338)
Accrued expenses	(23)
Total liabilities assumed	(361)
Net assets acquired, net of cash received of $1,327	38,000
Adjustment | Catheter Connections, Inc.
Business Acquisition [Line Items]
Trade receivables	7
Inventories	(87)
Prepaid expenses	(96)
Property and equipment	0
Goodwill	1,376
Total assets acquired	0
Trade payables	0
Accrued expenses	0
Total liabilities assumed	0
Net assets acquired, net of cash received of $1,327	0
Developed Technology Rights | Catheter Connections, Inc.
Business Acquisition [Line Items]
Intangibles	21,100
Developed Technology Rights | Preliminary Allocation | Catheter Connections, Inc.
Business Acquisition [Line Items]
Intangibles	22,900
Developed Technology Rights | Adjustment | Catheter Connections, Inc.
Business Acquisition [Line Items]
Intangibles	(1,800)
Customer lists | Catheter Connections, Inc.
Business Acquisition [Line Items]
Intangibles	700
Customer lists | Preliminary Allocation | Catheter Connections, Inc.
Business Acquisition [Line Items]
Intangibles	100
Customer lists | Adjustment | Catheter Connections, Inc.
Business Acquisition [Line Items]
Intangibles	600
Trademarks | Catheter Connections, Inc.
Business Acquisition [Line Items]
Intangibles	2,900
Trademarks | Preliminary Allocation | Catheter Connections, Inc.
Business Acquisition [Line Items]
Intangibles	2,900
Trademarks | Adjustment | Catheter Connections, Inc.
Business Acquisition [Line Items]
Intangibles	$ 0

Acquisitions - Purchase Price44

Acquisitions - Purchase Price Allocation (DFINE Inc. and HeRO Graft) (Details) - USD ($) $ in Thousands	3 Months Ended
	Dec. 31, 2016	Sep. 30, 2017	Feb. 04, 2016
Assets Acquired
Goodwill	$ 211,927	$ 234,043
HeRO®Graft
Assets Acquired
Inventories			$ 2,455
Property and equipment			290
Goodwill			2,555
Total assets acquired			18,500
DFINE, Inc.
Assets Acquired
Trade receivables	4,054
Other receivables	6
Inventories	8,585
Prepaid expenses	630
Property and equipment	1,630
Other long-term assets	145
Goodwill	24,818
Total assets acquired	114,268
Liabilities Assumed
Trade payables	(1,790)
Accrued expenses	(5,298)
Deferred income tax liabilities - current	(701)
Deferred income tax liabilities - noncurrent	(10,844)
Total liabilities assumed	(18,633)
Net assets acquired, net of cash received of $1,327	95,635
Cash received	1,327
Developed Technology Rights | HeRO®Graft
Assets Acquired
Intangibles			12,100
Developed Technology Rights | DFINE, Inc.
Assets Acquired
Intangibles	67,600
Customer lists | HeRO®Graft
Assets Acquired
Intangibles			400
Customer lists | DFINE, Inc.
Assets Acquired
Intangibles	2,400
Trademarks | HeRO®Graft
Assets Acquired
Intangibles			$ 700
Trademarks | DFINE, Inc.
Assets Acquired
Intangibles	$ 4,400

Acquisitions - Summary of Unaud

Acquisitions - Summary of Unaudited Consolidated Results of Operations, Including Proforma Results (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
As Reported
Net Sales (1)	$ 179,337	$ 156,975	$ 536,955	$ 446,123
Net income	$ (3,569)	$ 973	$ 20,717	$ 12,615
Basic (in dollars per share)	$ (0.07)	$ 0.02	$ 0.43	$ 0.28
Diluted (in dollars per share)	$ (0.07)	$ 0.02	$ 0.42	$ 0.28
Pro Forma
Net Sales, Pro Forma		$ 167,321	$ 539,715	$ 494,589
Net Income, Pro Forma		$ 1,174	$ 10,047	$ 16,454
Basic, Pro Forma (in dollars per share)		$ 0.03	$ 0.21	$ 0.37
Diluted, Pro Forma (in dollars per share)		$ 0.03	$ 0.20	$ 0.37

Segment Reporting - Operating I

Segment Reporting - Operating Income (Details) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017USD ($)	Sep. 30, 2016USD ($)	Sep. 30, 2017USD ($)segment	Sep. 30, 2016USD ($)
Segment Reporting [Abstract]
Number of Operating Segments | segment			2
Segment Reporting Information [Line Items]
Net Sales (1)	$ 179,337	$ 156,975	$ 536,955	$ 446,123
Operating Income (Loss)	879	2,987	19,850	22,274
Cardiovascular Segment
Segment Reporting Information [Line Items]
Net Sales (1)	172,723	150,503	517,140	428,571
Operating Income (Loss)	(1,207)	1,858	14,239	19,385
Endoscopy Segment
Segment Reporting Information [Line Items]
Net Sales (1)	6,614	6,472	19,815	17,552
Operating Income (Loss)	$ 2,086	$ 1,129	$ 5,611	$ 2,889

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Income Tax Disclosure [Abstract]
Income tax expense	$ 1,400	$ (978)	$ 3,900	$ 3,100
Overall effective tax rate			15.80%	20.00%

Revolving Credit Facility and48

Revolving Credit Facility and Long-Term Debt - Narrative (Details) - USD ($) $ in Thousands	Feb. 23, 2017	Sep. 30, 2017	Dec. 31, 2016	Jul. 06, 2016
Line of Credit Facility [Line Items]
2017 Debt facility	$ 7,000	$ 6,962	$ 0
Variable rate on 2017 debt facility		2.31611%
Outstanding borrowings		$ (278,462)
Credit Agreement
Line of Credit Facility [Line Items]
Outstanding borrowings		(271,500)
Maximum facility capital expenditures in the next 12 months		30,000
Remaining borrowing capacity on line of credit		$ 91,000
Debt subject to fixed interest rate			$ 45,000
London Interbank Offered Rate (LIBOR)
Line of Credit Facility [Line Items]
Interest rate (percent)	1.00%
Variable Rate 1 | Credit Agreement
Line of Credit Facility [Line Items]
Variable interest rate percent		2.485%
Debt subject to variable interest rate		$ 84,500
Variable Rate 2 | Credit Agreement
Line of Credit Facility [Line Items]
Variable interest rate percent		2.48667%	2.77%
Debt subject to variable interest rate		$ 12,000	$ 150,000
Revolving Credit Facility | Credit Agreement
Line of Credit Facility [Line Items]
Maximum borrowing capacity				$ 275,000
Interest rate increase if in event of default		2.00%
Term Loan | Credit Agreement
Line of Credit Facility [Line Items]
Debt instrument, face amount				150,000
Bridge Loan | Credit Agreement
Line of Credit Facility [Line Items]
Maximum borrowing capacity				$ 25,000
Interest Rate Swap 1 | Credit Agreement
Line of Credit Facility [Line Items]
Fixed interest rate percent		2.2325%	2.9825%
Debt subject to fixed interest rate		$ 126,300	$ 130,000
Interest Rate Swap 2 | Credit Agreement
Line of Credit Facility [Line Items]
Fixed interest rate percent		2.365%	3.115%
Debt subject to fixed interest rate		$ 48,800
Minimum | Revolving Credit Facility | Credit Agreement
Line of Credit Facility [Line Items]
Commitment fee percentage		0.15%
Maximum | Revolving Credit Facility | Credit Agreement
Line of Credit Facility [Line Items]
Commitment fee percentage		0.40%

Revolving Credit Facility and49

Revolving Credit Facility and Long-Term Debt - Principal Balances under Long-term Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Feb. 23, 2017	Dec. 31, 2016
Line of Credit Facility [Line Items]
Total debt	$ 277,940		$ 324,373
2017 Debt facility	6,962	$ 7,000	0
Less debt issuance costs	(522)		(627)
Less current portion	16,962		10,000
Long-term portion	260,978		314,373
Term Loan
Line of Credit Facility [Line Items]
Total debt	87,500		145,000
Revolving Credit Facility
Line of Credit Facility [Line Items]
Total debt	$ 184,000		$ 180,000

Revolving Credit Facility and50

Revolving Credit Facility and Long-Term Debt - Financial Covenants (Details) - Credit Agreement	9 Months Ended
	Sep. 30, 2017USD ($)
Debt Instrument [Line Items]
Consolidated EBITDA	$ 0
Consolidated Net Income	0
Facility Capital Expenditures	$ 30,000,000
July 1, 2017 through December 31, 2017
Debt Instrument [Line Items]
Consolidated Total Leverage Ratio	3.75
January 1, 2018 through March 31, 2018
Debt Instrument [Line Items]
Consolidated Total Leverage Ratio	3.5
April 1, 2018 and thereafter
Debt Instrument [Line Items]
Consolidated Total Leverage Ratio	3.25

Revolving Credit Facility and51

Revolving Credit Facility and Long-Term Debt - Future Minimum Payments on Long-term Debt (Details) $ in Thousands	Sep. 30, 2017USD ($)
Debt Disclosure [Abstract]
Remaining 2,017	$ 2,500
2,018	19,462
2,019	15,000
2,020	17,500
2,021	224,000
Total long-term debt	$ 278,462

Derivatives - Narrative (Detail

Derivatives - Narrative (Details) € in Thousands, ₩ in Thousands, ¥ in Thousands, ¥ in Thousands, £ in Thousands, SGD in Thousands, SFr in Thousands, SEK in Thousands, MXN in Thousands, HKD in Thousands, CAD in Thousands, BRL in Thousands, AUD in Thousands	Dec. 19, 2012USD ($)	Sep. 30, 2017USD ($)	Sep. 30, 2017CNY (¥)	Sep. 30, 2017MXN	Sep. 30, 2017CHF (SFr)	Sep. 30, 2017KRW (₩)	Sep. 30, 2017GBP (£)	Sep. 30, 2017CAD	Sep. 30, 2017JPY (¥)	Sep. 30, 2017SGD	Sep. 30, 2017SEK	Sep. 30, 2017EUR (€)	Sep. 30, 2017HKD	Sep. 30, 2017BRL	Sep. 30, 2017USD ($)	Sep. 30, 2017AUD	Dec. 31, 2016USD ($)	Aug. 05, 2016USD ($)
Derivative [Line Items]
Accumulated other comprehensive income (loss), interest rate swap, tax benefit																	$ (1,900,000)
Revenue and cost of sales
Derivative [Line Items]
Amount expected to be reclassified from accumulated other comprehensive income to earnings in next twelve months, gross		$ 461,000
Amount expected to be reclassified from accumulated other comprehensive income to earnings in next twelve months, net of tax		282,000
Interest expense
Derivative [Line Items]
Amount expected to be reclassified from accumulated other comprehensive income to earnings in next twelve months, gross		624,000
Amount expected to be reclassified from accumulated other comprehensive income to earnings in next twelve months, net of tax		$ 381,000
Interest rate swap
Derivative [Line Items]
Notional amount of derivative	$ 150,000,000																	$ 42,500,000
Fixed rate	0.9825%																	1.12%
Quarterly reduction of notional amount	50.00%
Accumulated other comprehensive income (loss), interest rate swap, tax benefit															$ (1,700,000)
Interest rate swap | Maximum
Derivative [Line Items]
Notional amount of derivative																		$ 175,000,000
Foreign currency forward contracts | Designated as hedging instrument
Derivative [Line Items]
Average number of contracts entered into per month			100	100	100	100	100	100	100	100	100	100	100	100	100	100
Foreign currency forward contracts | Not designated as hedging instrument
Derivative [Line Items]
Notional amount of derivative			¥ 39,954	MXN 17,537	SFr 278	₩ 1,800,000	£ 1,128	CAD 1,968	¥ 178,500	SGD 3,585	SEK 6,007	€ 21,801	HKD 11,000	BRL 8,500		AUD 4,599
Average number of contracts entered into per month			20	20	20	20	20	20	20	20	20	20	20	20	20	20

Derivatives - Forward Notional

Derivatives - Forward Notional Contracts (Details) - Sep. 30, 2017 - Foreign currency forward contracts € in Thousands, ₩ in Thousands, ¥ in Thousands, ¥ in Thousands, £ in Thousands, SGD in Thousands, SFr in Thousands, SEK in Thousands, MXN in Thousands, HKD in Thousands, DKK in Thousands, CAD in Thousands, BRL in Thousands, AUD in Thousands

CNY (¥)

MXN

CHF (SFr)

KRW (₩)

GBP (£)

CAD

JPY (¥)

SGD

SEK

EUR (€)

HKD

BRL

AUD

DKK

Not designated as hedging instrument

Derivative [Line Items]

Notional amount of derivative

¥ 39,954

MXN 17,537

SFr 278

₩ 1,800,000

£ 1,128

CAD 1,968

¥ 178,500

SGD 3,585

SEK 6,007

€ 21,801

HKD 11,000

BRL 8,500

AUD 4,599

Derivatives designated as cash flow hedges | Designated as hedging instrument

Derivative [Line Items]

Notional amount of derivative

MXN 64,425

SFr 1,088

£ 2,550

SEK 10,805

€ 5,555

DKK 7,775

Derivatives - Fair Value of Der

Derivatives - Fair Value of Derivative Instruments (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Designated as hedging instrument | Interest rate swap
Derivatives, Fair Value [Line Items]
Total Asset Derivatives	$ 4,388
Designated as hedging instrument | Interest rate swap | Other Assets (current)
Derivatives, Fair Value [Line Items]
Total Asset Derivatives	79	$ 0
Designated as hedging instrument | Interest rate swap | Other Assets (long-term)
Derivatives, Fair Value [Line Items]
Total Asset Derivatives	4,309	4,991
Designated as hedging instrument | Foreign currency forward contracts | Other Assets (long-term)
Derivatives, Fair Value [Line Items]
Total Asset Derivatives	158	18
Designated as hedging instrument | Foreign currency forward contracts | Prepaid expenses and other assets
Derivatives, Fair Value [Line Items]
Total Asset Derivatives	646	116
Designated as hedging instrument | Foreign currency forward contracts | Accrued expenses (current)
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	(286)	(275)
Designated as hedging instrument | Foreign currency forward contracts | Other Long-term Obligations
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	(96)	(18)
Not designated as hedging instrument | Foreign currency forward contracts | Prepaid expenses and other assets
Derivatives, Fair Value [Line Items]
Total Asset Derivatives	485	220
Not designated as hedging instrument | Foreign currency forward contracts | Accrued expenses (current)
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	$ (210)	$ (171)

Derivatives - Amount of Gain (L

Derivatives - Amount of Gain (Loss) Recognized in OCI and Income Statement (Details) - Derivatives designated as cash flow hedges - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Interest rate swap
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	$ 1	$ (256)	$ (611)	$ (1,503)
Interest rate swap | Interest expense
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	96	(153)	(8)	(519)
Foreign currency forward contracts
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI		0		0
Foreign currency forward contracts | Revenue
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	100		841
Amount of Gain/(Loss) reclassified from AOCI	(101)	0	(141)	0
Foreign currency forward contracts | Cost of goods sold
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	$ 250	$ 0	$ 213	$ 0

Derivatives - Gain (Loss) in th

Derivatives - Gain (Loss) in the Consolidated Statements of Income (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Not designated as hedging instrument | Foreign currency forward contracts | Other expense
Derivative [Line Items]
Gain (loss) on derivative	$ (1,459)	$ (76)	$ (4,150)	$ (222)

Fair Value Measurements - Finan

Fair Value Measurements - Financial Assets and (Liabilities) Carried at Fair Value (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Fair Value, Inputs, Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate contracts	$ 0	$ 0
Foreign currency contract liabilities, current and long-term	0
Foreign Currency Derivative Instruments Not Designated as Hedging Instruments, Liability at Fair Value		0
Foreign currency contract liabilities, current and long-term	0	0
Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate contracts	4,388	4,991
Foreign currency contract liabilities, current and long-term	(1,289)	(354)
Foreign currency contract liabilities, current and long-term	(592)	(464)
Fair Value, Inputs, Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate contracts	0	0
Foreign currency contract liabilities, current and long-term	0
Foreign Currency Derivative Instruments Not Designated as Hedging Instruments, Liability at Fair Value		0
Foreign currency contract liabilities, current and long-term	0	0
Estimate of Fair Value, Fair Value Disclosure
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate contracts	4,388	4,991
Foreign currency contract liabilities, current and long-term	(1,289)	(354)
Foreign currency contract liabilities, current and long-term	$ (592)	$ (464)

Fair Value Measurements - Liabi

Fair Value Measurements - Liability Measured on Recurring Basis, Unobservable Input Reconciliation (Details) - Contingent Consideration - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ 5,572	$ 898	$ 683	$ 1,024
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability, Purchases	5,500	0	10,400	0
Fair value adjustments recorded to income during the period	20	(193)	39	(136)
Contingent payments made	(15)	(16)	(45)	(199)
Ending balance	$ 11,077	$ 689	$ 11,077	$ 689

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value Inputs, Liabilities, Quantitative Information (Details) - Contingent Consideration - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2017	Dec. 31, 2016	Jun. 30, 2017	Sep. 30, 2016	Jun. 30, 2016	Dec. 31, 2015
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Contingent consideration liability	$ 11,077	$ 683	$ 5,572	$ 689	$ 898	$ 1,024
Revenue-based Payments
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Contingent consideration liability	$ 11,077	$ 683
Revenue-based Payments | Discounted Cash Flow | Fair Value, Inputs, Level 3
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Probability of milestone payment	100.00%	100.00%
Revenue-based Payments | Minimum | Discounted Cash Flow | Fair Value, Inputs, Level 3
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Discount rate	9.90%	9.90%
Revenue-based Payments | Maximum | Discounted Cash Flow | Fair Value, Inputs, Level 3
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Discount rate	15.00%	15.00%
Other Payments
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Contingent consideration asset	$ 528	$ 528
Other Payments | Discounted Cash Flow | Fair Value, Inputs, Level 3
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Probability of milestone payment	57.00%	57.00%
Discount rate	10.00%	10.00%

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment of other assets	$ 67	$ 0	$ 86	$ 90
Other Long-term Obligations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability	10,800		10,800		$ 595
Accrued expenses (current)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability	$ 243		$ 243		$ 88

Goodwill and Intangible Asset61

Goodwill and Intangible Assets - Goodwill (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2017USD ($)
Goodwill [Roll Forward]
Goodwill balance at January 1	$ 211,927
Effect of foreign exchange	2,418
Additions as the result of acquisitions	19,698
Goodwill balance at September 30	$ 234,043

Goodwill and Intangible Asset62

Goodwill and Intangible Assets - Other Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016	Sep. 30, 2016
Other
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 90,692		$ 77,387
Accumulated Amortization	(34,985)	$ (30,048)	(30,048)
Net Carrying Amount	55,707	$ 47,339	47,339
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	15,972		14,130
Accumulated Amortization	(3,586)		(3,165)
Net Carrying Amount	12,386		10,965
Distribution agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	6,626		6,626
Accumulated Amortization	(4,248)		(3,527)
Net Carrying Amount	2,378		3,099
License agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	23,804		20,695
Accumulated Amortization	(4,387)		(3,422)
Net Carrying Amount	19,417		17,273
Trademarks
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	16,220		12,380
Accumulated Amortization	(4,342)		(3,330)
Net Carrying Amount	11,878		9,050
Covenants not to compete
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,028		1,028
Accumulated Amortization	(961)		(936)
Net Carrying Amount	67		92
Customer lists
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	25,942		22,261
Accumulated Amortization	(17,461)		(15,401)
Net Carrying Amount	8,481		6,860
In-process technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,100
Accumulated Amortization	0
Net Carrying Amount	$ 1,100
Royalty agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount			267
Accumulated Amortization			(267)
Net Carrying Amount			$ 0

Goodwill and Intangible Asset63

Goodwill and Intangible Assets - Future Amortization Expense (Details) $ in Thousands	Sep. 30, 2017USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Remaining 2,017	$ 6,745
2,018	26,152
2,019	25,678
2,020	24,524
2,021	$ 18,013

Goodwill and Intangible Asset64

Goodwill and Intangible Assets - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Finite-Lived Intangible Assets [Line Items]
Aggregate amortization expense	$ 7	$ 5.7	$ 19.4	$ 13.6
Cardiovascular Segment
Finite-Lived Intangible Assets [Line Items]
Accumulated impairment loss	$ 8.3		$ 8.3

Commitments and Contingencies (

Commitments and Contingencies (Details) - USD ($) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2017
Commitments and Contingencies Disclosure [Abstract]
Legal Fees In Responding to Department Of Justice Inquiry	$ 2.1	$ 10.6

Issuance of Common Stock (Detai

Issuance of Common Stock (Details) - USD ($)	Mar. 28, 2017	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Equity [Abstract]
Common stock shares issued (in shares)	5,175,000	50,194,000		44,645,000
Proceeds from issuance of common stock	$ 136,600,000	$ 143,069,000	$ 4,422,000
Underwriting discounts and commissions	8,800,000
Other direct costs incurred	$ 816,000	$ 816,000	$ 0

Subsequent Events (Details)

Subsequent Events (Details) $ in Millions	Oct. 02, 2017USD ($)
Subsequent Event | ITL Healthcare Pty Ltd
Subsequent Event [Line Items]
Payments to acquire business	$ 11.3