Document And Entity Information
Document And Entity Information - USD ($) | 12 Months Ended | ||
Dec. 31, 2021 | Feb. 25, 2022 | Jun. 30, 2021 | |
Document Information [Line Items] | |||
Entity Central Index Key | 0000876378 | ||
Entity Registrant Name | ASENSUS SURGICAL, INC. | ||
Amendment Flag | false | ||
Current Fiscal Year End Date | --12-31 | ||
Document Fiscal Period Focus | FY | ||
Document Fiscal Year Focus | 2021 | ||
Document Type | 10-K | ||
Document Annual Report | true | ||
Document Period End Date | Dec. 31, 2021 | ||
Document Transition Report | false | ||
Entity File Number | 0-19437 | ||
Entity Incorporation, State or Country Code | DE | ||
Entity Tax Identification Number | 11-2962080 | ||
Entity Address, Address Line One | 1 TW Alexander Drive, Suite 160 | ||
Entity Address, City or Town | Durham | ||
Entity Address, State or Province | NC | ||
Entity Address, Postal Zip Code | 27703 | ||
City Area Code | 919 | ||
Local Phone Number | 765-8400 | ||
Title of 12(b) Security | Common Stock $0.001 par value per share | ||
Trading Symbol | ASXC | ||
Security Exchange Name | NYSEAMER | ||
Entity Well-known Seasoned Issuer | Yes | ||
Entity Voluntary Filers | No | ||
Entity Current Reporting Status | Yes | ||
Entity Interactive Data Current | Yes | ||
Entity Filer Category | Large Accelerated Filer | ||
Entity Small Business | false | ||
Entity Emerging Growth Company | false | ||
Entity Shell Company | false | ||
Entity Public Float | $ 732,000,000 | ||
Entity Common Stock, Shares Outstanding | 236,408,339 | ||
Auditor Name | BDO USA, LLP | ||
Auditor Location | Raleigh, North Carolina | ||
Auditor Firm ID | 243 | ||
ICFR Auditor Attestation Flag | true |
Consolidated Balance Sheets
Consolidated Balance Sheets - USD ($) $ in Thousands | Dec. 31, 2021 | Dec. 31, 2020 |
Current Assets: | ||
Cash and cash equivalents | $ 18,129 | $ 16,363 |
Short-term investments, available-for-sale | 80,262 | 0 |
Accounts receivable, net | 749 | 1,115 |
Inventories | 8,634 | 10,034 |
Prepaid expenses | 3,255 | 3,535 |
Employee retention tax credit receivable | 1,311 | 0 |
Other current assets | 957 | 2,966 |
Total Current Assets | 113,297 | 34,013 |
Restricted cash | 1,154 | 1,166 |
Long-term investments, available-for-sale | 37,435 | 0 |
Inventories, net of current portion | 7,074 | 8,813 |
Property and equipment, net | 10,971 | 10,342 |
Intellectual property, net | 9,892 | 22,267 |
Net deferred tax assets | 288 | 307 |
Operating lease right-of-use assets, net | 5,348 | 1,164 |
Other long-term assets | 1,014 | 186 |
Total Assets | 186,473 | 78,258 |
Current Liabilities: | ||
Accounts payable | 3,448 | 1,965 |
Accrued expenses | 5,176 | 5,615 |
Operating lease liabilities - current portion | 683 | 686 |
Deferred revenue | 543 | 789 |
Notes payable - current portion, net of debt discount | 0 | 1,228 |
Total Current Liabilities | 9,850 | 10,283 |
Long-Term Liabilities: | ||
Contingent consideration | 2,371 | 3,936 |
Noncurrent operating lease liabilities | 5,006 | 628 |
Notes payable, less current portion | 0 | 1,587 |
Warrant liabilities | 0 | 255 |
Total Liabilities | 17,227 | 16,689 |
Commitments and Contingencies (Note 20) | ||
Stockholders' Equity: | ||
Common stock $0.001 par value, 750,000,000 shares authorized at December 31, 2021 and December 31, 2020; 235,218,552 and 116,231,072 shares issued and outstanding at December 31, 2021 and December 31, 2020, respectively | 235 | 116 |
Preferred stock, $0.01 par value, 25,000,000 shares authorized, no shares issued and outstanding at December 31, 2021 and December 31, 2020 | 0 | 0 |
Additional paid-in capital | 954,649 | 781,397 |
Accumulated deficit | (785,374) | (722,912) |
Accumulated other comprehensive income | (264) | 2,968 |
Total Stockholders' Equity | 169,246 | 61,569 |
Total Liabilities and Stockholders' Equity | 186,473 | 78,258 |
Intellectual Property [Member] | ||
Current Assets: | ||
Intellectual property, net | $ 9,892 | $ 22,267 |
Consolidated Balance Sheets (Pa
Consolidated Balance Sheets (Parentheticals) - $ / shares | Dec. 31, 2021 | Dec. 31, 2020 |
Common stock, par value (in dollars per share) | $ 0.001 | $ 0.001 |
Common stock, shares authorized (in shares) | 750,000,000 | 750,000,000 |
Common stock, shares issued (in shares) | 235,218,552 | 116,231,072 |
Common stock, shares outstanding (in shares) | 235,218,552 | 116,231,072 |
Preferred stock, par value (in dollars per share) | $ 0.01 | $ 0.01 |
Preferred stock, shares authorized (in shares) | 25,000,000 | 25,000,000 |
Preferred stock, shares issued (in shares) | 0 | 0 |
Preferred stock, shares outstanding (in shares) | 0 | 0 |
Consolidated Statements of Oper
Consolidated Statements of Operations and Comprehensive Loss - USD ($) shares in Thousands, $ in Thousands | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Revenue: | |||
Revenue | $ 8,232 | $ 3,175 | $ 8,531 |
Cost of revenue: | |||
Cost of revenue | 11,096 | 5,166 | 20,731 |
Gross loss | (2,864) | (1,991) | (12,200) |
Operating Expenses: | |||
Research and development | 19,348 | 16,621 | 22,468 |
Sales and marketing | 13,395 | 13,064 | 28,014 |
General and administrative | 19,323 | 14,137 | 18,758 |
Amortization of intangible assets | 11,254 | 10,801 | 10,301 |
Change in fair value of contingent consideration | (1,565) | 2,924 | (9,553) |
Restructuring and other charges | 0 | 851 | 1,374 |
Goodwill impairment | 0 | 0 | 78,969 |
Intangible assets impairment | 0 | 0 | 7,912 |
Total Operating Expenses | 61,755 | 58,398 | 142,375 |
Operating Loss | (64,619) | (60,389) | (154,575) |
Other Income (Expense) | |||
Gain (loss) on extinguishment of debt | 2,847 | 0 | (1,006) |
Change in fair value of warrant liabilities | (1,981) | (336) | 2,248 |
Interest income | 590 | 35 | 582 |
Interest expense | (370) | (19) | (3,607) |
Employee retention tax credit | 1,311 | 0 | 0 |
Other expense, net | (15) | (119) | (967) |
Total Other Income (Expense), net | 2,382 | (439) | (2,750) |
Loss before income taxes | (62,237) | (60,828) | (157,325) |
Income tax (expense) benefit | (225) | 1,516 | 3,124 |
Net loss | (62,462) | (59,312) | (154,201) |
Deemed dividend related to beneficial conversion feature of preferred stock | 0 | (412) | 0 |
Deemed dividend related to conversion of preferred stock into common stock | 0 | (299) | 0 |
Net loss attributable to common stockholders | (62,462) | (60,023) | (154,201) |
Comprehensive loss: | |||
Net loss | (62,462) | (59,312) | (154,201) |
Foreign currency translation (loss) gain | (2,985) | 4,338 | (2,708) |
Unrealized loss on available-for-sale investments | (247) | 0 | 0 |
Comprehensive loss | $ (65,694) | $ (54,974) | $ (156,909) |
Net loss per common share attributable to common stockholders - basic and diluted (in dollars per share) | $ (0.28) | $ (0.85) | $ (8.69) |
Weighted average number of shares used in computing net loss per common share - basic and diluted (in shares) | 226,960 | 70,809 | 17,737 |
Product [Member] | |||
Revenue: | |||
Revenue | $ 6,712 | $ 1,612 | $ 7,104 |
Cost of revenue: | |||
Cost of revenue | 7,974 | 2,254 | 16,439 |
Service [Member] | |||
Revenue: | |||
Revenue | 1,520 | 1,563 | 1,427 |
Cost of revenue: | |||
Cost of revenue | 3,122 | 2,912 | 4,292 |
SurgiBot System [Member] | |||
Operating Expenses: | |||
Gain (loss) from sale of assets, net | 0 | 0 | 97 |
Auto Lap [Member] | |||
Operating Expenses: | |||
Gain (loss) from sale of assets, net | $ 0 | $ 0 | $ (15,965) |
Consolidated Statements of Stoc
Consolidated Statements of Stockholders' Equity - USD ($) shares in Thousands, $ in Thousands | Cumulative Effect, Period of Adoption, Adjustment [Member]Common Stock [Member] | Cumulative Effect, Period of Adoption, Adjustment [Member]Preferred Stock [Member] | Cumulative Effect, Period of Adoption, Adjustment [Member]Treasury Stock [Member] | Cumulative Effect, Period of Adoption, Adjustment [Member]Additional Paid-in Capital [Member] | Cumulative Effect, Period of Adoption, Adjustment [Member]Retained Earnings [Member] | Cumulative Effect, Period of Adoption, Adjustment [Member]AOCI Attributable to Parent [Member] | Cumulative Effect, Period of Adoption, Adjustment [Member] | Public Offering [Member]Common Stock [Member] | Public Offering [Member]Preferred Stock [Member] | Public Offering [Member]Treasury Stock [Member] | Public Offering [Member]Additional Paid-in Capital [Member] | Public Offering [Member]Retained Earnings [Member] | Public Offering [Member]AOCI Attributable to Parent [Member] | Public Offering [Member] | Common Stock [Member] | Preferred Stock [Member] | Treasury Stock [Member] | Additional Paid-in Capital [Member] | Retained Earnings [Member] | AOCI Attributable to Parent [Member] | Total |
Balance (in shares) at Dec. 31, 2018 | 16,642 | 0 | 0 | ||||||||||||||||||
Balance at Dec. 31, 2018 | $ 0 | $ 0 | $ 0 | $ (7) | $ 7 | $ 0 | $ 0 | $ 17 | $ 0 | $ 0 | $ 676,572 | $ (509,406) | $ 1,338 | $ 168,521 | |||||||
Stock-based compensation | $ 0 | $ 0 | $ 0 | 11,508 | 0 | 0 | 11,508 | ||||||||||||||
Issuance of common stock, net of issuance costs (in shares) | 3,571 | 0 | 0 | ||||||||||||||||||
Issuance of common stock, net of issuance costs | $ 4 | $ 0 | $ 0 | 25,773 | 0 | 0 | 25,777 | ||||||||||||||
Issuance of common stock consideration of MST (in shares) | 370 | 0 | 0 | ||||||||||||||||||
Issuance of common stock consideration of MST | $ 0 | $ 0 | $ 0 | 6,599 | 0 | 0 | 6,599 | ||||||||||||||
Exercise of stock options and warrants (in shares) | 38 | 0 | 0 | ||||||||||||||||||
Exercise of stock options and warrants | $ 0 | $ 0 | $ 0 | 538 | 0 | 0 | 538 | ||||||||||||||
Award of restricted stock units (in shares) | 70 | 0 | 0 | ||||||||||||||||||
Award of restricted stock units | $ 0 | $ 0 | $ 0 | 0 | 0 | 0 | 0 | ||||||||||||||
Return of common stock to pay withholding taxes on restricted stock (in shares) | 0 | 0 | 15 | ||||||||||||||||||
Return of common stock to pay withholding taxes on restricted stock | $ 0 | $ 0 | $ 0 | (499) | 0 | 0 | (499) | ||||||||||||||
Cancellation of treasury stock (in shares) | 0 | 0 | (15) | ||||||||||||||||||
Cancellation of treasury stock | $ 0 | $ 0 | $ 0 | 0 | 0 | 0 | 0 | ||||||||||||||
Other comprehensive income (loss) | 0 | 0 | 0 | 0 | 0 | (2,708) | (2,708) | ||||||||||||||
Net loss | $ 0 | $ 0 | $ 0 | 0 | (154,201) | 0 | (154,201) | ||||||||||||||
Balance (in shares) at Dec. 31, 2019 | 20,691 | 0 | 0 | ||||||||||||||||||
Balance at Dec. 31, 2019 | $ 21 | $ 0 | $ 0 | 720,484 | (663,600) | (1,370) | 55,535 | ||||||||||||||
Stock-based compensation | 7,911 | 7,911 | |||||||||||||||||||
Issuance of common stock, net of issuance costs (in shares) | 14,122 | 7,937 | 0 | 66,241 | 0 | 0 | |||||||||||||||
Issuance of common stock, net of issuance costs | $ 14 | $ 79 | $ 0 | $ 13,384 | $ 0 | $ 0 | $ 13,477 | $ 66 | $ 0 | $ 0 | 33,780 | 0 | 0 | 33,846 | |||||||
Exercise of stock options and warrants (in shares) | 4,913 | 0 | 0 | ||||||||||||||||||
Exercise of stock options and warrants | $ 5 | $ 0 | $ 0 | 3,335 | 0 | 0 | 3,340 | ||||||||||||||
Award of restricted stock units (in shares) | 286 | 0 | 0 | ||||||||||||||||||
Award of restricted stock units | $ 0 | $ 0 | $ 0 | 0 | 0 | 0 | 0 | ||||||||||||||
Return of common stock to pay withholding taxes on restricted stock (in shares) | 0 | 0 | 28 | ||||||||||||||||||
Return of common stock to pay withholding taxes on restricted stock | $ 0 | $ 0 | $ 0 | (36) | 0 | 0 | (36) | ||||||||||||||
Cancellation of treasury stock (in shares) | 0 | 0 | (28) | ||||||||||||||||||
Cancellation of treasury stock | $ 0 | $ 0 | $ 0 | 0 | 0 | 0 | 0 | ||||||||||||||
Other comprehensive income (loss) | 0 | 0 | 0 | 0 | 0 | 4,338 | 4,338 | ||||||||||||||
Net loss | $ 0 | $ 0 | $ 0 | 0 | (59,312) | 0 | (59,312) | ||||||||||||||
Conversion of preferred stock to common stock (in shares) | 7,937 | (7,937) | 0 | ||||||||||||||||||
Conversion of preferred stock to common stock | $ 8 | $ (79) | $ 0 | 71 | 0 | 0 | 0 | ||||||||||||||
Exchange of shares for Series B Warrants (in shares) | 2,041 | 0 | 0 | ||||||||||||||||||
Exchange of shares for Series B Warrants | $ 2 | $ 0 | $ 0 | 2,468 | 0 | 0 | 2,470 | ||||||||||||||
Balance (in shares) at Dec. 31, 2020 | 116,231 | 0 | 0 | ||||||||||||||||||
Balance at Dec. 31, 2020 | $ 116 | $ 0 | $ 0 | 781,397 | (722,912) | 2,968 | 61,569 | ||||||||||||||
Stock-based compensation | $ 0 | $ 0 | $ 0 | 9,429 | 0 | 0 | 9,429 | ||||||||||||||
Issuance of common stock, net of issuance costs (in shares) | 71,787 | 0 | 0 | ||||||||||||||||||
Issuance of common stock, net of issuance costs | $ 72 | $ 0 | $ 0 | 131,857 | 0 | 0 | 131,929 | ||||||||||||||
Exercise of stock options and warrants (in shares) | 45,630 | 0 | 0 | ||||||||||||||||||
Exercise of stock options and warrants | $ 46 | $ 0 | $ 0 | 33,029 | 0 | 0 | 33,075 | ||||||||||||||
Award of restricted stock units (in shares) | 1,571 | 0 | 0 | ||||||||||||||||||
Award of restricted stock units | $ 1 | $ 0 | $ 0 | 0 | 0 | 0 | 1 | ||||||||||||||
Return of common stock to pay withholding taxes on restricted stock (in shares) | 0 | 0 | 320 | ||||||||||||||||||
Return of common stock to pay withholding taxes on restricted stock | $ 0 | $ 0 | $ 0 | (1,063) | 0 | 0 | (1,063) | ||||||||||||||
Cancellation of treasury stock (in shares) | 0 | 0 | (320) | ||||||||||||||||||
Cancellation of treasury stock | $ 0 | $ 0 | $ 0 | 0 | 0 | 0 | 0 | ||||||||||||||
Other comprehensive income (loss) | 0 | 0 | 0 | 0 | 0 | (3,232) | (3,232) | ||||||||||||||
Net loss | $ 0 | $ 0 | $ 0 | 0 | (62,462) | 0 | (62,462) | ||||||||||||||
Balance (in shares) at Dec. 31, 2021 | 235,219 | 0 | 0 | ||||||||||||||||||
Balance at Dec. 31, 2021 | $ 235 | $ 0 | $ 0 | $ 954,649 | $ (785,374) | $ (264) | $ 169,246 |
Consolidated Statements of Cash
Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Operating Activities: | |||
Net loss | $ (62,462) | $ (59,312) | $ (154,201) |
Adjustments to reconcile net loss to net cash and cash equivalents used in operating activities: | |||
Goodwill and intangible assets impairment | 0 | 0 | 86,881 |
Depreciation | 2,857 | 2,898 | 2,166 |
Amortization of intangible assets | 11,254 | 10,801 | 10,301 |
Amortization of debt discount and debt issuance costs | 0 | 0 | 1,513 |
Amortization of discounts and premiums on investments, net | 409 | 0 | (327) |
Stock-based compensation | 9,429 | 7,911 | 11,508 |
Interest expense on deferred consideration - MST acquisition | 0 | 0 | 756 |
(Gain) loss on extinguishment of debt | (2,847) | 0 | 1,006 |
Deferred tax expense (benefit) | 225 | (1,516) | (3,124) |
Bad debt expense | 144 | 0 | 1,634 |
Change in inventory reserves | (492) | (3,034) | 8,931 |
Change in fair value of warrant liabilities | 1,981 | 336 | (2,248) |
Change in fair value of contingent consideration | (1,565) | 2,924 | (9,553) |
Changes in operating assets and liabilities: | |||
Accounts receivable | 174 | (447) | 6,083 |
Inventories | (611) | (4,164) | (16,404) |
Operating lease right-of-use assets | (4,254) | 1,106 | 2,271 |
Prepaid expenses | 146 | 824 | 2,541 |
Employee retention tax credit receivable | (1,311) | 0 | 0 |
Other current and long-term assets | 902 | 366 | (5,441) |
Accounts payable | 1,614 | (1,758) | (668) |
Accrued expenses | (475) | (2,219) | (168) |
Deferred revenue | (229) | (105) | (959) |
Operating lease liabilities | 4,452 | (1,203) | (2,515) |
Other long-term liabilities | 0 | (83) | 2,401 |
Net cash and cash equivalents used in operating activities | (40,659) | (46,675) | (73,484) |
Investing Activities: | |||
Proceeds from sale of AutoLap assets | 0 | 0 | 15,965 |
Purchase of available-for-sale investments | (122,330) | 0 | (12,883) |
Proceeds from maturities of available-for-sale investments | 4,030 | 0 | 65,000 |
Purchase of property and equipment | (1,368) | (3) | (437) |
Net cash and cash equivalents used in investing activities | (119,668) | (3) | 67,645 |
Financing Activities: | |||
Proceeds from issuance of common stock, preferred stock and warrants under 2020 financing, net of issuance costs | 0 | 13,478 | 0 |
Proceeds from issuance of common stock, net of issuance costs | 131,929 | 33,847 | 25,777 |
Proceeds from notes payable, net of issuance costs | 0 | 2,815 | 0 |
Payment of note payable | 0 | 0 | (31,425) |
Taxes paid related to net share settlement of vesting of restricted stock units | (1,063) | (36) | (499) |
Payment of contingent consideration | 0 | (74) | 0 |
Proceeds from exercise of stock options and warrants | 30,839 | 3,340 | 538 |
Net cash and cash equivalents provided by financing activities | 161,705 | 53,370 | (5,609) |
Effect of exchange rate changes on cash and cash equivalents | 376 | 270 | 364 |
Net increase in cash, cash equivalents and restricted cash | 1,754 | 6,962 | (11,084) |
Cash, cash equivalents and restricted cash, beginning of period | 17,529 | 10,567 | 21,651 |
Cash, cash equivalents and restricted cash, end of period | 19,283 | 17,529 | 10,567 |
Supplemental Disclosure for Cash Flow Information: | |||
Interest paid | 0 | 0 | 2,187 |
Cash paid for taxes | 170 | 82 | 75 |
Supplemental Schedule of Non-cash Investing and Financing Activities: | |||
Transfer of inventories to property and equipment | 3,244 | 8,113 | 486 |
Right-of-use assets recognized related to new lease obligations | 5,119 | 0 | 0 |
Reclass of warrant liability to common stock and additional paid-in capital | 2,236 | 0 | 0 |
Exchange of common stock for Series B Warrants | 0 | 2,470 | 0 |
Transfer of in-process research and development to intellectual property | 0 | 2,425 | 0 |
Deemed dividend related to beneficial conversion feature of preferred stock | 0 | 412 | 0 |
Deemed dividend related to conversion of preferred stock into common stock | 0 | 299 | 0 |
Issuance of common stock - MST acquisition | 0 | 0 | 6,600 |
Proceeds from sale of AutoLap assets exchanged for settlement of Company obligations | 0 | 0 | 1,000 |
Transfer of property and equipment to inventories | 0 | 0 | 323 |
Conversion of preferred stock to common stock | 0 | 79 | 0 |
Auto Lap [Member] | |||
Adjustments to reconcile net loss to net cash and cash equivalents used in operating activities: | |||
Gain (loss) from sale of assets, net | 0 | 0 | (15,965) |
SurgiBot System [Member] | |||
Adjustments to reconcile net loss to net cash and cash equivalents used in operating activities: | |||
Gain (loss) from sale of assets, net | $ 0 | $ 0 | $ 97 |
Note 1 - Organization and Capit
Note 1 - Organization and Capitalization | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Organization, Consolidation, Basis of Presentation, Business Description and Accounting Policies [Text Block] | 1. Organization and Capitalization Asensus Surgical, Inc. (formerly known as TransEnterix, Inc.) (the "Company") is a medical device company that is digitizing the interface between the surgeon and the patient to pioneer a new era of Performance-Guided Surgery™ by unlocking clinical intelligence for surgeons to enable consistently superior outcomes and a new standard of surgery. The Company is focused on the market development for and commercialization of the Senhance® Surgical System, which digitizes laparoscopic minimally invasive surgery, or MIS. The Senhance System is the first 3mm 5mm The Senhance System is available for sale in Europe, the United States, Japan, Taiwan, Russia and select other countries. • The Senhance System has a CE Mark in Europe for adult and pediatric laparoscopic abdominal and pelvic surgery, as well as limited thoracic surgeries excluding cardiac and vascular surgery. • In the United States, the Company has received 510 31 • In Japan, the Company has received regulatory approval and reimbursement for 98 • The Senhance System has received its registration certificate by the Russian medical device regulatory agency, Roszdravnadzor, allowing for its sale and utilization throughout the Russian Federation. In 2020, February 12, 2020, 3mm On March 13, 2020, first September 23, 2020, first September 1, 2021, January 19, 2021, July 28, 2021, 5mm two The Company has also developed the SurgiBot System, a single-port, robotically enhanced laparoscopic surgical platform. In December 2017, March 2023. no |
Note 2 - Summary of Significant
Note 2 - Summary of Significant Accounting Policies | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Significant Accounting Policies [Text Block] | 2. Summary of Significant Accounting Policies Basis of Presentation The accompanying Consolidated Financial Statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) and include the accounts of the Company and its direct and indirect wholly owned subsidiaries. All inter-company accounts and transactions have been eliminated in consolidation. Reclassifications Certain amounts reported previously have been reclassified to conform to the current year presentation, with no December 31, 2019. Liquidity The Company had an accumulated deficit of $785.4 million and working capital of $103.4 million as of December 31, 2021. not may The Company believes the COVID- 19 In 2021, January 2021 January 2021 2020 “2020 2021, 2021 December 31, 2021. 2021 As of December 31, 2021, While the Company believes that its existing cash, cash equivalents, and short-term investments as of December 31, 2021 12 may may 2021 Risk and Uncertainties The Company is subject to risks similar to other similarly sized companies in the medical device industry. These risks include, without limitation: potential negative impacts on the Company's operations caused by the COVID- 19 The COVID- 19 2021 19 19 Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Significant items subject to such estimates and assumptions include impairment considerations for long- term assets, fair value estimates related to contingent consideration, warrant liabilities, stock compensation expense, revenue recognition, accounts receivable reserves, short-term and long-term investments, excess and obsolete inventory reserves, inventory classification between current and non-current, measurement of lease liabilities and corresponding right-of-use (“ROU”) assets, and deferred tax asset valuation allowances. Principles of Consolidation and Foreign Currency Considerations The accompanying consolidated financial statements include the accounts of the Company and its direct and indirect wholly owned subsidiaries, Asensus Surgical US, Inc., Asensus International, Inc., Asensus Surgical Italia S.r.l., Asensus Surgical Europe S.à.r.l., Asensus Surgical Taiwan Ltd., Asensus Surgical Japan K.K., Asensus Surgical Israel Ltd., Asensus Surgical Netherlands B.V., and Asensus Surgical Canada, Inc. All inter-company accounts and transactions have been eliminated in consolidation. The functional currency of the Company’s operational foreign subsidiaries is predominantly the Euro. The assets and liabilities of the Company’s foreign subsidiaries are translated into U.S. dollars at exchange rates in effect at the balance sheet date. Income and expense items are translated at the average exchange rates prevailing during the period. The cumulative translation effect for a subsidiary using a functional currency other than the U.S. dollar is included in accumulated other comprehensive income or loss as a separate component of stockholders’ equity. The Company’s intercompany accounts are denominated in the functional currency of the foreign subsidiary. Gains and losses resulting from the remeasurement of intercompany receivables that the Company considers to be of a long-term investment nature are recorded as a cumulative translation adjustment in accumulated other comprehensive income or loss as a separate component of stockholders’ equity, while gains and losses resulting from the remeasurement of intercompany receivables from a foreign subsidiary for which the Company anticipates settlement in the foreseeable future are recorded in the consolidated statements of operations and comprehensive loss. The net gains and losses included in net loss in the consolidated statements of operations and comprehensive loss for the years ended December 31, 2021, 2020, 2019 not Cash and Cash Equivalents, Restricted Cash, and Investments The Company considers all highly liquid investments with original maturities of 90 Restricted cash as of December 31, 2021 2020 The Company’s investments as of December 31, 2021 December 31, 2020. December 31, 2021. no December 31, 2021. no December 31, 2020 2019. December 31, 2021 December 31, 2020 2019. 90 one one Concentrations and Credit Risk The Company’s principal financial instruments subject to potential concentration of credit risk are cash and cash equivalents, and investments, including amounts held in money market funds, commercial paper, and corporate bonds. The Company places cash deposits with a federally insured financial institution. The Company maintains its cash at banks and financial institutions it considers to be of high credit quality; however, the Company’s domestic cash deposits may may not not not The Company’s accounts receivable are derived from sales and leases to customers located throughout the world. The Company evaluates its customers’ financial condition and, generally, requires no December 31, 2021, 2020 2019, three December 31, 2021. seven December 31, 2020. two 2021, nine 2020, six 2019. Accounts Receivable Accounts receivable are recorded at net realizable value, which includes an allowance for estimated uncollectible accounts. The allowance for uncollectible accounts was determined on a customer specific basis based on deemed collectability. The allowance for doubtful accounts was $1.7 million and $1.8 million as of December 31, 2021 December 31, 2020, Inventories Inventories are stated at the lower of cost (determined on a first first not Any inventory on hand at the measurement date in excess of the Company's current requirements based on anticipated levels of sales is classified as long-term on the Company's consolidated balance sheets. The Company's classification of long-term inventory requires it to estimate the portion of on hand inventory that can be realized over the upcoming twelve Identifiable Intangible Assets Definite-Lived Intangible Assets - Intellectual Property Intellectual property consists of purchased patent rights and developed technology acquired as part of a business acquisition. Developed technology includes reclassified in-process research and development (“IPR&D”) assets related to (i) the Senhance System acquired in 2015 2017 2018 2020. The Company periodically evaluates intellectual property for impairment whenever events or changes in circumstances indicate that the carrying amount may not December 31, 2021, 2020 2019. Indefinite-Lived Intangible Assets IPR&D assets represent the fair value assigned to technologies that were acquired, which at the time of acquisition have not no The Company reclassifies IPR&D assets to intellectual property when development is complete, which generally occurs upon regulatory approval when the Company is able to commercialize products. The completed IPR&D assets are then classified as definite-lived intangible assets and are amortized based on their estimated useful lives at that point in time. If development is terminated or abandoned, the Company may The Company performed an impairment test of its IPR&D at the end of the third 2019 third 2019, December 31, 2019 no December 31, 2020, Property and Equipment Property and equipment consists primarily of operating lease Senhance System assets, machinery, manufacturing equipment, demonstration equipment, computer equipment, furniture, and leasehold improvements, and purchased software which are recorded at cost less accumulated depreciation. Depreciation is recorded using the straight-line method over the estimated useful lives of the assets as follows: Years Operating lease assets – Senhance System leasing 5 Machinery, manufacturing, and demonstration equipment 3 - 5 Computer equipment 3 Furniture 5 Leasehold improvements Lesser of lease term or 3 to 10 Purchased Software 5 The Company reviews its property and equipment assets for possible impairment whenever events or changes in circumstances indicate that the carrying amount of the assets may not not December 31, 2021, 2020, 2019. Operating Leases We have operating leases for our corporate office buildings, vehicles, and machinery and equipment. At inception, we determine whether an agreement represents a lease and, at commencement, we evaluate each lease agreement to determine whether the lease constitutes an operating or financing lease. On January 1, 2019, No. 2016 02, not not not Adoption of ASU No. 2016 02 not not Employee Retention Tax Credit Receivable The Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) included an Employee Retention Tax Credit (“ERTC”) provision designed to encourage employers to keep employees on their payroll. The ERTC is a refundable tax credit against certain payroll taxes paid by employers for eligible wages. We assessed the government assistance in accordance with Topic 958 605, Not December 31, 2021, Notes Payable Payroll Protection Program The Company’s policy is to account for forgivable loans received through the U.S. Small Business Administration (the “SBA”) under the CARES Act Payroll Protection Program (“PPP”), as debt in accordance with ASC 470, June 10, 2021, Contingent Consideration Contingent consideration is recorded as a liability and is the estimate of the fair value of potential milestone payments related to business acquisitions. Contingent consideration is measured at fair value using a Monte-Carlo simulation utilizing significant unobservable inputs including the probability of achieving each of the potential milestones, future Euro-to-USD exchange rates, revenue volatility and an estimated discount rate associated with the risks of the expected cash flows attributable to the various milestones. Significant increases or decreases in any of the probabilities of success or changes in expected achievement of any of these milestones would result in a significantly higher or lower fair value of these milestones, respectively, and commensurate changes to the associated liability. The contingent consideration is revalued at each reporting period and changes in fair value are recognized in the consolidated statements of operations and comprehensive loss. On September 21, 2015, 2016, December 31, 2021, €15.0 €25.0 Warrant Liabilities The Company’s Series B Warrants (see Note 16 first 2021. Revenue Recognition The Company’s revenue consists of product revenue resulting from the sale and lease of Senhance Systems, Senhance System components, instruments and accessories, and service revenue. The Company accounts for a contract with a customer when there is a legally enforceable contract between the Company and the customer, the rights of the parties are identified, the contract has commercial substance, and collectability of the contract consideration is probable. The Company's revenues are measured based on consideration specified in the contract with each customer, net of any sales incentives and taxes collected from customers that are remitted to government authorities. The Company’s Senhance System sale arrangements generally include a five first four The Company’s Senhance System sale arrangements generally contain multiple products and services. For these consolidated sale arrangements, the Company accounts for individual products and services as separate performance obligations if they are distinct, which is if a product or service is separately identifiable from other items in the consolidated package, and if a customer can benefit from it on its own or with other resources that are readily available to the customer. The Company’s Senhance System sale arrangements may For arrangements that contain multiple performance obligations, revenue is allocated to each performance obligation based on its relative estimated standalone selling price. When available, standalone selling prices are based on observable prices at which the Company separately sells the products or services; however due to limited sales to date, standalone selling prices generally are not not The Company recognizes revenues when or as the performance obligations are satisfied by transferring control of the product or service to a customer. The Company generally recognizes revenue for the performance obligations as follows: • System sales. For Senhance Systems and Senhance System components sold directly to end customers (including those arising from Senhance System purchases under lease rights to purchase), revenue is recognized when the Company transfers control to the customer, which is generally at the point when acceptance occurs that indicates customer acknowledgment of delivery or installation, depending on the terms of the arrangement. For lease buyouts, where the customer has already acknowledged installation of the system, transfer of control occurs when the Company receives an executed contract for the lease buyout of the Senhance System. For Senhance Systems sold through distributors, for which distributors are responsible for installation, revenue is recognized generally at the time of shipment. The Company’s Senhance System arrangements generally do not one not • Instruments and accessories. Revenue from sales of instruments and accessories is recognized when control is transferred to the customers, which generally occurs at the time of shipment, but also occurs at the time of delivery depending on the customer arrangement. • Service. Service revenue is recognized ratably over the term of the service period as the customers benefit from the service throughout the service period. Revenue related to services performed on a time-and-materials basis is recognized when performed. The following table presents revenue disaggregated by type and geography: Years Ended December 31, 2021 2020 2019 (in thousands) U.S. Systems $ 380 $ 282 $ 90 Instruments and accessories 270 187 108 Services 383 380 338 Total U.S. revenue 1,033 849 536 Outside of U.S. ("OUS") Systems 4,363 490 5,459 Instruments and accessories 1,699 653 1,447 Services 1,137 1,183 1,089 Total OUS revenue 7,199 2,326 7,995 Total Systems 4,743 772 5,549 Instruments and accessories 1,969 840 1,555 Services 1,520 1,563 1,427 Total revenue $ 8,232 $ 3,175 $ 8,531 The Company recognizes sales by geographic area based on the country in which the customer is based. Operating lease revenue from Senhance System leasing is included as Systems revenues in the above table and was approximately $1.3 million, $0.7 million, and $0 million in the years ended December 31, 2021, 2020 2019, Transaction price allocated to remaining performance obligations relates to amounts allocated to products and services for which the revenue has not December 31, 2021, 2020, 2019, December 31, 2021 one five The Company invoices its customers based on the billing schedules in its sales arrangements. Payments are generally due 30 60 December 31, 2021 2020, not December 31, 2021, 2020 2019 In connection with assets recognized from the costs to obtain a contract with a customer, the Company determined that the sales incentive programs for its sales team do not not Senhance System Leasing The Company enters into lease arrangements with certain qualified customers. Revenue related to arrangements including lease elements are allocated to lease and non-lease elements based on their relative standalone selling prices. Lease elements generally include a Senhance System, while non-lease elements generally include instruments, accessories, and services. For some lease arrangements, the customers are provided with the right to purchase the leased Senhance System at some point during and/or at the end of the lease term. In some arrangements lease payments are based on the usage of the Senhance System. In determining whether a transaction should be classified as a sales-type, operating, or direct financing lease, the Company considers the following terms at lease commencement: ( 1 2 3 4 5 no December 31, 2021 Revenue related to lease elements from operating lease arrangements is generally recognized on a straight-line basis over the lease term or based upon Senhance System usage and is presented as product revenue. Revenue related to lease elements from operating lease arrangements was approximately $1.3 million, $0.7 million, $0 million for the years ended December 31, 2021, 2020 2019, Cost of Revenue Cost of revenue consists of contract manufacturing, materials, labor and manufacturing overhead incurred internally to produce the products. Depreciation expense related to leased systems is included in the cost of revenue. Shipping and handling costs incurred by the Company are included in the cost of revenue. We expense all inventory obsolescence provisions as cost of revenue. Research and Development Costs Research and development expenses primarily consist of engineering, product development and regulatory expenses, incurred in the design, development, testing and enhancement of our products. Research and development costs are expensed as incurred. Stock-Based Compensation The Company recognizes expenses for share-based awards exchanged for services rendered equal to the estimated fair value of these awards over the requisite service period. The Company recognizes as expense, the grant-date fair value of stock options and other stock-based compensation issued to employees and non-employee directors over the requisite service periods, which are typically the vesting periods. The Company uses the Black-Scholes-Merton model to estimate the fair value of stock options. The volatility assumption used in the Black-Scholes-Merton model is based on the Company’s historical volatility. The expected term of options granted has been determined based upon the simplified method, because the Company does not not not The fair value of restricted stock units is determined by the market price of the Company’s common stock on the date of grant. The Company records as expense the fair value of stock-based compensation awards, including stock options and restricted stock units. Compensation expense for stock-based compensation was approximately $9.4 million, $7.9 million, and $11.5 million for the years ended December 31, 2021, 2020, 2019 Income Taxes The Company accounts for income taxes using the asset and liability method, which requires the recognition of deferred tax assets or liabilities for the temporary differences between financial reporting and tax basis of the Company’s assets and liabilities, and for tax carryforwards at enacted statutory rates in effect for the years in which the asset or liability is expected to be realized. The effect on deferred taxes of a change in tax rates is recognized in income during the period that includes the enactment date. In addition, valuation allowances are established when necessary to reduce deferred tax assets and liabilities to the amounts expected to be realized. The Company has elected to account for global intangible low-taxed income (“GILTI”) as a period expense in the year the tax is incurred. The Company recognizes the financial statement benefit of an income tax position only after determining that the relevant taxing authority would more likely than not not 50% Tax regulations within each jurisdiction are subject to the interpretation of the related tax laws and regulations and require application of significant judgment. The Company is subject to U.S. federal and various state, local and foreign jurisdictions. Due to the Company’s net operating loss carryforwards, the Company may Revision of Previously Disclosed Amounts During the course of preparing the Company’s consolidated financial statements as of and for the year ended December 31 2021, 382 383 11—Income Comprehensive Loss Comprehensive loss is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. Segments The Company operates in one not Approximately 77% and 27% of the Company’s total consolidated assets are located within the U.S. as of December 31, 2021 2020, December 31, 2021 2020, December 31, 2021 2020, December 31, 2021 2020, The Company recognizes sales by geographic area based on the country in which the customer is based. For the years ended December 31, 2021, 2020 2019, December 31, 2021, December 31, 2020, December 31, 2019, Impact of Recently Issued Accounting Standards In December 2019, 2019 12, 2019 12 740, 2019 12 January 1, 2021; not In June 2016, 2016 13, 326 December 15, 2022, not In August 2020, 2020 06 470 20 815 40 December 15, 2021, The Company has evaluated all other issued and unadopted ASUs and believes the adoption of these standards will not |
Note 3 - Acquisitions
Note 3 - Acquisitions | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Business Combination Disclosure [Text Block] | 3. Acquisitions MST Medical Surgery Technologies Ltd. Acquisition On September 23, 2018, two October 31, 2018, Under the terms of the MST Purchase Agreement, at the closing the Buyers purchased substantially all of the assets of MST. The acquisition price consisted of two second $6.6 one August 7, 2019, February 7, 2020. On July 3, 2019, October 15, 2019, 2019 December 31, 2019, Senhance Surgical Robotic System On September 21, 2015, February 25, 2021, On December 30, 2016, third €15.0 €25.0 The Third Tranche payments will be accelerated in the event that (i) the Company or Asensus International is acquired, (ii) the Company significantly reduces or suspends selling efforts of the Senhance System, or (iii) the Company acquires a business that offers alternative products that are directly competitive with the Senhance System. The remaining amounts due to Sofar are included in contingent consideration as of December 31, 2021 2020 |
Note 4 - Cash, Cash Equivalents
Note 4 - Cash, Cash Equivalents, and Restricted Cash | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Cash, Cash Equivalents, and Restricted Cash Disclosure [Text Block] | 4. Cash, Cash Equivalents, and Restricted Cash Cash, cash equivalents and restricted cash consist of the following: December 31, December 31, 2021 2020 (in thousands) Cash $ 8,343 $ 6,679 Money Market 5,287 9,684 Commerical Paper 4,499 - Total cash and cash equivalents $ 18,129 $ 16,363 Restricted Cash 1,154 1,166 Total $ 19,283 $ 17,529 Restricted cash at December 31, 2021 2020 2018. |
Note 5 - Investments, Available
Note 5 - Investments, Available-for-sale | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block] | 5. Investments, available-for-sale The aggregate fair values of investment securities along with unrealized gains and losses determined on an individual investment security basis and included in other comprehensive income are as follows: December 31, 2021 (in thousands) Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments Long-term investments Commerical Paper $ 50,705 $ - $ (46 ) $ 50,659 $ 50,660 $ - Corporate Bonds 67,239 1 (202 ) 67,038 29,602 37,435 Total Investments $ 117,944 $ 1 $ (248 ) $ 117,697 $ 80,262 $ 37,435 The following table summarizes the contractual maturities of the Company’s available-for-sale investments, as of December 31, 2021: Amortized Cost Fair Value Mature in less than one year $ 80,336 $ 80,262 Mature in one to two years 37,608 37,435 Total $ 117,944 $ 117,697 Actual maturities may December 31, 2021, 2020 2019, December 31, 2021 |
Note 6 - Fair Value
Note 6 - Fair Value | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Fair Value Disclosures [Text Block] | 6. Fair Value The Company held certain assets and liabilities that are required to be measured at fair value on a recurring basis. These assets and liabilities include cash and cash equivalents, restricted cash, contingent consideration and warrant liabilities. ASC 820 10 three one three 1, 2, 1, 3, not 1, 2, 3 December 31, 2021 2020. For assets and liabilities recorded at fair value, it is the Company’s policy to maximize the use of observable inputs and minimize the use of unobservable inputs when developing fair value measurements, in accordance with the fair value hierarchy. Fair value measurements for assets and liabilities where there exists limited or no may not may As prescribed by U.S. GAAP, the Company groups assets and liabilities at fair value in three 1 2 The determination of where an asset or liability falls in the hierarchy requires significant judgment. The Company evaluates its hierarchy disclosures and based on various factors, it is possible that an asset or liability may The carrying values of accounts receivable, other current assets, accounts payable, and certain accrued expenses as of December 31, 2021 2020 December 31, 2020, The following are the major categories of assets and liabilities measured at fair value on a recurring basis as of December 31, 2021 2020, 1 2 3 December 31, 2021 (in thousands) Description Quoted Prices in Significant Other Significant Total Assets measured at fair value Cash and cash equivalents (1) $ 18,129 $ - $ - $ 18,129 Restricted cash 1,154 - - $ 1,154 Short-term investments - 80,262 - $ 80,262 Long-term investments - 37,435 - $ 37,435 Total assets measured at fair value $ 19,283 $ 117,697 $ - $ 136,980 Liabilities measured at fair value Contingent consideration $ - $ - $ 2,371 $ 2,371 Total liabilities measured at fair value $ - $ - $ 2,371 $ 2,371 ( 1 90 December 31, 2020 (in thousands) Description Quoted Prices in Significant Other Significant Total Assets measured at fair value Cash and cash equivalents $ 16,363 $ - $ - $ 16,363 Restricted cash 1,166 - - 1,166 Total assets measured at fair value $ 17,529 $ - $ - $ 17,529 Liabilities measured at fair value Contingent consideration $ - $ - $ 3,936 $ 3,936 Warrant liabilities - - 255 255 Total liabilities measured at fair value $ - $ - $ 4,191 $ 4,191 The Company’s financial liabilities consisted of contingent consideration payable to Sofar related to the Senhance Acquisition (Note 3 3 December 31, 2021 December 31, 2020 December 31, 2019 The following table presents quantitative information about the inputs and valuation methodologies used for the Company’s fair value measurements for contingent consideration as of December 31, 2021 2020: December 31, Valuation Significant 2021 2020 Contingent consideration Probability Milestone dates 2031 2025 Discount rate 9.5% 9.5% Revenue volatility 39.0% 71.0% On April 28, 2017, October 31, 2017. February 24, 2020 , 3,373,900 March 2020 December 31, 2020. first 2021 The change in fair value of all outstanding Series B warrants for the years ended December 31, 2021 2020 December 31, 2019, The following table presents the inputs and valuation methodologies used for the Company’s fair value of the Series B warrants: December 31, December 31, December 31, Series B Warrants 2021 2020 2019 Valuation methodology Black-Scholes-Merton Black-Scholes-Merton Monte Carlo Term (years) 1.22 1.32 2.32 Risk free rate 0.07 % 0.10 % 1.59 % Dividends - - - Volatility 174.00 % 150.97 % 109.80 % Share price $ 4.21 $ 0.63 $ 1.47 The following table summarizes the change in fair value, as determined by Level 3 December 31, 2021, 2020 2019: Fair Value Measurement at Reporting Date (Level 3) (in thousands) Series B Warrants Contingent consideration Balance at December 31, 2018 $ 4,636 $ 10,637 Change in fair value (2,248 ) (9,553 ) Balance at December 31, 2019 $ 2,388 $ 1,084 Exchange of warrants for common stock (2,469 ) - Payment for contingent consideration - (74 ) Change in fair value 336 2,924 Balance at December 31, 2020 $ 255 $ 3,936 Exercise of warrants $ (2,236 ) $ - Change in fair value 1,981 $ (1,565 ) Balanceat December 31, 2021 $ - $ 2,371 Current portion $ - $ - Long-term portion - 2,371 Balance at December 31, 2021 $ - $ 2,371 |
Note 7 - Accounts Receivable, N
Note 7 - Accounts Receivable, Net | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Loans, Notes, Trade and Other Receivables Disclosure [Text Block] | 7. Accounts Receivable, Net The following table presents the components of accounts receivable: December 31, 2021 December 31, 2020 (In thousands) Gross accounts receivable $ 2,426 $ 2,917 Allowance for uncollectible accounts (1,677 ) (1,802 ) Total accounts receivable, net $ 749 $ 1,115 The Company recorded $0.1 million, $0 million, and $1.6 million in bad debt expense during the years ended December 31, 2021, 2020 2019, |
Note 8 - Inventories
Note 8 - Inventories | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Inventory Disclosure [Text Block] | 8. Inventories The components of inventories are as follows: December 31, 2021 (in thousands) Gross Carrying Amount Reserve Balance Net Carrying Amount Finished goods $ 10,566 $ (2,987 ) $ 7,579 Raw materials 10,824 (2,695 ) 8,129 Total inventories $ 21,390 $ (5,682 ) $ 15,708 Current Portion $ 9,931 $ (1,297 ) $ 8,634 Long-term portion 11,459 (4,385 ) 7,074 Total inventories $ 21,390 $ (5,682 ) $ 15,708 December 31, 2020 (in thousands) Gross Carrying Amount Reserve Balance Net Carrying Amount Finished goods $ 13,858 $ (3,109 ) $ 10,749 Raw materials 11,163 (3,065 ) 8,098 Total inventories $ 25,021 $ (6,174 ) $ 18,847 Current Portion $ 11,444 $ (1,410 ) $ 10,034 Long-term portion 13,577 (4,764 ) 8,813 Total inventories $ 25,021 $ (6,174 ) $ 18,847 The Company records an inventory reserve for estimated excess and obsolete inventory based upon historical consumption and assumptions about future demand for its products. The Company recorded a write-down of obsolete inventory for the year-ended December 31, 2019 twelve December 31, 2021 2020, |
Note 9 - Property and Equipment
Note 9 - Property and Equipment | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Property, Plant and Equipment Disclosure [Text Block] | 9. Property and Equipment Property and equipment consisted of the following: December 31, 2021 December 31, 2020 (In thousands) Machinery, manufacturing, and demonstration equipment $ 8,289 $ 9,909 Operating lease assets - Senhance System leasing 10,143 8,906 Computer equipment 325 2,297 Furniture 644 640 Leasehold improvements 1,259 2,309 Total property and equipment 20,660 24,061 Accumulated depreciation and amortization (9,689 ) (13,719 ) Property and equipment, net $ 10,971 $ 10,342 Depreciation expense was approximately $2.9 million, $2.9 million and $2.2 million for the years ended December 31, 2021, 2020, 2019, |
Note 10 - Goodwill, In-process
Note 10 - Goodwill, In-process Research and Development and Intellectual Property | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Goodwill and Intangible Assets Disclosure [Text Block] | 10. Goodwill, In-Process Research and Development and Intellectual Property Goodwill Goodwill consisted of $93.8 million that was recorded in connection with the 2013 3, 3, 2016. December 31, 2019 Goodwill (In thousands) Balance at December 31, 2018 $ 80,131 Foreign currency translation impact (1,162 ) Impairment (78,969 ) Balance at December 31, 2019 $ — The Company performed an annual impairment test of goodwill at December 31 one may not third 2019, September 30, 2019, In-Process Research and Development As described in Note 3, October 31, 2018, The Company performed an impairment test of its IPR&D at the end of the third 2019 third 2019, December 31, 2019 no December 31, 2020, The carrying value of the Company’s IPR&D assets and the change in the balance for the years ended December 31, 2020 2019 In-Process Research and Development (In thousands) Balance at December 31, 2018 $ 10,747 Impairment (7,912 ) Foreign currency translation impact (365 ) Balance at December 31, 2019 2,470 Impairment — Foreign currency translation impact (45 ) Transfer of in-process research and development to intellectual property (2,425 ) Balance at December 31, 2020 $ — Intellectual Property On September 21, 2015, October 13, 2017, On March 13, 2020, The components of gross intellectual property, accumulated amortization, and net intellectual property as of December 31, 2021 2020 December 31, 2021 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (58,912 ) $ (262 ) $ 9,664 Technology and patents purchased 400 (199 ) 27 228 Total intellectual property $ 69,238 $ (59,111 ) $ (235 ) $ 9,892 December 31, 2020 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (51,734 ) $ 4,872 $ 21,976 Technology and patents purchased 400 (168 ) 59 291 Total intellectual property $ 69,238 $ (51,902 ) $ 4,931 $ 22,267 The weighted average remaining useful life of the developed technology and technology and patents purchased was 1.6 years and 5.3 years, respectively as of December 31, 2021. The estimated future amortization expense of intangible assets as of December 31, 2021 Year ending December 31, 2021 (In thousands) 2022 8,218 2023 400 2024 400 2025 400 2026 400 Thereafter 74 Total $ 9,892 |
Note 11 - Income Taxes
Note 11 - Income Taxes | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Income Tax Disclosure [Text Block] | 11. Income Taxes The components for the income tax expense (benefit) are as follows for the years ended December 31 2021 2020 2019 Current income taxes Federal $ - $ - $ - State - - - Foreign 232 169 100 Deferred income taxes Federal - - - State - - - Foreign (7 ) (1,685 ) (3,224 ) Total income tax expense (benefit) $ 225 $ (1,516 ) $ (3,124 ) The United States and foreign components of loss from operations before taxes are as follows for the years ended December 31 2021 2020 2019 United States $ (32,094 ) $ (34,398 ) $ (91,935 ) Foreign (30,143 ) (26,430 ) (65,390 ) Total loss from operations before taxes $ (62,237 ) $ (60,828 ) $ (157,325 ) Significant components of the Company’s deferred tax assets consist of the following at December 31 2021 2020 Deferred Tax assets: Stock-based compensation $ 2,440 $ 4,253 Accrued expenses and other 2,423 906 Research credit carryforward 564 - Fixed Assets 101 385 Capitalized start-up costs and other intangibles 1,109 2,686 Net operating loss carryforwards 75,237 63,786 81,874 72,016 Valuation Allowance (78,294 ) (67,312 ) Net deferred tax asset 3,580 4,704 Deferred tax liabilities Fixed assets and other (1,176 ) (1,590 ) Purchase accounting intangibles (2,116 ) (2,807 ) Net deferred tax liability (3,292 ) (4,397 ) Net deferred tax asset (liability) $ 288 $ 307 During the current year, the Company completed an assessment of the available net operating loss and tax credit carryforwards under Section 382 383 382, 2020. 382 383 382 December 31, 2020 December 31, 2020 $7.2 Since the limitation affected the prior period, the Company has determined that its December 31, 2020 no no At December 31, 2021 2020, not not. December 31, 2021, $253 382 382 2027, December 31, 2021, $204 382. 382 2022, December 31, 2021, 2027. 383, $8.8 At December 31, 2021, 2034; 2023, 2040. The Company has evaluated its tax positions to consider whether it has any unrecognized tax benefits. As of December 31, 2021, none not twelve not Note that the Company removed $1.6 million of the unrecognized tax benefits associated with R&D credit carryforwards that it expects to expire unused due to Section 383 December 31, 2020. The following is a tabular reconciliation of the Company’s change in gross unrecognized tax positions at December 31 2021 2020 2019 Beginning balance $ - $ 1,512 $ 1,363 Gross increases for tax positions related to current periods 141 108 149 Gross decreases related to 382 limitations - (1,620 ) - Ending balance $ 141 $ - $ 1,512 The Company recognizes interest and penalties related to uncertain tax positions in the provision for income taxes. As of December 31, 2021 2020, The Company has analyzed its filing positions in all significant federal, state, and foreign jurisdictions where it is required to file income tax returns, as well as open tax years in these jurisdictions. With few exceptions, the Company is no 2018, 2018 may No Taxes computed at the then-current statutory federal income tax rate of 21% are reconciled to the provision for income taxes as follows for the years ended December 31: 2021 2020 2019 Amount Percent of Pretax Earnings Amount Percent of Pretax Earnings Amount Percent of Pretax Earnings United States federal tax at statutory rate $ (13,070 ) 21.0 % $ (12,774 ) 21.0 % $ (33,038 ) 21.0 % State taxes (net of deferred benefit) (2,205 ) 3.5 % (1,768 ) 2.9 % (4,778 ) 3.0 % Nondeductible expenses (440 ) 0.7 % 719 (1.2 %) 709 (0.5 %) Change in fair market value of contingent consideration (397 ) 0.6 % 717 (1.2 %) (2,342 ) 1.5 % Warrant remeasurment and financing costs 502 (0.8 %) 82 (0.1 %) (551 ) 0.4 % Research & Development (705 ) 1.1 % (542 ) 0.9 % (743 ) 0.5 % Change in unrecognized tax benefits 141 (0.2 %) (1,512 ) 2.5 % 149 (0.1 %) Foreign tax rate differential 1,911 (3.1 %) 1,589 -2.6 % 2,590 (1.6 %) Goodwill and investment impairments - - - - (6,638 ) 4.2 % Adjustment for 382 Limitations - - 67,255 (110.6 %) - 0.0 % True-up to Stock Compensation - Cancellations 2,832 (4.6 %) - - - 0.0 % Change in enacted tax rates and other, net 731 (1.0 %) 533 (0.9 %) (253 ) 0.2 % Change in valuation allowance 10,925 (17.6 %) (55,815 ) 91.8 % 41,771 26.6 % Income tax expense (benefit) $ 225 (0.4 %) $ (1,516 ) 2.5 % $ (3,124 ) 2.0 % |
Note 12 - Operating Leases
Note 12 - Operating Leases | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Lessee, Operating Leases [Text Block] | 12. Operating Leases We determine if an arrangement is a lease or service contract at inception. Where an arrangement is a lease, we determine if it is an operating lease or a finance lease. Subsequently, if the arrangement is modified, we reevaluate our classification. We have entered into operating leases for corporate office buildings, vehicles, and machinery and equipment. Some of our lease agreements have renewal options, tenant improvement allowances, rent escalation clauses, and assignment and subletting clauses. While our operating leases range from one ten may one six may one Operating lease liabilities presented on the consolidated balance sheets represents the present value of the remaining lease payments, discounted using the Company’s incremental borrowing rate, which ranges between 6.1% and 8.5% based on the terms of the lease. Operating lease costs for the year ended December 31, 2021, 2020 2019 December 31, 2021, 2020 2019 Supplemental balance sheet information, as of December 31, 2021 2020, December 31, 2021 2020 Weighted-average remaining lease term (in years) 7.8 1.8 Weighted-average discount rate 7.8 % 8.2 % Maturities of operating lease obligations were as follows (in thousands): Fiscal Year 2022 $ 994 2023 1,008 2024 918 2025 920 2026 854 Thereafter 3,004 Total minimum lease payments $ 7,698 Less: Amount of lease payments representing interest (2,009 ) Present value of future minimum lease payments $ 5,689 During 2021 three first first 2021; second second third fourth 2021. three |
Note 13 - Accrued Expenses
Note 13 - Accrued Expenses | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Accrued Liabilities [Text Block] | 13. Accrued Expenses The following table presents the components of accrued expenses: December 31, 2021 December 31, 2020 (In thousands) Compensation and benefits $ 3,682 $ 4,541 Consulting and other vendors 128 66 Other 124 177 Royalties 247 147 Legal and professional fees 503 314 Taxes and other assessments 492 351 Interest — 19 Total $ 5,176 $ 5,615 |
Note 14 - Notes Payable
Note 14 - Notes Payable | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Debt Disclosure [Text Block] | 14. Notes Payable Paycheck Protection Program On April 27, 2020, December 31, 2020, On June 10, 2021, December 31, 2021 December, 31, 2020 2019, Hercules Loan Agreement On May 23, 2018, two 2019. In connection with the entry into the AutoLap Sale Agreement with respect to the AutoLap assets, the Company commenced discussions with the Agent in order to obtain the required consent of the Agent and the Lender with respect to the sale of the AutoLap assets. In connection with obtaining such consent, the Company entered into the Consent and Second Amendment to the Loan and Security Agreement on July 10, 2019 ( On November 4, 2019, December 31, 2019. |
Note 15 - Stock-based Compensat
Note 15 - Stock-based Compensation | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Share-based Payment Arrangement [Text Block] | 15. Stock-Based Compensation Overview On July 22, 2021, 2021 December 31, 2021, Under the Plan, which is administered by the Compensation Committee, the Company may may not no may ten During the years ended December 31, 2021, 2020 2019, Stock Options The Company recognizes as expense, the grant-date fair value of stock options and other stock-based compensation issued to employees and non-employee directors over the requisite service periods, which are typically the vesting periods. The Company uses the Black-Scholes-Merton model to estimate the fair value of its stock-based payments. The volatility assumption used in the Black-Scholes-Merton model is based on the calculated historical volatility based on the Company’s historical volatility. The expected term of options granted by the Company has been determined based upon the simplified method, because the Company does not not not The fair value of options granted were estimated using the Black-Scholes-Merton option pricing model based on the assumptions in the table below: Year Ended December 31, 2021 2020 2019 Expected dividend yield 0% 0% 0% Expected volatility 118% - 139% 82% - 126% 81% - 92% Risk-free interest rate 0.33% - 1.11% 0.2% - 1.69% 1.39% - 2.66% Expected life (in years) 3.8 - 4.5 3.8 - 6.1 5.5 - 6.1 The following table summarizes the Company’s stock option activity, including grants to non-employees, for the year ended December 31, 2021: Number of Weighted- Weighted-Average Options outstanding at December 31, 2020 4,361,872 $ 10.49 6.05 Granted 1,490,266 4.06 Forfeited (285,391 ) 8.10 Cancelled (610,287 ) 30.32 Exercised (315,800 ) 0.67 Options outstanding at December 31, 2021 4,640,660 $ 6.64 5.66 The following table summarizes information about stock options outstanding at December 31, 2021: Number of Shares Weighted- Weighted-Average Aggregate Exercisable at December 31, 2021 1,887,155 $ 11.50 5.40 $ 0.7 Vested or expected to vest at December 31, 2021 4,498,953 $ 6.75 5.65 $ 1.4 The Company granted 1,490,266, 3,005,964, and 623,272 options to employees and non-employees during the years ended December 31, 2021, 2020, 2019, As of December 31, 2021, Restricted Stock Units During 2021, 2020, 2019, two three not The following is a summary of the RSU activity, including performance restricted stock units, for the years ended December 31, 2021, 2020, 2019: Number of Weighted- Unvested December 31, 2018 382,098 $ 20.24 Granted 192,987 31.42 Vested (85,153 ) 25.98 Forfeited (46,005 ) 21.38 Unvested December 31, 2019 443,927 $ 23.88 Granted 3,112,382 0.67 Vested (313,508 ) 19.38 Forfeited (245,402 ) 6.54 Unvested December 31, 2020 2,997,399 $ 1.41 Granted 3,133,753 2.77 Vested (1,891,869 ) 1.63 Forfeited (400,253 ) 1.86 Unvested December 31, 2021 3,839,030 $ 2.36 As of December 31, 2021, 2020, 2019, December 31, 2021, Performance Restricted Stock Units In 2021 2020, October 1, 2023 October 1, 2022, 2021 2020 December 31, 2021 2020, |
Note 16 - Warrants
Note 16 - Warrants | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Warrants Disclosure [Text Block] | 16. Warrants On August 14, 2015, first seven None December 31, 2021, 2020, 2019. On April 28, 2017, 510 October 13, 2017, October 31, 2017. fifth December 31, 2021. On February 24, 2020 , March 2020 December 31, 2020 . February 2021. On March 10, 2020, one one December 31, 2021, March 10, 2021. The Series C Warrants and Series D Warrants are equity classified. The fair value of the Series C Warrants and Series D Warrants on the issuance date was determined using a Black-Scholes Merton model. The unit proceeds were then allocated to the Common Stock, Series A Preferred Stock, Series C Warrants, and Series D Warrants, respectively, based on their relative fair values. As a result, the Company determined that a beneficial conversion feature was created by the difference between the effective conversion price of the preferred stock and the fair value of the Company's Common Stock as of the issuance date. The Company therefore recorded a beneficial conversion feature of $0.4 million as a deemed dividend included in additional paid-in capital and an immediate charge to earnings available to common stockholders for the year ended December 31, 2020. On May 10, 2017, five first None December 31, 2021, 2020 2019. On September 12, 2017, third twenty-five fifty twenty-five ten February 2018, None December 31, 2021, 2020 2019. Number of Weighted- Weighted- Weighted- Outstanding at December 31, 2018 333,034 13.39 3.70 3.38 Exercised (15,385 ) 13.00 - - Reserve for future issuance 1,753,523 1.39 2.20 1.22 Outstanding at December 31, 2019 2,071,172 $ 2.05 2.40 $ 1.34 Granted 50,735,292 0.68 2.40 0.19 Exercised (4,911,764 ) 0.68 - - Exchanged (2,040,757 ) 1.24 - - Reserve for future issuance 644,966 0.35 1.30 0.45 Unvested December 31, 2020 46,498,909 $ 0.71 2.40 $ 0.20 Exercised (45,317,101 ) 0.68 - - Expired (61,508 ) 1.35 - - Outstanding at December 31, 2021 1,120,300 $ 1.94 3.00 $ 0.55 The aggregate intrinsic value of the common stock warrants in the above table was $0.4 million, $0.2 million, and $0.2 million at December 31, 2021, 2020, 2019, |
Note 17 - Equity Offerings
Note 17 - Equity Offerings | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Stockholders' Equity Note Disclosure [Text Block] | 17. Equity Offerings At-the-Market Offerings On August 12, 2019, “2019 “2019 2019 February 2020. On October 9, 2020, 2019 “2020 January 2021. On May 19, 2021, “2021 “2021 The following table summarizes the total sales under the 2019, 2020, 2021 December 31, 2021, 2020 2019, December 31, 2021 2020 2019 Total shares of common stock sold 20,237,045 23,008,639 1,374,685 Average price per share $ 1.53 $ 0.90 $ 5.23 Gross proceeds $ 30,943 $ 20,822 $ 7,193 Commissions $ 928 $ 625 $ 212 Net proceeds $ 30,015 $ 20,197 $ 6,981 Public Offerings of Securities On March 10, 2020, March 2020 All of the shares of Series A Preferred Stock were converted to 7.9 million shares of common stock by the holders by June 30, 2020. December 31, 2020. The net proceeds to the Company from the March 2020 4.9 December 31, 2020, On July 6, 2020, On January 12, 2021, On January 29, 2021, February 1, 2021, During the year ended December 31, 2021, Firm Commitment Offering On September 4, 2019, 2019 30 December 31, 2019. not |
Note 18 - Basic and Diluted Net
Note 18 - Basic and Diluted Net Loss Per Share | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Earnings Per Share [Text Block] | 18. Basic and Diluted Net Loss per Share Basic net loss per common share is computed by dividing net loss attributable to common stockholders by the weighted average number of common shares outstanding during the period. Diluted net loss per common share is computed giving effect to all potential dilutive common shares that were outstanding during the period when the effect is dilutive. Potential dilutive common shares consist of incremental shares issuable upon exercise of stock options, restricted stock units, warrants and preferred stock. For the year ended December 31, 2020, December 31, 2021, 2020, 2019, no Potential common shares not December 31, December 31, December 31, 2021 2020 2019 Stock options 4,640,660 4,361,872 1,830,958 Stock warrants 1,120,300 46,498,909 2,071,172 Nonvested restricted stock units 3,839,030 2,959,099 443,927 Total 9,599,990 53,819,880 4,346,057 |
Note 19 - Restructuring
Note 19 - Restructuring | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Restructuring and Related Activities Disclosure [Text Block] | 19. Restructuring During the fourth 2019, December 31, 2019. December 31, 2020, 2020. December 31, 2020, Restructuring Liability (In thousands) Balance at December 31, 2019 $ 882 Amount charged to operating expenses 851 Cash payments (1,733 ) Balance at December 31, 2020 $ — |
Note 20 - Commitments and Conti
Note 20 - Commitments and Contingencies | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Commitments and Contingencies Disclosure [Text Block] | 20. Commitments and Contingencies Legal Proceedings No December 31, 2021, 2020 2019. License and Supply Agreements As discussed in Note 3, September 2015, 2022, 2023, 2024 |
Note 21 - Related Person Transa
Note 21 - Related Person Transactions | 12 Months Ended |
Dec. 31, 2021 | |
Notes to Financial Statements | |
Related Party Transactions Disclosure [Text Block] | 21. Related Person Transactions In March 2018, 1 1 December 31, 2021, 2020 2019, |
Significant Accounting Policies
Significant Accounting Policies (Policies) | 12 Months Ended |
Dec. 31, 2021 | |
Accounting Policies [Abstract] | |
Basis of Accounting, Policy [Policy Text Block] | Basis of Presentation The accompanying Consolidated Financial Statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) and include the accounts of the Company and its direct and indirect wholly owned subsidiaries. All inter-company accounts and transactions have been eliminated in consolidation. |
Reclassification, Comparability Adjustment [Policy Text Block] | Reclassifications Certain amounts reported previously have been reclassified to conform to the current year presentation, with no December 31, 2019. |
Substantial Doubt about Going Concern [Policy Text Block] | Liquidity The Company had an accumulated deficit of $785.4 million and working capital of $103.4 million as of December 31, 2021. not may The Company believes the COVID- 19 In 2021, January 2021 January 2021 2020 “2020 2021, 2021 December 31, 2021. 2021 As of December 31, 2021, While the Company believes that its existing cash, cash equivalents, and short-term investments as of December 31, 2021 12 may may 2021 |
Risk And Uncertainties, Policy [Policy Text Block] | Risk and Uncertainties The Company is subject to risks similar to other similarly sized companies in the medical device industry. These risks include, without limitation: potential negative impacts on the Company's operations caused by the COVID- 19 The COVID- 19 2021 19 19 |
Use of Estimates, Policy [Policy Text Block] | Use of Estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Significant items subject to such estimates and assumptions include impairment considerations for long- term assets, fair value estimates related to contingent consideration, warrant liabilities, stock compensation expense, revenue recognition, accounts receivable reserves, short-term and long-term investments, excess and obsolete inventory reserves, inventory classification between current and non-current, measurement of lease liabilities and corresponding right-of-use (“ROU”) assets, and deferred tax asset valuation allowances. |
Consolidation, Policy [Policy Text Block] | Principles of Consolidation and Foreign Currency Considerations The accompanying consolidated financial statements include the accounts of the Company and its direct and indirect wholly owned subsidiaries, Asensus Surgical US, Inc., Asensus International, Inc., Asensus Surgical Italia S.r.l., Asensus Surgical Europe S.à.r.l., Asensus Surgical Taiwan Ltd., Asensus Surgical Japan K.K., Asensus Surgical Israel Ltd., Asensus Surgical Netherlands B.V., and Asensus Surgical Canada, Inc. All inter-company accounts and transactions have been eliminated in consolidation. The functional currency of the Company’s operational foreign subsidiaries is predominantly the Euro. The assets and liabilities of the Company’s foreign subsidiaries are translated into U.S. dollars at exchange rates in effect at the balance sheet date. Income and expense items are translated at the average exchange rates prevailing during the period. The cumulative translation effect for a subsidiary using a functional currency other than the U.S. dollar is included in accumulated other comprehensive income or loss as a separate component of stockholders’ equity. The Company’s intercompany accounts are denominated in the functional currency of the foreign subsidiary. Gains and losses resulting from the remeasurement of intercompany receivables that the Company considers to be of a long-term investment nature are recorded as a cumulative translation adjustment in accumulated other comprehensive income or loss as a separate component of stockholders’ equity, while gains and losses resulting from the remeasurement of intercompany receivables from a foreign subsidiary for which the Company anticipates settlement in the foreseeable future are recorded in the consolidated statements of operations and comprehensive loss. The net gains and losses included in net loss in the consolidated statements of operations and comprehensive loss for the years ended December 31, 2021, 2020, 2019 not |
Cash and Cash Equivalents, Restricted Cash, and Investments, Policy [Policy Text Block] | Cash and Cash Equivalents, Restricted Cash, and Investments The Company considers all highly liquid investments with original maturities of 90 Restricted cash as of December 31, 2021 2020 The Company’s investments as of December 31, 2021 December 31, 2020. December 31, 2021. no December 31, 2021. no December 31, 2020 2019. December 31, 2021 December 31, 2020 2019. 90 one one |
Concentration Risk, Credit Risk, Policy [Policy Text Block] | Concentrations and Credit Risk The Company’s principal financial instruments subject to potential concentration of credit risk are cash and cash equivalents, and investments, including amounts held in money market funds, commercial paper, and corporate bonds. The Company places cash deposits with a federally insured financial institution. The Company maintains its cash at banks and financial institutions it considers to be of high credit quality; however, the Company’s domestic cash deposits may may not not not The Company’s accounts receivable are derived from sales and leases to customers located throughout the world. The Company evaluates its customers’ financial condition and, generally, requires no December 31, 2021, 2020 2019, three December 31, 2021. seven December 31, 2020. two 2021, nine 2020, six 2019. |
Receivable [Policy Text Block] | Accounts Receivable Accounts receivable are recorded at net realizable value, which includes an allowance for estimated uncollectible accounts. The allowance for uncollectible accounts was determined on a customer specific basis based on deemed collectability. The allowance for doubtful accounts was $1.7 million and $1.8 million as of December 31, 2021 December 31, 2020, |
Inventory, Policy [Policy Text Block] | Inventories Inventories are stated at the lower of cost (determined on a first first not Any inventory on hand at the measurement date in excess of the Company's current requirements based on anticipated levels of sales is classified as long-term on the Company's consolidated balance sheets. The Company's classification of long-term inventory requires it to estimate the portion of on hand inventory that can be realized over the upcoming twelve |
Goodwill and Intangible Assets, Policy [Policy Text Block] | Identifiable Intangible Assets Definite-Lived Intangible Assets - Intellectual Property Intellectual property consists of purchased patent rights and developed technology acquired as part of a business acquisition. Developed technology includes reclassified in-process research and development (“IPR&D”) assets related to (i) the Senhance System acquired in 2015 2017 2018 2020. The Company periodically evaluates intellectual property for impairment whenever events or changes in circumstances indicate that the carrying amount may not December 31, 2021, 2020 2019. Indefinite-Lived Intangible Assets IPR&D assets represent the fair value assigned to technologies that were acquired, which at the time of acquisition have not no The Company reclassifies IPR&D assets to intellectual property when development is complete, which generally occurs upon regulatory approval when the Company is able to commercialize products. The completed IPR&D assets are then classified as definite-lived intangible assets and are amortized based on their estimated useful lives at that point in time. If development is terminated or abandoned, the Company may The Company performed an impairment test of its IPR&D at the end of the third 2019 third 2019, December 31, 2019 no December 31, 2020, |
Property, Plant and Equipment, Policy [Policy Text Block] | Property and Equipment Property and equipment consists primarily of operating lease Senhance System assets, machinery, manufacturing equipment, demonstration equipment, computer equipment, furniture, and leasehold improvements, and purchased software which are recorded at cost less accumulated depreciation. Depreciation is recorded using the straight-line method over the estimated useful lives of the assets as follows: Years Operating lease assets – Senhance System leasing 5 Machinery, manufacturing, and demonstration equipment 3 - 5 Computer equipment 3 Furniture 5 Leasehold improvements Lesser of lease term or 3 to 10 Purchased Software 5 The Company reviews its property and equipment assets for possible impairment whenever events or changes in circumstances indicate that the carrying amount of the assets may not not December 31, 2021, 2020, 2019. |
Lessee, Leases [Policy Text Block] | Operating Leases We have operating leases for our corporate office buildings, vehicles, and machinery and equipment. At inception, we determine whether an agreement represents a lease and, at commencement, we evaluate each lease agreement to determine whether the lease constitutes an operating or financing lease. On January 1, 2019, No. 2016 02, not not not Adoption of ASU No. 2016 02 not not |
Employer Retention Tax Credit, Policy [Policy Text Block] | Employee Retention Tax Credit Receivable The Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”) included an Employee Retention Tax Credit (“ERTC”) provision designed to encourage employers to keep employees on their payroll. The ERTC is a refundable tax credit against certain payroll taxes paid by employers for eligible wages. We assessed the government assistance in accordance with Topic 958 605, Not December 31, 2021, |
Debt, Policy [Policy Text Block] | Notes Payable Payroll Protection Program The Company’s policy is to account for forgivable loans received through the U.S. Small Business Administration (the “SBA”) under the CARES Act Payroll Protection Program (“PPP”), as debt in accordance with ASC 470, June 10, 2021, |
Contingent Consideration [Policy Text Block] | Contingent Consideration Contingent consideration is recorded as a liability and is the estimate of the fair value of potential milestone payments related to business acquisitions. Contingent consideration is measured at fair value using a Monte-Carlo simulation utilizing significant unobservable inputs including the probability of achieving each of the potential milestones, future Euro-to-USD exchange rates, revenue volatility and an estimated discount rate associated with the risks of the expected cash flows attributable to the various milestones. Significant increases or decreases in any of the probabilities of success or changes in expected achievement of any of these milestones would result in a significantly higher or lower fair value of these milestones, respectively, and commensurate changes to the associated liability. The contingent consideration is revalued at each reporting period and changes in fair value are recognized in the consolidated statements of operations and comprehensive loss. On September 21, 2015, 2016, December 31, 2021, €15.0 €25.0 |
Warrant Liabilities [Policy Text Block] | Warrant Liabilities The Company’s Series B Warrants (see Note 16 first 2021. |
Revenue [Policy Text Block] | Revenue Recognition The Company’s revenue consists of product revenue resulting from the sale and lease of Senhance Systems, Senhance System components, instruments and accessories, and service revenue. The Company accounts for a contract with a customer when there is a legally enforceable contract between the Company and the customer, the rights of the parties are identified, the contract has commercial substance, and collectability of the contract consideration is probable. The Company's revenues are measured based on consideration specified in the contract with each customer, net of any sales incentives and taxes collected from customers that are remitted to government authorities. The Company’s Senhance System sale arrangements generally include a five first four The Company’s Senhance System sale arrangements generally contain multiple products and services. For these consolidated sale arrangements, the Company accounts for individual products and services as separate performance obligations if they are distinct, which is if a product or service is separately identifiable from other items in the consolidated package, and if a customer can benefit from it on its own or with other resources that are readily available to the customer. The Company’s Senhance System sale arrangements may For arrangements that contain multiple performance obligations, revenue is allocated to each performance obligation based on its relative estimated standalone selling price. When available, standalone selling prices are based on observable prices at which the Company separately sells the products or services; however due to limited sales to date, standalone selling prices generally are not not The Company recognizes revenues when or as the performance obligations are satisfied by transferring control of the product or service to a customer. The Company generally recognizes revenue for the performance obligations as follows: • System sales. For Senhance Systems and Senhance System components sold directly to end customers (including those arising from Senhance System purchases under lease rights to purchase), revenue is recognized when the Company transfers control to the customer, which is generally at the point when acceptance occurs that indicates customer acknowledgment of delivery or installation, depending on the terms of the arrangement. For lease buyouts, where the customer has already acknowledged installation of the system, transfer of control occurs when the Company receives an executed contract for the lease buyout of the Senhance System. For Senhance Systems sold through distributors, for which distributors are responsible for installation, revenue is recognized generally at the time of shipment. The Company’s Senhance System arrangements generally do not one not • Instruments and accessories. Revenue from sales of instruments and accessories is recognized when control is transferred to the customers, which generally occurs at the time of shipment, but also occurs at the time of delivery depending on the customer arrangement. • Service. Service revenue is recognized ratably over the term of the service period as the customers benefit from the service throughout the service period. Revenue related to services performed on a time-and-materials basis is recognized when performed. The following table presents revenue disaggregated by type and geography: Years Ended December 31, 2021 2020 2019 (in thousands) U.S. Systems $ 380 $ 282 $ 90 Instruments and accessories 270 187 108 Services 383 380 338 Total U.S. revenue 1,033 849 536 Outside of U.S. ("OUS") Systems 4,363 490 5,459 Instruments and accessories 1,699 653 1,447 Services 1,137 1,183 1,089 Total OUS revenue 7,199 2,326 7,995 Total Systems 4,743 772 5,549 Instruments and accessories 1,969 840 1,555 Services 1,520 1,563 1,427 Total revenue $ 8,232 $ 3,175 $ 8,531 The Company recognizes sales by geographic area based on the country in which the customer is based. Operating lease revenue from Senhance System leasing is included as Systems revenues in the above table and was approximately $1.3 million, $0.7 million, and $0 million in the years ended December 31, 2021, 2020 2019, Transaction price allocated to remaining performance obligations relates to amounts allocated to products and services for which the revenue has not December 31, 2021, 2020, 2019, December 31, 2021 one five The Company invoices its customers based on the billing schedules in its sales arrangements. Payments are generally due 30 60 December 31, 2021 2020, not December 31, 2021, 2020 2019 In connection with assets recognized from the costs to obtain a contract with a customer, the Company determined that the sales incentive programs for its sales team do not not |
Lessor, Leases [Policy Text Block] | Senhance System Leasing The Company enters into lease arrangements with certain qualified customers. Revenue related to arrangements including lease elements are allocated to lease and non-lease elements based on their relative standalone selling prices. Lease elements generally include a Senhance System, while non-lease elements generally include instruments, accessories, and services. For some lease arrangements, the customers are provided with the right to purchase the leased Senhance System at some point during and/or at the end of the lease term. In some arrangements lease payments are based on the usage of the Senhance System. In determining whether a transaction should be classified as a sales-type, operating, or direct financing lease, the Company considers the following terms at lease commencement: ( 1 2 3 4 5 no December 31, 2021 Revenue related to lease elements from operating lease arrangements is generally recognized on a straight-line basis over the lease term or based upon Senhance System usage and is presented as product revenue. Revenue related to lease elements from operating lease arrangements was approximately $1.3 million, $0.7 million, $0 million for the years ended December 31, 2021, 2020 2019, |
Cost of Goods and Service [Policy Text Block] | Cost of Revenue Cost of revenue consists of contract manufacturing, materials, labor and manufacturing overhead incurred internally to produce the products. Depreciation expense related to leased systems is included in the cost of revenue. Shipping and handling costs incurred by the Company are included in the cost of revenue. We expense all inventory obsolescence provisions as cost of revenue. |
Research and Development Expense, Policy [Policy Text Block] | Research and Development Costs Research and development expenses primarily consist of engineering, product development and regulatory expenses, incurred in the design, development, testing and enhancement of our products. Research and development costs are expensed as incurred. |
Share-based Payment Arrangement [Policy Text Block] | Stock-Based Compensation The Company recognizes expenses for share-based awards exchanged for services rendered equal to the estimated fair value of these awards over the requisite service period. The Company recognizes as expense, the grant-date fair value of stock options and other stock-based compensation issued to employees and non-employee directors over the requisite service periods, which are typically the vesting periods. The Company uses the Black-Scholes-Merton model to estimate the fair value of stock options. The volatility assumption used in the Black-Scholes-Merton model is based on the Company’s historical volatility. The expected term of options granted has been determined based upon the simplified method, because the Company does not not not The fair value of restricted stock units is determined by the market price of the Company’s common stock on the date of grant. The Company records as expense the fair value of stock-based compensation awards, including stock options and restricted stock units. Compensation expense for stock-based compensation was approximately $9.4 million, $7.9 million, and $11.5 million for the years ended December 31, 2021, 2020, 2019 |
Income Tax, Policy [Policy Text Block] | Income Taxes The Company accounts for income taxes using the asset and liability method, which requires the recognition of deferred tax assets or liabilities for the temporary differences between financial reporting and tax basis of the Company’s assets and liabilities, and for tax carryforwards at enacted statutory rates in effect for the years in which the asset or liability is expected to be realized. The effect on deferred taxes of a change in tax rates is recognized in income during the period that includes the enactment date. In addition, valuation allowances are established when necessary to reduce deferred tax assets and liabilities to the amounts expected to be realized. The Company has elected to account for global intangible low-taxed income (“GILTI”) as a period expense in the year the tax is incurred. The Company recognizes the financial statement benefit of an income tax position only after determining that the relevant taxing authority would more likely than not not 50% Tax regulations within each jurisdiction are subject to the interpretation of the related tax laws and regulations and require application of significant judgment. The Company is subject to U.S. federal and various state, local and foreign jurisdictions. Due to the Company’s net operating loss carryforwards, the Company may Revision of Previously Disclosed Amounts During the course of preparing the Company’s consolidated financial statements as of and for the year ended December 31 2021, 382 383 11—Income |
Comprehensive Income, Policy [Policy Text Block] | Comprehensive Loss Comprehensive loss is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. |
Segment Reporting, Policy [Policy Text Block] | Segments The Company operates in one not Approximately 77% and 27% of the Company’s total consolidated assets are located within the U.S. as of December 31, 2021 2020, December 31, 2021 2020, December 31, 2021 2020, December 31, 2021 2020, The Company recognizes sales by geographic area based on the country in which the customer is based. For the years ended December 31, 2021, 2020 2019, December 31, 2021, December 31, 2020, December 31, 2019, |
New Accounting Pronouncements, Policy [Policy Text Block] | Impact of Recently Issued Accounting Standards In December 2019, 2019 12, 2019 12 740, 2019 12 January 1, 2021; not In June 2016, 2016 13, 326 December 15, 2022, not In August 2020, 2020 06 470 20 815 40 December 15, 2021, The Company has evaluated all other issued and unadopted ASUs and believes the adoption of these standards will not |
Note 2 - Summary of Significa_2
Note 2 - Summary of Significant Accounting Policies (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Schedule of Property Plant and Equipment Useful Life [Table Text Block] | Years Operating lease assets – Senhance System leasing 5 Machinery, manufacturing, and demonstration equipment 3 - 5 Computer equipment 3 Furniture 5 Leasehold improvements Lesser of lease term or 3 to 10 Purchased Software 5 |
Disaggregation of Revenue [Table Text Block] | Years Ended December 31, 2021 2020 2019 (in thousands) U.S. Systems $ 380 $ 282 $ 90 Instruments and accessories 270 187 108 Services 383 380 338 Total U.S. revenue 1,033 849 536 Outside of U.S. ("OUS") Systems 4,363 490 5,459 Instruments and accessories 1,699 653 1,447 Services 1,137 1,183 1,089 Total OUS revenue 7,199 2,326 7,995 Total Systems 4,743 772 5,549 Instruments and accessories 1,969 840 1,555 Services 1,520 1,563 1,427 Total revenue $ 8,232 $ 3,175 $ 8,531 |
Note 4 - Cash, Cash Equivalen_2
Note 4 - Cash, Cash Equivalents, and Restricted Cash (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Schedule of Cash, Cash Equivalents, and Restricted Cash [Table Text Block] | December 31, December 31, 2021 2020 (in thousands) Cash $ 8,343 $ 6,679 Money Market 5,287 9,684 Commerical Paper 4,499 - Total cash and cash equivalents $ 18,129 $ 16,363 Restricted Cash 1,154 1,166 Total $ 19,283 $ 17,529 |
Note 5 - Investments, Availab_2
Note 5 - Investments, Available-for-sale (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Debt Securities, Available-for-sale [Table Text Block] | December 31, 2021 (in thousands) Amortized Cost Unrealized Gain Unrealized Loss Fair Value Short-term investments Long-term investments Commerical Paper $ 50,705 $ - $ (46 ) $ 50,659 $ 50,660 $ - Corporate Bonds 67,239 1 (202 ) 67,038 29,602 37,435 Total Investments $ 117,944 $ 1 $ (248 ) $ 117,697 $ 80,262 $ 37,435 Amortized Cost Fair Value Mature in less than one year $ 80,336 $ 80,262 Mature in one to two years 37,608 37,435 Total $ 117,944 $ 117,697 |
Note 6 - Fair Value (Tables)
Note 6 - Fair Value (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Fair Value, Assets Measured on Recurring Basis [Table Text Block] | December 31, 2021 (in thousands) Description Quoted Prices in Significant Other Significant Total Assets measured at fair value Cash and cash equivalents (1) $ 18,129 $ - $ - $ 18,129 Restricted cash 1,154 - - $ 1,154 Short-term investments - 80,262 - $ 80,262 Long-term investments - 37,435 - $ 37,435 Total assets measured at fair value $ 19,283 $ 117,697 $ - $ 136,980 Liabilities measured at fair value Contingent consideration $ - $ - $ 2,371 $ 2,371 Total liabilities measured at fair value $ - $ - $ 2,371 $ 2,371 December 31, 2020 (in thousands) Description Quoted Prices in Significant Other Significant Total Assets measured at fair value Cash and cash equivalents $ 16,363 $ - $ - $ 16,363 Restricted cash 1,166 - - 1,166 Total assets measured at fair value $ 17,529 $ - $ - $ 17,529 Liabilities measured at fair value Contingent consideration $ - $ - $ 3,936 $ 3,936 Warrant liabilities - - 255 255 Total liabilities measured at fair value $ - $ - $ 4,191 $ 4,191 |
Fair Value Measurement Inputs and Valuation Techniques [Table Text Block] | December 31, Valuation Significant 2021 2020 Contingent consideration Probability Milestone dates 2031 2025 Discount rate 9.5% 9.5% Revenue volatility 39.0% 71.0% December 31, December 31, December 31, Series B Warrants 2021 2020 2019 Valuation methodology Black-Scholes-Merton Black-Scholes-Merton Monte Carlo Term (years) 1.22 1.32 2.32 Risk free rate 0.07 % 0.10 % 1.59 % Dividends - - - Volatility 174.00 % 150.97 % 109.80 % Share price $ 4.21 $ 0.63 $ 1.47 |
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block] | Fair Value Measurement at Reporting Date (Level 3) (in thousands) Series B Warrants Contingent consideration Balance at December 31, 2018 $ 4,636 $ 10,637 Change in fair value (2,248 ) (9,553 ) Balance at December 31, 2019 $ 2,388 $ 1,084 Exchange of warrants for common stock (2,469 ) - Payment for contingent consideration - (74 ) Change in fair value 336 2,924 Balance at December 31, 2020 $ 255 $ 3,936 Exercise of warrants $ (2,236 ) $ - Change in fair value 1,981 $ (1,565 ) Balanceat December 31, 2021 $ - $ 2,371 Current portion $ - $ - Long-term portion - 2,371 Balance at December 31, 2021 $ - $ 2,371 |
Note 7 - Accounts Receivable,_2
Note 7 - Accounts Receivable, Net (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Schedule of Accounts, Notes, Loans and Financing Receivable [Table Text Block] | December 31, 2021 December 31, 2020 (In thousands) Gross accounts receivable $ 2,426 $ 2,917 Allowance for uncollectible accounts (1,677 ) (1,802 ) Total accounts receivable, net $ 749 $ 1,115 |
Note 8 - Inventories (Tables)
Note 8 - Inventories (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Schedule of Inventory, Current [Table Text Block] | December 31, 2021 (in thousands) Gross Carrying Amount Reserve Balance Net Carrying Amount Finished goods $ 10,566 $ (2,987 ) $ 7,579 Raw materials 10,824 (2,695 ) 8,129 Total inventories $ 21,390 $ (5,682 ) $ 15,708 Current Portion $ 9,931 $ (1,297 ) $ 8,634 Long-term portion 11,459 (4,385 ) 7,074 Total inventories $ 21,390 $ (5,682 ) $ 15,708 December 31, 2020 (in thousands) Gross Carrying Amount Reserve Balance Net Carrying Amount Finished goods $ 13,858 $ (3,109 ) $ 10,749 Raw materials 11,163 (3,065 ) 8,098 Total inventories $ 25,021 $ (6,174 ) $ 18,847 Current Portion $ 11,444 $ (1,410 ) $ 10,034 Long-term portion 13,577 (4,764 ) 8,813 Total inventories $ 25,021 $ (6,174 ) $ 18,847 |
Note 9 - Property and Equipme_2
Note 9 - Property and Equipment (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Property, Plant and Equipment [Table Text Block] | December 31, 2021 December 31, 2020 (In thousands) Machinery, manufacturing, and demonstration equipment $ 8,289 $ 9,909 Operating lease assets - Senhance System leasing 10,143 8,906 Computer equipment 325 2,297 Furniture 644 640 Leasehold improvements 1,259 2,309 Total property and equipment 20,660 24,061 Accumulated depreciation and amortization (9,689 ) (13,719 ) Property and equipment, net $ 10,971 $ 10,342 |
Note 10 - Goodwill, In-proces_2
Note 10 - Goodwill, In-process Research and Development and Intellectual Property (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Schedule of Goodwill [Table Text Block] | Goodwill (In thousands) Balance at December 31, 2018 $ 80,131 Foreign currency translation impact (1,162 ) Impairment (78,969 ) Balance at December 31, 2019 $ — |
Schedule of Finite-Lived Intangible Assets [Table Text Block] | In-Process Research and Development (In thousands) Balance at December 31, 2018 $ 10,747 Impairment (7,912 ) Foreign currency translation impact (365 ) Balance at December 31, 2019 2,470 Impairment — Foreign currency translation impact (45 ) Transfer of in-process research and development to intellectual property (2,425 ) Balance at December 31, 2020 $ — December 31, 2021 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (58,912 ) $ (262 ) $ 9,664 Technology and patents purchased 400 (199 ) 27 228 Total intellectual property $ 69,238 $ (59,111 ) $ (235 ) $ 9,892 December 31, 2020 (in thousands) Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Impact Net Carrying Amount Developed technology $ 68,838 $ (51,734 ) $ 4,872 $ 21,976 Technology and patents purchased 400 (168 ) 59 291 Total intellectual property $ 69,238 $ (51,902 ) $ 4,931 $ 22,267 |
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block] | Year ending December 31, 2021 (In thousands) 2022 8,218 2023 400 2024 400 2025 400 2026 400 Thereafter 74 Total $ 9,892 |
Note 11 - Income Taxes (Tables)
Note 11 - Income Taxes (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Schedule of Components of Income Tax Expense (Benefit) [Table Text Block] | 2021 2020 2019 Current income taxes Federal $ - $ - $ - State - - - Foreign 232 169 100 Deferred income taxes Federal - - - State - - - Foreign (7 ) (1,685 ) (3,224 ) Total income tax expense (benefit) $ 225 $ (1,516 ) $ (3,124 ) |
Schedule of Income before Income Tax, Domestic and Foreign [Table Text Block] | 2021 2020 2019 United States $ (32,094 ) $ (34,398 ) $ (91,935 ) Foreign (30,143 ) (26,430 ) (65,390 ) Total loss from operations before taxes $ (62,237 ) $ (60,828 ) $ (157,325 ) |
Schedule of Deferred Tax Assets and Liabilities [Table Text Block] | 2021 2020 Deferred Tax assets: Stock-based compensation $ 2,440 $ 4,253 Accrued expenses and other 2,423 906 Research credit carryforward 564 - Fixed Assets 101 385 Capitalized start-up costs and other intangibles 1,109 2,686 Net operating loss carryforwards 75,237 63,786 81,874 72,016 Valuation Allowance (78,294 ) (67,312 ) Net deferred tax asset 3,580 4,704 Deferred tax liabilities Fixed assets and other (1,176 ) (1,590 ) Purchase accounting intangibles (2,116 ) (2,807 ) Net deferred tax liability (3,292 ) (4,397 ) Net deferred tax asset (liability) $ 288 $ 307 |
Schedule of Unrecognized Tax Benefits Roll Forward [Table Text Block] | 2021 2020 2019 Beginning balance $ - $ 1,512 $ 1,363 Gross increases for tax positions related to current periods 141 108 149 Gross decreases related to 382 limitations - (1,620 ) - Ending balance $ 141 $ - $ 1,512 |
Schedule of Effective Income Tax Rate Reconciliation [Table Text Block] | 2021 2020 2019 Amount Percent of Pretax Earnings Amount Percent of Pretax Earnings Amount Percent of Pretax Earnings United States federal tax at statutory rate $ (13,070 ) 21.0 % $ (12,774 ) 21.0 % $ (33,038 ) 21.0 % State taxes (net of deferred benefit) (2,205 ) 3.5 % (1,768 ) 2.9 % (4,778 ) 3.0 % Nondeductible expenses (440 ) 0.7 % 719 (1.2 %) 709 (0.5 %) Change in fair market value of contingent consideration (397 ) 0.6 % 717 (1.2 %) (2,342 ) 1.5 % Warrant remeasurment and financing costs 502 (0.8 %) 82 (0.1 %) (551 ) 0.4 % Research & Development (705 ) 1.1 % (542 ) 0.9 % (743 ) 0.5 % Change in unrecognized tax benefits 141 (0.2 %) (1,512 ) 2.5 % 149 (0.1 %) Foreign tax rate differential 1,911 (3.1 %) 1,589 -2.6 % 2,590 (1.6 %) Goodwill and investment impairments - - - - (6,638 ) 4.2 % Adjustment for 382 Limitations - - 67,255 (110.6 %) - 0.0 % True-up to Stock Compensation - Cancellations 2,832 (4.6 %) - - - 0.0 % Change in enacted tax rates and other, net 731 (1.0 %) 533 (0.9 %) (253 ) 0.2 % Change in valuation allowance 10,925 (17.6 %) (55,815 ) 91.8 % 41,771 26.6 % Income tax expense (benefit) $ 225 (0.4 %) $ (1,516 ) 2.5 % $ (3,124 ) 2.0 % |
Note 12 - Operating Leases (Tab
Note 12 - Operating Leases (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Lease, Cost [Table Text Block] | December 31, 2021 2020 Weighted-average remaining lease term (in years) 7.8 1.8 Weighted-average discount rate 7.8 % 8.2 % |
Lessee, Operating Lease, Liability, Maturity [Table Text Block] | Fiscal Year 2022 $ 994 2023 1,008 2024 918 2025 920 2026 854 Thereafter 3,004 Total minimum lease payments $ 7,698 Less: Amount of lease payments representing interest (2,009 ) Present value of future minimum lease payments $ 5,689 |
Note 13 - Accrued Expenses (Tab
Note 13 - Accrued Expenses (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Schedule of Accrued Liabilities [Table Text Block] | December 31, 2021 December 31, 2020 (In thousands) Compensation and benefits $ 3,682 $ 4,541 Consulting and other vendors 128 66 Other 124 177 Royalties 247 147 Legal and professional fees 503 314 Taxes and other assessments 492 351 Interest — 19 Total $ 5,176 $ 5,615 |
Note 15 - Stock-based Compens_2
Note 15 - Stock-based Compensation (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block] | Year Ended December 31, 2021 2020 2019 Expected dividend yield 0% 0% 0% Expected volatility 118% - 139% 82% - 126% 81% - 92% Risk-free interest rate 0.33% - 1.11% 0.2% - 1.69% 1.39% - 2.66% Expected life (in years) 3.8 - 4.5 3.8 - 6.1 5.5 - 6.1 |
Share-based Payment Arrangement, Option, Activity [Table Text Block] | Number of Weighted- Weighted-Average Options outstanding at December 31, 2020 4,361,872 $ 10.49 6.05 Granted 1,490,266 4.06 Forfeited (285,391 ) 8.10 Cancelled (610,287 ) 30.32 Exercised (315,800 ) 0.67 Options outstanding at December 31, 2021 4,640,660 $ 6.64 5.66 |
Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested and Expected to Vest, Exercisable [Table Text Block] | Number of Shares Weighted- Weighted-Average Aggregate Exercisable at December 31, 2021 1,887,155 $ 11.50 5.40 $ 0.7 Vested or expected to vest at December 31, 2021 4,498,953 $ 6.75 5.65 $ 1.4 |
Share-based Payment Arrangement, Restricted Stock Unit, Activity [Table Text Block] | Number of Weighted- Unvested December 31, 2018 382,098 $ 20.24 Granted 192,987 31.42 Vested (85,153 ) 25.98 Forfeited (46,005 ) 21.38 Unvested December 31, 2019 443,927 $ 23.88 Granted 3,112,382 0.67 Vested (313,508 ) 19.38 Forfeited (245,402 ) 6.54 Unvested December 31, 2020 2,997,399 $ 1.41 Granted 3,133,753 2.77 Vested (1,891,869 ) 1.63 Forfeited (400,253 ) 1.86 Unvested December 31, 2021 3,839,030 $ 2.36 |
Note 16 - Warrants (Tables)
Note 16 - Warrants (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Schedule of Stockholders' Equity Note, Warrants or Rights [Table Text Block] | Number of Weighted- Weighted- Weighted- Outstanding at December 31, 2018 333,034 13.39 3.70 3.38 Exercised (15,385 ) 13.00 - - Reserve for future issuance 1,753,523 1.39 2.20 1.22 Outstanding at December 31, 2019 2,071,172 $ 2.05 2.40 $ 1.34 Granted 50,735,292 0.68 2.40 0.19 Exercised (4,911,764 ) 0.68 - - Exchanged (2,040,757 ) 1.24 - - Reserve for future issuance 644,966 0.35 1.30 0.45 Unvested December 31, 2020 46,498,909 $ 0.71 2.40 $ 0.20 Exercised (45,317,101 ) 0.68 - - Expired (61,508 ) 1.35 - - Outstanding at December 31, 2021 1,120,300 $ 1.94 3.00 $ 0.55 |
Note 17 - Equity Offerings (Tab
Note 17 - Equity Offerings (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Schedule of Sales Under Sales Agency Agreement [Table Text Block] | December 31, 2021 2020 2019 Total shares of common stock sold 20,237,045 23,008,639 1,374,685 Average price per share $ 1.53 $ 0.90 $ 5.23 Gross proceeds $ 30,943 $ 20,822 $ 7,193 Commissions $ 928 $ 625 $ 212 Net proceeds $ 30,015 $ 20,197 $ 6,981 |
Note 18 - Basic and Diluted N_2
Note 18 - Basic and Diluted Net Loss Per Share (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share [Table Text Block] | December 31, December 31, December 31, 2021 2020 2019 Stock options 4,640,660 4,361,872 1,830,958 Stock warrants 1,120,300 46,498,909 2,071,172 Nonvested restricted stock units 3,839,030 2,959,099 443,927 Total 9,599,990 53,819,880 4,346,057 |
Note 19 - Restructuring (Tables
Note 19 - Restructuring (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Notes Tables | |
Restructuring and Related Costs [Table Text Block] | Restructuring Liability (In thousands) Balance at December 31, 2019 $ 882 Amount charged to operating expenses 851 Cash payments (1,733 ) Balance at December 31, 2020 $ — |
Note 1 - Organization and Cap_2
Note 1 - Organization and Capitalization (Details Textual) - China National Scientific and Instruments and Materials Company [Member] - USD ($) $ in Millions | 1 Months Ended | 48 Months Ended |
Dec. 31, 2017 | Dec. 31, 2021 | |
Proceeds from Distribution Agreement | $ 15 | |
Distribution Agreement, Minimum Royalties Receivable Upon Regulatory Approval | $ 14 | |
Maximum [Member] | ||
Expected Proceeds from Distribution Agreement | $ 29 |
Note 2 - Summary of Significa_3
Note 2 - Summary of Significant Accounting Policies 1 (Details Textual) $ in Thousands, € in Millions | Jun. 10, 2021USD ($) | Jan. 29, 2021USD ($) | Jan. 12, 2021USD ($) | Apr. 27, 2020USD ($) | Jan. 31, 2021USD ($) | Sep. 30, 2019USD ($) | Dec. 31, 2021USD ($) | Dec. 31, 2021EUR (€) | Dec. 31, 2020USD ($) | Dec. 31, 2019USD ($) |
Retained Earnings (Accumulated Deficit), Ending Balance | $ (785,374) | $ (722,912) | ||||||||
Working Capital | 103,400 | |||||||||
Proceeds from Warrant Exercises | 30,600 | |||||||||
Cash, Cash Equivalents, Short-term and Long-term Investments, Excluding Restricted Cash | 135,800 | |||||||||
Restricted Cash and Cash Equivalents, Noncurrent, Total | 1,154 | 1,166 | ||||||||
Debt Securities, Available-for-sale, Total | 117,697 | 0 | ||||||||
Debt Securities, Available-for-sale, Realized Gain (Loss), Total | 0 | 0 | $ 0 | |||||||
Other Comprehensive Income (Loss), Reclassification Adjustment from AOCI for Sale of Securities, before Tax, Total | 0 | 0 | ||||||||
Accounts Receivable, Credit Loss Expense (Reversal) | 144 | 0 | 1,634 | |||||||
Accounts Receivable, Allowance for Credit Loss, Ending Balance | 1,677 | 1,802 | ||||||||
Impairment of Intangible Assets, Finite-lived | 0 | 0 | 7,912 | |||||||
Other Income, Employer Retention Tax Credit | 1,311 | 0 | 0 | |||||||
Business Combination, Contingent Consideration, Liability, Total | $ 2,371 | 3,936 | ||||||||
Period Of Service Sale Arrangement (Year) | 5 years | 5 years | ||||||||
Period of Service Sale Arrangement at Stated Service Price (Year) | 4 years | 4 years | ||||||||
Operating Lease, Lease Income, Total | $ 1,300 | 700 | 0 | |||||||
Revenue, Remaining Performance Obligation, Amount | 3,000 | 3,100 | 3,700 | |||||||
Contract with Customer, Asset, after Allowance for Credit Loss, Current, Total | 100 | 100 | ||||||||
Contract with Customer, Liability, Revenue Recognized | 600 | 600 | 1,000 | |||||||
Share-based Payment Arrangement, Expense | $ 9,400 | 7,900 | 11,500 | |||||||
Number of Operating Segments | 1 | 1 | ||||||||
Assets, Total | $ 186,473 | 78,258 | ||||||||
Non-US [Member] | ||||||||||
Assets, Total | 43,200 | 56,800 | ||||||||
Senhance Surgical Robotic System Acquisition[Member] | ||||||||||
Business Combination, Contingent Consideration, Liability, Total | $ 2,400 | |||||||||
Business Combination, Contingent Consideration, Liability, Related Milestone | € | € 15 | |||||||||
Paycheck Protection Program CARES Act [Member] | ||||||||||
Debt Instrument, Decrease, Forgiveness | $ 2,800 | $ 2,800 | ||||||||
Minimum [Member] | Senhance Surgical Robotic System Acquisition[Member] | ||||||||||
Business Combination Contingent Consideration Arrangements Target Revenue | € | € 25 | |||||||||
Patents [Member] | ||||||||||
Finite-Lived Intangible Asset, Useful Life (Year) | 10 years | 10 years | ||||||||
Developed Technology Rights [Member] | Minimum [Member] | ||||||||||
Finite-Lived Intangible Asset, Useful Life (Year) | 5 years | 5 years | ||||||||
Developed Technology Rights [Member] | Maximum [Member] | ||||||||||
Finite-Lived Intangible Asset, Useful Life (Year) | 7 years | 7 years | ||||||||
Intellectual Property [Member] | ||||||||||
Impairment of Intangible Assets, Finite-lived | $ 0 | 0 | 0 | |||||||
In Process Research and Development [Member] | ||||||||||
Impairment of Intangible Assets, Finite-lived | $ 7,900 | $ 0 | $ (7,912) | |||||||
Accounts Receivable [Member] | Customer Concentration Risk [Member] | Three Customers [Member] | ||||||||||
Number of Major Customers | 3 | 3 | ||||||||
Concentration Risk, Percentage | 61.00% | 61.00% | ||||||||
Accounts Receivable [Member] | Customer Concentration Risk [Member] | Seven Customers [Member] | ||||||||||
Number of Major Customers | 7 | |||||||||
Concentration Risk, Percentage | 68.00% | |||||||||
Revenue Benchmark [Member] | Customer Concentration Risk [Member] | Two Customers [Member] | ||||||||||
Number of Major Customers | 2 | 2 | ||||||||
Concentration Risk, Percentage | 52.00% | 52.00% | ||||||||
Revenue Benchmark [Member] | Customer Concentration Risk [Member] | Nine Customers [Member] | ||||||||||
Number of Major Customers | 9 | |||||||||
Concentration Risk, Percentage | 55.00% | |||||||||
Revenue Benchmark [Member] | Customer Concentration Risk [Member] | Six Customers [Member] | ||||||||||
Number of Major Customers | 6 | |||||||||
Concentration Risk, Percentage | 82.00% | |||||||||
Revenue Benchmark [Member] | Geographic Concentration Risk [Member] | UNITED STATES | ||||||||||
Concentration Risk, Percentage | 13.00% | 13.00% | 27.00% | 6.00% | ||||||
Revenue Benchmark [Member] | Geographic Concentration Risk [Member] | Europe [Member] | ||||||||||
Concentration Risk, Percentage | 62.00% | 62.00% | 53.00% | 39.00% | ||||||
Revenue Benchmark [Member] | Geographic Concentration Risk [Member] | Asia [Member] | ||||||||||
Concentration Risk, Percentage | 25.00% | 25.00% | 20.00% | 55.00% | ||||||
Revenue Benchmark [Member] | Geographic Concentration Risk [Member] | GERMANY | ||||||||||
Concentration Risk, Percentage | 47.00% | 47.00% | 28.00% | 23.00% | ||||||
Revenue Benchmark [Member] | Geographic Concentration Risk [Member] | JAPAN | ||||||||||
Concentration Risk, Percentage | 22.00% | 22.00% | 10.00% | |||||||
Revenue Benchmark [Member] | Geographic Concentration Risk [Member] | TAIWAN, PROVINCE OF CHINA | ||||||||||
Concentration Risk, Percentage | 10.00% | 53.00% | ||||||||
Assets, Total [Member] | Geographic Concentration Risk [Member] | UNITED STATES | ||||||||||
Concentration Risk, Percentage | 77.00% | 77.00% | 27.00% | |||||||
Assets, Total [Member] | Geographic Concentration Risk [Member] | Non-US [Member] | ||||||||||
Concentration Risk, Percentage | 23.00% | 23.00% | 73.00% | |||||||
Long-lived Assets [Member] | Geographic Concentration Risk [Member] | UNITED STATES | ||||||||||
Concentration Risk, Percentage | 63.00% | 63.00% | 11.00% | |||||||
Long-lived Assets [Member] | Geographic Concentration Risk [Member] | SWITZERLAND | ||||||||||
Concentration Risk, Percentage | 22.00% | 22.00% | 41.00% | |||||||
Long-lived Assets [Member] | Geographic Concentration Risk [Member] | ITALY | ||||||||||
Concentration Risk, Percentage | 13.00% | 13.00% | 48.00% | |||||||
Public Offering [Member] | ||||||||||
Proceeds from Issuance of Common Stock | $ 79,600 | $ 73,400 | ||||||||
Registered Direct Offering [Member] | ||||||||||
Proceeds from Issuance of Common Stock | $ 28,600 | 28,600 | ||||||||
ATM Offering [Member] | ||||||||||
Proceeds from Issuance of Common Stock | $ 27,300 | |||||||||
The 2021 ATM Offering [Member] | ||||||||||
Payments of Stock Issuance Costs | $ 2,800 |
Note 2 - Summary of Significa_4
Note 2 - Summary of Significant Accounting Policies 2 (Details Textual) - Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2022-01-01 | Dec. 31, 2021 |
Minimum [Member] | |
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Period (Year) | 1 year |
Maximum [Member] | |
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Period (Year) | 5 years |
Note 2 - Summary of Significa_5
Note 2 - Summary of Significant Accounting Policies - Estimated Useful Lives of Assets (Details) | 12 Months Ended |
Dec. 31, 2021 | |
Operating Lease Assets [Member] | |
Property and equipment, estimated useful lives (Year) | 5 years |
Machinery, Manufacturing and Demonstration Equipment [Member] | Minimum [Member] | |
Property and equipment, estimated useful lives (Year) | 3 years |
Machinery, Manufacturing and Demonstration Equipment [Member] | Maximum [Member] | |
Property and equipment, estimated useful lives (Year) | 5 years |
Computer Equipment [Member] | |
Property and equipment, estimated useful lives (Year) | 3 years |
Furniture and Fixtures [Member] | |
Property and equipment, estimated useful lives (Year) | 5 years |
Leasehold Improvements [Member] | Minimum [Member] | |
Property and equipment, estimated useful lives (Year) | 3 years |
Leasehold Improvements [Member] | Maximum [Member] | |
Property and equipment, estimated useful lives (Year) | 10 years |
Purchased Software [Member] | |
Property and equipment, estimated useful lives (Year) | 5 years |
Note 2 - Summary of Significa_6
Note 2 - Summary of Significant Accounting Policies - Revenue Disaggregated by Type and Geography (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Revenue | $ 8,232 | $ 3,175 | $ 8,531 |
Systems [Member] | |||
Revenue | 4,743 | 772 | 5,549 |
Instruments and Accessories [Member] | |||
Revenue | 1,969 | 840 | 1,555 |
Service [Member] | |||
Revenue | 1,520 | 1,563 | 1,427 |
UNITED STATES | |||
Revenue | 1,033 | 849 | 536 |
UNITED STATES | Systems [Member] | |||
Revenue | 380 | 282 | 90 |
UNITED STATES | Instruments and Accessories [Member] | |||
Revenue | 270 | 187 | 108 |
UNITED STATES | Service [Member] | |||
Revenue | 383 | 380 | 338 |
Non-US [Member] | |||
Revenue | 7,199 | 2,326 | 7,995 |
Non-US [Member] | Systems [Member] | |||
Revenue | 4,363 | 490 | 5,459 |
Non-US [Member] | Instruments and Accessories [Member] | |||
Revenue | 1,699 | 653 | 1,447 |
Non-US [Member] | Service [Member] | |||
Revenue | $ 1,137 | $ 1,183 | $ 1,089 |
Note 3 - Acquisitions (Details
Note 3 - Acquisitions (Details Textual) - USD ($) $ in Millions | Oct. 15, 2019 | Aug. 07, 2019 | Oct. 31, 2018 | Dec. 31, 2019 |
Auto Lap [Member] | ||||
Disposal Group, Including Discontinued Operation, Consideration | $ 17 | |||
Proceeds from Sale of Productive Assets, Total | 16 | |||
Disposal Group Including Discontinued Operation Consideration Receivable | $ 1 | |||
Gain (Loss) on Disposition of Assets, Total | $ 16 | |||
Medical Surgery Technologies Limited [Member] | ||||
Payments to Acquire Businesses, Gross | $ 5.8 | |||
Business Acquisition, Equity Interest Issued or Issuable, Number of Shares (in shares) | 370,423 | 242,310 | ||
Business Combination, Consideration Transferred, Equity Interests Issued and Issuable | $ 6.6 |
Note 4 - Cash, Cash Equivalen_3
Note 4 - Cash, Cash Equivalents, and Restricted Cash (Details Textual) - USD ($) $ in Thousands | Dec. 31, 2021 | Dec. 31, 2020 |
Restricted Cash and Cash Equivalents, Noncurrent, Total | $ 1,154 | $ 1,166 |
Note 4 - Cash, Cash Equivalen_4
Note 4 - Cash, Cash Equivalents, and Restricted Cash - Cash, Cash Equivalents, and Restricted Cash (Details) - USD ($) $ in Thousands | Dec. 31, 2021 | Dec. 31, 2020 |
Cash | $ 8,343 | $ 6,679 |
Money Market | 5,287 | 9,684 |
Commerical Paper | 4,499 | 0 |
Total cash and cash equivalents | 18,129 | 16,363 |
Restricted Cash and Cash Equivalents, Noncurrent, Total | 1,154 | 1,166 |
Total | $ 19,283 | $ 17,529 |
Note 5 - Investments, Availab_3
Note 5 - Investments, Available-for-sale (Details Textual) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Proceeds from Sale of Debt Securities, Available-for-sale | $ 0 | $ 0 | $ 0 |
Note 5 - Investments, Availab_4
Note 5 - Investments, Available-for-sale - Summary of Investment Securities (Details) - USD ($) $ in Thousands | Dec. 31, 2021 | Dec. 31, 2020 |
Amortized Cost | $ 117,944 | |
Unrealized Gain | 1 | |
Unrealized Loss | (248) | |
Fair Value | 117,697 | $ 0 |
Short-term investments | 80,262 | 0 |
Long-term investments | 37,435 | 0 |
Mature in less than one year, amortized cost | 80,336 | |
Mature in less than one year, fair value | 80,262 | |
Mature in one to two years, amortized cost | 37,608 | |
Mature in one to two years, fair value | 37,435 | |
Total, amortized cost | 117,944 | |
Total, fair value | 117,697 | $ 0 |
Corporate Debt Securities [Member] | ||
Amortized Cost | 67,239 | |
Unrealized Gain | 1 | |
Unrealized Loss | (202) | |
Fair Value | 67,038 | |
Short-term investments | 29,602 | |
Long-term investments | 37,435 | |
Total, amortized cost | 67,239 | |
Total, fair value | 67,038 | |
Commercial Paper [Member] | ||
Amortized Cost | 50,705 | |
Unrealized Gain | 0 | |
Unrealized Loss | (46) | |
Fair Value | 50,659 | |
Short-term investments | 50,660 | |
Long-term investments | 0 | |
Total, amortized cost | 50,705 | |
Total, fair value | $ 50,659 |
Note 6 - Fair Value (Details Te
Note 6 - Fair Value (Details Textual) - USD ($) $ / shares in Units, $ in Thousands | Feb. 24, 2020 | Apr. 28, 2017 | Sep. 30, 2021 | Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Mar. 31, 2020 |
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration, Liability | $ (1,565) | $ 2,924 | $ (9,553) | ||||
Number of Units Sold (in shares) | 24,900,000 | ||||||
Number of Shares in Each Unit (in shares) | 0.077 | ||||||
Shares Issued, Price Per Share (in dollars per share) | $ 1 | ||||||
Stock issued During Period, Value, Exchange of Shares for Warrants | $ 2,470 | ||||||
Share-based Compensation Arrangement by Share-based Payment Award, Non-Option Equity Instruments, Outstanding, Number, Ending Balance (in shares) | 46,498,909 | ||||||
Fair Value Adjustment of Warrants | $ 2,000 | $ 1,981 | $ 336 | $ (2,248) | |||
Series A Warrant [Member] | |||||||
Class of Warrant or Right, Number of Securities Called by Each Warrant or Right (in shares) | 0.077 | ||||||
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share) | $ 13 | ||||||
Series B Warrant [Member] | |||||||
Class of Warrant or Right, Number of Securities Called by Each Warrant or Right (in shares) | 0.058 | ||||||
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share) | $ 0.35 | $ 13 | $ 0.35 | $ 0.35 | |||
Class of Warrant or Right, Outstanding (in shares) | 3,638,780 | 567,660 | |||||
Share-based Compensation Arrangement by Share-based Payment Award, Non-Option Equity Instruments, Outstanding, Number, Ending Balance (in shares) | 567,660 | ||||||
Series B Warrant [Member] | Exchange Agreement [Member] | |||||||
Class of Warrant or Right, Number of Securities Called by Each Warrant or Right (in shares) | 0.61 | ||||||
Class of Warrant or Right, Outstanding (in shares) | 3,373,900 | ||||||
Stock issued During Period, Shares, Exchange of Shares for Warrants (in shares) | 2,040,757 | ||||||
Stock issued During Period, Value, Exchange of Shares for Warrants | $ 2,500 |
Note 6 - Fair Value - Summary o
Note 6 - Fair Value - Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis (Details) - USD ($) $ in Thousands | Dec. 31, 2021 | Dec. 31, 2020 | |
Cash and cash equivalents | $ 18,129 | [1] | $ 16,363 |
Restricted cash | 1,154 | 1,166 | |
Short-term investments | 80,262 | 0 | |
Long-term investments | 37,435 | 0 | |
Total assets measured at fair value | 136,980 | 17,529 | |
Contingent consideration | 2,371 | 3,936 | |
Total liabilities measured at fair value | 2,371 | 4,191 | |
Warrant liabilities | 0 | 255 | |
Fair Value, Inputs, Level 1 [Member] | |||
Cash and cash equivalents | 18,129 | [1] | 16,363 |
Restricted cash | 1,154 | 1,166 | |
Short-term investments | 0 | ||
Long-term investments | 0 | ||
Total assets measured at fair value | 19,283 | 17,529 | |
Contingent consideration | 0 | 0 | |
Total liabilities measured at fair value | 0 | 0 | |
Warrant liabilities | 0 | ||
Fair Value, Inputs, Level 2 [Member] | |||
Cash and cash equivalents | 0 | [1] | 0 |
Restricted cash | 0 | 0 | |
Short-term investments | 80,262 | ||
Long-term investments | 37,435 | ||
Total assets measured at fair value | 117,697 | 0 | |
Contingent consideration | 0 | 0 | |
Total liabilities measured at fair value | 0 | 0 | |
Warrant liabilities | 0 | ||
Fair Value, Inputs, Level 3 [Member] | |||
Cash and cash equivalents | 0 | [1] | 0 |
Restricted cash | 0 | 0 | |
Short-term investments | 0 | ||
Long-term investments | 0 | ||
Total assets measured at fair value | 0 | 0 | |
Contingent consideration | 2,371 | 3,936 | |
Total liabilities measured at fair value | $ 2,371 | 4,191 | |
Warrant liabilities | $ 255 | ||
[1] | Includes investments that are readily convertible to cash with original maturities of 90 days or less. |
Note 6 - Fair Value - Quantitat
Note 6 - Fair Value - Quantitative Information about Inputs and Valuation Methodologies Used for Fair Value Measurements Classification (Details) | Dec. 31, 2021yr$ / shares | Dec. 31, 2020yr$ / shares | Dec. 31, 2019yr$ / shares |
Series B Warrant [Member] | |||
Share price (in dollars per share) | $ / shares | $ 4.21 | $ 0.63 | $ 1.47 |
Measurement Input, Expected Term [Member] | Series B Warrant [Member] | |||
Warrants, measurement input (Year) | yr | 1.22 | 1.32 | 2.32 |
Measurement Input, Price Volatility [Member] | Series B Warrant [Member] | |||
Warrants, measurement input (Year) | 1.7400 | 1.5097 | 1.0980 |
Measurement Input, Risk Free Interest Rate [Member] | Series B Warrant [Member] | |||
Warrants, measurement input (Year) | 0.0007 | 0.0010 | 0.0159 |
Measurement Input, Expected Dividend Payment [Member] | Series B Warrant [Member] | |||
Warrants, measurement input (Year) | 0 | 0 | 0 |
Senhance Surgical Robotic System Acquisition[Member] | Fair Value, Inputs, Level 3 [Member] | Measurement Input, Discount Rate [Member] | |||
Contingent consideration, measurement input | 0.095 | 0.095 | |
Senhance Surgical Robotic System Acquisition[Member] | Fair Value, Inputs, Level 3 [Member] | Measurement Input, Price Volatility [Member] | |||
Contingent consideration, measurement input | 0.390 | 0.710 |
Note 6 - Fair Value - Summary_2
Note 6 - Fair Value - Summary of Change in Fair Value for Warrants and Contingent Consideration (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Warrant [Member] | |||
Balance | $ 255 | $ 2,388 | $ 4,636 |
Change in fair value | 1,981 | 336 | (2,248) |
Settlement | (2,236) | (2,469) | |
Balance | 0 | 255 | 2,388 |
Current portion | 0 | ||
Long-term portion | 0 | ||
Contingent Consideration [Member] | |||
Balance | 3,936 | 1,084 | 10,637 |
Change in fair value | (1,565) | 2,924 | (9,553) |
Settlement | 0 | (74) | |
Balance | 2,371 | $ 3,936 | $ 1,084 |
Current portion | 0 | ||
Long-term portion | $ 2,371 |
Note 7 - Accounts Receivable,_3
Note 7 - Accounts Receivable, Net (Details Textual) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Accounts Receivable, Credit Loss Expense (Reversal) | $ 144 | $ 0 | $ 1,634 |
Note 7 - Accounts Receivable,_4
Note 7 - Accounts Receivable, Net - Summary of Accounts Receivable (Details) - USD ($) $ in Thousands | Dec. 31, 2021 | Dec. 31, 2020 |
Gross accounts receivable | $ 2,426 | $ 2,917 |
Allowance for uncollectible accounts | (1,677) | (1,802) |
Total accounts receivable, net | $ 749 | $ 1,115 |
Note 8 - Inventories (Details T
Note 8 - Inventories (Details Textual) - USD ($) $ in Millions | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Inventory Write-down | $ 7.4 | ||
Reserve Estimate, Change [Member] | |||
Inventory Write-down | $ 0.5 | $ 3 | |
Systems [Member] | |||
Inventory Write-down | $ 1.5 |
Note 8 - Inventories - Componen
Note 8 - Inventories - Components of Inventories (Details) - USD ($) $ in Thousands | Dec. 31, 2021 | Dec. 31, 2020 |
Finished goods, gross | $ 10,566 | $ 13,858 |
Finished goods, reserve | (2,987) | (3,109) |
Finished goods, net | 7,579 | 10,749 |
Raw materials, gross | 10,824 | 11,163 |
Raw materials, reserve | (2,695) | (3,065) |
Raw materials, net | 8,129 | 8,098 |
Total inventories, gross | 21,390 | 25,021 |
Total inventories, reserve | (5,682) | (6,174) |
Total inventories, net | 15,708 | 18,847 |
Current Portion, gross | 9,931 | 11,444 |
Current Portion, reserve | (1,297) | (1,410) |
Inventories | 8,634 | 10,034 |
Long-term portion, gross | 11,459 | 13,577 |
Long-term portion, reserve | (4,385) | (4,764) |
Inventories, net of current portion | $ 7,074 | $ 8,813 |
Note 9 - Property and Equipme_3
Note 9 - Property and Equipment (Details Textual) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Depreciation, Total | $ 2,857 | $ 2,898 | $ 2,166 |
Note 9 - Property and Equipme_4
Note 9 - Property and Equipment - Summary of Property and Equipment (Details) - USD ($) $ in Thousands | Dec. 31, 2021 | Dec. 31, 2020 |
Property, plant and equipment, gross | $ 20,660 | $ 24,061 |
Accumulated depreciation and amortization | (9,689) | (13,719) |
Property and equipment, net | 10,971 | 10,342 |
Machinery, Manufacturing and Demonstration Equipment [Member] | ||
Property, plant and equipment, gross | 8,289 | 9,909 |
Operating Lease Assets [Member] | ||
Property, plant and equipment, gross | 10,143 | 8,906 |
Computer Equipment [Member] | ||
Property, plant and equipment, gross | 325 | 2,297 |
Furniture and Fixtures [Member] | ||
Property, plant and equipment, gross | 644 | 640 |
Leasehold Improvements [Member] | ||
Property, plant and equipment, gross | $ 1,259 | $ 2,309 |
Note 10 - Goodwill, In-proces_3
Note 10 - Goodwill, In-process Research and Development and Intellectual Property (Details Textual) $ in Thousands | Oct. 31, 2018USD ($) | Sep. 21, 2015USD ($) | Sep. 30, 2019USD ($) | Dec. 31, 2019USD ($) | Dec. 31, 2021USD ($) | Dec. 31, 2020USD ($) | Dec. 31, 2019USD ($) | Dec. 31, 2016USD ($) | Dec. 31, 2018USD ($) | Sep. 23, 2018USD ($) | Sep. 03, 2013USD ($) |
Goodwill, Ending Balance | $ 0 | $ 0 | $ 80,131 | ||||||||
Goodwill, Impairment Loss | $ 79,000 | $ 0 | $ 0 | 78,969 | $ 61,700 | ||||||
Number of Reporting Units | 1 | ||||||||||
Impairment of Intangible Assets, Finite-lived | $ 0 | 0 | 7,912 | ||||||||
Intellectual Property [Member] | |||||||||||
Impairment of Intangible Assets, Finite-lived | $ 0 | $ 0 | $ 0 | ||||||||
Developed Technology Rights [Member] | Weighted Average [Member] | |||||||||||
Finite-Lived Intangible Assets, Remaining Amortization Period (Year) | 1 year 7 months 6 days | ||||||||||
Technology-Based Intangible Assets [Member] | Weighted Average [Member] | |||||||||||
Finite-Lived Intangible Assets, Remaining Amortization Period (Year) | 5 years 3 months 18 days | ||||||||||
In Process Research and Development [Member] | |||||||||||
Impairment of Intangible Assets, Finite-lived | $ 7,900 | ||||||||||
Safe Stitch Medical Inc [Member] | |||||||||||
Goodwill, Ending Balance | $ 93,800 | ||||||||||
Senhance Surgical Robotic System Acquisition[Member] | |||||||||||
Goodwill, Ending Balance | $ 38,300 | ||||||||||
Senhance Surgical Robotic System Acquisition[Member] | Intellectual Property [Member] | |||||||||||
Intangible Assets, Net (Excluding Goodwill), Total | $ 17,100 | ||||||||||
Discount Rate Used in Discounted Cash Flows | 45.00% | ||||||||||
Medical Surgery Technologies Limited [Member] | |||||||||||
Goodwill, Ending Balance | $ 9,600 | ||||||||||
Medical Surgery Technologies Limited [Member] | In Process Research and Development [Member] | |||||||||||
Intangible Assets, Net (Excluding Goodwill), Total | $ 10,600 | ||||||||||
Discount Rate Used in Discounted Cash Flows | 15.00% |
Note 10 - Goodwill, In-proces_4
Note 10 - Goodwill, In-process Research and Development and Intellectual Property - Goodwill (Details) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | |||
Sep. 30, 2019 | Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2016 | |
Goodwill balance | $ 0 | $ 80,131 | |||
Foreign currency translation impact | (1,162) | ||||
Impairment | $ (79,000) | $ 0 | $ 0 | (78,969) | $ (61,700) |
Goodwill balance | $ 0 |
Note 10 - Goodwill, In-proces_5
Note 10 - Goodwill, In-process Research and Development and Intellectual Property - In-process Research and Development and Intellectual Property (Details) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | ||
Sep. 30, 2019 | Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Finite-Lived Intangible Assets, Net | $ 22,267 | |||
Impairment | 0 | $ 0 | $ 7,912 | |
Finite-Lived Intangible Assets, Net | 9,892 | 22,267 | ||
Finite-Lived Intangible Assets, Gross | 69,238 | 69,238 | ||
Finite-Lived Intangible Assets, Accumulated Amortization | (59,111) | (51,902) | ||
Finite-Lived Intangible Assets, Foreign Currency Translation Impact | (235) | 4,931 | ||
Intellectual property, net | 9,892 | 22,267 | ||
In Process Research and Development [Member] | ||||
Finite-Lived Intangible Assets, Net | 0 | 2,470 | 10,747 | |
Impairment | $ 7,900 | 0 | (7,912) | |
Foreign currency translation impact | (45) | (365) | ||
Transfer of in-process research and development to intellectual property | (2,425) | |||
Finite-Lived Intangible Assets, Net | 0 | 2,470 | ||
Intellectual property, net | 0 | $ 2,470 | ||
Developed Technology Rights [Member] | ||||
Finite-Lived Intangible Assets, Net | 21,976 | |||
Finite-Lived Intangible Assets, Net | 9,664 | 21,976 | ||
Finite-Lived Intangible Assets, Gross | 68,838 | 68,838 | ||
Finite-Lived Intangible Assets, Accumulated Amortization | (58,912) | (51,734) | ||
Finite-Lived Intangible Assets, Foreign Currency Translation Impact | (262) | 4,872 | ||
Intellectual property, net | 9,664 | 21,976 | ||
Technology-Based Intangible Assets [Member] | ||||
Finite-Lived Intangible Assets, Net | 291 | |||
Finite-Lived Intangible Assets, Net | 228 | 291 | ||
Finite-Lived Intangible Assets, Gross | 400 | 400 | ||
Finite-Lived Intangible Assets, Accumulated Amortization | (199) | (168) | ||
Finite-Lived Intangible Assets, Foreign Currency Translation Impact | 27 | 59 | ||
Intellectual property, net | $ 228 | $ 291 |
Note 10 - Goodwill, In-proces_6
Note 10 - Goodwill, In-process Research and Development and Intellectual Property - Amortization Expense of Intangible Assets (Details) - USD ($) $ in Thousands | Dec. 31, 2021 | Dec. 31, 2020 |
Total | $ 9,892 | $ 22,267 |
Intellectual Property [Member] | ||
2022 | 8,218 | |
2023 | 400 | |
2024 | 400 | |
2025 | 400 | |
2026 | 400 | |
Thereafter | 74 | |
Total | $ 9,892 | $ 22,267 |
Note 11 - Income Taxes (Details
Note 11 - Income Taxes (Details Textual) - USD ($) $ in Thousands | 12 Months Ended | |||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount | $ 11,000 | |||
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations | 0 | $ 1,620 | $ 0 | |
Unrecognized Tax Benefits, Ending Balance | 141 | 0 | $ 1,512 | $ 1,363 |
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued, Total | $ 0 | $ 0 | ||
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent | 21.00% | 21.00% | 21.00% | |
Impact of 382 Ownership Changes [Member] | ||||
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount | $ (65,600) | |||
Research Tax Credit Carryforward [Member] | ||||
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount | (7,200) | |||
Increase (Decrease) in Tax Credit Carryforward | (7,200) | |||
Assessment of Net Operating Loss [Member] | ||||
Write-down of Operating Loss Carryforward | 58,400 | |||
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount | (58,400) | |||
Domestic Tax Authority [Member] | ||||
Increase (Decrease) in Operating Loss Carryforwards | (253,000) | |||
Operating Loss Carryforwards, Total | 397,200 | |||
Operating Loss Carryforwards, Subject to Expiration | 254,500 | |||
Operating Loss Carryforwards, Not Subject to Expiration | 142,700 | |||
Domestic Tax Authority [Member] | Research Tax Credit Carryforward [Member] | ||||
Tax Credit Carryforward, Amount | 9,400 | |||
State and Local Jurisdiction [Member] | ||||
Increase (Decrease) in Operating Loss Carryforwards | (204,000) | |||
Operating Loss Carryforwards, Total | 309,200 | |||
Operating Loss Carryforwards, Subject to Expiration | 299,900 | |||
Operating Loss Carryforwards, Not Subject to Expiration | 9,300 | |||
Foreign Tax Authority [Member] | Ministry of Economic Affairs and Finance, Italy [Member] | ||||
Operating Loss Carryforwards, Total | 25,200 | |||
Foreign Tax Authority [Member] | Luxembourg Inland Revenue [Member] | ||||
Operating Loss Carryforwards, Subject to Expiration | 96,600 | |||
Foreign Tax Authority [Member] | Swiss Federal Tax Administration (FTA) [Member] | ||||
Operating Loss Carryforwards, Subject to Expiration | 90,600 | |||
Foreign Tax Authority [Member] | Canada Revenue Agency [Member] | ||||
Operating Loss Carryforwards, Subject to Expiration | $ 500 |
Note 11 - Income Taxes - Income
Note 11 - Income Taxes - Income Tax Expense (Benefit) (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Federal | $ 0 | $ 0 | $ 0 |
State | 0 | 0 | 0 |
Foreign | 232 | 169 | 100 |
Federal | 0 | 0 | 0 |
State | 0 | 0 | 0 |
Foreign | (7) | (1,685) | (3,224) |
Total income tax expense (benefit) | $ 225 | $ (1,516) | $ (3,124) |
Note 11 - Income Taxes - Domest
Note 11 - Income Taxes - Domestic and Foreign Components of Loss from Operations (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
United States | $ (32,094) | $ (34,398) | $ (91,935) |
Foreign | (30,143) | (26,430) | (65,390) |
Loss before income taxes | $ (62,237) | $ (60,828) | $ (157,325) |
Note 11 - Income Taxes - Deferr
Note 11 - Income Taxes - Deferred Tax Assets (Details) - USD ($) $ in Thousands | Dec. 31, 2021 | Dec. 31, 2020 |
Stock-based compensation | $ 2,440 | $ 4,253 |
Accrued expenses and other | 2,423 | 906 |
Research credit carryforward | 564 | 0 |
Fixed Assets | 101 | 385 |
Capitalized start-up costs and other intangibles | 1,109 | 2,686 |
Net operating loss carryforwards | 75,237 | 63,786 |
Deferred Tax Assets, Gross, Total | 81,874 | 72,016 |
Valuation Allowance | (78,294) | (67,312) |
Net deferred tax asset | 3,580 | 4,704 |
Fixed assets and other | (1,176) | (1,590) |
Purchase accounting intangibles | (2,116) | (2,807) |
Net deferred tax liability | (3,292) | (4,397) |
Net deferred tax asset (liability) | $ 288 | $ 307 |
Note 11 - Income Taxes - Unreco
Note 11 - Income Taxes - Unrecognized Tax Positions (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Beginning balance | $ 0 | $ 1,512 | $ 1,363 |
Gross increases for tax positions related to current periods | 141 | 108 | 149 |
Gross decreases related to 382 limitations | 0 | (1,620) | 0 |
Ending balance | $ 141 | $ 0 | $ 1,512 |
Note 11 - Income Taxes - Effect
Note 11 - Income Taxes - Effective Income Tax Reconciliation (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
United States federal tax at statutory rate, amount | $ (13,070) | $ (12,774) | $ (33,038) |
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent | 21.00% | 21.00% | 21.00% |
State taxes (net of deferred benefit), amount | $ (2,205) | $ (1,768) | $ (4,778) |
State taxes (net of deferred benefit), percent | 3.50% | 2.90% | 3.00% |
Nondeductible expenses, amount | $ (440) | $ 719 | $ 709 |
Nondeductible expenses, percent | 0.70% | (1.20%) | (0.50%) |
Change in fair market value of contingent consideration, amount | $ (397) | $ 717 | $ (2,342) |
Change in fair market value of contingent consideration, percent | 0.60% | (1.20%) | 1.50% |
Warrant remeasurment and financing costs, amount | $ 502 | $ 82 | $ (551) |
Warrant remeasurment and financing costs, percent | (0.80%) | (0.10%) | 0.40% |
Research & Development, amount | $ (705) | $ (542) | $ (743) |
Research & Development, percent | 1.10% | 0.90% | 0.50% |
Change in unrecognized tax benefits, amount | $ 141 | $ (1,512) | $ 149 |
Change in unrecognized tax benefits, percent | (0.20%) | 2.50% | (0.10%) |
Foreign tax rate differential, amount | $ 1,911 | $ 1,589 | $ 2,590 |
Foreign tax rate differential, percent | (3.10%) | (2.60%) | (1.60%) |
Goodwill and investment impairments, amount | $ 0 | $ 0 | $ (6,638) |
Goodwill and investment impairments, percent | 0.00% | 0.00% | 4.20% |
Adjustment for 382 Limitations, amount | $ 0 | $ 67,255 | $ 0 |
Adjustment for 382 Limitations, percent | 0.00% | (110.60%) | 0.00% |
True-up to Stock Compensation - Cancellations, amount | $ 2,832 | $ 0 | $ 0 |
True-up to Stock Compensation - Cancellations, percent | (4.60%) | 0.00% | 0.00% |
Change in enacted tax rates and other, net, amount | $ 731 | $ 533 | $ (253) |
Change in enacted tax rates and other, net, percent | (1.00%) | (0.90%) | 0.20% |
Change in valuation allowance, amount | $ 10,925 | $ (55,815) | $ 41,771 |
Change in valuation allowance, percent | (17.60%) | 91.80% | 26.60% |
Total income tax expense (benefit) | $ 225 | $ (1,516) | $ (3,124) |
Income tax expense (benefit), percent | (0.40%) | 2.50% | 2.00% |
Note 12 - Operating Leases (Det
Note 12 - Operating Leases (Details Textual) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Operating Lease, Weighted Average Discount Rate, Percent | 7.80% | 8.20% | |
Operating Lease, Cost | $ 1,800 | $ 2,000 | $ 2,100 |
Operating Lease, Payments | 1,500 | $ 1,500 | $ 1,700 |
Lessee, Operating Lease, Liability, to be Paid, Total | $ 7,698 | ||
First Lease [Member] | |||
Lessee, Operating Lease, Term of Contract (Year) | 125 months | ||
Second Lease [Member] | |||
Lessee, Operating Lease, Term of Contract (Year) | 60 months | ||
Third Lease [Member] | |||
Lessee, Operating Lease, Term of Contract (Year) | 87 months | ||
Three Operating Leases [Member] | |||
Lessee, Operating Lease, Liability, to be Paid, Total | $ 7,100 | ||
Minimum [Member] | |||
Lessee, Operating Lease, Term of Contract (Year) | 1 year | ||
Lessee, Operating Lease, Renewal Term (Year) | 1 year | ||
Operating Lease, Weighted Average Discount Rate, Percent | 6.10% | ||
Maximum [Member] | |||
Lessee, Operating Lease, Term of Contract (Year) | 10 years | ||
Lessee, Operating Lease, Renewal Term (Year) | 6 years | ||
Operating Lease, Weighted Average Discount Rate, Percent | 8.50% |
Note 12 - Operating Leases - Su
Note 12 - Operating Leases - Supplemental Information (Details) | Dec. 31, 2021 | Dec. 31, 2020 |
Weighted-average remaining lease term (in years) (Year) | 7 years 9 months 18 days | 1 year 9 months 18 days |
Weighted-average discount rate | 7.80% | 8.20% |
Note 12 - Operating Leases - Mi
Note 12 - Operating Leases - Minimum Lease Payments (Details) $ in Thousands | Dec. 31, 2021USD ($) |
2022 | $ 994 |
2023 | 1,008 |
2024 | 918 |
2025 | 920 |
2026 | 854 |
Thereafter | 3,004 |
Total minimum lease payments | 7,698 |
Less: Amount of lease payments representing interest | (2,009) |
Present value of future minimum lease payments | $ 5,689 |
Note 13 - Accrued Expenses - Co
Note 13 - Accrued Expenses - Components of Accrued Expenses (Details) - USD ($) $ in Thousands | Dec. 31, 2021 | Dec. 31, 2020 |
Compensation and benefits | $ 3,682 | $ 4,541 |
Consulting and other vendors | 128 | 66 |
Other | 124 | 177 |
Royalties | 247 | 147 |
Legal and professional fees | 503 | 314 |
Taxes and other assessments | 492 | 351 |
Interest | 0 | 19 |
Total | $ 5,176 | $ 5,615 |
Note 14 - Notes Payable (Detail
Note 14 - Notes Payable (Details Textual) - USD ($) $ in Thousands | Jun. 10, 2021 | Apr. 27, 2020 | Nov. 04, 2019 | Jul. 10, 2019 | Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Jul. 09, 2019 |
Gain (Loss) on Extinguishment of Debt, Total | $ 2,847 | $ 0 | $ (1,006) | |||||
Hercules Loan Agreement [Member] | ||||||||
Gain (Loss) on Extinguishment of Debt, Total | $ 1,000 | |||||||
Extinguishment of Debt, Amount | 16,400 | |||||||
Payment for Debt Extinguishment or Debt Prepayment Cost | $ 1,400 | |||||||
Paycheck Protection Program CARES Act [Member] | ||||||||
Debt Instrument, Decrease, Forgiveness | $ 2,800 | $ 2,800 | ||||||
Notes Payable, Noncurrent, Total | 1,600 | |||||||
Notes Payable, Current, Total | 1,200 | |||||||
Proceeds from Issuance of Long-term Debt, Total | $ 2,800 | |||||||
Gain (Loss) on Extinguishment of Debt, Total | $ 2,800 | $ 0 | $ 0 | |||||
Hercules Loan Agreement [Member] | ||||||||
Repayments of Debt | $ 15,000 | |||||||
Long-term Debt, Total | $ 30,000 |
Note 15 - Stock-based Compens_3
Note 15 - Stock-based Compensation (Details Textual) - USD ($) $ / shares in Units, $ in Millions | Jul. 22, 2021 | Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 |
Share-based Payment Arrangement, Expense | $ 9.4 | $ 7.9 | $ 11.5 | |
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Gross (in shares) | 1,490,266 | 3,005,964 | 623,272 | |
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value (in dollars per share) | $ 2.40 | $ 0.53 | $ 21.23 | |
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total | $ 4 | |||
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year) | 1 year 6 months | |||
Restricted Stock Units (RSUs) [Member] | ||||
Share-based Payment Arrangement, Expense | $ 4.8 | $ 1.7 | $ 3.2 | |
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total | $ 4.3 | |||
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year) | 1 year 3 months 18 days | |||
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period (Year) | 2 years | 3 years | ||
Performance Shares [Member] | ||||
Share-based Payment Arrangement, Expense | $ 0.9 | $ 0.1 | ||
Asensus Surgical, Inc. Amended and Restated Incentive Compensation Plan [Member] | ||||
Share-based Compensation Arrangement by Share-based Payment Award, Number of Additional Shares Authorized (in shares) | 22,000,000 | |||
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized (in shares) | 32,072,308 | |||
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant (in shares) | 20,755,273 | |||
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period (Year) | 10 years |
Note 15 - Stock-based Compens_4
Note 15 - Stock-based Compensation - Stock Option Valuation Assumptions (Details) | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Expected dividend yield | 0.00% | 0.00% | 0.00% |
Minimum [Member] | |||
Expected volatility | 118.00% | 82.00% | 81.00% |
Risk-free interest rate | 0.33% | 0.20% | 1.39% |
Expected life (in years) (Year) | 3 years 9 months 18 days | 3 years 9 months 18 days | 5 years 6 months |
Maximum [Member] | |||
Expected volatility | 139.00% | 126.00% | 92.00% |
Risk-free interest rate | 1.11% | 1.69% | 2.66% |
Expected life (in years) (Year) | 4 years 6 months | 6 years 1 month 6 days | 6 years 1 month 6 days |
Note 15 - Stock-based Compens_5
Note 15 - Stock-based Compensation - Stock Option Activity (Details) - $ / shares | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Options, Outstanding, Number of Shares (in shares) | 4,361,872 | ||
Options, Outstanding, Weighted Average Exercise Price (in dollars per share) | $ 10.49 | ||
Options, Outstanding, Weighted Average Remaining Contractual Term (Year) | 5 years 7 months 28 days | 6 years 18 days | |
Options, Granted, Number of Shares (in shares) | 1,490,266 | 3,005,964 | 623,272 |
Options, Grants in Period, Weighted Average Exercise Price (in dollars per share) | $ 4.06 | ||
Options, Forfeited, Number of Shares (in shares) | (285,391) | ||
Options, Forfeitures in Period, Weighted Average Exercise Price (in dollars per share) | $ 8.10 | ||
Options, Cancelled, Number of Shares (in shares) | (610,287) | ||
Options, Expirations in Period, Weighted Average Exercise Price (in dollars per share) | $ 30.32 | ||
Options, Exercised, Number of Shares (in shares) | (315,800) | ||
Options, Exercises in Period, Weighted Average Exercise Price (in dollars per share) | $ 0.67 | ||
Options, Outstanding, Number of Shares (in shares) | 4,640,660 | 4,361,872 | |
Options, Outstanding, Weighted Average Exercise Price (in dollars per share) | $ 6.64 | $ 10.49 |
Note 15 - Stock-based Compens_6
Note 15 - Stock-based Compensation - Stock Options Outstanding (Details) $ / shares in Units, $ in Millions | 12 Months Ended |
Dec. 31, 2021USD ($)$ / sharesshares | |
Options, Exercisable, Number of Shares (in shares) | shares | 1,887,155 |
Options, Exercisable, Weighted Average Exercise Price (in dollars per share) | $ / shares (in dollars per share) | $ / shares | $ 11.50 |
Options, Exercisable, Weighted Average Remaining Contractual Term (Year) | 5 years 4 months 24 days |
Options, Exercisable, Aggregate Intrinsic Value | $ | $ 0.7 |
Options, Vested and Expected to Vest, Exercisable, Number of Shares (in shares) | shares | 4,498,953 |
Options, Vested and Expected to Vest, Exercisable, Weighted Average Exercise Price (in dollars per share) | $ / shares | $ 6.75 |
Options, Vested and Expected to Vest, Exercisable, Weighted Average Remaining Contractual Term (Year) | 5 years 7 months 24 days |
Options, Vested or Expected to Vest, Aggregate Intrinsic Value | $ | $ 1.4 |
Note 15 - Stock-based Compens_7
Note 15 - Stock-based Compensation - RSU Activity (Details) - $ / shares | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Beginning of period, Restricted stock units, Unvested, weighted average grant date fair value (in dollars per share) | $ 0.20 | ||
End of period, Restricted stock units, Unvested, weighted average grant date fair value (in dollars per share) | $ 0.20 | ||
Restricted Stock Units (RSUs) [Member] | |||
Beginning of period, Restricted stock units, Unvested (in shares) | 2,997,399 | 443,927 | 382,098 |
Beginning of period, Restricted stock units, Unvested, weighted average grant date fair value (in dollars per share) | $ 1.41 | $ 23.88 | $ 20.24 |
Restricted stock units, Granted (in shares) | 3,133,753 | 3,112,382 | 192,987 |
Restricted stock units, Granted, weighted average grant date fair value (in dollars per share) | $ 2.77 | $ 0.67 | $ 31.42 |
Restricted stock units, Vested (in shares) | (1,891,869) | (313,508) | (85,153) |
Restricted stock units, Vested, weighted average grant date fair value (in dollars per share) | $ 1.63 | $ 19.38 | $ 25.98 |
Restricted stock units, Forfeited (in shares) | (400,253) | (245,402) | (46,005) |
Restricted stock units, Forfeited, weighted average grant date fair value (in dollars per share) | $ 1.86 | $ 6.54 | $ 21.38 |
End of period, Restricted stock units, Unvested (in shares) | 3,839,030 | 2,997,399 | 443,927 |
End of period, Restricted stock units, Unvested, weighted average grant date fair value (in dollars per share) | $ 2.36 | $ 1.41 | $ 23.88 |
Note 16 - Warrants (Details Tex
Note 16 - Warrants (Details Textual) - USD ($) $ / shares in Units, $ in Thousands | Mar. 10, 2020 | Feb. 24, 2020 | Sep. 12, 2017 | Apr. 28, 2017 | Aug. 14, 2015 | Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Mar. 31, 2020 | May 10, 2017 |
Number of Units Sold (in shares) | 24,900,000 | |||||||||
Number of Shares in Each Unit (in shares) | 0.077 | |||||||||
Equity Offering, Price Per Unit (in dollars per share) | $ 1 | |||||||||
Stock issued During Period, Value, Exchange of Shares for Warrants | $ 2,470 | |||||||||
Preferred Stock Dividends and Other Adjustments, Total | 400 | |||||||||
Stock Warrants [Member] | ||||||||||
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Aggregate Intrinsic Value, Outstanding | $ 400 | $ 200 | ||||||||
Series A Warrant [Member] | ||||||||||
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share) | $ 13 | |||||||||
Class of Warrant or Right, Number of Securities Called by Each Warrant or Right (in shares) | 0.077 | |||||||||
Series B Warrant [Member] | ||||||||||
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share) | $ 0.35 | $ 13 | $ 0.35 | $ 0.35 | ||||||
Class of Warrant or Right, Number of Securities Called by Each Warrant or Right (in shares) | 0.058 | |||||||||
Class of Warrant or Right, Outstanding (in shares) | 3,638,780 | 567,660 | ||||||||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights (in shares) | 567,660 | |||||||||
Series B Warrant [Member] | Exchange Agreement [Member] | ||||||||||
Class of Warrant or Right, Number of Securities Called by Each Warrant or Right (in shares) | 0.61 | |||||||||
Class of Warrant or Right, Outstanding (in shares) | 3,373,900 | |||||||||
Stock issued During Period, Shares, Exchange of Shares for Warrants (in shares) | 2,040,757 | |||||||||
Stock issued During Period, Value, Exchange of Shares for Warrants | $ 2,500 | |||||||||
Series C Warrants [Member] | ||||||||||
Class of Warrant or Right, Issued During Period (in shares) | 25,367,646 | |||||||||
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share) | $ 0.68 | |||||||||
Class of Warrant or Right, Exercised During Period (in shares) | 25,306,942 | |||||||||
Class of Warrant or Right, Number of Securities Called by Each Warrant or Right (in shares) | 1 | |||||||||
Series D Warrants [Member] | ||||||||||
Class of Warrant or Right, Issued During Period (in shares) | 25,367,646 | |||||||||
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share) | $ 0.68 | |||||||||
Class of Warrant or Right, Exercised During Period (in shares) | 24,354,263 | |||||||||
Class of Warrant or Right, Number of Securities Called by Each Warrant or Right (in shares) | 1 | |||||||||
Warrants Issued in Connection with the Innovatus Loan Agreement [Member] | ||||||||||
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share) | $ 13 | |||||||||
Warrants and Rights Outstanding, Term (Year) | 5 years | |||||||||
Class of Warrant or Right, Exercised During Period (in shares) | 0 | 0 | 0 | |||||||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights (in shares) | 95,750 | |||||||||
Service Warrants [Member] | ||||||||||
Class of Warrant or Right, Issued During Period (in shares) | 73,076 | |||||||||
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share) | $ 13 | |||||||||
Warrants and Rights Outstanding, Term (Year) | 10 years | |||||||||
Class of Warrant or Right, Exercised During Period (in shares) | 0 | 0 | 0 | |||||||
Class of Warrant or Right, Percentage of Vesting, Date of Execution Agreement | 25.00% | |||||||||
Class of Warrant or Right, Percentage of Vesting, Completion of Hiring the Sales Team | 50.00% | |||||||||
Class of Warrant or Right, Percentage of Vesting, Achieving Cumulative Product Revenue | 25.00% | |||||||||
Class of Warrant or Right, Vesting, Cumulative Product Revenue | $ 15,000 | |||||||||
SVB Loan Agreement [Member] | Second Warrants Issued in Connection with First Tranche Borrowings [Member] | ||||||||||
Class of Warrant or Right, Issued During Period (in shares) | 8,684 | |||||||||
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share) | $ 40.30 | |||||||||
Warrants and Rights Outstanding, Term (Year) | 7 years | |||||||||
Class of Warrant or Right, Exercised During Period (in shares) | 0 | 0 | 0 |
Note 16 - Warrants - Warrant Ac
Note 16 - Warrants - Warrant Activity (Details) - $ / shares | 12 Months Ended | |||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Outstanding, number of warrant shares (in shares) | 46,498,909 | |||
Outstanding, weighted average exercise price (in dollars per share) | $ 0.71 | |||
Outstanding, weighted average remaining contractual life (Year) | 2 years 4 months 24 days | |||
Outstanding, weighted average fair value (in dollars per share) | $ 0.20 | |||
Exercised, number of warrant shares (in shares) | (45,317,101) | |||
Exercised, weighted average exercise price (in dollars per share) | $ 0.68 | |||
Reserve for future issuance, number of warrant shares (in shares) | 644,966 | 1,753,523 | ||
Reserve for future issuance, weighted average exercise pric (in dollars per share) | $ 0.35 | $ 1.39 | ||
Reserve for future issuance, weighted average remaining contractual life (Year) | 1 year 3 months 18 days | 2 years 2 months 12 days | ||
Reserve for future issuance, weighted average fair value (in dollars per share) | $ 0.45 | $ 1.22 | ||
Exchanged, number of warrant shares (in shares) | (61,508) | |||
Expired, weighted average exercise price (in dollars per share) | $ 1.35 | |||
Outstanding, number of warrant shares (in shares) | 46,498,909 | |||
Outstanding, weighted average exercise price (in dollars per share) | $ 0.71 | |||
Stock Warrants [Member] | ||||
Outstanding, number of warrant shares (in shares) | 2,071,172 | 333,034 | ||
Outstanding, weighted average exercise price (in dollars per share) | $ 2.05 | $ 13.39 | ||
Outstanding, weighted average remaining contractual life (Year) | 3 years | 2 years 4 months 24 days | 3 years 8 months 12 days | |
Outstanding, weighted average fair value (in dollars per share) | $ 0.55 | $ 1.34 | $ 3.38 | |
Exercised, number of warrant shares (in shares) | (4,911,764) | (15,385) | ||
Exercised, weighted average exercise price (in dollars per share) | $ 0.68 | $ 13 | ||
Granted, number of warrant shares (in shares) | 50,735,292 | |||
Granted, weighted average exercise price (in dollars per share) | $ 0.68 | |||
Granted, weighted average remaining contractual life (Year) | 2 years 4 months 24 days | |||
Restricted stock units, Granted, weighted average grant date fair value (in dollars per share) | $ 0.19 | |||
Exchanged, number of warrant shares (in shares) | (2,040,757) | |||
Exchanged, weighted average exercise price (in dollars per share) | $ 1.24 | |||
Outstanding, number of warrant shares (in shares) | 1,120,300 | 2,071,172 | 333,034 | |
Outstanding, weighted average exercise price (in dollars per share) | $ 1.94 | $ 2.05 | $ 13.39 |
Note 17 - Equity Offerings (Det
Note 17 - Equity Offerings (Details Textual) - USD ($) $ / shares in Units, $ in Thousands | Jan. 29, 2021 | Jan. 12, 2021 | Jul. 06, 2020 | Mar. 10, 2020 | Sep. 04, 2019 | Jan. 31, 2021 | Jun. 30, 2020 | Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | May 19, 2021 | Oct. 09, 2020 | Mar. 31, 2020 | Feb. 24, 2020 | Aug. 12, 2019 | Apr. 28, 2017 |
Shares Issued, Price Per Share (in dollars per share) | $ 1 | |||||||||||||||
Convertible Preferred Stock Converted to Other Securities | $ 0 | $ 299 | $ 0 | |||||||||||||
Proceeds from Issuance of Equity Net | 0 | 13,478 | 0 | |||||||||||||
Proceeds from Warrant Exercises | 30,600 | |||||||||||||||
Stock Issued During Period, Value, New Issues | 131,929 | 33,846 | 25,777 | |||||||||||||
Proceeds from Issuance of Common Stock, Net | $ 131,929 | $ 33,847 | $ 25,777 | |||||||||||||
Stock Issued During Period, Shares, Warrants Exercised (in shares) | 45,317,101 | |||||||||||||||
Preferred Stock [Member] | ||||||||||||||||
Stock Issued During Period, Shares, New Issues (in shares) | 0 | 0 | 0 | |||||||||||||
Stock Issued During Period, Shares, Conversion of Convertible Securities (in shares) | 7,900,000 | (7,937,000) | ||||||||||||||
Stock Issued During Period Shares Stock Options and Warrants Exercised (in shares) | 0 | 0 | 0 | |||||||||||||
Stock Issued During Period, Value, New Issues | $ 0 | $ 0 | $ 0 | |||||||||||||
Common Stock [Member] | ||||||||||||||||
Stock Issued During Period, Shares, New Issues (in shares) | 71,787,000 | 66,241,000 | 3,571,000 | |||||||||||||
Stock Issued During Period, Shares, Conversion of Convertible Securities (in shares) | 7,937,000 | |||||||||||||||
Stock Issued During Period Shares Stock Options and Warrants Exercised (in shares) | 45,630,000 | 4,913,000 | 38,000 | |||||||||||||
Stock Issued During Period, Value, New Issues | $ 72 | $ 66 | $ 4 | |||||||||||||
Series C Warrants [Member] | ||||||||||||||||
Proceeds from Warrant Exercises | $ 3,300 | |||||||||||||||
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share) | $ 0.68 | |||||||||||||||
Series D Warrants [Member] | ||||||||||||||||
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share) | $ 0.68 | |||||||||||||||
Series B Warrant [Member] | ||||||||||||||||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights (in shares) | 567,660 | |||||||||||||||
Class of Warrant or Right, Exercise Price of Warrants or Rights (in dollars per share) | $ 0.35 | $ 0.35 | $ 0.35 | $ 13 | ||||||||||||
Class of Warrant or Right, Outstanding (in shares) | 567,660 | 3,638,780 | ||||||||||||||
The 2019 ATM Offering [Member] | ||||||||||||||||
Stock Offering Agreement, Maximum Share Value | $ 25,000 | |||||||||||||||
The 2020 ATM Offering [Member] | ||||||||||||||||
Stock Offering Agreement, Maximum Share Value | $ 40,000 | |||||||||||||||
The 2021 ATM Offering [Member] | ||||||||||||||||
Stock Offering Agreement, Maximum Share Value | $ 100,000 | |||||||||||||||
Public Offering [Member] | ||||||||||||||||
Stock Issued During Period, Shares, New Issues (in shares) | 26,545,832 | 42,857,142 | ||||||||||||||
Shares Issued, Price Per Share (in dollars per share) | $ 3 | $ 0.35 | ||||||||||||||
Proceeds from Issuance of Equity Net | $ 13,600 | $ 13,500 | ||||||||||||||
Stock Issued During Period, Value, New Issues | $ 13,477 | |||||||||||||||
Proceeds from Issuance of Common Stock | $ 79,600 | $ 73,400 | ||||||||||||||
Proceeds from Issuance of Common Stock, Net | $ 73,400 | |||||||||||||||
Public Offering [Member] | Preferred Stock [Member] | ||||||||||||||||
Stock Issued During Period, Shares, New Issues (in shares) | 7,937,000 | |||||||||||||||
Stock Issued During Period, Value, New Issues | $ 79 | |||||||||||||||
Public Offering [Member] | Common Stock [Member] | ||||||||||||||||
Stock Issued During Period, Shares, New Issues (in shares) | 14,122,000 | |||||||||||||||
Stock Issued During Period, Value, New Issues | $ 14 | |||||||||||||||
Public Offering [Member] | Series C Warrants [Member] | ||||||||||||||||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights (in shares) | 3,308,823 | |||||||||||||||
Public Offering [Member] | Series D Warrants [Member] | ||||||||||||||||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights (in shares) | 3,308,823 | |||||||||||||||
Public Offering [Member] | Class A Units [Member] | ||||||||||||||||
Stock Issued During Period, Shares, New Issues (in shares) | 14,121,766 | |||||||||||||||
Shares Issued, Price Per Share (in dollars per share) | $ 0.68 | |||||||||||||||
Public Offering [Member] | Class B Units [Member] | ||||||||||||||||
Stock Issued During Period, Shares, New Issues (in shares) | 7,937,057 | |||||||||||||||
Shares Issued, Price Per Share (in dollars per share) | $ 0.68 | |||||||||||||||
Registered Direct Offering [Member] | ||||||||||||||||
Stock Issued During Period, Shares, New Issues (in shares) | 25,000,000 | |||||||||||||||
Shares Issued, Price Per Share (in dollars per share) | $ 1.25 | |||||||||||||||
Stock Issued During Period, Value, New Issues | $ 31,250 | |||||||||||||||
Proceeds from Issuance of Common Stock | $ 28,600 | $ 28,600 | ||||||||||||||
Underwriting Agreement [Member] | ||||||||||||||||
Stock Issued During Period, Shares, New Issues (in shares) | 2,153,846 | |||||||||||||||
Proceeds from Issuance of Common Stock | $ 18,800 | |||||||||||||||
Over-Allotment Option [Member] | ||||||||||||||||
Stock Issued During Period, Shares, New Issues (in shares) | 323,077 |
Note 17 - Equity Offerings - Su
Note 17 - Equity Offerings - Summary of Sales Under Offering (Details) - USD ($) $ / shares in Units, $ in Thousands | 12 Months Ended | |||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Apr. 28, 2017 | |
Average price per share (in dollars per share) | $ 1 | |||
Net proceeds | $ 0 | $ 13,478 | $ 0 | |
The 2019, 2020, and 2021 ATM Offerings [Member] | ||||
Total shares of common stock sold (in shares) | 20,237,045 | 23,008,639 | 1,374,685 | |
Average price per share (in dollars per share) | $ 1.53 | $ 0.90 | $ 5.23 | |
Gross proceeds | $ 30,943 | $ 20,822 | $ 7,193 | |
Commissions | 928 | 625 | 212 | |
Net proceeds | $ 30,015 | $ 20,197 | $ 6,981 |
Note 18 - Basic and Diluted N_3
Note 18 - Basic and Diluted Net Loss per Share - Antidilutive Securities Excluded from Computation of Earnings Per Share (Details) - shares | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares) | 9,599,990 | 53,819,880 | 4,346,057 |
Share-based Payment Arrangement, Option [Member] | |||
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares) | 4,640,660 | 4,361,872 | 1,830,958 |
Warrant [Member] | |||
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares) | 1,120,300 | 46,498,909 | 2,071,172 |
Restricted Stock Units (RSUs) [Member] | |||
Antidilutive Securities Excluded from Computation of Earnings Per Share (in shares) | 3,839,030 | 2,959,099 | 443,927 |
Note 19 - Restructuring (Detail
Note 19 - Restructuring (Details Textual) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended |
Dec. 31, 2019 | Dec. 31, 2020 | |
Restructuring Charges, Total | $ 8,800 | $ 851 |
Inventory Write Down [Member] | Cost of Sales [Member] | ||
Restructuring Charges, Total | 7,400 | |
Employee Severance [Member] | ||
Restructuring Charges, Total | $ 900 | |
Employee Severance [Member] | Restructuring and Other Charges [Member] | ||
Restructuring Charges, Total | $ 1,400 |
Note 19 - Restructuring - Restr
Note 19 - Restructuring - Restructuring Liability (Details) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended |
Dec. 31, 2019 | Dec. 31, 2020 | |
Balance | $ 882 | |
Amount charged to operating expenses | $ 8,800 | 851 |
Cash payments | (1,733) | |
Balance | $ 882 | $ 0 |
Note 20 - Commitments and Con_2
Note 20 - Commitments and Contingencies (Details Textual) - Senhance Surgical Robotic System Acquisition[Member] - License and Supply Agreement [Member] $ in Millions | Dec. 31, 2021USD ($) |
Contractual Obligation, to be Paid, Year One | $ 2.3 |
Contractual Obligation, to be Paid, Year Two | 0.1 |
Contractual Obligation, to be Paid, Year Three | $ 0.2 |
Note 21 - Related Person Tran_2
Note 21 - Related Person Transactions (Details Textual) - USD ($) | 12 Months Ended | ||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | |
Asensus Surgical Europe S.à.R.L [Member] | 1 Med S.A. [Member] | Service Supply Agreement [Member] | |||
Related Party Transaction, Expenses from Transactions with Related Party | $ 186,000 | $ 110,000 | $ 12,000 |