ICU Medical (ICUI) 10-Q 7 Aug 23 2023 Q2 Quarterly report Financial data

DEI Document

DEI Document - shares	6 Months Ended
	Jun. 30, 2023	Jul. 31, 2023
Document And Entity Information [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2023
Document Transition Report	false
Entity File Number	001-34634
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	33-0022692
Entity Address, Address Line One	951 Calle Amanecer
Entity Address, City or Town	San Clemente
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92673
City Area Code	949
Local Phone Number	366-2183
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
Title of 12(b) Security	Common stock, par value $0.10 per share
Trading Symbol	ICUI
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding		24,135,869
Entity Central Index Key	0000883984
Entity Registrant Name	ICU MEDICAL INC/DE
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q2

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
CURRENT ASSETS:
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents	$ 195,887	$ 208,784	[1]
Short-term investment securities	1,812	4,224	[1]
TOTAL CASH, CASH EQUIVALENTS AND INVESTMENT SECURITIES	197,699	213,008	[1]
Accounts receivable, net of allowance for doubtful accounts	162,225	221,719	[1]
Inventories	775,269	696,009	[1]
Prepaid income taxes	13,766	15,528	[1]
Prepaid expenses and other current assets	95,783	88,932	[1]
TOTAL CURRENT ASSETS	1,244,742	1,235,196	[1]
PROPERTY AND EQUIPMENT, net	616,540	636,113	[1]
Operating Lease, Right-of-Use Asset	76,028	74,864	[1]
Long-term investment securities	0	516
GOODWILL	1,464,478	1,449,258	[1]
INTANGIBLE ASSETS, net	929,830	982,766	[1]
Deferred Income Tax Assets	31,466	31,466
OTHER ASSETS	99,960	105,462	[1]
TOTAL ASSETS	4,463,044	4,515,641	[1]
CURRENT LIABILITIES:
Accounts payable	167,054	215,902	[1]
Accrued liabilities	254,508	242,769	[1]
Long-term Debt, Current Maturities	40,375	29,688
Income tax liability	19,954	6,200	[1]
Contingent earn-out liability	1,989	0
TOTAL CURRENT LIABILITIES	483,880	494,559	[1]
Contingent Earn-Out Liability, Noncurrent	26,944	25,572	[1]
Long-term Debt, Excluding Current Maturities	1,600,720	1,623,675
Other long-term liabilities	109,858	114,104
DEFERRED INCOME TAXES	89,684	126,007	[1]
INCOME TAX LIABILITY	37,140	41,796	[1]
COMMITMENTS AND CONTINGENCIES	0	0	[1]
STOCKHOLDERS' EQUITY:
Convertible preferred stock, $1.00 par value Authorized-500 shares; Issued and outstanding - none	0	0	[1]
Common stock, $0.10 par value - Authorized-80,000 shares	2,411	2,399	[1]
Additional paid-in capital	1,345,057	1,331,249	[1]
Treasury Stock, at cost	(1,611)	(243)	[1]
Retained earnings	817,755	837,501	[1]
Accumulated other comprehensive loss	(48,794)	(80,978)	[1]
TOTAL STOCKHOLDERS' EQUITY	2,114,818	2,089,928	[1]
TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY	$ 4,463,044	$ 4,515,641	[1]
[1]December 31, 2022 balances were derived from audited consolidated financial statements.

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Accounts Receivable, Allowance for Credit Loss	$ 10,028	$ 8,530
Convertible preferred stock, par value	$ 1
Convertible preferred stock, authorized shares	500,000
Convertible preferred stock, issued shares	0	0
Convertible preferred stock, outstanding shares	0	0
Common stock, par value	$ 0.10
Common stock, shares authorized	80,000,000
Common stock, shares issued	24,114,000	23,995,000
Common stock, shares outstanding	24,104,000	23,993,000
Treasury Stock, Common, Shares	10,048	1,633

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
REVENUES:
Revenue from Contract with Customer, Excluding Assessed Tax	$ 549,310	$ 561,004	$ 1,117,959	$ 1,104,126
Cost of goods sold	356,983	393,411	733,591	767,706
Gross Profit	192,327	167,593	384,368	336,420
OPERATING EXPENSES:
Selling, general and administrative	150,895	158,748	303,467	311,960
Research and development	22,302	22,562	42,063	46,433
Restructuring, strategic transaction and integration	12,354	13,525	23,367	47,430
Change in fair value of contingent earn-out	4,016	(27,194)	3,316	(27,194)
TOTAL OPERATING EXPENSES	189,567	167,641	372,213	378,629
(LOSS) INCOME FROM OPERATIONS	2,760	(48)	12,155	(42,209)
Interest Expense	(24,121)	(15,440)	(46,636)	(28,495)
OTHER (EXPENSE) INCOME, net	(1,502)	(1,366)	(1,771)	(951)
(Loss) Income from Continuing Operations before Income Taxes, Noncontrolling Interest	(22,863)	(16,854)	(36,252)	(71,655)
BENEFIT (PROVISION) FOR INCOME TAXES	12,929	9,380	16,506	26,113
NET (LOSS) INCOME	$ (9,934)	$ (7,474)	$ (19,746)	$ (45,542)
NET INCOME PER SHARE
Basic (in dollars per share)	$ (0.41)	$ (0.31)	$ (0.82)	$ (1.91)
Diluted (in dollars per share)	$ (0.41)	$ (0.31)	$ (0.82)	$ (1.91)
WEIGHTED AVERAGE NUMBER OF SHARES
Basic (in shares)	24,075	23,897	24,045	23,787
Diluted (in shares)	24,075	23,897	24,045	23,787

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Net (Loss) Income	$ (9,934)	$ (7,474)	$ (19,746)	$ (45,542)
Other comprehensive income (loss), net of tax
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), after Reclassification and Tax	5,274	8,144	(303)	31,716
Foreign currency translation adjustment, net of taxes of $0 for all periods	7,569	(99,805)	32,552	(104,751)
Other Comprehensive Income (Loss), Other Adjustments, after Tax	(34)	14	(65)	29
Other comprehensive income (loss), net of taxes	12,809	(91,647)	32,184	(73,006)
Comprehensive Income	$ 2,875	$ (99,121)	$ 12,438	$ (118,548)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Comprehensive Income (Paranthetical) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Statement of Comprehensive Income [Abstract]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), after Reclassification, Tax	$ 1,687	$ 4,730	$ (57)	$ 11,681
Other Comprehensive Income (Loss), Foreign Currency Translation Adjustment, Tax	0	0	0	0
Other Comprehensive (Income) Loss, Defined Benefit Plan, after Reclassification Adjustment, Tax	$ 0	$ 0	$ 0	$ 0

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Stockholders' Equity Statement - USD ($) $ in Thousands	Total	Common Stock Shares [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Treasury Stock, Common	Retained Earnings [Member]	AOCI Attributable to Parent [Member]
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock, shares issued		21,280,000
Stockholders' Equity Attributable to Parent at Dec. 31, 2021	$ 1,616,031		$ 2,128	$ 721,412	$ (27)	$ 911,787	$ (19,269)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock Issued During Period, Shares, New Issues		154,000
Stock Issued During Period, Value, New Issues	2,974		12	(2,965)	5,927
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation		(37,000)
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	(8,743)				(8,743)
Stock Issued During Period, Shares, Acquisitions		2,500,000
Stock Issued During Period, Value, Acquisitions	575,975		250	575,725
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	12,092			12,092
Other Comprehensive income (loss), net of Tax	18,641						18,641
Other Comprehensive (Loss) Income, Foreign Currency Transaction and Translation Gain (Loss) Arising During Period, Net of Tax	18,641
Net Income Attributable to Parent	(38,068)					(38,068)
Stockholders' Equity Attributable to Parent at Mar. 31, 2022	2,178,902		2,390	1,306,264	(2,843)	873,719	(628)
Stockholders' Equity Attributable to Parent at Dec. 31, 2021	$ 1,616,031		2,128	721,412	(27)	911,787	(19,269)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation	(44,759)
Other Comprehensive income (loss), net of Tax	$ (73,006)
Stockholders' Equity Attributable to Parent at Jun. 30, 2022	2,085,866		2,390	1,309,598	(92)	866,245	(92,275)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock, shares issued		23,897,000
Stockholders' Equity Attributable to Parent at Mar. 31, 2022	2,178,902		2,390	1,306,264	(2,843)	873,719	(628)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock Issued During Period, Shares, New Issues		10,000
Stock Issued During Period, Value, New Issues	18		0		4,446
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation		(8,000)
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	(1,695)				(1,695)
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	7,762			7,762
Adjustments to Additional Paid in Capital, Other				(4,428)
Other Comprehensive income (loss), net of Tax	(91,647)						(91,647)
Other Comprehensive (Loss) Income, Foreign Currency Transaction and Translation Gain (Loss) Arising During Period, Net of Tax	(91,647)
Net Income Attributable to Parent	(7,474)					(7,474)
Stockholders' Equity Attributable to Parent at Jun. 30, 2022	$ 2,085,866		2,390	1,309,598	(92)	866,245	(92,275)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock, shares issued		23,899,000
Common stock, shares issued	23,995,000	23,995,000
Stockholders' Equity Attributable to Parent at Dec. 31, 2022	$ 2,089,928		2,399	1,331,249	(243)	837,501	(80,978)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock Issued During Period, Shares, New Issues		172,000
Stock Issued During Period, Value, New Issues	171		12	(503)	662
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation		(53,000)
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	(8,425)				(8,425)
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	9,158			9,158
Other Comprehensive income (loss), net of Tax	19,375						19,375
Other Comprehensive (Loss) Income, Foreign Currency Transaction and Translation Gain (Loss) Arising During Period, Net of Tax	19,379
Net Income Attributable to Parent	(9,812)					(9,812)
Stockholders' Equity Attributable to Parent at Mar. 31, 2023	2,100,399		2,411	1,339,908	(8,006)	827,689	(61,603)
Stockholders' Equity Attributable to Parent at Dec. 31, 2022	$ 2,089,928		2,399	1,331,249	(243)	837,501	(80,978)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation	(54,371)
Adjustments to Additional Paid in Capital, Other				4
Other Comprehensive income (loss), net of Tax	$ 32,184
Stockholders' Equity Attributable to Parent at Jun. 30, 2023	2,114,818		2,411	1,345,057	(1,611)	817,755	(48,794)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock, shares issued		24,114,000
Stockholders' Equity Attributable to Parent at Mar. 31, 2023	2,100,399		2,411	1,339,908	(8,006)	827,689	(61,603)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Stock Issued During Period, Shares, New Issues		2,000
Stock Issued During Period, Value, New Issues	2,062		0	(4,626)	6,688
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation		(2,000)
Share-based Payment Arrangement, Decrease for Tax Withholding Obligation	(293)				(293)
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	9,773			9,773
Adjustments to Additional Paid in Capital, Other				2
Other Comprehensive income (loss), net of Tax	12,809						12,809
Other Comprehensive (Loss) Income, Foreign Currency Transaction and Translation Gain (Loss) Arising During Period, Net of Tax	12,811
Net Income Attributable to Parent	(9,934)					(9,934)
Stockholders' Equity Attributable to Parent at Jun. 30, 2023	$ 2,114,818		$ 2,411	$ 1,345,057	$ (1,611)	$ 817,755	$ (48,794)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock, shares issued	24,114,000	24,114,000

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
CASH FLOWS FROM OPERATING ACTIVITIES:
Net (Loss) Income	$ (19,746)	$ (45,542)
Depreciation and amortization	113,244	119,697
Amortization of Inventory Step-up	0	22,676
Noncash lease expense	11,110	10,888
Provision for doubtful accounts	399	(99)
Provision for warranty and returns	7,070	1,483
Stock compensation	18,931	19,854
Loss on disposal of property and equipment	1,019	267
Bond premium amortization	8	211
Debt Issuance Costs amortization	3,404	3,495
Change in fair value of contingent earn-out	3,316	(27,194)
Sparepartsusage	10,056	5,229
Other Noncash Income (Expense)	2,909	(2,807)
Accounts receivable	46,796	(1,090)
Inventories	(76,040)	(100,024)
Prepaid expenses and other assets	2,983	4,710
Increase (Decrease) in Other Operating Assets	(12,698)	(17,323)
Accounts payable	(46,864)	22,149
Accrued liabilities	(104)	(33,509)
Income taxes, including excess tax benefits and deferred income taxes	(26,022)	(45,798)
Net cash provided by operating activities	39,771	(62,727)
CASH FLOWS FROM INVESTING ACTIVITIES:
Purchases of property and equipment	(32,489)	(48,039)
Proceeds from sale of asset	1,431	900
Intangible assets additions	(4,651)	(4,440)
Purchases of investment securities	0	(3,397)
Proceeds from sale of investment securities	2,920	26,198
Net cash used in investing activities	(32,789)	(1,872,942)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of long-term debt, net of lender debt issuance costs	0	1,672,631
Repayments of Long-term Debt	14,813	18,125
Payments of Debt Issuance Costs	0	(1,852)
Proceeds from exercise of stock options	2,233	2,992
Finance Lease, Principal Payments	(436)	(321)
Payment, Tax Withholding, Share-based Payment Arrangement	8,718	10,438
Net cash (used in) provided by financing activities	(21,734)	1,644,887
Effect of Exchange Rate on Cash [Abstract]
Effect of Exchange Rate on Cash, Cash Equivalents, Restricted Cash, and Restricted Cash Equivalents, Continuing Operations	1,855	(6,347)
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents, Period Increase (Decrease), Including Exchange Rate Effect	(12,897)	(297,129)
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents	195,887	255,698
Supplemental Cash Flow Information [Abstract]
Capital Expenditures Incurred but Not yet Paid	2,362	5,539
NON-CASH INVESTING ACTIVITIES
Payments to Acquire Businesses, Net of Cash Acquired	0	(1,844,164)
SmithsMedical
CASH FLOWS FROM OPERATING ACTIVITIES:
Net (Loss) Income		65,500
Change in fair value of contingent earn-out	$ 3,300
NON-CASH INVESTING ACTIVITIES
Fair Value of Assets Acquired		1,658,692
Net Cash Paid (Received) for current and prior acquisitions		(1,844,164)
Business Combination, Consideration Transferred, Equity Interests Issued and Issuable		(575,975)
Business Combination, Liabilities Arising from Contingencies, Amount Recognized		(55,158)
Goodwill, Period Increase (Decrease)		1,437,811
Liabilities Assumed		$ (621,206)

Basis of Presentation_

Basis of Presentation:	6 Months Ended
	Jun. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation [Text Block]	Basis of Presentation The accompanying unaudited interim condensed consolidated financial statements of ICU Medical, Inc., ("ICU" or the "Company"), a Delaware corporation, have been prepared in accordance with accounting principles generally accepted in the United States of America ("U.S.") and pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”) and reflect all adjustments, consisting of only normal recurring adjustments, which are, in the opinion of management, necessary for a fair statement of the consolidated results for the interim periods presented. Results for the interim period are not necessarily indicative of results for the full year. Certain information and footnote disclosures normally included in annual consolidated financial statements prepared in accordance with generally accepted accounting principles have been condensed or omitted pursuant to such rules and regulations. The condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto included in the Annual Report on Form 10-K of ICU for the year ended December 31, 2022. We develop, manufacture and sell innovative medical products used in infusion therapy, vascular access, and vital care applications. ICU's product portfolio includes ambulatory, syringe, and large volume IV pumps and safety software; dedicated and non-dedicated IV sets, needlefree IV connectors, peripheral IV catheters, and sterile IV solutions; closed system transfer devices and pharmacy compounding systems; as well as a range of respiratory, anesthesia, patient monitoring, and temperature management products. We sell the majority of our products through our direct sales force and through independent distributors throughout the U.S. and internationally. We also sell certain products on an original equipment manufacturer basis to other medical device manufacturers. All subsidiaries are wholly owned and are included in the condensed consolidated financial statements. All intercompany balances and transactions have been eliminated. Certain reclassifications have been made to the prior year financial statements and footnotes to conform to the presentation used in the current year. In the statements of operations we reclassified interest income to interest expense, net from other expense, net and in Note 5: Revenues, certain reclassifications were made to revenues disaggregated by product line and by geography. Also, in Note 9: Fair Value Measurements the table indicating the Level inputs for the assets and liabilities measured at fair value on a recurring basis was updated to correct the Level input identified for the hedge assets and liabilities. These reclassifications had no impact on total revenues, net loss, shareholder's equity or cash flows as previously reported.

New Accounting Pronouncements_

New Accounting Pronouncements:	6 Months Ended
	Jun. 30, 2023
Accounting Standards Update and Change in Accounting Principle [Abstract]
New Accounting Pronouncements and Changes in Accounting Principles [Text Block]	New Accounting Pronouncements Recently Issued Accounting Standards In March 2020, the Financial Accounting Standards Board issued ASU No. 2020-04, Reference Rate Reform (Topic 848) - Facilitation of the Effects of Reference Rate Reform on Financial Reporting. The amendments in this update provide optional guidance for a limited period of time to ease the potential burden for reference rate reform on financial reporting. Due to concerns about structural risks of interbank offered rates and, particularly, the risk of cessation of the London Interbank Offered Rate ("LIBOR"), regulators around the world have undertaken reference rate reform initiatives to identify alternative reference rates that are more observable or transaction-based and less susceptible to manipulation. The amendments in this update apply only to contracts, hedging relationships, and other transactions that reference LIBOR or another reference rate expected to be discontinued as a result of reference rate reform. Optional expedients may be applied to contracts that are modified as a result of the reference rate reform. Modifications of contracts within the scope of Topic 470, Debt, should be accounted for by prospectively adjusting the effective interest rate. Modifications of contracts within the scope of ASC 842, Leases, should be accounted for as a continuation of the existing contracts with no reassessments of the lease classification and the discount rate (incremental borrowing rate). Exceptions to Topic 815, Derivatives and Hedging, results in not having a dedesignation of a hedging relationship if certain criteria are met. The amendments in this ASU are effective for all entities as of March 12, 2020 through December 31, 2022. ASU No. 2022-06, Reference Rate Reform: Deferral of the Sunset Date of Topic 848 deferred the sunset date to December 31, 2024. In November 2021, we entered into two forward-starting swaps whereby the variable leg of the swap referenced LIBOR. These swaps were amended in early 2022 to transition to an alternative reference rate (see Note 8: Derivatives and Hedging Activities). The amendments in this ASU allow for certain expedients that will allow us to assume that our hedged interest payments are probable of occurring regardless of any expected modification in their terms related to reference rate reform and will allow us to continue hedge accounting for a cash flow hedge for which the hedged interest rate risk changes if the hedge is highly effective under ASC 815, Derivatives and Hedging, or the optional expedient under this ASU is elected. The impact of this ASU on our contracts has not been and is not expected to be material.

Business Combinations and Asset

Business Combinations and Asset Acquisitions	6 Months Ended
	Jun. 30, 2023
Business Combination and Asset Acquisition [Abstract]
Business Combination Disclosure	Acquisitions 2022 Acquisition On January 6, 2022, we acquired 100.0% of the equity interests in Smiths Medical, the holding company of Smiths Group plc's global medical device business, from Smiths Group International Holdings Limited (“Smiths”). Consistent with our strategic growth plans, the acquisition of Smiths Medical enabled us to broaden our product offerings to include syringe and ambulatory infusion devices, vascular access, and vital care products and to strengthen and expand our global market reach. Total cash consideration for the acquisition was $1.9 billion, which was financed with existing cash balances and proceeds from the credit agreement entered into on January 6, 2022 (see Note 17: Long-Term Debt). We also issued share consideration to Smiths of 2.5 million shares of our common stock. The fair value of the common shares issued to Smiths was determined based on the opening market price of our common stock on the acquisition date. Smiths may be entitled to an additional $100.0 million in cash consideration contingent on our common stock achieving certain price targets for certain periods after closing in accordance with the terms of the Share Sale and Purchase Agreement (the "Purchase Agreement"). In the event that (a) on or prior to the third anniversary of closing the 30-day volume-weighted average price for our common stock, as defined in the Purchase Agreement, equals or exceeds $300.00 per share or (b) on or prior to the fourth anniversary of closing the 45-day volume-weighted average price for our common stock, as defined in the Purchase Agreement, equals or exceeds $300.00 per share (each a "Price Target"), and provided Smiths beneficially owns at least 50.0% of the shares of common stock issued at closing at the time the Price Target is achieved, then Smiths will be entitled to receive the additional $100.0 million in cash consideration. The fair value of the contingent consideration was determined using an option pricing model, specifically the Monte Carlo Simulation. In the analysis, the determinants of payout are simulated in a risk neutral framework over a large number of simulation paths. The fair value of the contingent consideration is then calculated as the average present value across all simulated paths. Smiths became a related party to us when we issued 2.5 million shares of our common stock as partial consideration for the acquisition of Smiths Medical. Additionally, we entered into a transition services agreement ("TSA") with certain members of Smiths Group, plc. The TSA includes certain information technology, human resource and tax support services for an initial term of twelve months with the option to extend up to 24 months. During the three and six months ended June 30, 2023, we expensed $3.9 million and $7.9 million, respectively, for services provided under the TSA. As of June 30, 2023, we have $1.0 million in open payables related to the services received under the TSA. Final Purchase Price Allocation The following table summarizes the final purchase price and the final allocation of the purchase price related to the assets acquired and liabilities assumed (in thousands): Cash consideration for acquired assets $ 1,922,955 Fair value of contingent consideration payable to Smiths 53,520 Issuance of ICU Medical, Inc. common shares: Number of shares issued to Smiths 2,500 Price per share (ICU's opening market price on the acquisition date) $ 230.39 Fair value of ICU shares issued to Smiths $ 575,975 Total Consideration $ 2,552,450 Purchase Price Allocation: Cash and cash equivalents $ 78,791 Accounts receivable 106,132 Inventories 228,919 Prepaid expenses and other current assets 53,554 Property, plant and equipment 206,333 Operating lease right-of-use assets 55,161 Intangible assets (1) 945,000 Other assets 379 Accounts payable (105,291) Accrued liabilities (2) (173,151) Income tax payable (40,312) Other long-term liabilities (85,490) Deferred income taxes (187,455) Total identifiable net assets acquired $ 1,082,570 Goodwill - not tax deductible 1,469,880 Estimated Purchase Consideration $ 2,552,450 _______________________________ (1) Identifiable intangible assets include $510.0 million of customer relationships, $400.0 million of developed technology, $30.0 million of internally developed software, and $5.0 million of trademark. The estimated weighted-average amortization period for the total identifiable intangible assets is approximately nine eight ten five six (2) Accrued liabilities includes, among other things, accrued warranty reserves, accrued restructuring initiatives, accrued salaries and related benefits, deferred revenue and accrued sales and use taxes. The identifiable intangible assets and other long-lived assets acquired have been valued utilizing Level 3 inputs as defined in Note 9: Fair Value Measurements. The fair value of identifiable intangible assets was generally developed using the income approach and are based on critical estimates, judgments and assumptions derived from: analysis of market conditions; discount rate; discounted cash flows; royalty rates; customer retention rates; and/or estimated useful lives. Certain other intangible assets were valued using a cost to replace method, estimating the labor and non-labor costs required to replace the asset under the premise that it was not part of the transaction. Property, plant and equipment was valued with the consideration of remaining economic lives. The raw materials inventory was valued at historical cost and adjusted for any obsolescence which we estimate to approximate replacement cost, the work in process inventory was valued at estimated sales proceeds less costs to complete and costs to sell, and finished goods inventory was valued at estimated sales proceeds less costs to sell. The prepaid expenses and other current assets and assumed liabilities were recorded at their carrying values as of the date of the acquisition, as their carrying values approximated their fair values due to their short-term nature. Unaudited Pro Forma Information Smiths Medical is included in our consolidated results beginning on January 7, 2022. Total revenues and net loss attributable to Smiths Medical for the period from January 7, 2022 to June 30, 2022 were estimated to be $437.8 million and $65.5 million, respectively, and for the three months ended June 30, 2022 were estimated to be $222.9 million and $26.0 million, respectively. The following unaudited pro forma financial information presents the combined results of operations of ICU and Smiths Medical as if the acquisition had occurred on January 1, 2022. The pro forma financial information is presented for informational purposes only and is not indicative of the results of operations that would have been achieved if the acquisition had taken place on the date indicated or of results that may occur in the future. (In thousands) Three months ended June 30, 2022 Six months ended June 30, 2022 Revenues $ 561,004 $ 1,124,823 Net Loss $ (7,474) $ (59,425)

Restructuring, Strategic Transa

Restructuring, Strategic Transaction and Integration (Notes)	6 Months Ended
	Jun. 30, 2023
Restructuring and Related Activities [Abstract]
Restructuring and Related Activities Disclosure	Restructuring, Strategic Transaction and Integration Restructuring, strategic transaction and integration expenses were $12.4 million and $13.5 million for the three months ended June 30, 2023 and 2022, respectively and $23.4 million and $47.4 million for the six months ended June 30, 2023 and 2022, respectively. Restructuring During the three and six months ended June 30, 2023, restructuring charges were $1.3 million and $4.0 million, respectively, as compared to $1.7 million and $4.9 million, respectively, for the three and six months ended June 30, 2022 and were primarily related to severance costs for all periods. The following table summarizes the activity in our restructuring-related accrual by major type of cost (in thousands): Severance Pay and Benefits Retention and Facility Closure Costs Total Accrued balance, January 1, 2023 $ 4,416 $ 1,507 $ 5,923 Charges incurred 2,732 — 2,732 Payments (1,284) — (1,284) Other (1) (291) (620) (911) Currency translation 70 16 86 Accrued balance, March 31, 2023 $ 5,643 $ 903 $ 6,546 Charges incurred 1,290 20 1,310 Payments (3,302) (27) (3,329) Currency translation 227 17 244 Accrued balance, June 30, 2023 $ 3,858 $ 913 $ 4,771 __________________________ (1) Other, primarily relates to prior year accrued restructuring charges for estimated facility closure costs that were reversed during the three months ended March 31, 2023. Strategic Transaction and Integration Expenses We incurred and expensed $11.1 million and $11.8 million in strategic transaction and integration expenses during the three months ended June 30, 2023 and 2022, respectively, and we incurred and expensed $19.4 million and $42.5 million in strategic transaction and integration expenses during the six months ended June 30, 2023 and 2022, respectively, which are

Revenue (Notes)

Revenue (Notes)	6 Months Ended
	Jun. 30, 2023
Revenue from Contract with Customer [Abstract]
Revenue from Contract with Customer [Text Block]	Revenue Revenue Recognition As part of the integration of our acquisition of Smiths Medical, we have now migrated to our new business unit structure of Consumables, Infusion Systems and Vital Care. The vast majority of our sales of products within these business units are made on a stand-alone basis to hospitals and distributors. Our revenues are recorded at the net sales price, which includes an estimate for variable consideration related to rebates, chargebacks and product returns. Revenue is typically recognized upon transfer of control of the products, which we deem to be at point of shipment. However, for purposes of revenue recognition for our software licenses and renewals, we consider the control of these products to be transferred to a customer at a certain point in time; therefore, we recognize revenue at the start of the applicable license term. Payment is typically due in full within 30 days of delivery or the start of the contract term. Revenue is recorded in an amount that reflects the consideration we expect to be entitled to in exchange for those goods or services. We offer certain volume-based rebates to our distribution customers, which we record as variable consideration when calculating the transaction price. Rebates are offered on both a fixed and tiered/variable basis. In both cases, we use information available at the time and our historical experience with each customer to estimate the most likely rebate amount. We also provide chargebacks to distributors that sell to end customers at prices determined under a contract between us and the end customer. Chargebacks are the difference between the prices we charge our distribution customers and the contracted prices we have with the end customer which are processed as credits to our distribution customers. In estimating the expected value of chargeback amounts in order to determine the transaction price, we use information available at the time, including our historical experience. We also warranty products against defects and have a policy permitting the return of defective products, for which we accrue and expense at the time of sale using information available at that time and our historical experience. We also provide for extended service-type warranties, which we consider to be separate performance obligations. We allocate a portion of the transaction price to the extended service-type warranty based on its estimated relative stand-alone selling price, and recognize revenue over the period the warranty service is provided. Revenue disaggregated The following table represents our revenues disaggregated by product line (in thousands): Three months ended Six months ended Product line 2023 2022 2023 2022 Consumables $ 236,976 $ 240,995 $ 473,098 $ 481,184 Infusion Systems 153,142 148,644 314,855 286,871 Vital Care 159,192 171,365 330,006 336,071 Total Revenues $ 549,310 $ 561,004 $ 1,117,959 $ 1,104,126 For the three and six months ended June 30, 2023 and 2022, net sales to Medline made up approximately 15% of total revenues. The following table represents our revenues disaggregated by geography (in thousands): Three months ended Six months ended Geography 2023 2022 2023 2022 United States $ 347,866 $ 363,866 $ 707,053 $ 711,657 Europe, the Middle East and Africa 89,994 87,415 188,980 173,619 APAC 60,031 60,447 118,655 125,278 Other Foreign 51,419 49,276 103,271 93,572 Total Revenues $ 549,310 $ 561,004 $ 1,117,959 $ 1,104,126 Contract balances The following table presents the changes in our contract balances for the six months ended June 30, 2023 and 2022 (in thousands): Contract Liabilities Beginning balance, January 1, 2023 $ (45,866) Equipment revenue recognized 16,793 Equipment revenue deferred (16,625) Software revenue recognized 9,041 Software revenue deferred (8,875) Government grant deferred income (944) Government grant recognized* 647 Other deferred revenue (688) Other deferred revenue recognized 3,514 Ending balance, June 30, 2023 $ (43,003) Beginning balance, January 1, 2022 $ (7,461) Fair value of acquired deferred revenue (51,245) Equipment revenue recognized 14,606 Equipment revenue deferred (7,349) Software revenue recognized 8,737 Software revenue deferred (9,067) Government grant deferred income (2,972) Government grant recognized* 232 Other deferred revenue (1,005) Other deferred revenue recognized 2,458 Ending balance, June 30, 2022 $ (53,066) ____________________________ * The government grant deferred income is amortized over the life of the related depreciable asset as a reduction to depreciation expense. Our contract liabilities are included in accrued liabilities or other long-term liabilities in our condensed consolidated balance sheet based on the expected timing of payments. As of June 30, 2023, revenue from remaining performance obligations is as follows: Recognition Timing (in millions) < 12 Months > 12 Months Equipment deferred revenue $ (15,605) $ (790) Software deferred revenue (8,001) (699) Government grant deferred income* (1,451) (13,064) Other deferred revenue** (2,591) (802) Total $ (27,648) $ (15,355) _________________________________ *The government grant deferred income is amortized over the life of the related depreciable asset as a reduction to depreciation expense. **Other deferred revenue includes pump development programs, purchased training and extended warranty.

Leases (Notes)

Leases (Notes)	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
Lessee, Operating Leases [Text Block]	Leases We determine if an arrangement is a lease at inception. Our operating lease assets are separately stated in operating lease right-of-use ("ROU") assets and our financing lease assets are included in other assets on our condensed consolidated balance sheets. Our lease liabilities are included in accrued liabilities and other long-term liabilities on our condensed consolidated balance sheets. We have elected not to recognize an ROU asset and lease liability for leases with terms of twelve months or less. Lease ROU assets and lease liabilities are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. Most of our leases do not provide an implicit rate, therefore we use our incremental borrowing rate, which is the rate incurred to borrow on a collateralized basis over a similar term based on the information available at commencement date. Our lease ROU assets exclude lease incentives and initial direct costs incurred. Our lease terms include options to extend when it is reasonably certain that we will exercise that option. All of our leases have stated lease payments, which may include fixed rental increases. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. Our leases are for corporate, research and development and sales and support offices, distribution facilities, device service centers and certain equipment. Our leases have original lease terms of one year to fifteen years, some of which include options to extend the leases for up to an additional five years. For all of our leases, we do not include optional periods of extension in our current lease terms because we determine the exercise of options to extend is not reasonably certain. The following table presents the components of our lease cost (in thousands): Three months ended Six months ended 2023 2022 2023 2022 Operating lease cost $ 6,043 $ 5,475 $ 12,193 $ 10,653 Finance lease cost — interest 31 28 60 57 Finance lease cost — reduction of ROU asset 254 170 479 340 Short-term lease cost 13 3 26 6 Total lease cost $ 6,341 $ 5,676 $ 12,758 $ 11,056 Interest expense on our finance leases is included in interest expense, net in our condensed consolidated statements of operations. The reduction of the operating and finance ROU assets is included as noncash lease expense in selling, general and administrative expenses in our condensed consolidated statements of operations. The following table presents the supplemental cash flow information related to our leases (in thousands): Six months ended 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 12,336 $ 12,887 Operating cash flows from finance leases $ 60 $ 57 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 10,153 $ 3,829 Finance leases $ 804 $ 38 The following table presents the supplemental balance sheet information related to our operating leases (in thousands, except lease term and discount rate): As of June 30, 2023 December 31, 2022 Operating leases Operating lease right-of-use assets $ 76,028 $ 74,864 Accrued liabilities $ 19,187 $ 18,169 Other long-term liabilities 59,875 60,916 Total operating lease liabilities $ 79,062 $ 79,085 Weighted-Average Remaining Lease Term Operating leases 5.9 years 6.1 years Weighted-Average Discount Rate Operating leases 4.32 % 4.34 % The following table presents the supplemental balance sheet information related to our finance leases (in thousands, except lease term and discount rate): As of June 30, 2023 December 31, 2022 Finance leases Finance lease right-of-use assets $ 3,019 $ 2,598 Accrued liabilities $ 979 $ 816 Other long-term liabilities 2,134 1,855 Total finance lease liabilities $ 3,113 $ 2,671 Weighted-Average Remaining Lease Term Finance leases 4.3 years 4.8 years Weighted-Average Discount Rate Finance leases 4.77 % 4.23 % As of June 30, 2023, the maturities of our operating and finance lease liabilities for each of the next five years are approximately (in thousands): Operating Leases Finance Leases Remainder of 2023 $ 11,523 $ 601 2024 20,540 907 2025 15,225 686 2026 13,451 563 2027 9,831 248 2028 14,452 189 Thereafter 3,868 236 Total Lease Payments 88,890 3,430 Less imputed interest (9,828) (317) Total $ 79,062 $ 3,113

Net Income Per Share_

Net Income Per Share:	6 Months Ended
	Jun. 30, 2023
Earnings Per Share [Abstract]
Net Income Per Share [Text Block]	Net Loss Per Share Basic earnings per share is computed by dividing net income by the weighted-average number of common shares outstanding during the period. Diluted earnings per share is computed by dividing net income by the weighted-average number of common shares outstanding during the period plus dilutive securities. Dilutive securities include outstanding common stock options and unvested restricted stock units, less the number of shares that could have been purchased with the proceeds from the exercise of the options, using the treasury stock method. Options and restricted stock units that are anti-dilutive are not included in the treasury stock method calculation. Due to the net loss for the three and six months ended June 30, 2023 and 2022, any potentially dilutive common shares were not included in the computation of diluted earnings per share as they would have had an anti-dilutive effect; therefore, basic and diluted net loss per share are equal for each of the three and six months ended June 30, 2023 and 2022. The following table presents the calculation of net earnings per common share (“EPS”) — basic and diluted (in thousands, except per share data): Three months ended Six months ended 2023 2022 2023 2022 Net loss $ (9,934) $ (7,474) $ (19,746) $ (45,542) Weighted-average number of common shares outstanding (basic) 24,075 23,897 24,045 23,787 Dilutive securities (1) — — — — Weighted-average common and common equivalent shares outstanding (diluted) 24,075 23,897 24,045 23,787 EPS — basic $ (0.41) $ (0.31) $ (0.82) $ (1.91) EPS — diluted $ (0.41) $ (0.31) $ (0.82) $ (1.91) _______________________________ (1) Due to the net loss for the three and six months ended June 30, 2023 and 2022, there are no potentially dilutive common shares included in the computation of diluted earnings per share.

Derivative Financial Instrument

Derivative Financial Instruments (Notes)	3 Months Ended
	Jun. 30, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Instruments and Hedging Activities Disclosure [Text Block]	Derivatives and Hedging Activities Hedge Accounting and Hedging Program The purposes of our cash flow hedging programs are to manage the foreign currency exchange rate risk on forecasted revenues and expenses denominated in currencies other than the functional currency of the operating unit, and to manage floating interest rate risk associated with future interest payments on the variable-rate term loans issued in January 2022. We do not issue derivatives for trading or speculative purposes. To receive hedge accounting treatment, all hedging relationships are formally documented at the inception of the hedge, and the hedges must be highly effective in offsetting changes to future cash flows on hedged transactions. The derivative instruments we utilize, including various foreign exchange contracts and interest rate swaps, are designated and qualify as cash flow hedges. Our derivative instruments are recorded at fair value on the condensed consolidated balance sheets and are classified based on the instrument's maturity date. We record gains or losses from changes in the fair values of the derivative instruments as a component of other comprehensive income (loss) and we reclassify those gains or losses into earnings in the same line item associated with the forecasted transaction and in the same period during which the hedged transaction affects earnings. If the underlying forecasted transaction does not occur, or it becomes probable that it will not occur, we reclassify the gain or loss on the related derivative instrument from accumulated other comprehensive loss into earnings immediately. Foreign Currency Exchange Rate Risk Foreign Exchange Forward Contracts We enter into foreign exchange forward contracts to hedge a portion of our forecasted foreign currency-denominated revenues and expenses to minimize the effect of foreign exchange rate movements on the related cash flows. These contracts are agreements to buy or sell a quantity of a currency at a predetermined future date and at a predetermined exchange rate. Our foreign exchange forward contracts hedge exposures principally denominated in Mexican Pesos ("MXN"), Euros, Czech Koruna ("CZK"), Japanese Yen ("JPY"), Swedish Krona ("SEK"), Danish Krone ("DKK"), Chinese Renminbi ("CNH"), Canadian Dollar ("CAD"), U.S. Dollar ("USD") and Australian Dollar ("AUD") and have varying maturities with an average term of approximately eleven months. The total notional amount of these outstanding derivative contracts as of June 30, 2023 was $176.7 million, which included the notional equivalent of $45.9 million in MXN, $30.4 million in Euros, $8.6 million in CZK, $18.4 million in JPY, $7.9 million in CNH, $18.0 million in CAD, $13.2 million in AUD, $30.3 million in USD and $4.1 million in other foreign currencies, with terms currently through January 2025. Cross-currency Par Forward Contracts We have entered into cross-currency par forward contracts to hedge a portion of our Mexico forecasted expenses denominated in MXN. These contracts are agreements to exchange cash flows from one currency to another at specified intervals over the contract term with all exchanges occurring at the same predetermined rate. In November 2021, we entered into a one-year cross-currency par forward contract with a term from December 1, 2021 to December 1, 2022. The total notional amount of this outstanding derivative as of June 30, 2022 was approximately 208.2 million MXN. This derivative instrument matured in equal monthly amounts at a fixed forward rate of 21.60 MXN/USD. Floating Interest Rate Risk In November 2021, in anticipation of entering into the new senior secured credit facilities in January 2022, which includes a variable-rate term loan A and a variable-rate term loan B (see Note 17: Long-Term Debt), we entered into two forward-starting interest rate swaps. In February 2022, certain terms under the agreements were amended to reflect the transition from LIBOR to the Secured Overnight Financing Rate ("SOFR"), an alternative reference rate. Under the interest rate swap agreements, we exchange, at specified intervals, the difference between fixed and floating interest amounts calculated by reference to an agreed-upon notional amount. Effective March 30, 2022, the term loan A swap, as amended, has an initial notional amount of $300.0 million, reducing to $150.0 million evenly on a quarterly basis excluding its final maturity on March 30, 2027. We will pay a fixed rate of 1.32% and will receive the greater of 3-months USD SOFR or (0.15)%. Effective March 30, 2022, the term loan B swap, as amended, has an initial notional amount of $750.0 million, reducing to $46.9 million evenly on a quarterly basis excluding its final maturity on March 30, 2026. We will pay a fixed rate of 1.17% and will receive the greater of 3-months USD SOFR or 0.35%. In June 2023, we entered into an additional interest rate swap that hedges both term loan A and term loan B interest payments. The total notional amount of the swap is $300 million. The hedge matures on June 30, 2028. We will pay a fixed rate of 3.88% and will receive 3-months USD SOFR. These swaps effectively convert the relevant portion of the floating-rate term loans to fixed rates. The following table presents the fair values of our derivative instruments included within the Condensed Consolidated Balance Sheets (in thousands): Derivatives Designated as Cash Flow Hedging Instruments Condensed Consolidated Balance Sheet Location Foreign Exchange Contracts Interest Rate Swaps Gross Derivatives As of June 30, 2023 Prepaid expenses and other current assets $ 11,533 $ 31,702 $ 43,235 Other assets 897 17,229 18,126 Total assets $ 12,430 $ 48,931 $ 61,361 Accrued liabilities $ 3,806 $ — $ 3,806 Other long-term liabilities 105 — 105 Total liabilities $ 3,911 $ — $ 3,911 As of December 31, 2022 Prepaid expenses and other current assets $ 4,860 $ 28,431 $ 33,291 Other assets 94 26,753 26,847 Total assets $ 4,954 $ 55,184 $ 60,138 Accrued liabilities $ 1,847 $ — $ 1,847 Other long-term liabilities 167 — 167 Total liabilities $ 2,014 $ — $ 2,014 We recognized the following gains on our derivative instruments designated as cash flow hedges in other comprehensive income before reclassifications to net loss (in thousands): Gain Recognized in Other Comprehensive Income Three months ended Six months ended 2023 2022 2023 2022 Derivatives designated as cash flow hedging instruments: Foreign exchange contracts $ 6,051 $ 5,225 $ 8,503 $ 8,337 Interest rate swaps 11,324 9,146 8,740 39,197 Total derivatives designated as cash flow hedging instruments $ 17,375 $ 14,371 $ 17,243 $ 47,534 The following table presents the effects of our derivative instruments designated as cash flow hedges on the Condensed Consolidated Statements of Operations (in thousands): Gain (Loss) Reclassified From Accumulated Other Comprehensive Loss into Income Three months ended Six months ended Location of Gain (Loss) Recognized in Income 2023 2022 2023 2022 Derivatives designated as cash flow hedging instruments: Foreign exchange contracts Total revenues $ 473 $ 1,813 $ (1,448) $ 4,356 Foreign exchange contracts Cost of goods sold 2,316 1,563 3,816 1,049 Foreign exchange contracts Other expense, net (1) — — 229 — Foreign exchange contracts Interest expense (2) — 5 13 255 Interest rate swaps Interest expense 7,625 (1,524) 14,993 (1,524) Total derivatives designated as cash flow hedging instruments $ 10,414 $ 1,857 $ 17,603 $ 4,136 _______________________________ (1) Represents location of gain reclassified from accumulated other comprehensive loss into income as a result of ineffectiveness. (2) Represents location of gain reclassified from accumulated other comprehensive loss into income as a result of forecasted transactions no longer probable of occurring.

Fair Value Measures and Disclos

Fair Value Measures and Disclosures (Notes)	6 Months Ended
	Jun. 30, 2023
Fair Value Disclosures [Abstract]
Fair Value Disclosures	Fair Value Measurements Fair value is the price that would be received from selling an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. There are three levels of inputs that may be used to measure fair value: • Level 1: quoted prices in active markets for identical assets or liabilities; • Level 2: inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices in active markets for similar assets or liabilities, quoted prices for identical or similar assets or liabilities in markets that are not active, or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities; or • Level 3: unobservable inputs that are supported by little or no market activity and that are significant to the fair values of the assets or liabilities. Contingent Earn-out Liabilities On January 6, 2022, we acquired Smiths Medical with a combination of cash consideration and share consideration issued at closing. Total consideration for the acquisition includes a potential earn-out payment of $100.0 million in cash contingent on our common stock achieving certain Price Targets from the closing date to either the third or fourth anniversary of closing (see Note 3: Acquisitions for additional information) and provided Smiths beneficially owns at least 50.0% of the shares of common stock issued at closing at the time the Price Target is achieved. The initial estimated fair value of the earn-out was determined to be $53.5 million. The initial fair value of the earn-out was determined using a Monte Carlo simulation model. The model utilized several assumptions including volatility and the risk-free interest rate. The assumed volatility is based on the average of the historical volatility of our common stock price and the implied volatility of certain at-the-money traded options. The risk-free interest rate is equal to the yield on U.S. Treasury securities at constant maturity for the period commensurate with the term of the earn-out. At each reporting date subsequent to the acquisition, we remeasure the earn-out liability and recognize any changes in its fair value in our consolidated statements of operations. If the probability of achieving the Price Targets during their respective measurement periods is significantly greater than initially anticipated, the realization of an additional liability and related expense will have a significant impact on our consolidated financial statements in the period recognized. As of June 30, 2023, the estimated fair value of the contingent earn-out is $22.6 million. In November 2021, we acquired a small foreign infusion systems supplier. Total consideration for the acquisition included a potential earn-out payment of up to $2.5 million, consisting of (i) a cash payment of $1.0 million contingent on the achievement of certain revenue targets for the annual period ending December 31, 2022 and, separately, (ii) a cash payment of $1.5 million contingent on certain product-related regulatory certifications obtained by May 26, 2024. As of December 31, 2022, the measurement period related to (i) above ended, and based on the actual revenue achieved during the measurement period we determined that the fair value of the contingent earn-out was zero as the minimum threshold for earning the earn-out was not met. As of June 30, 2023, the estimated fair value for the contingent earn-out related to certain product-related regulatory certifications was estimated to be $1.5 million. In August 2021, we entered into an agreement with one of our international distributors whereby that distributor would not compete with us in a specific territory for a three-year period that will end in September 2024. The terms of the agreement include a contingent earn-out payment. The contingent earn-out payment shall not exceed $6.0 million, which will be earned based on certain revenue targets over a twelve-month measurement period determined by the highest four consecutive quarters commencing over a two-year period starting on the closing date of the agreement and provided that the distributor is in compliance with its obligations under the agreement. As of June 30, 2023, the estimated fair value of the contingent earn-out is $4.3 million. The estimated fair value of the contingent earn-out is calculated using a probability-weighted cash flow model based on historical revenue streams and the likelihood that the revenue targets will be met. Our contingent earn-out liabilities are separately stated on our condensed consolidated balance sheets. The following tables provide a reconciliation of the Level 3 earn-out liabilities measured at estimated fair value (in thousands): Earn-out Liability Accrued balance, January 1, 2023 $ 25,572 Change in fair value of earn-out (included in income from operations as a separate line item) (1) (700) Currency translation 33 Accrued balance, March 31, 2023 24,905 Change in fair value of earn-out (included in income from operations as a separate line item) (2) 4,016 Other 11 Currency translation 1 Accrued balance, June 30, 2023 $ 28,933 Earn-out Liability Accrued balance, January 1, 2022 $ 2,589 Acquisition date fair value estimate of earn-out (3) 55,158 Currency translation (46) Accrued balance, March 31, 2022 57,701 Change in fair value of earn-out (included in income from operations as a separate line item) (1) (27,194) Currency translation (98) Accrued balance, June 30, 2022 $ 30,409 _______________________________ (1) Primarily relates to Smiths Medical. (2) $2.3 million relates to Smiths Medical and $1.7 million relates to the earn-out in connection with our acquisition of a small foreign infusions systems supplier. (3) $53.5 million relates to our acquisition of Smiths Medical and $1.6 million relates to our acquisition of a small foreign infusions systems supplier in the fourth quarter of 2021 (see Note 3: Acquisitions). The following tables provide quantitative information about Level 3 inputs for fair value measurement of our earn-out liabilities related to Smiths Medical: Smiths Medical Earn-out Liability Simulation Input As of As of Volatility 34.00 % 38.00 % Risk-Free Rate 4.62 % 4.17 % Investments, Foreign Exchange Contracts and Interest Rate Contracts Our investments consist of corporate and government bonds and U.S. treasury securities. The fair value of our corporate and government bonds is estimated using observable market-based inputs such as quoted prices, interest rates and yield curves or Level 2 inputs. The fair value of our U.S. treasury securities are based on quoted market prices in active markets and are included in the Level 1 fair value hierarchy. The fair value of our Level 2 foreign exchange contracts, including forward contracts and cross-currency par forward contracts, is estimated using observable market inputs such as known notional value amounts, spot and forward exchange rates. These inputs relate to liquid, heavily traded currencies with active markets which are available for the full term of the derivative. The fair value of our Level 2 interest rate swaps is estimated using a pricing model that reflects the terms of the contracts, including the period to maturity, and relies on observable market inputs such as known notional value amounts and USD interest rate curves. Our assets and liabilities measured at fair value on a recurring basis consisted of the following Level 1, 2 and 3 inputs as defined above (in thousands): Fair value measurements as of June 30, 2023 Total carrying Quoted prices Significant Significant Assets: Available-for-sale debt securities: Short-term corporate bonds $ 1,313 $ — $ 1,313 $ — Short-term government bonds 499 — 499 — Foreign exchange contracts: Prepaid expenses and other current assets 11,533 — 11,533 — Other assets 897 — 897 — Interest rate contracts: Prepaid expenses and other current assets 31,702 — 31,702 — Other assets 17,229 — 17,229 — Total Assets $ 63,173 $ — $ 63,173 $ — Liabilities: Contingent earn-out liability - ST $ 1,989 $ — $ — $ 1,989 Contingent earn-out liability - LT 26,944 — — 26,944 Foreign exchange contracts: Accrued liabilities 3,806 — 3,806 — Other long-term liabilities 105 — 105 — Total Liabilities $ 32,844 $ — $ 3,911 $ 28,933 Fair value measurements as of December 31, 2022 Total carrying Quoted prices Significant Significant Assets: Available-for-sale debt securities: Short-term corporate bonds $ 2,314 $ — $ 2,314 $ — Short-term U.S. treasury securities 1,412 1,412 — — Short-term government bonds 498 — 498 — Long-term corporate bonds 516 — 516 — Foreign exchange forwards: Prepaid expenses and other current assets 4,860 — 4,860 — Other assets 94 — 94 — Interest rate contracts: Prepaid expenses and other current assets 28,431 — 28,431 — Other assets 26,753 — 26,753 — Total Assets $ 64,878 $ 1,412 $ 63,466 $ — Liabilities: Contingent earn-out liability - LT $ 25,572 $ — $ — $ 25,572 Foreign exchange contracts: Accrued liabilities 1,847 — 1,847 — Other long-term liabilities 167 — 167 — Total Liabilities $ 27,586 $ — $ 2,014 $ 25,572

Investment Securities (Notes)

Investment Securities (Notes)	6 Months Ended
	Jun. 30, 2023
Investments, Debt and Equity Securities [Abstract]
investments in Debt and Marketable Equity Securities and Equity Method Investments [Text Block]	Investment Securities Investments in Available-for-sale Securities Our available-for-sale investment securities currently consist of short-term corporate bonds and short-term government bonds and are considered “investment grade” and are carried at fair value. We assess our investment in available-for-sale debt securities for impairment each reporting period. If an unrealized loss exists, we determine whether any portion of the decline in fair value below the amortized cost basis is credit-related by reviewing several factors, including, but not limited to, the extent of the fair value decline and changes in the financial condition of the issuer. We record an impairment for credit-related losses through an allowance, limited to the amount of the unrealized loss. If we either intend to sell or it is more likely than not we will be required to sell the debt security before its anticipated recovery, any allowance is written off and the amortized cost basis is written down to fair value through a charge against net earnings. Unrealized gains and non-credit-related unrealized losses are recorded, net of tax, in other comprehensive income (loss). We did not have any investments in available-for-sale debt securities in unrealized loss positions as of June 30, 2023 or December 31, 2022. The amortized cost of the debt securities are adjusted for the amortization of premiums computed under the effective interest method. Such amortization is included in interest expense, net in our condensed consolidated statements of operations. Realized gains and losses are accounted for on the specific identification method. There have been no realized gains or losses on the disposal of these investments. The scheduled maturities of the outstanding debt securities are between 2023 and 2024. All short-term investment securities are callable within one year. Our short-term and long-term investments in available-for-sale securities consist of the following (in thousands): As of June 30, 2023 Amortized Cost Unrealized Holding Fair Value Short-term corporate bonds $ 1,313 $ — $ 1,313 Short-term government bonds 499 — 499 Total investment securities $ 1,812 $ — $ 1,812 As of December 31, 2022 Amortized Cost Unrealized Holding Fair Value Short-term corporate bonds $ 2,314 $ — $ 2,314 Short-term U.S. treasury securities 1,412 — 1,412 Short-term government bonds 498 — 498 Long-term corporate bonds 516 — 516 Total investment securities $ 4,740 $ — $ 4,740 Investments in Non-Marketable Equity Securities During the third quarter of 2021, we acquired an approximate 20% non-marketable equity interest in a nonpublic company and entered into a three-year distribution agreement where we have the exclusive rights to market, sell and distribute the company's products in exchange for a cash payment of $3.3 million. In addition, we were granted an exclusive license for all of the seller's intellectual property. At the expiration of the distribution agreement we have the right but not the obligation to acquire the remaining interest in the business. We apply the equity method of accounting for investments when we determine we have a significant influence, but not a controlling interest in the investee. We determine whether we have significant influence by considering key factors such as ownership interest, representation on the board of directors, participation in policy making decisions, business relationship and material intra-entity transactions, among other factors. Our equity method investment is reported at cost and adjusted each period for our share of the investee's income or (loss) and dividend paid, if any. We eliminate any intra-entity profits to the extent of our beneficial interest. We record our share of the investee's income or (loss) on a one quarter lag. We report our proportionate share of the investee's income or (loss) resulting from this investment in other income, net in our condensed consolidated statements of operations. The carrying value of our equity method investment is reported in other assets on our condensed consolidated balance sheets (see Note 11: Prepaid Expenses and Other Current Assets and Other Assets). We assess our equity method investments for impairment on an annual basis or whenever events or circumstances indicate that the carrying value of the investment may not be recoverable. Our recorded share of the investee's loss was not material for the three and six months ended June 30, 2023 and 2022. We did not receive any dividend distributions from this investment during the three and six months ended June 30, 2023 and 2022. Our non-marketable equity method investment consists of the following (in thousands): As of June 30, 2023 December 31, 2022 Equity method investment $ 3,161 $ 3,178

Prepaids and Other Current Asse

Prepaids and Other Current Assets (Notes)	6 Months Ended
	Jun. 30, 2023
Prepaid Expense and Other Assets [Abstract]
Prepaids, other current assets and other noncurrent assets [Text Block]	Prepaid Expenses and Other Current Assets and Other Assets Prepaid expenses and other current assets consist of the following (in thousands): As of June 30, 2023 December 31, 2022 Other prepaid expenses and receivables $ 24,967 $ 21,635 Prepaid vendor expenses 1,305 3,052 Deferred costs 6,432 2,395 Prepaid insurance and property taxes 7,987 16,322 VAT/GST receivable 2,618 3,546 Deferred tax charge 4,984 3,830 Foreign exchange contracts 11,533 4,860 Interest rate contracts 31,702 28,431 Deposits 1,233 1,329 Other 3,022 3,532 $ 95,783 $ 88,932 Other assets consist of the following (in thousands): As of June 30, 2023 December 31, 2022 Pump lease receivables $ 28,091 $ 27,086 Spare parts 41,245 38,498 Equity method investment 3,161 3,178 Deferred debt issuance costs 4,297 5,156 Finance lease right-of-use assets 3,019 2,598 Interest rate contracts 17,229 26,753 Other 2,918 2,193 $ 99,960 $ 105,462

Inventories_

Inventories:	6 Months Ended
	Jun. 30, 2023
Inventory Disclosure [Abstract]
Inventories [Text Block]	Inventories Inventories are stated at the lower of cost or net realizable value with cost determined using the first-in, first-out method. Inventory costs include material, labor and overhead related to the manufacturing of our products. Inventories consist of the following (in thousands): As of June 30, 2023 December 31, 2022 Raw materials $ 298,441 $ 286,964 Work in process 73,110 73,795 Finished goods 403,718 335,250 Total inventories $ 775,269 $ 696,009

Property and Equipment_

Property and Equipment:	6 Months Ended
	Jun. 30, 2023
Property, Plant and Equipment [Abstract]
Property and Equipment [Text Block]	Property, Plant and Equipment Property, plant and equipment consists of the following (in thousands): As of June 30, 2023 December 31, 2022 Machinery and equipment $ 449,210 $ 414,811 Land, building and building improvements 276,062 274,063 Molds 79,845 77,203 Computer equipment and software 120,805 115,214 Furniture and fixtures 30,309 29,876 Instruments placed with customers (1) 107,281 98,481 Construction in progress 127,795 152,909 Total property, plant and equipment, cost 1,191,307 1,162,557 Accumulated depreciation (574,767) (526,444) Property, plant and equipment, net $ 616,540 $ 636,113 ______________________________ (1) Instruments placed with customers consist of drug-delivery and monitoring systems placed with customers under operating leases. Depreciation expense was $24.4 million and $47.8 million for the three and six months ended June 30, 2023, respectively, and $24.9 million and $46.4 million for the three and six months ended June 30, 2022, respectively.

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Notes)	6 Months Ended
	Jun. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets Disclosure [Text Block]	Goodwill and Intangible Assets, Net Goodwill The following table presents the changes in the carrying amount of our goodwill (in thousands): Total Balance as of January 1, 2023 $ 1,449,258 Currency translation 15,220 Balance as of June 30, 2023 $ 1,464,478 Intangible Assets, Net Intangible assets, carried at cost less accumulated amortization and amortized on a straight-lined basis, were as follows (in thousands): Weighted-Average Amortization Life in Years June 30, 2023 Cost Accumulated Net Patents 10 $ 31,434 $ 19,588 $ 11,846 Customer contracts 12 9,975 6,586 3,389 Non-contractual customer relationships 8 552,419 136,133 416,286 Trademarks 1 5,425 5,425 — Trade name 15 18,248 6,555 11,693 Developed technology 10 587,123 138,278 448,845 Non-compete 3 9,100 6,350 2,750 Total amortized intangible assets $ 1,213,724 $ 318,915 $ 894,809 Internally developed software* $ 35,021 $ 35,021 Total intangible assets $ 1,248,745 $ 318,915 $ 929,830 ______________________________ * Internally developed software will be amortized when the projects are complete and the assets are ready for their intended use. Weighted-Average Amortization Life in Years December 31, 2022 Cost Accumulated Net Patents 10 $ 29,998 $ 18,610 $ 11,388 Customer contracts 12 10,026 6,443 3,583 Non-contractual customer relationships 8 546,935 101,556 445,379 Trademarks 1 5,425 5,425 — Trade name 15 18,251 5,959 12,292 Developed technology 10 583,176 108,708 474,468 Non-compete 3 9,100 5,250 3,850 Total amortized intangible assets $ 1,202,911 $ 251,951 $ 950,960 Internally developed software* $ 31,806 $ 31,806 Total intangible assets $ 1,234,717 $ 251,951 $ 982,766 ______________________________ * Internally developed software will be amortized when the projects are complete and the assets are ready for their intended use. Intangible assets with definite lives are amortized on a straight-line basis over their estimated useful lives. Intangible asset amortization expense was $33.1 million and $65.4 million during the three and six months ended June 30, 2023, respectively, and $41.6 million and $73.3 million during the three and six months ended June 30, 2022, respectively. As of June 30, 2023 estimated annual amortization for our intangible assets for each of the next five years is approximately (in thousands): Remainder of 2023 $ 66,435 2024 132,106 2025 124,565 2026 123,879 2027 117,818 2028 109,154 Thereafter 220,852 Total $ 894,809

Accrued Liabilities (Notes)

Accrued Liabilities (Notes)	6 Months Ended
	Jun. 30, 2023
Accrued Liabilities [Abstract]
Accounts Payable and Accrued Liabilities Disclosure [Text Block]	Accrued Liabilities and Other Long-Term Liabilities Accrued liabilities consist of the following (in thousands): As of June 30, 2023 December 31, 2022 Salaries and benefits $ 55,701 $ 44,304 Incentive compensation 27,578 30,254 Operating lease liability-ST 19,187 18,169 Accrued sales taxes 6,043 5,844 Restructuring accrual 4,771 5,923 Deferred revenue 27,686 30,838 Accrued other taxes 3,960 5,794 Accrued professional fees 6,730 5,317 Italy medical device payback provision (2) 22,360 7,900 Legal accrual 2,667 3,137 Distribution fees 14,041 17,063 Warranties and returns 3,530 3,097 Field service corrective action (1) 28,684 24,517 Accrued freight 14,820 17,988 Foreign exchange contracts 3,806 1,847 Accrued research and development 2,211 3,538 Accrued audit fees 7,031 6,279 Defined benefit plan 2,331 2,928 Accrued interest 716 1,033 Other 655 6,999 $ 254,508 $ 242,769 ___________________________ (1) Relates to field service corrective actions associated with certain products in connection with a 2021 Warning Letter received by Smiths Medical from the FDA following an inspection of Smiths Medical’s Oakdale, Minnesota Facility, see Note 19: Commitments and Contingencies for further detail. (2) As of December 31, 2022, there was $12.1 million in payback provision recorded as a reduction to accounts receivable, net. The Company reclassified such amount to accrued liabilities as of June 30, 2023. This amount was not reclassified as of December 31, 2022 to conform to the current year presentation. As of June 30, 2023 December 31, 2022 Operating lease liability-LT $ 59,875 $ 60,916 Benefits 5,084 5,314 Accrued rent 930 997 Finance lease liability-LT 2,134 1,855 Deferred revenue 15,356 16,239 Field service corrective action (1) 22,849 25,294 Other 3,630 3,489 $ 109,858 $ 114,104

Income Taxes_

Income Taxes:	6 Months Ended
	Jun. 30, 2023
Income Tax Disclosure [Abstract]
Income Tax Disclosure [Text Block]	Income Taxes Income taxes were accrued at an estimated effective tax rate of 57% and 46% for the three and six months ended June 30, 2023, respectively, as compared to 56% and 36% for the three and six months ended June 30, 2022, respectively. The effective tax rate for the three and six months ended June 30, 2023 differs from the federal statutory rate of 21% principally because of the effect of the mix of U.S. and foreign incomes, state income taxes, section 162(m) excess compensation, foreign-derived intangible income ("FDII") and tax credits and the following discrete items recognized during the interim period: • Net unrecognized tax benefits resulting primarily from the expiration of statute of limitations during the three and six months ended June 30, 2023 of $6.0 million and $6.0 million, respectively. • Excess tax benefit recognized on stock option exercises and the vesting of restricted stock units during the three and six months ended June 30, 2023 of $0.9 million and $0.2 million, respectively. • The revaluation of the contingent consideration during the three and six months ended June 30, 2023 of $4.0 million and $3.3 million, respectively, resulted in a tax expense of $0.0 million for both periods. The effective tax rate for the three and six months ended June 30, 2022 differs from the federal statutory rate of 21% principally because of the effect of the mix of U.S. and foreign incomes, state income taxes, section 162(m) excess compensation, FDII and tax credits. The effective tax rate during the three and six months ended June 30, 2022 included a discrete tax benefit of $0.0 million and $2.6 million, respectively, related to excess tax benefits recognized on stock option exercises and the vesting of restricted stock units during the period and the revaluation of the contingent consideration during the three and six months ended June 30, 2022 resulted in a tax expense of $0.0 million for both periods.

Long-Term Obligations (Notes)

Long-Term Obligations (Notes)	6 Months Ended
	Jun. 30, 2023
LOng-Term Obligations Disclosure [Abstract]
Long-term Debt [Text Block]	Long-Term Debt 2022 Credit Agreement On January 6, 2022, in connection with the acquisition of Smiths Medical, we entered into a Credit Agreement (the "Credit Agreement") with Wells Fargo Bank, National Association, Wells Fargo Securities, LLC, Barclays Bank PLC and certain other financial institutions (the “Lenders”) for $2.2 billion of senior secured credit facilities. The senior secured credit facilities include (i) a five-year Tranche A term loan of $850.0 million (the "Term Loan A"), (ii) a seven-year Tranche B term loan of $850.0 million (the "Term Loan B") and (iii) a five-year revolving credit facility of $500.0 million (the "Revolving Credit Facility"), with separate sub-limits of $50.0 million for letters of credit and swingline loans (collectively, the "Senior Secured Credit Facilities"). We used the proceeds from borrowings under the Term Loan A and the Term Loan B (collectively, the "Term Loans") to fund a portion of the cash consideration for the purchase of Smiths Medical and the related fees and expenses incurred in connection with the acquisition. We did not incur borrowings under the Revolving Credit Facility on the closing date of the acquisition. The proceeds from any future borrowings under the Revolving Credit Facility may be used for working capital and other general corporate purposes. In connection with entering into the Credit Agreement, during the period ended March 31, 2022, we incurred $37.8 million in debt discount and issuance costs, which were allocated to the Term Loan A, the Term Loan B and the Revolving Credit Facility based on lender commitment amounts relative to each type of fees paid. The lender and third-party discount and issuance costs allocated to the Term Loan A and the Term Loan B were $15.8 million and $13.4 million, respectively, and are reflected as a direct deduction from the face amount of the corresponding term loans on the condensed consolidated balance sheet. These costs are being amortized to interest expense over the respective terms of the loans using the effective interest method. The issuance costs allocated to the Revolving Credit Facility were $8.6 million, which are capitalized and included in prepaid expenses and other current assets and other assets on our condensed consolidated balance sheets. These costs are being amortized to interest expense over the term of the Revolving Credit Facility using the straight-line method. The net funds received from the Term Loan A and the Term Loan B, after deducting debt issuance costs, were $834.2 million and $836.6 million, respectively. Maturity Dates The maturity date for the Term Loan A and the Revolving Credit Facility is January 6, 2027, and the maturity date for the Term Loan B is January 6, 2029. Pursuant to the terms and conditions of the Credit Agreement, the maturity dates of the Term Loans and the Revolving Credit Facility may be extended upon our request, subject to the consent of the Lenders. Interest Rate Terms In general, the Term Loans and borrowings under the Revolving Credit Facility denominated in U.S. dollars bear interest, at our option, on either: (1) the Base Rate, as defined below, plus the applicable margin, as indicated below ("Base Rate Loans") or (2) the Adjusted Term Secured Overnight Financing Rate ("Adjusted Term SOFR"), as defined below, plus the applicable margin, as indicated below ("Term SOFR Loans"). The Base Rate is defined as the highest of (a) the Prime Rate, (b) the Federal Funds Rate plus 0.50% and (c) Adjusted Term SOFR (as defined below) for a one-month period plus, in each case, 1.00%. Adjusted Term SOFR is the rate per annum equal to (a) the Term SOFR plus (b) the Term SOFR Adjustment. Term SOFR is the forward-looking term rate based on SOFR and is calculated separately for Term SOFR Loans and Base Rate Loans, as specified in the Credit Agreement. The Term SOFR Adjustment is a percentage per annum of 0.10% for Base Rate Loans and between 0.10% to 0.25% for Term SOFR Loans based on the applicable interest period. Revolving Credit Facility Commitment Fee The Revolving Credit Facility has a per annum commitment fee at an initial rate of 0.25% which is applied to the available amount of the Revolving Credit Facility. Effective on the first Adjustment Date, as defined in the Credit Agreement, occurring subsequent to our quarter ending June 30, 2022, the commitment fee will be determined by reference to the leverage ratio in effect from time to time as set forth in the table below. Applicable Interest Margins The Term Loan A and borrowings under the Revolving Credit Facility have an initial applicable margin of 0.75% per annum for Base Rate Loans and 1.75% per annum for Term SOFR Loans. Effective on the first Adjustment Date, as defined in the Credit Agreement, occurring subsequent to our quarter ending June 30, 2022, the applicable margin for the Term Loan A and borrowings under the Revolving Credit Facility will be determined by reference to the leverage ratio in effect from time to time as set forth in the following table: Leverage Ratio Applicable Margin for Term SOFR Loans Applicable Margin for Base Rate Loans Commitment Fee Rate Greater than 4.00 to 1.0 2.25% 1.25% 0.35% Less than or equal to 4.00 to 1.0 but greater than 3.00 to 1.0 2.00% 1.00% 0.30% Less than or equal to 3.00 to 1.0 but greater than 2.50 to 1.0 1.75% 0.75% 0.25% Less than or equal to 2.50 to 1.0 but greater than 2.00 to 1.0 1.50% 0.50% 0.20% Less than or equal to 2.00 to 1.0 1.25% 0.25% 0.15% The Term Loan B has an initial applicable margin of 1.5% per annum for Base Rate Loans and 2.5% per annum for Term SOFR Loans. Effective on the first Adjustment Date, as defined in the Credit Agreement, occurring subsequent to our quarter ending June 30, 2022, the applicable margin for the Term Loan B will be determined by reference to the leverage ratio in effect from time to time as set forth in the following table: Leverage Ratio Applicable Margin for Term SOFR Loans Applicable Margin for Base Rate Loans Greater than 2.75 to 1.0 2.50% 1.50% Less than 2.75 to 1.0 2.25% 1.25% Principal Payments Principal payments on the Term Loans are due on the last day of each calendar quarter commencing on June 30, 2022. The Term Loan A will amortize in nineteen consecutive quarterly installments in an amount equal to 2.50% of the original principal amount in each of the first two years, 5.00% in each of the third and fourth years and 7.50% in the fifth year, with a final payment of the remaining outstanding principal balance due on the maturity date. The Term Loan B matures in twenty-seven consecutive quarterly installments in an amount equal to 0.25% of the original principal amount, with a final payment of the remaining outstanding principal balance due on the maturity date. We may borrow, prepay and re-borrow amounts under the Revolving Credit Facility, in accordance with the terms and conditions of the Credit Agreement, with all outstanding amounts due at maturity. During March 2022, we prepaid $16.0 million in principal payments on the Term Loan A principal balance. For the six months ended June 30, 2023 and 2022 total principal payments on both Term Loans were $14.8 million and $18.1 million, respectively. Interest Payments Interest payments on Base Rate Loans are payable quarterly in arrears on the last business day of each calendar quarter and the applicable maturity date. Interest periods on Term SOFR Loans will be determined, at our option, as either one, three or six months and will be payable on the last day of each interest period and the applicable maturity date. In the case of any interest periods of more than three months' duration, the interest payment will be payable on each day prior to the last day of such interest period that occurs at three-month intervals. The commitment fee on the Revolving Credit Facility is payable quarterly in arrears on the third business day following the last day of each calendar quarter and at the maturity date. The commitment fee is included in interest expense in our condensed consolidated statements of operations. Guarantors and Collateral Our obligations under the Credit Agreement are unconditionally guaranteed, on a joint and several basis, by ICU Medical, Inc. and certain of our existing subsidiaries. Debt Covenants The Credit Agreement contains affirmative and negative covenants, including certain financial covenants. The negative covenants include restrictions regarding the incurrence of liens and indebtedness, certain merger and acquisition transactions, asset sales and other dispositions, other investments, dividends, share purchases and payments affecting subsidiaries, changes in nature of business, fiscal year or organizational documents, prepayments and redemptions of subordinated and other junior debt, transactions with affiliates, and other matters. The financial covenants include the Senior Secured Leverage Ratio and the Interest Coverage Ratio, both defined below, and pertain to the Term Loan A and the Revolving Credit Facility. The Senior Secured Leverage Ratio is defined, at any measurement date, as the ratio of: (a) all Funded Debt, as defined in the Credit Agreement, that is secured by a lien on any asset or property minus the lesser of (i) all unrestricted cash and cash equivalents and (ii) $500.0 million, to (b) Consolidated EBITDA, as defined in the Credit Agreement, for the most recently completed four fiscal quarters, calculated on a pro forma basis. The maximum Senior Secured Leverage Ratio is 4.50 to 1.00 until June 30, 2024. Thereafter, the maximum Senior Secured Leverage Ratio is 4.00 to 1.00, with limited permitted exception. The Interest Coverage ratio is defined, at any measurement date, as the ratio of Consolidated EBITDA, as defined in the Credit Agreement, to Consolidated Interest Expense, as defined in the Credit Agreement, paid or payable in cash, for the most recently completed four fiscal quarters. The minimum Interest Coverage ratio is 3.00 to 1.00. We were in compliance with all financial covenants as of June 30, 2023. The Credit Agreement contains customary events of default, including, among others: non-payments of principal and interest; breach of representations and warranties; covenant defaults; cross-defaults and cross-acceleration to certain other material indebtedness; the existence of bankruptcy or insolvency proceedings; certain events under ERISA; material judgments; and a change of control. If an event of default occurs and is not cured within any applicable grace period or is not waived, the administrative agent and the Lenders are entitled to take various actions, including, without limitation, the acceleration of all amounts due and the termination of commitments under the Senior Secured Credit Facilities. 2017 Credit Facility On November 8, 2017, we entered into a five-year senior secured revolving credit facility with various lenders for $150.0 million, with Wells Fargo Bank, National Association as the administrative agent, swingline lender and issuing lender (the "Prior Credit Facility"). The Prior Credit Facility, which was set to mature on November 8, 2022, was terminated in connection with entering into the Credit Agreement on January 6, 2022. The carrying values of our long-term debt consist of the following (in thousands): Effective Interest Rate As of Effective Interest Rate As of Senior Secured Credit Facilities: Term Loan A — principal 7.52 % $ 823,438 3.99 % $ 834,000 Term Loan B — principal 7.86 % 839,375 4.61 % 843,625 Revolving Credit Facility — principal — % — — % — Less unamortized debt issuance costs (1) (21,718) (24,262) Total carrying value of long-term debt 1,641,095 1,653,363 Less current portion of long-term debt 40,375 29,688 Long-term debt, net $ 1,600,720 $ 1,623,675 _______________________________ (1) Comprised of $10.9 million and $10.8 million relating to the Term Loan A and the Term Loan B, respectively, as of June 30, 2023. As of June 30, 2023, the aggregate amount of principal repayments of our long-term debt (including any current portion) for each of the next five years is approximately (in thousands): Remainder of 2023 $ 14,875 2024 51,000 2025 51,000 2026 72,250 2027 672,563 2028 8,500 Thereafter 792,625 Total $ 1,662,813 The following table presents the total interest expense related to our long-term debt (in thousands): Three months ended Six months ended 2023 2022 2023 2022 Contractual interest $ 30,836 $ 12,622 $ 60,099 $ 22,639 Amortization of debt issuance costs 1,703 1,799 3,404 3,442 Commitment fee — Revolving Credit Facility 383 309 751 661 Total long-term debt-related interest expense $ 32,922 $ 14,730 64,254 26,742

Commitments and Contingencies_

Commitments and Contingencies:	6 Months Ended
	Jun. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies [Text Block]	Commitments and Contingencies Legal Proceedings From time to time, we are involved in various legal proceedings, most of which are routine litigation, in the normal course of business. Our management does not believe that the resolution of the unsettled legal proceedings that we are involved with will have a material adverse impact on our financial position or results of operations. Off-Balance Sheet Arrangements In the normal course of business, we have agreed to indemnify our officers and directors to the maximum extent permitted under Delaware law and to indemnify customers as to certain intellectual property matters or other matters related to sales of our products. There is no maximum limit on the indemnification that may be required under these agreements. Although we can provide no assurances, we have never incurred, nor do we expect to incur, any material liability for indemnification. Contingencies On January 6, 2022, we acquired Smiths Medical. Total consideration for the acquisition includes a potential earn-out payment of $100.0 million in cash contingent on our common stock achieving a certain volume-weighted average price from the closing date to either the third or fourth anniversary of closing. As of June 30, 2023, the estimated fair value of the contingent earn-out is $22.6 million (see Note 9: Fair Value Measurements). Prior to being acquired, during 2021, Smiths Medical received a Warning Letter from the FDA following an inspection of Smiths Medical’s Oakdale, Minnesota Facility. The Warning Letter cited, among other things, failures to comply with FDA's medical device reporting requirements and failures to comply with applicable portions of the Quality System Regulation. A provision for the estimated costs related to the field service corrective action was recorded on the opening acquired balance sheet of Smiths Medical in the amount of $55.1 million. The initial estimate recorded was based on a probability-weighted estimate of the costs required to settle the obligation. The actual costs to be incurred are dependent upon the scope of the work necessary to achieve regulatory clearance and could differ from the original estimate. The estimated field service corrective action recorded at June 30, 2023 is $47.4 million. In November 2021, we acquired a small foreign infusion systems supplier. Total consideration for the acquisition included a potential earn-out payment of up to $2.5 million, consisting of (i) a cash payment of $1.0 million contingent on the achievement of certain revenue targets for the annual period ending December 31, 2022 and, separately, (ii) a cash payment of $1.5 million contingent on certain product-related regulatory certifications obtained by May 26, 2024. As of December 31, 2022, the measurement period related to (i) above ended and based on the actual revenue achieved during the measurement period we determined that the fair value of the contingent earn-out was zero as the minimum threshold for earning the earn-out was not met. As of June 30, 2023, the estimated fair value of the contingent earn-out related to certain product-related regulatory certification was estimated to be $1.5 million (see Note 9: Fair Value Measurements). In August 2021, we entered into an agreement with one of our international distributors whereby that distributor would not compete with us in a specific territory for a three-year period that will end in September 2024. The terms of the agreement include a contingent earn-out payment. The contingent earn-out shall not exceed $6.0 million, which will be earned based on certain revenue targets over a twelve-month measurement period determined by the highest four consecutive quarters commencing over a two-year period starting on the closing date of the agreement and provided that the distributor is in compliance with its obligations under the agreement. As of June 30, 2023, the estimated fair value of the contingent earn-out is $4.3 million (see Note 9: Fair Value Measurements). Commitments

Collaborative and Other Arrange

Collaborative and Other Arrangements (Notes)	6 Months Ended
	Jun. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Collaborative Arrangement Disclosure [Text Block]	Collaborative and Other Arrangements    On February 3, 2017, we entered into two Manufacturing and Supply Agreements ("MSAs") whereby (i) Pfizer will manufacture and supply us with certain agreed upon products for an initial five-year term with a one-time two-year option to extend and (ii) we will manufacture and supply Pfizer certain agreed upon products for a term of five or ten years depending on the product, also with a one-time two-year option to extend. The MSAs provide each party with mutually beneficial interests and both of the MSAs are to be jointly managed by both Pfizer and ICU. The initial supply price, which is subject to an annual update, is in full consideration for all costs associated with the manufacture, documentation, packaging and certification of the products. On January 1, 2021, we amended our MSA with Pfizer, whereby we manufacture and supply certain agreed upon products to Pfizer. The amendments included a change to the term of the agreement to end on December 31, 2024 with Pfizer's unilateral election to extend through December 31, 2025. Other changes to the terms of the MSA included (i) amendments to our level of supply of products to Pfizer, (ii) certain changes to our manufacturing lines, (iii) updates to our supply price with added volume price tiers for annual periods and (iv) certain minimum purchase requirements for certain products. On February 1, 2022, effective as of January 1, 2022, upon our request, Pfizer executed a Product Addendum (the "Product Addendum") to our MSA, whereby Pfizer manufactures and supplies to us certain agreed upon products. The Product Addendum includes the supply of additional product to us subject to certain time and pricing terms and conditions. The Product Addendum includes a minimum purchase obligation of $29.6 million and expired on November 30, 2022. As of November 30, 2022, we had satisfied the minimum purchase obligations under the Product Addendum.

Equity

Equity	6 Months Ended
	Jun. 30, 2023
Equity [Abstract]
Stockholders' Equity Note Disclosure	Stockholders' Equity Shareholders Agreement At the completion of the Smiths Medical acquisition on January 6, 2022, Smiths owned approximately 10.5% of the total outstanding shares of our common stock (see Note 3: Acquisitions). At closing, in connection with the issuance of the share consideration, we entered into a Shareholders Agreement (the “Shareholders Agreement”) with Smiths. The Shareholders Agreement imposes certain restrictions on Smiths including prohibiting certain transfers of the shares of our common stock issued (i) for 6 months following the closing of the acquisition and (ii) to certain of our competitors and certain other parties, as well as customary standstill limitations. The Shareholders Agreement also permits Smiths to designate one individual for election to our Board of Directors (the "Board") so long as Smiths beneficially owns at least 5.0% of the total outstanding shares of our common stock. On February 1, 2022, our Board appointed a new director designated by Smiths pursuant to the Shareholders Agreement who was elected to the Board at the 2022 Annual Meeting of Stockholders held in May 2022. This appointment expanded the size of our Board from eight to nine members. See our Current Report on Form 8-K filed on February 1, 2022 for additional information. Treasury Stock In August 2019, our Board approved a share purchase plan to purchase up to $100.0 million of our common stock. This plan has no expiration date. During the three months ended June 30, 2023, we did not purchase any shares of our common stock under our share purchase plan. As of June 30, 2023, all of the $100.0 million available for purchase was remaining under the plan. We are currently limited on share purchases in accordance with the terms and conditions of our Credit Agreement (see Note 17: Long-Term Debt). For the six months ended June 30, 2023, we withheld 54,371 shares of our common stock from employee vested restricted stock units in consideration for $8.7 million in payments made on the employees' behalf for their minimum statutory income tax withholding obligations. For the six months ended June 30, 2022, we withheld 44,759 shares of our common stock from employee vested restricted stock units in consideration for $10.4 million in payments made on the employees' behalf for their minimum statutory income tax withholding obligations. Treasury stock is used to issue shares for stock option exercises and restricted stock grants. Accumulated Other Comprehensive (Loss) Income ("AOCI") The components of AOCI, net of tax, were as follows (in thousands): Foreign Currency Translation Adjustments Unrealized (Losses) Gains on Cash Flow Hedges Other Adjustments Total Balance as of January 1, 2023 $ (122,973) $ 40,779 $ 1,216 $ (80,978) Other comprehensive income (loss) before 24,983 (113) (31) 24,839 Amounts reclassified from AOCI — (5,464) — (5,464) Other comprehensive income (loss) 24,983 (5,577) (31) 19,375 Balance as of March 31, 2023 $ (97,990) $ 35,202 $ 1,185 $ (61,603) Other comprehensive (loss) income before reclassifications 7,569 13,175 (34) 20,710 Amounts reclassified from AOCI — (7,901) — (7,901) Other comprehensive income (loss) 7,569 5,274 (34) 12,809 Balance as of June 30, 2023 $ (90,421) $ 40,476 $ 1,151 $ (48,794) Foreign Currency Translation Adjustments Unrealized (Losses) Gains on Cash Flow Hedges Other Adjustments Total Balance as of January 1, 2022 $ (19,045) $ (237) $ 13 $ (19,269) Other comprehensive (loss) income before (4,946) 25,782 15 20,851 Amounts reclassified from AOCI — (2,210) — (2,210) Other comprehensive (loss) income (4,946) 23,572 15 18,641 Balance as of March 31, 2022 $ (23,991) $ 23,335 $ 28 $ (628) Other comprehensive (loss) income before reclassifications (99,805) 10,245 14 (89,546) Amounts reclassified from AOCI — (2,101) — (2,101) Other comprehensive (loss) income (99,805) 8,144 14 (91,647) Balance as of June 30, 2022 $ (123,796) $ 31,479 $ 42 $ (92,275)

Transfers and Servicing

Transfers and Servicing	6 Months Ended
	Jun. 30, 2023
Transfers and Servicing [Abstract]
Transfers and Servicing of Financial Assets	Accounts Receivable Purchase Program On January 19, 2023, we entered into a revolving $150 million uncommitted receivables purchase agreement with Bank of The West ("BOW") which provides for a less expensive form of capital. The discount rate applied to the sold receivables equals a rate per annum equal to the sum of (i) an applicable margin of 1.75%, plus (ii) Term SOFR for a period equal to the discount period which is calculated with respect to the payment terms of the specific receivable. The accounts receivable sold have payment terms ranging between 30 and 60 days, and are related to customer accounts with good credit history. The transfer of the purchased accounts receivable under the agreement is intended to be an absolute and irrevocable transfer constituting a true sale as the transferred receivables have been isolated beyond the reach of the Company and our creditors, even in bankruptcy or other receivership. We do not retain effective control over the sold receivables and BOW has the right upon purchase to pledge and/or exchange the transferred assets without restrictions. The Company acts as collection agent for BOW and collection services are undertaken by our accounts receivable personnel in their normal course of business and collected funds are remitted to BOW. We do not have any continuing involvement with the sold receivables other than the collection services which does not provide us with more than a trivial benefit. The discount rate has been negotiated net of consideration for the collection services, the cost of collection is immaterial to the Company; therefore, we did not separately record any related servicing assets or liabilities related to the sold receivables. For the six months ended June 30, 2023, the carrying value of trade receivables sold to BOW in connection with the purchase program was $290.3 million. In exchange for the sale of trade receivables, we received cash of $288.6 million. For the three and six months ended June 30, 2023, the sale of the receivables resulted in a loss of $0.9 million and $1.7 million, respectively, recorded in other expense, net in our condensed consolidated statement of operations. For the six months ended June 30, 2023, we have collected and remitted $231.0 million in cash to BOW. As of June 30, 2023, cash remaining to be collected on behalf of BOW was $59.3 million, which has been removed from our condensed consolidated balance sheet as of June 30, 2023 and is reflected as cash provided by operating activities in the condensed consolidated statement of cash flows. There were no such balances at December 31, 2022. The carrying value of the sold receivables approximated the fair value at June 30, 2023.

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2023
Subsequent Events [Abstract]
Subsequent Events [Text Block]	Subsequent EventsDuring July 2023, Pfizer Inc.’s manufacturing plant in Rocky Mount, North Carolina, sustained heavy damage to the warehouse section of the facility and its stored inventory from a tornado. This facility manufactures certain sterile injectable products on behalf of ICU, see Note 20: Collaborative and Other Arrangements. During the six months ended June 30, 2023 and the twelve months ended December 31, 2022, our revenues manufactured at this facility were approximately $7.2 million and $37.6 million,

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022
Pay vs Performance Disclosure
Net Income Attributable to Parent	$ (9,934)	$ (9,812)	$ (7,474)	$ (38,068)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Jun. 30, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Terminated	false

Business Combinations and Ass_2

Business Combinations and Asset Acquisitions (Tables)	3 Months Ended
	Jun. 30, 2023
Business Combination and Asset Acquisition [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following table summarizes the final purchase price and the final allocation of the purchase price related to the assets acquired and liabilities assumed (in thousands): Cash consideration for acquired assets $ 1,922,955 Fair value of contingent consideration payable to Smiths 53,520 Issuance of ICU Medical, Inc. common shares: Number of shares issued to Smiths 2,500 Price per share (ICU's opening market price on the acquisition date) $ 230.39 Fair value of ICU shares issued to Smiths $ 575,975 Total Consideration $ 2,552,450 Purchase Price Allocation: Cash and cash equivalents $ 78,791 Accounts receivable 106,132 Inventories 228,919 Prepaid expenses and other current assets 53,554 Property, plant and equipment 206,333 Operating lease right-of-use assets 55,161 Intangible assets (1) 945,000 Other assets 379 Accounts payable (105,291) Accrued liabilities (2) (173,151) Income tax payable (40,312) Other long-term liabilities (85,490) Deferred income taxes (187,455) Total identifiable net assets acquired $ 1,082,570 Goodwill - not tax deductible 1,469,880 Estimated Purchase Consideration $ 2,552,450 _______________________________ (1) Identifiable intangible assets include $510.0 million of customer relationships, $400.0 million of developed technology, $30.0 million of internally developed software, and $5.0 million of trademark. The estimated weighted-average amortization period for the total identifiable intangible assets is approximately nine eight ten five six (2) Accrued liabilities includes, among other things, accrued warranty reserves, accrued restructuring initiatives, accrued salaries and related benefits, deferred revenue and accrued sales and use taxes.
Business Acquisition, Pro Forma Information	(In thousands) Three months ended June 30, 2022 Six months ended June 30, 2022 Revenues $ 561,004 $ 1,124,823 Net Loss $ (7,474) $ (59,425)

Restructuring, Strategic Tran_2

Restructuring, Strategic Transaction and Integration (Tables)	6 Months Ended
	Jun. 30, 2023
Restructuring and Related Activities [Abstract]
Restructuring and Related Costs [Table Text Block]	The following table summarizes the activity in our restructuring-related accrual by major type of cost (in thousands): Severance Pay and Benefits Retention and Facility Closure Costs Total Accrued balance, January 1, 2023 $ 4,416 $ 1,507 $ 5,923 Charges incurred 2,732 — 2,732 Payments (1,284) — (1,284) Other (1) (291) (620) (911) Currency translation 70 16 86 Accrued balance, March 31, 2023 $ 5,643 $ 903 $ 6,546 Charges incurred 1,290 20 1,310 Payments (3,302) (27) (3,329) Currency translation 227 17 244 Accrued balance, June 30, 2023 $ 3,858 $ 913 $ 4,771 __________________________

Revenue (Tables)

Revenue (Tables)	6 Months Ended
	Jun. 30, 2023
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue [Table Text Block]	The following table represents our revenues disaggregated by geography (in thousands): Three months ended Six months ended Geography 2023 2022 2023 2022 United States $ 347,866 $ 363,866 $ 707,053 $ 711,657 Europe, the Middle East and Africa 89,994 87,415 188,980 173,619 APAC 60,031 60,447 118,655 125,278 Other Foreign 51,419 49,276 103,271 93,572 Total Revenues $ 549,310 $ 561,004 $ 1,117,959 $ 1,104,126
Contract with Customer, Asset and Liability [Table Text Block]	The following table presents the changes in our contract balances for the six months ended June 30, 2023 and 2022 (in thousands): Contract Liabilities Beginning balance, January 1, 2023 $ (45,866) Equipment revenue recognized 16,793 Equipment revenue deferred (16,625) Software revenue recognized 9,041 Software revenue deferred (8,875) Government grant deferred income (944) Government grant recognized* 647 Other deferred revenue (688) Other deferred revenue recognized 3,514 Ending balance, June 30, 2023 $ (43,003) Beginning balance, January 1, 2022 $ (7,461) Fair value of acquired deferred revenue (51,245) Equipment revenue recognized 14,606 Equipment revenue deferred (7,349) Software revenue recognized 8,737 Software revenue deferred (9,067) Government grant deferred income (2,972) Government grant recognized* 232 Other deferred revenue (1,005) Other deferred revenue recognized 2,458 Ending balance, June 30, 2022 $ (53,066)

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
Lease, Cost [Table Text Block]	The following table presents the components of our lease cost (in thousands): Three months ended Six months ended 2023 2022 2023 2022 Operating lease cost $ 6,043 $ 5,475 $ 12,193 $ 10,653 Finance lease cost — interest 31 28 60 57 Finance lease cost — reduction of ROU asset 254 170 479 340 Short-term lease cost 13 3 26 6 Total lease cost $ 6,341 $ 5,676 $ 12,758 $ 11,056
Cash Flow, Supplemental Disclosures [Text Block]	The following table presents the supplemental cash flow information related to our leases (in thousands): Six months ended 2023 2022 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 12,336 $ 12,887 Operating cash flows from finance leases $ 60 $ 57 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 10,153 $ 3,829 Finance leases $ 804 $ 38
Assets and Liabilities, Leases [Table Text Block]	The following table presents the supplemental balance sheet information related to our operating leases (in thousands, except lease term and discount rate): As of June 30, 2023 December 31, 2022 Operating leases Operating lease right-of-use assets $ 76,028 $ 74,864 Accrued liabilities $ 19,187 $ 18,169 Other long-term liabilities 59,875 60,916 Total operating lease liabilities $ 79,062 $ 79,085 Weighted-Average Remaining Lease Term Operating leases 5.9 years 6.1 years Weighted-Average Discount Rate Operating leases 4.32 % 4.34 % The following table presents the supplemental balance sheet information related to our finance leases (in thousands, except lease term and discount rate): As of June 30, 2023 December 31, 2022 Finance leases Finance lease right-of-use assets $ 3,019 $ 2,598 Accrued liabilities $ 979 $ 816 Other long-term liabilities 2,134 1,855 Total finance lease liabilities $ 3,113 $ 2,671 Weighted-Average Remaining Lease Term Finance leases 4.3 years 4.8 years Weighted-Average Discount Rate Finance leases 4.77 % 4.23 %
Lessee, Operating Lease, Liability, Maturity [Table Text Block]	As of June 30, 2023, the maturities of our operating and finance lease liabilities for each of the next five years are approximately (in thousands): Operating Leases Finance Leases Remainder of 2023 $ 11,523 $ 601 2024 20,540 907 2025 15,225 686 2026 13,451 563 2027 9,831 248 2028 14,452 189 Thereafter 3,868 236 Total Lease Payments 88,890 3,430 Less imputed interest (9,828) (317) Total $ 79,062 $ 3,113

Net Income Per Share (Tables)

Net Income Per Share (Tables)	6 Months Ended
	Jun. 30, 2023
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	The following table presents the calculation of net earnings per common share (“EPS”) — basic and diluted (in thousands, except per share data): Three months ended Six months ended 2023 2022 2023 2022 Net loss $ (9,934) $ (7,474) $ (19,746) $ (45,542) Weighted-average number of common shares outstanding (basic) 24,075 23,897 24,045 23,787 Dilutive securities (1) — — — — Weighted-average common and common equivalent shares outstanding (diluted) 24,075 23,897 24,045 23,787 EPS — basic $ (0.41) $ (0.31) $ (0.82) $ (1.91) EPS — diluted $ (0.41) $ (0.31) $ (0.82) $ (1.91) _______________________________ (1) Due to the net loss for the three and six months ended June 30, 2023 and 2022, there are no potentially dilutive common shares included in the computation of diluted earnings per share.

Derivative Financial Instrume_2

Derivative Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Cash Flow Hedging Instruments, Statements of Financial Performance and Financial Position, Location [Table Text Block]	The following table presents the fair values of our derivative instruments included within the Condensed Consolidated Balance Sheets (in thousands): Derivatives Designated as Cash Flow Hedging Instruments Condensed Consolidated Balance Sheet Location Foreign Exchange Contracts Interest Rate Swaps Gross Derivatives As of June 30, 2023 Prepaid expenses and other current assets $ 11,533 $ 31,702 $ 43,235 Other assets 897 17,229 18,126 Total assets $ 12,430 $ 48,931 $ 61,361 Accrued liabilities $ 3,806 $ — $ 3,806 Other long-term liabilities 105 — 105 Total liabilities $ 3,911 $ — $ 3,911 As of December 31, 2022 Prepaid expenses and other current assets $ 4,860 $ 28,431 $ 33,291 Other assets 94 26,753 26,847 Total assets $ 4,954 $ 55,184 $ 60,138 Accrued liabilities $ 1,847 $ — $ 1,847 Other long-term liabilities 167 — 167 Total liabilities $ 2,014 $ — $ 2,014 We recognized the following gains on our derivative instruments designated as cash flow hedges in other comprehensive income before reclassifications to net loss (in thousands): Gain Recognized in Other Comprehensive Income Three months ended Six months ended 2023 2022 2023 2022 Derivatives designated as cash flow hedging instruments: Foreign exchange contracts $ 6,051 $ 5,225 $ 8,503 $ 8,337 Interest rate swaps 11,324 9,146 8,740 39,197 Total derivatives designated as cash flow hedging instruments $ 17,375 $ 14,371 $ 17,243 $ 47,534 The following table presents the effects of our derivative instruments designated as cash flow hedges on the Condensed Consolidated Statements of Operations (in thousands):
Schedule of Cash Flow Hedges Included in Accumulated Other Comprehensive Income (Loss) [Table Text Block]	Gain (Loss) Reclassified From Accumulated Other Comprehensive Loss into Income Three months ended Six months ended Location of Gain (Loss) Recognized in Income 2023 2022 2023 2022 Derivatives designated as cash flow hedging instruments: Foreign exchange contracts Total revenues $ 473 $ 1,813 $ (1,448) $ 4,356 Foreign exchange contracts Cost of goods sold 2,316 1,563 3,816 1,049 Foreign exchange contracts Other expense, net (1) — — 229 — Foreign exchange contracts Interest expense (2) — 5 13 255 Interest rate swaps Interest expense 7,625 (1,524) 14,993 (1,524) Total derivatives designated as cash flow hedging instruments $ 10,414 $ 1,857 $ 17,603 $ 4,136 _______________________________ (1) Represents location of gain reclassified from accumulated other comprehensive loss into income as a result of ineffectiveness. (2) Represents location of gain reclassified from accumulated other comprehensive loss into income as a result of forecasted transactions no longer probable of occurring.

Fair Value Measures and Discl_2

Fair Value Measures and Disclosures (Tables)	6 Months Ended
	Jun. 30, 2023
Fair Value Disclosures [Abstract]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation	The following tables provide a reconciliation of the Level 3 earn-out liabilities measured at estimated fair value (in thousands): Earn-out Liability Accrued balance, January 1, 2023 $ 25,572 Change in fair value of earn-out (included in income from operations as a separate line item) (1) (700) Currency translation 33 Accrued balance, March 31, 2023 24,905 Change in fair value of earn-out (included in income from operations as a separate line item) (2) 4,016 Other 11 Currency translation 1 Accrued balance, June 30, 2023 $ 28,933 Earn-out Liability Accrued balance, January 1, 2022 $ 2,589 Acquisition date fair value estimate of earn-out (3) 55,158 Currency translation (46) Accrued balance, March 31, 2022 57,701 Change in fair value of earn-out (included in income from operations as a separate line item) (1) (27,194) Currency translation (98) Accrued balance, June 30, 2022 $ 30,409 _______________________________ (1) Primarily relates to Smiths Medical. (2) $2.3 million relates to Smiths Medical and $1.7 million relates to the earn-out in connection with our acquisition of a small foreign infusions systems supplier. (3) $53.5 million relates to our acquisition of Smiths Medical and $1.6 million relates to our acquisition of a small foreign infusions systems supplier in the fourth quarter of 2021 (see Note 3: Acquisitions).
Fair Value Measurement Inputs and Valuation Techniques	The following tables provide quantitative information about Level 3 inputs for fair value measurement of our earn-out liabilities related to Smiths Medical: Smiths Medical Earn-out Liability Simulation Input As of As of Volatility 34.00 % 38.00 % Risk-Free Rate 4.62 % 4.17 %
Fair Value, by Balance Sheet Grouping	Our assets and liabilities measured at fair value on a recurring basis consisted of the following Level 1, 2 and 3 inputs as defined above (in thousands): Fair value measurements as of June 30, 2023 Total carrying Quoted prices Significant Significant Assets: Available-for-sale debt securities: Short-term corporate bonds $ 1,313 $ — $ 1,313 $ — Short-term government bonds 499 — 499 — Foreign exchange contracts: Prepaid expenses and other current assets 11,533 — 11,533 — Other assets 897 — 897 — Interest rate contracts: Prepaid expenses and other current assets 31,702 — 31,702 — Other assets 17,229 — 17,229 — Total Assets $ 63,173 $ — $ 63,173 $ — Liabilities: Contingent earn-out liability - ST $ 1,989 $ — $ — $ 1,989 Contingent earn-out liability - LT 26,944 — — 26,944 Foreign exchange contracts: Accrued liabilities 3,806 — 3,806 — Other long-term liabilities 105 — 105 — Total Liabilities $ 32,844 $ — $ 3,911 $ 28,933 Fair value measurements as of December 31, 2022 Total carrying Quoted prices Significant Significant Assets: Available-for-sale debt securities: Short-term corporate bonds $ 2,314 $ — $ 2,314 $ — Short-term U.S. treasury securities 1,412 1,412 — — Short-term government bonds 498 — 498 — Long-term corporate bonds 516 — 516 — Foreign exchange forwards: Prepaid expenses and other current assets 4,860 — 4,860 — Other assets 94 — 94 — Interest rate contracts: Prepaid expenses and other current assets 28,431 — 28,431 — Other assets 26,753 — 26,753 — Total Assets $ 64,878 $ 1,412 $ 63,466 $ — Liabilities: Contingent earn-out liability - LT $ 25,572 $ — $ — $ 25,572 Foreign exchange contracts: Accrued liabilities 1,847 — 1,847 — Other long-term liabilities 167 — 167 — Total Liabilities $ 27,586 $ — $ 2,014 $ 25,572

Investment Securities (Tables)

Investment Securities (Tables)	6 Months Ended
	Jun. 30, 2023
Investments, Debt and Equity Securities [Abstract]
Schedule of Available-for-sale Securities Reconciliation [Table Text Block]	Our short-term and long-term investments in available-for-sale securities consist of the following (in thousands): As of June 30, 2023 Amortized Cost Unrealized Holding Fair Value Short-term corporate bonds $ 1,313 $ — $ 1,313 Short-term government bonds 499 — 499 Total investment securities $ 1,812 $ — $ 1,812 As of December 31, 2022 Amortized Cost Unrealized Holding Fair Value Short-term corporate bonds $ 2,314 $ — $ 2,314 Short-term U.S. treasury securities 1,412 — 1,412 Short-term government bonds 498 — 498 Long-term corporate bonds 516 — 516 Total investment securities $ 4,740 $ — $ 4,740
Equity Method Investments [Table Text Block]	Our non-marketable equity method investment consists of the following (in thousands): As of June 30, 2023 December 31, 2022 Equity method investment $ 3,161 $ 3,178

Prepaids and Other Current As_2

Prepaids and Other Current Assets (Tables)	6 Months Ended
	Jun. 30, 2023
Prepaid Expense and Other Assets [Abstract]
Prepaid Expenses and Other Current Assets [Table Text Block]	Prepaid expenses and other current assets consist of the following (in thousands): As of June 30, 2023 December 31, 2022 Other prepaid expenses and receivables $ 24,967 $ 21,635 Prepaid vendor expenses 1,305 3,052 Deferred costs 6,432 2,395 Prepaid insurance and property taxes 7,987 16,322 VAT/GST receivable 2,618 3,546 Deferred tax charge 4,984 3,830 Foreign exchange contracts 11,533 4,860 Interest rate contracts 31,702 28,431 Deposits 1,233 1,329 Other 3,022 3,532 $ 95,783 $ 88,932
Schedule of Other Assets, Noncurrent[TableTextBlock]	Other assets consist of the following (in thousands): As of June 30, 2023 December 31, 2022 Pump lease receivables $ 28,091 $ 27,086 Spare parts 41,245 38,498 Equity method investment 3,161 3,178 Deferred debt issuance costs 4,297 5,156 Finance lease right-of-use assets 3,019 2,598 Interest rate contracts 17,229 26,753 Other 2,918 2,193 $ 99,960 $ 105,462

Inventories (Tables)

Inventories (Tables)	6 Months Ended
	Jun. 30, 2023
Inventory Disclosure [Abstract]
Schedule of Inventory, Current [Table Text Block]	Inventories consist of the following (in thousands): As of June 30, 2023 December 31, 2022 Raw materials $ 298,441 $ 286,964 Work in process 73,110 73,795 Finished goods 403,718 335,250 Total inventories $ 775,269 $ 696,009

Property and Equipment (Tables)

Property and Equipment (Tables)	6 Months Ended
	Jun. 30, 2023
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment [Table Text Block]	Property, plant and equipment consists of the following (in thousands): As of June 30, 2023 December 31, 2022 Machinery and equipment $ 449,210 $ 414,811 Land, building and building improvements 276,062 274,063 Molds 79,845 77,203 Computer equipment and software 120,805 115,214 Furniture and fixtures 30,309 29,876 Instruments placed with customers (1) 107,281 98,481 Construction in progress 127,795 152,909 Total property, plant and equipment, cost 1,191,307 1,162,557 Accumulated depreciation (574,767) (526,444) Property, plant and equipment, net $ 616,540 $ 636,113

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill [Table Text Block]	The following table presents the changes in the carrying amount of our goodwill (in thousands): Total Balance as of January 1, 2023 $ 1,449,258 Currency translation 15,220 Balance as of June 30, 2023 $ 1,464,478
Schedule of Intangible Assets and Goodwill [Table Text Block]	Intangible assets, carried at cost less accumulated amortization and amortized on a straight-lined basis, were as follows (in thousands): Weighted-Average Amortization Life in Years June 30, 2023 Cost Accumulated Net Patents 10 $ 31,434 $ 19,588 $ 11,846 Customer contracts 12 9,975 6,586 3,389 Non-contractual customer relationships 8 552,419 136,133 416,286 Trademarks 1 5,425 5,425 — Trade name 15 18,248 6,555 11,693 Developed technology 10 587,123 138,278 448,845 Non-compete 3 9,100 6,350 2,750 Total amortized intangible assets $ 1,213,724 $ 318,915 $ 894,809 Internally developed software* $ 35,021 $ 35,021 Total intangible assets $ 1,248,745 $ 318,915 $ 929,830 ______________________________ * Internally developed software will be amortized when the projects are complete and the assets are ready for their intended use. Weighted-Average Amortization Life in Years December 31, 2022 Cost Accumulated Net Patents 10 $ 29,998 $ 18,610 $ 11,388 Customer contracts 12 10,026 6,443 3,583 Non-contractual customer relationships 8 546,935 101,556 445,379 Trademarks 1 5,425 5,425 — Trade name 15 18,251 5,959 12,292 Developed technology 10 583,176 108,708 474,468 Non-compete 3 9,100 5,250 3,850 Total amortized intangible assets $ 1,202,911 $ 251,951 $ 950,960 Internally developed software* $ 31,806 $ 31,806 Total intangible assets $ 1,234,717 $ 251,951 $ 982,766
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]	As of June 30, 2023 estimated annual amortization for our intangible assets for each of the next five years is approximately (in thousands): Remainder of 2023 $ 66,435 2024 132,106 2025 124,565 2026 123,879 2027 117,818 2028 109,154 Thereafter 220,852 Total $ 894,809

Accrued Liabilities (Tables)

Accrued Liabilities (Tables)	6 Months Ended
	Jun. 30, 2023
Accrued Liabilities [Abstract]
Schedule of Accrued Liabilities [Table Text Block]	Accrued liabilities consist of the following (in thousands): As of June 30, 2023 December 31, 2022 Salaries and benefits $ 55,701 $ 44,304 Incentive compensation 27,578 30,254 Operating lease liability-ST 19,187 18,169 Accrued sales taxes 6,043 5,844 Restructuring accrual 4,771 5,923 Deferred revenue 27,686 30,838 Accrued other taxes 3,960 5,794 Accrued professional fees 6,730 5,317 Italy medical device payback provision (2) 22,360 7,900 Legal accrual 2,667 3,137 Distribution fees 14,041 17,063 Warranties and returns 3,530 3,097 Field service corrective action (1) 28,684 24,517 Accrued freight 14,820 17,988 Foreign exchange contracts 3,806 1,847 Accrued research and development 2,211 3,538 Accrued audit fees 7,031 6,279 Defined benefit plan 2,331 2,928 Accrued interest 716 1,033 Other 655 6,999 $ 254,508 $ 242,769 ___________________________ (1) Relates to field service corrective actions associated with certain products in connection with a 2021 Warning Letter received by Smiths Medical from the FDA following an inspection of Smiths Medical’s Oakdale, Minnesota Facility, see Note 19: Commitments and Contingencies for further detail. (2) As of December 31, 2022, there was $12.1 million in payback provision recorded as a reduction to accounts receivable, net. The Company reclassified such amount to accrued liabilities as of June 30, 2023. This amount was not reclassified as of December 31, 2022 to conform to the current year presentation. As of June 30, 2023 December 31, 2022 Operating lease liability-LT $ 59,875 $ 60,916 Benefits 5,084 5,314 Accrued rent 930 997 Finance lease liability-LT 2,134 1,855 Deferred revenue 15,356 16,239 Field service corrective action (1) 22,849 25,294 Other 3,630 3,489 $ 109,858 $ 114,104

Long-Term Obligations (Tables)

Long-Term Obligations (Tables)	3 Months Ended
	Jun. 30, 2023
LOng-Term Obligations Disclosure [Abstract]
Schedule of Long-term Debt Instruments	The carrying values of our long-term debt consist of the following (in thousands): Effective Interest Rate As of Effective Interest Rate As of Senior Secured Credit Facilities: Term Loan A — principal 7.52 % $ 823,438 3.99 % $ 834,000 Term Loan B — principal 7.86 % 839,375 4.61 % 843,625 Revolving Credit Facility — principal — % — — % — Less unamortized debt issuance costs (1) (21,718) (24,262) Total carrying value of long-term debt 1,641,095 1,653,363 Less current portion of long-term debt 40,375 29,688 Long-term debt, net $ 1,600,720 $ 1,623,675 _______________________________ (1) Comprised of $10.9 million and $10.8 million relating to the Term Loan A and the Term Loan B, respectively, as of June 30, 2023.
Schedule of Maturities of Long-term Debt	As of June 30, 2023, the aggregate amount of principal repayments of our long-term debt (including any current portion) for each of the next five years is approximately (in thousands): Remainder of 2023 $ 14,875 2024 51,000 2025 51,000 2026 72,250 2027 672,563 2028 8,500 Thereafter 792,625 Total $ 1,662,813
Interest expense on long term debt	The following table presents the total interest expense related to our long-term debt (in thousands): Three months ended Six months ended 2023 2022 2023 2022 Contractual interest $ 30,836 $ 12,622 $ 60,099 $ 22,639 Amortization of debt issuance costs 1,703 1,799 3,404 3,442 Commitment fee — Revolving Credit Facility 383 309 751 661 Total long-term debt-related interest expense $ 32,922 $ 14,730 64,254 26,742
Applicable Margin Based on Leverage Ratio	Effective on the first Adjustment Date, as defined in the Credit Agreement, occurring subsequent to our quarter ending June 30, 2022, the applicable margin for the Term Loan A and borrowings under the Revolving Credit Facility will be determined by reference to the leverage ratio in effect from time to time as set forth in the following table: Leverage Ratio Applicable Margin for Term SOFR Loans Applicable Margin for Base Rate Loans Commitment Fee Rate Greater than 4.00 to 1.0 2.25% 1.25% 0.35% Less than or equal to 4.00 to 1.0 but greater than 3.00 to 1.0 2.00% 1.00% 0.30% Less than or equal to 3.00 to 1.0 but greater than 2.50 to 1.0 1.75% 0.75% 0.25% Less than or equal to 2.50 to 1.0 but greater than 2.00 to 1.0 1.50% 0.50% 0.20% Less than or equal to 2.00 to 1.0 1.25% 0.25% 0.15%

Equity (Tables)

Equity (Tables)	6 Months Ended
	Jun. 30, 2023
Equity [Abstract]
Schedule of Accumulated Other Comprehensive Income (Loss)	The components of AOCI, net of tax, were as follows (in thousands): Foreign Currency Translation Adjustments Unrealized (Losses) Gains on Cash Flow Hedges Other Adjustments Total Balance as of January 1, 2023 $ (122,973) $ 40,779 $ 1,216 $ (80,978) Other comprehensive income (loss) before 24,983 (113) (31) 24,839 Amounts reclassified from AOCI — (5,464) — (5,464) Other comprehensive income (loss) 24,983 (5,577) (31) 19,375 Balance as of March 31, 2023 $ (97,990) $ 35,202 $ 1,185 $ (61,603) Other comprehensive (loss) income before reclassifications 7,569 13,175 (34) 20,710 Amounts reclassified from AOCI — (7,901) — (7,901) Other comprehensive income (loss) 7,569 5,274 (34) 12,809 Balance as of June 30, 2023 $ (90,421) $ 40,476 $ 1,151 $ (48,794) Foreign Currency Translation Adjustments Unrealized (Losses) Gains on Cash Flow Hedges Other Adjustments Total Balance as of January 1, 2022 $ (19,045) $ (237) $ 13 $ (19,269) Other comprehensive (loss) income before (4,946) 25,782 15 20,851 Amounts reclassified from AOCI — (2,210) — (2,210) Other comprehensive (loss) income (4,946) 23,572 15 18,641 Balance as of March 31, 2022 $ (23,991) $ 23,335 $ 28 $ (628) Other comprehensive (loss) income before reclassifications (99,805) 10,245 14 (89,546) Amounts reclassified from AOCI — (2,101) — (2,101) Other comprehensive (loss) income (99,805) 8,144 14 (91,647) Balance as of June 30, 2022 $ (123,796) $ 31,479 $ 42 $ (92,275)

Business Combinations and Ass_3

Business Combinations and Asset Acquisitions Foreign Infusion Distributor(Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2023
Business Acquisition [Line Items]
Payments to Acquire Businesses, Gross		$ 1,922,955
Contingent Consideration, Gross ST	$ 1,000
Contingent Consideration, Gross LT	1,500
Foreign Infusion System Supplier
Business Acquisition [Line Items]
contingent consideration gross	$ 2,500

Business Combinations and Ass_4

Business Combinations and Asset Acquisitions (Details) - USD ($) shares in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022	[1]
Business Acquisition [Line Items]
Contingent Earn-Out Liability, Noncurrent	$ 26,944,000	$ 26,944,000		$ 25,572,000
Minimum Stock Price Target for Earn-out Payment	$ 300	$ 300
Required Share Holding Of Stock Issued At Acquisition	0.500	0.500
Related Party Transaction, Purchases from Related Party	$ 3,900,000	$ 7,900,000
related party open payables	$ 1,000,000	$ 1,000,000
SmithsMedical
Business Acquisition [Line Items]
Business Acquisition, Percentage of Voting Interests Acquired	100%	100%
Business Combination, Consideration Transferred, Cash	$ 1,900,000,000	$ 1,900,000,000
Contingent Earn-Out Liability, Noncurrent	$ 100,000,000	$ 100,000,000
Business Acquisition, Equity Interest Issued or Issuable, Number of Shares		2,500	2,500
[1]December 31, 2022 balances were derived from audited consolidated financial statements.

Business Combinations and Ass_5

Business Combinations and Asset Acquisitions Smiths Medical (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Mar. 31, 2022	Jun. 30, 2023	Jun. 30, 2022
Business Acquisition [Line Items]
Payments to Acquire Businesses, Gross			$ 1,922,955
Business Combination, Consideration Transferred, Liabilities Incurred		$ 55,158
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life			9 years
Customer Relationships
Business Acquisition [Line Items]
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life			8 years
Technology-Based Intangible Assets
Business Acquisition [Line Items]
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life			10 years
Software Development
Business Acquisition [Line Items]
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life			5 years
Trademarks [Member]
Business Acquisition [Line Items]
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life			6 years
SmithsMedical
Business Acquisition [Line Items]
Business Combination, Consideration Transferred, Liabilities Incurred		$ 53,500	$ 53,520
Business Acquisition, Equity Interest Issued or Issuable, Number of Shares			2,500	2,500
Business Acquisition, Share Price	$ 230.39		$ 230.39
Business Acquisition, Equity Interest Issued or Issuable, Value Assigned	$ 575,975		$ 575,975
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Cash and Equivalents	78,791		78,791
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Receivables	106,132		106,132
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Inventory	228,919		228,919
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Prepaid Expense and Other Assets	53,554		53,554
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Property, Plant, and Equipment	206,333		206,333
business combination, recognized identifiable asset acquired and liability assumed,	55,161		55,161
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles	945,000		945,000
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Other Noncurrent Assets	379		379
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities, Accounts Payable	105,291		105,291
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Liabilities	173,151		173,151
Business Combinations, Identified Assumed Liabilities Recognized, Income tax payable	(40,312)		(40,312)
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Noncurrent Liabilities, Other	(85,490)		(85,490)
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Deferred Tax Liabilities	(187,455)		(187,455)
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Net	1,082,570		1,082,570
Business combination, goodwill- non deductible	1,469,880		1,469,880
Business Combination, Consideration Transferred	2,552,450		2,552,450
SmithsMedical | Customer Relationships
Business Acquisition [Line Items]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles	510,000		510,000
SmithsMedical | developed technology
Business Acquisition [Line Items]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles	400,000		400,000
SmithsMedical | Trademarks and Trade Names
Business Acquisition [Line Items]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles	5,000		5,000
SmithsMedical | Software and Software Development Costs
Business Acquisition [Line Items]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles	$ 30,000		$ 30,000

Business Combinations and Ass_6

Business Combinations and Asset Acquisitions Smiths Medical Pro Forma (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Business Combination and Asset Acquisition [Abstract]
Business Acquisition, Pro Forma Revenue			$ 1,124,823	$ 561,004
Business Acquisition [Line Items]
Revenues	$ 549,310	$ 561,004	1,117,959	1,104,126
Net (Loss) Income	(9,934)	(7,474)	(19,746)	(45,542)
Pro Forma Adjustment - Amortization		1,300		55,500
Pro Forma Adjustment - Finance Costs		800		25,400
Business Acquisition, Pro Forma Net Income (Loss)	$ (7,474)		$ (59,425)
Pro Forma Adjustment - Amortization		1,300		55,500
Pro Forma Adjustment - Finance Costs		800		25,400
SmithsMedical
Business Acquisition [Line Items]
Revenues		222,900		437,800
Net (Loss) Income		$ 26,000		$ 65,500

Restructuring, Strategic Tran_3

Restructuring, Strategic Transaction and Integration Restructuring (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Restructuring and Related Activities [Abstract]
Restructuring, strategic transaction and integration	$ 12,400	$ 13,500	$ 23,400	$ 47,400
Restructuring Costs	$ 1,300	$ 1,700	$ 4,000	$ 4,900

Restructuring, Strategic Tran_4

Restructuring, Strategic Transaction and Integration Liability (Details) - USD ($) $ in Thousands	3 Months Ended
	Jun. 30, 2023	Mar. 31, 2023
Restructuring Cost and Reserve [Line Items]
Restructuring Reserve	$ 6,546	$ 5,923
Restructuring Charges	1,310	2,732
Payments for Restructuring	3,329	1,284
Restructuring Reserve, Foreign Currency Translation Gain (Loss)	(244)	(86)
Restructuring Reserve	4,771	6,546
Restructuring Reserve, Accrual Adjustment		(911)
Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring Reserve	5,643	4,416
Restructuring Charges	1,290	2,732
Payments for Restructuring	3,302	1,284
Restructuring Reserve, Foreign Currency Translation Gain (Loss)	(227)	(70)
Restructuring Reserve	3,858	5,643
Restructuring Reserve, Accrual Adjustment		(291)
Facility Closing [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring Reserve	903	1,507
Restructuring Charges	20	0
Payments for Restructuring	27	0
Restructuring Reserve, Foreign Currency Translation Gain (Loss)	(17)	(16)
Restructuring Reserve	$ 913	903
Restructuring Reserve, Accrual Adjustment		$ (620)

Strategic Transaction and Integ

Strategic Transaction and Integration (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Restructuring and Related Activities [Abstract]
Strategic Transaction and Integration	$ 11.1	$ 11.8	$ 19.4	$ 42.5

Revenue (Details)

Revenue (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Disaggregation of Revenue [Line Items]
Revenues	$ 549,310,000	$ 561,004,000	$ 1,117,959,000	$ 1,104,126,000
Customer Concentration Risk
Disaggregation of Revenue [Line Items]
Revenues			0.15
Infusion Systems [Member]
Disaggregation of Revenue [Line Items]
Revenues	$ 153,142,000	$ 148,644,000	$ 314,855,000	$ 286,871,000

Revenue Disaggregated Revenue b

Revenue Disaggregated Revenue by Geography (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Disaggregation of Revenue [Line Items]
Revenues	$ 549,310	$ 561,004	$ 1,117,959	$ 1,104,126
EMEA [Member]
Disaggregation of Revenue [Line Items]
Revenues	89,994	87,415	188,980	173,619
UNITED STATES
Disaggregation of Revenue [Line Items]
Revenues	347,866	363,866	707,053	711,657
Asia Pacific
Disaggregation of Revenue [Line Items]
Revenues	60,031	60,447	118,655	125,278
Other foreign countries [Member]
Disaggregation of Revenue [Line Items]
Revenues	$ 51,419	$ 49,276	$ 103,271	$ 93,572

Revenue Disaggregated Revenue_2

Revenue Disaggregated Revenue by Product Line (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Disaggregation of Revenue [Line Items]
Revenues	$ 549,310	$ 561,004	$ 1,117,959	$ 1,104,126
Infusion Consumables [Member]
Disaggregation of Revenue [Line Items]
Revenues	236,976	240,995	473,098	481,184
Infusion Systems [Member]
Disaggregation of Revenue [Line Items]
Revenues	153,142	148,644	314,855	286,871
Vital Care
Disaggregation of Revenue [Line Items]
Revenues	$ 159,192	$ 171,365	$ 330,006	$ 336,071

Revenue Contract Liabilities (D

Revenue Contract Liabilities (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Movement in Deferred Revenue [Roll Forward]
Contract with Customer, Liability	$ (45,866)	$ (7,461)
Contract with Customer, Liability	(43,003)	(53,066)
Short Term
Movement in Deferred Revenue [Roll Forward]
Revenue, Remaining Performance Obligation, Amount	(27,648)
Long Term
Movement in Deferred Revenue [Roll Forward]
Revenue, Remaining Performance Obligation, Amount	(15,355)
SmithsMedical
Movement in Deferred Revenue [Roll Forward]
Contract with Customer, Liability		(51,245)
Equipment revenue [Member]
Movement in Deferred Revenue [Roll Forward]
Increase (Decrease) in Deferred Revenue	16,793	14,606
Deferred Revenue, Additions	(16,625)	(7,349)
Equipment revenue [Member] | Short Term
Movement in Deferred Revenue [Roll Forward]
Revenue, Remaining Performance Obligation, Amount	(15,605)
Equipment revenue [Member] | Long Term
Movement in Deferred Revenue [Roll Forward]
Revenue, Remaining Performance Obligation, Amount	(790)
Software revenue [Member]
Movement in Deferred Revenue [Roll Forward]
Increase (Decrease) in Deferred Revenue	9,041	8,737
Deferred Revenue, Additions	(8,875)	(9,067)
Software revenue [Member] | Short Term
Movement in Deferred Revenue [Roll Forward]
Revenue, Remaining Performance Obligation, Amount	(8,001)
Software revenue [Member] | Long Term
Movement in Deferred Revenue [Roll Forward]
Revenue, Remaining Performance Obligation, Amount	(699)
Government Grant Revenue
Movement in Deferred Revenue [Roll Forward]
Increase (Decrease) in Deferred Revenue	647	232
Deferred Revenue, Additions	(944)	(2,972)
Government Grant Revenue | Short Term
Movement in Deferred Revenue [Roll Forward]
Revenue, Remaining Performance Obligation, Amount	(1,451)
Government Grant Revenue | Long Term
Movement in Deferred Revenue [Roll Forward]
Revenue, Remaining Performance Obligation, Amount	(13,064)
Other deferred revenue
Movement in Deferred Revenue [Roll Forward]
Increase (Decrease) in Deferred Revenue	3,514	2,458
Deferred Revenue, Additions	(688)	$ (1,005)
Other deferred revenue | Short Term
Movement in Deferred Revenue [Roll Forward]
Revenue, Remaining Performance Obligation, Amount	(2,591)
Other deferred revenue | Long Term
Movement in Deferred Revenue [Roll Forward]
Revenue, Remaining Performance Obligation, Amount	$ (802)

Leases Text (Details)

Leases Text (Details)	6 Months Ended
	Jun. 30, 2023
Lessee, Lease, Description [Line Items]
Lessee, Operating Lease, Option to Extend	5 years
Maximum [Member]
Lessee, Lease, Description [Line Items]
Lessee, Operating Lease, Term of Contract	15 years
Minimum [Member]
Lessee, Lease, Description [Line Items]
Lessee, Operating Lease, Term of Contract	1 year

Leases (Details)

Leases (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Leases [Abstract]
Operating Lease, Cost	$ 6,043	$ 5,475	$ 12,193	$ 10,653
Finance Lease, Interest Expense	31	28	60	57
Finance Lease, Right-of-Use Asset, Amortization	254	170	479	340
Short-term Lease, Cost	13	3	26	6
Lease, Cost	$ 6,341	$ 5,676	$ 12,758	$ 11,056

Leases Cash Flow, Operating Act

Leases Cash Flow, Operating Activities, Lessee (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Leases [Abstract]
Operating Lease, Payments	$ 12,336	$ 12,887
Finance Lease, Interest Payment on Liability	60	57
Right-of-Use Asset Obtained in Exchange for Operating Lease Liability	10,153	3,829
Right-of-Use Asset Obtained in Exchange for Finance Lease Liability	$ 804	$ 38

Leases Assets and Liabilities,

Leases Assets and Liabilities, Lessee (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Leases [Abstract]
Operating Lease, Right-of-Use Asset	$ 76,028	$ 74,864	[1]
Operating Lease, Liability, Current	19,187	18,169
Operating Lease, Liability, Noncurrent	59,875	60,916
Operating Lease, Liability	$ 79,062	$ 79,085
Operating Lease, Weighted Average Remaining Lease Term	5 years 10 months 24 days	6 years 1 month 6 days
Operating Lease, Weighted Average Discount Rate, Percent	4.32%	4.34%
Finance Lease, Right-of-Use Asset	$ 3,019	$ 2,598
Finance Lease, Liability, Current	979	816
Finance Lease, Liability, Noncurrent	2,134	1,855
Finance Lease, Liability	$ 3,113	$ 2,671
Finance Lease, Weighted Average Remaining Lease Term	4 years 3 months 18 days	4 years 9 months 18 days
Finance Lease, Weighted Average Discount Rate, Percent	4.77%	4.23%
[1]December 31, 2022 balances were derived from audited consolidated financial statements.

Leases Maturity (Details)

Leases Maturity (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Leases [Abstract]
Lessee, Operating Lease, Liability, Payments, Remainder of Fiscal Year	$ 11,523
Lessee, Operating Lease, Liability, Payments, Due Next Twelve Months	20,540
Lessee, Operating Lease, Liability, Payments, Due Year Two	15,225
Lessee, Operating Lease, Liability, Payments, Due Year Three	13,451
Lessee, Operating Lease, Liability, Payments, Due Year Four	9,831
Lessee, Operating Lease, Liability, Payments, Due Year Five	14,452
Lessee, Operating Lease, Liability, Payments, Due after Year Five	3,868
Lessee, Operating Lease, Liability, Payments, Due	88,890
Lessee, Operating Lease, Liability, Undiscounted Excess Amount	(9,828)
Operating Lease, Liability	79,062	$ 79,085
Finance Lease, Liability, Payments, Remainder of Fiscal Year	601
Finance Lease, Liability, Payments, Due Next Twelve Months	907
Finance Lease, Liability, Payments, Due Year Two	686
Finance Lease, Liability, Payments, Due Year Three	563
Finance Lease, Liability, Payments, Due Year Four	248
Finance Lease, Liability, Payments, Due Year Five	189
Finance Lease, Liability, Payments, Due after Year Five	236
Finance Lease, Liability, Payment, Due	3,430
Finance Lease, Liability, Undiscounted Excess Amount	(317)
Finance Lease, Liability	$ 3,113	$ 2,671

Net Income Per Share (Details)

Net Income Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Net (Loss) Income	$ (9,934)	$ (7,474)	$ (19,746)	$ (45,542)
Weighted average number of common shares outstanding (for basic calculation)	24,075	23,897	24,045	23,787
Dilutive securities	0	0	0	0
Diluted (in shares)	24,075	23,897	24,045	23,787
EPS - basic	$ (0.41)	$ (0.31)	$ (0.82)	$ (1.91)
Diluted (In dollars per share)	$ (0.41)	$ (0.31)	$ (0.82)	$ (1.91)

Net Income Per Share (Details 1

Net Income Per Share (Details 1) - $ / shares shares in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Earnings Per Share [Abstract]
Dilutive securities	0	0	0	0
Diluted (in shares)	24,075	23,897	24,045	23,787
Basic (in dollars per share)	$ (0.41)	$ (0.31)	$ (0.82)	$ (1.91)
Diluted (in dollars per share)	$ (0.41)	$ (0.31)	$ (0.82)	$ (1.91)

Derivative Financial Instrume_3

Derivative Financial Instruments Foreign Exchange Forward Contracts(Details)	Jun. 30, 2023 USD ($)
Derivative [Line Items]
Derivative, Notional Amount	$ 176,700,000
other currencies
Derivative [Line Items]
Derivative, Notional Amount	4,100,000
Mexico, Pesos
Derivative [Line Items]
Derivative, Notional Amount	45,900,000
Euro Member Countries, Euro
Derivative [Line Items]
Derivative, Notional Amount	30,400,000
Czech Republic, Koruny
Derivative [Line Items]
Derivative, Notional Amount	8,600,000
Japan, Yen
Derivative [Line Items]
Derivative, Notional Amount	18,400,000
China, Yuan Renminbi
Derivative [Line Items]
Derivative, Notional Amount	7,900,000
Canada, Dollars
Derivative [Line Items]
Derivative, Notional Amount	18,000,000
Australia, Dollars
Derivative [Line Items]
Derivative, Notional Amount	13,200,000
United States of America, Dollars
Derivative [Line Items]
Derivative, Notional Amount	$ 30,300,000

Derivative Financial Instrume_4

Derivative Financial Instruments (Details)	Jun. 30, 2023 USD ($)	Dec. 31, 2022 MXN ($)
Derivative [Line Items]
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	$ 7,700,000
Derivative, Notional Amount	176,700,000
Mexico, Pesos
Derivative [Line Items]
Derivative, Notional Amount	45,900,000
China, Yuan Renminbi
Derivative [Line Items]
Derivative, Notional Amount	$ 7,900,000
Hedge 2 [Member]
Derivative [Line Items]
Derivative, Forward Exchange Rate	21.60
Derivative Asset, Notional Amount		$ 208,200,000

Derivative Financial Instrume_5

Derivative Financial Instruments Interest Rate Swaps (Details)	Jun. 30, 2023 USD ($)
Derivative [Line Items]
Derivative, Notional Amount	$ 176,700,000
Interest Rate Swap | Term Loan A
Derivative [Line Items]
Derivative, Notional Amount	300,000,000
Interest Rate Swap Ending Notional Value	$ 150,000,000
Derivative, Fixed Interest Rate	1.32%
derivative variable rate floor	(0.0015)
Interest Rate Swap | Term Loan B
Derivative [Line Items]
Derivative, Notional Amount	$ 750,000,000
Interest Rate Swap Ending Notional Value	$ 46,900,000
Derivative, Fixed Interest Rate	1.17%
derivative variable rate floor	0.0035
Interest Rate Swap | Swap 3 - Term Loan A & B
Derivative [Line Items]
Derivative, Notional Amount	$ 300,000,000
Interest Rate Swap | Swap 3
Derivative [Line Items]
Derivative, Fixed Interest Rate	3.88%

Derivative Financial Instrume_6

Derivative Financial Instruments Derivative Instruments and Hedging Activities - FV of Derivative Instruments Included Within Consolidated Balance Sheet (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Derivatives, Fair Value [Line Items]
Derivative Asset	$ 61,361	$ 60,138
Derivative Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accrued liabilities	Accrued liabilities
Derivative Asset, Current	$ 43,235	$ 33,291
Derivative Asset, Noncurrent	18,126	26,847
Derivative Liability, Current	$ 3,806	$ 1,847
Derivative Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other long-term liabilities	Other long-term liabilities
Derivative Liability, Noncurrent	$ 105	$ 167
Derivative Liability	$ 3,911	$ 2,014
Derivative Asset, Current, Statement of Financial Position [Extensible Enumeration]	Prepaid expenses and other current assets	Prepaid expenses and other current assets
Derivative Asset, Noncurrent, Statement of Financial Position [Extensible Enumeration]	OTHER ASSETS	OTHER ASSETS
Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Derivative Asset	$ 12,430	$ 4,954
Derivative Asset, Current	11,533	4,860
Derivative Asset, Noncurrent	897	94
Derivative Liability, Current	3,806	1,847
Derivative Liability, Noncurrent	105	167
Derivative Liability	3,911	2,014
Interest Rate Swap
Derivatives, Fair Value [Line Items]
Derivative Asset	48,931	55,184
Derivative Asset, Current	31,702	28,431
Derivative Asset, Noncurrent	17,229	26,753
Derivative Liability, Current	0	0
Derivative Liability, Noncurrent	0	0
Derivative Liability	$ 0	$ 0

Derivative Financial Instrume_7

Derivative Financial Instruments Derivative Instruments and Hedging Activities - Cash Flow Hedge Activity Included in Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Other Comprehensive Income (Loss), before Tax	$ 17,375	$ 14,371	$ 17,243	$ 47,534
Foreign Exchange Contract
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Other Comprehensive Income (Loss), before Tax	6,051	5,225	8,503	8,337
Interest Rate Swap
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Other Comprehensive Income (Loss), before Tax	$ 11,324	$ 9,146	$ 8,740	$ 39,197

Derivative Financial Instrume_8

Derivative Financial Instruments Derivative Instruments and Hedging Activities - Amounts Affecting Consolidated Statements of Income (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Derivative Instruments, Gain (Loss) [Line Items]
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	$ 7,700		$ 7,700
Interest Rate Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net	32,700		32,700
Derivative, Net Hedge Ineffectiveness Gain (Loss)	0		229	$ 0
Cash Flow Hedging [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments, Gain Reclassified from Accumulated OCI into Income, Effective Portion	10,414	$ 1,857
Derivative Instruments, Gain (Loss) Reclassified from Accumulated OCI into Income, Effective Portion, Net			17,603	4,136
Foreign Exchange Contract | Cash Flow Hedging [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Gain on Discontinuation of Cash Flow Hedge Due to Forecasted Transaction Probable of Not Occurring	0	5	$ 13	255
Derivative Instrument, Gain (Loss) Reclassified from AOCI into Income, Effective Portion, Statement of Income or Comprehensive Income [Extensible Enumeration]			Revenue from Contract with Customer, Excluding Assessed Tax
Foreign Exchange Contract | Trading Revenue | Cash Flow Hedging [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments, Gain (Loss) Reclassified from Accumulated OCI into Income, Effective Portion, Net	(473)	(1,813)	$ (1,448)	4,356
Foreign Exchange Contract | Cost of Sales [Member] | Cash Flow Hedging [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments, Gain (Loss) Reclassified from Accumulated OCI into Income, Effective Portion, Net	(2,316)	(1,563)	$ 3,816	1,049
Derivative Instrument, Gain (Loss) Reclassified from AOCI into Income, Effective Portion, Statement of Income or Comprehensive Income [Extensible Enumeration]			Cost of goods sold
Interest Rate Swap | Cash Flow Hedging [Member]
Derivative Instruments, Gain (Loss) [Line Items]
Derivative Instruments, Loss Reclassified from Accumulated OCI into Income, Effective Portion		$ (1,524)		$ (1,524)
Derivative Instruments, Gain (Loss) Reclassified from Accumulated OCI into Income, Effective Portion, Net	$ (7,625)		$ 14,993
Derivative Instrument, Gain (Loss) Reclassified from AOCI into Income, Effective Portion, Statement of Income or Comprehensive Income [Extensible Enumeration]			Interest Expense

Fair Value Measures and Discl_3

Fair Value Measures and Disclosures (Details) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2023 USD ($)	Jun. 30, 2023 USD ($)	Dec. 31, 2022 USD ($)	Mar. 31, 2022 USD ($)	Jan. 06, 2022 USD ($)	Dec. 31, 2021 USD ($)
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
CONTINGENT EARN-OUT LIABILITY	$ 28,933	$ 28,933	$ 25,572	$ 24,905
Contingent Consideration, Gross ST	1,000
Contingent Consideration, Gross LT	$ 1,500
Ownership requirement for Earnout Payment	0.500	0.500
Liability
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
contingent consideration gross		$ 6,000
CONTINGENT EARN-OUT LIABILITY	$ 4,300	4,300
SmithsMedical
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
contingent consideration gross	100,000
Business Combination, Contingent Consideration, Liability	22,600	22,600			$ 53,500
Foreign Infusion System Supplier
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
contingent consideration gross	2,500
CONTINGENT EARN-OUT LIABILITY						$ 2,589
Business Combination, Contingent Consideration, Liability	$ 1,500	$ 1,500

Fair Value Measures and Discl_4

Fair Value Measures and Disclosures Liabilities Recurring Basis Unobservable Input Reconciliation Roll Forward (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2023	Dec. 31, 2022	Dec. 31, 2021
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
CONTINGENT EARN-OUT LIABILITY	$ 28,933			$ 24,905	$ 28,933	$ 25,572
Fair Value, Liability, Recurring Basis, Still Held, Unrealized Gain (Loss)		$ (700)
Business Combination, Contingent Consideration, Other change in amount	11
Business Combination, Consideration Transferred, Liabilities Incurred				55,158
Currency translation on earn-out	1	$ 33	$ (98)	(46)
Foreign Infusion System Supplier
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
CONTINGENT EARN-OUT LIABILITY							$ 2,589
Fair Value, Liability, Recurring Basis, Still Held, Unrealized Gain (Loss)	1,700
Business Combination, Consideration Transferred, Liabilities Incurred				1,600
SmithsMedical
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Fair Value, Liability, Recurring Basis, Still Held, Unrealized Gain (Loss)	2,300		(27,194)
Business Combination, Consideration Transferred, Liabilities Incurred				53,500	$ 53,520
Smiths Medical & Foreign Infusion Systems Supplier
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
CONTINGENT EARN-OUT LIABILITY			$ 30,409	$ 57,701
Fair Value, Liability, Recurring Basis, Still Held, Unrealized Gain (Loss)	$ 4,016

Fair Value Measures and Discl_5

Fair Value Measures and Disclosures Liability Measurement Inputs (Details) - SmithsMedical	Jun. 30, 2023	Jan. 06, 2022
Measurement Input, Risk Free Interest Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Business Combination, Contingent Consideration, Liability, Measurement Input	0.0462	0.0417
Measurement Input, Price Volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Business Combination, Contingent Consideration, Liability, Measurement Input	0.3400	0.3800

Fair Value Measures and Discl_6

Fair Value Measures and Disclosures Assets and Liabilities by Balance Sheet Grouping (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022		Jun. 30, 2022
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Short-term investment securities	$ 1,812	$ 4,224	[1]
Long-term investment securities	0	516
Assets, Fair Value Disclosure	$ 63,173	$ 64,878
Derivative Asset, Current, Statement of Financial Position [Extensible Enumeration]	Prepaid expenses and other current assets	Prepaid expenses and other current assets
Derivative Asset, Noncurrent, Statement of Financial Position [Extensible Enumeration]	OTHER ASSETS	OTHER ASSETS
Derivative Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accrued liabilities	Accrued liabilities
Derivative Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other long-term liabilities	Other long-term liabilities
current
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	$ 11,533	$ 4,860
Interest Rate Derivative Assets, at Fair Value	31,702			$ 28,431
Foreign Currency Contracts, Liability, Fair Value Disclosure	3,806	1,847
noncurrent
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	897			94
Interest Rate Derivative Assets, at Fair Value	17,229			26,753
Foreign Currency Contracts, Liability, Fair Value Disclosure	105	167
Corporate Bond Securities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Short-term investment securities	1,313	2,314
US Treasury Securities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Short-term investment securities		1,412
US Government Debt Securities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Short-term investment securities	499	498		498
Earn-out liability [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Nonfinancial Liabilities Fair Value Disclosure	26,944	25,572
Liabilities, Total [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Nonfinancial Liabilities Fair Value Disclosure		27,586
Financial Liabilities Fair Value Disclosure	32,844
Earn-out liability ST
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Nonfinancial Liabilities Fair Value Disclosure	1,989
Prepaid Expenses and Other Current Assets [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	11,533	4,860
Interest Rate Derivative Assets, at Fair Value	31,702	28,431
Fair Value, Inputs, Level 1 [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term investment securities		0
Assets, Fair Value Disclosure	0	1,412
Fair Value, Inputs, Level 1 [Member] | current
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	0	0
Interest Rate Derivative Assets, at Fair Value	0			0
Foreign Currency Contracts, Liability, Fair Value Disclosure	0	0
Fair Value, Inputs, Level 1 [Member] | noncurrent
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	0			0
Interest Rate Derivative Assets, at Fair Value	0			0
Foreign Currency Contracts, Liability, Fair Value Disclosure	0	0
Fair Value, Inputs, Level 1 [Member] | Corporate Bond Securities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Short-term investment securities	0	0
Fair Value, Inputs, Level 1 [Member] | US Treasury Securities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Short-term investment securities		1,412
Fair Value, Inputs, Level 1 [Member] | US Government Debt Securities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Short-term investment securities	0			0
Fair Value, Inputs, Level 1 [Member] | Earn-out liability [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Nonfinancial Liabilities Fair Value Disclosure	0	0
Fair Value, Inputs, Level 1 [Member] | Liabilities, Total [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Nonfinancial Liabilities Fair Value Disclosure		0
Financial Liabilities Fair Value Disclosure	0
Fair Value, Inputs, Level 1 [Member] | ST Earnout Liability
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Nonfinancial Liabilities Fair Value Disclosure	0
Fair Value, Inputs, Level 2 [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term investment securities		516
Assets, Fair Value Disclosure	63,173	63,466
Fair Value, Inputs, Level 2 [Member] | current
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	11,533	4,860
Interest Rate Derivative Assets, at Fair Value	31,702			28,431
Foreign Currency Contracts, Liability, Fair Value Disclosure	3,806	1,847
Fair Value, Inputs, Level 2 [Member] | noncurrent
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	897			94
Interest Rate Derivative Assets, at Fair Value	17,229			26,753
Foreign Currency Contracts, Liability, Fair Value Disclosure	105	167
Fair Value, Inputs, Level 2 [Member] | Corporate Bond Securities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Short-term investment securities	1,313	2,314
Fair Value, Inputs, Level 2 [Member] | US Treasury Securities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Short-term investment securities		0
Fair Value, Inputs, Level 2 [Member] | US Government Debt Securities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Short-term investment securities	499			498
Fair Value, Inputs, Level 2 [Member] | Earn-out liability [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Nonfinancial Liabilities Fair Value Disclosure	0	0
Fair Value, Inputs, Level 2 [Member] | Liabilities, Total [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Nonfinancial Liabilities Fair Value Disclosure		2,014
Financial Liabilities Fair Value Disclosure	3,911
Fair Value, Inputs, Level 2 [Member] | ST Earnout Liability
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Nonfinancial Liabilities Fair Value Disclosure	0
Fair Value, Inputs, Level 3 [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term investment securities		0
Assets, Fair Value Disclosure	0	0
Fair Value, Inputs, Level 3 [Member] | current
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	0	0
Interest Rate Derivative Assets, at Fair Value	0			0
Foreign Currency Contracts, Liability, Fair Value Disclosure	0	0
Fair Value, Inputs, Level 3 [Member] | noncurrent
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	0			0
Interest Rate Derivative Assets, at Fair Value	0			0
Foreign Currency Contracts, Liability, Fair Value Disclosure	0	0
Fair Value, Inputs, Level 3 [Member] | Corporate Bond Securities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Short-term investment securities	0	0
Fair Value, Inputs, Level 3 [Member] | US Treasury Securities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Short-term investment securities		0
Fair Value, Inputs, Level 3 [Member] | US Government Debt Securities
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Short-term investment securities	0			$ 0
Fair Value, Inputs, Level 3 [Member] | Earn-out liability [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Nonfinancial Liabilities Fair Value Disclosure	26,944	25,572
Fair Value, Inputs, Level 3 [Member] | Liabilities, Total [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Nonfinancial Liabilities Fair Value Disclosure		$ 25,572
Financial Liabilities Fair Value Disclosure	28,933
Fair Value, Inputs, Level 3 [Member] | ST Earnout Liability
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Nonfinancial Liabilities Fair Value Disclosure	$ 1,989
[1]December 31, 2022 balances were derived from audited consolidated financial statements.

Investment Securities (Details)

Investment Securities (Details) $ in Millions	6 Months Ended
	Jun. 30, 2023 USD ($)
Investments, Debt and Equity Securities [Abstract]
Gain (Loss) on Sale of Investments	$ 0

Investment Securities Table (De

Investment Securities Table (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Mar. 31, 2023	Jun. 30, 2023	Dec. 31, 2022		Jun. 30, 2022
Debt Securities, Available-for-sale [Line Items]
Debt Securities, Available-for-sale, Amortized Cost		$ 1,812	$ 4,740
Debt Securities, Available-for-sale, Unrealized Loss	$ 0	0
Short-term investment securities		1,812	4,224	[1]
Long-term investment securities		0	516
Debt Securities, Available-for-sale		1,812	4,740
Corporate Debt Securities
Debt Securities, Available-for-sale [Line Items]
Debt Securities, Available-for-sale, Amortized Cost, Current		1,313	2,314
Debt Securities, Available-for-sale, Noncurrent			516
Debt Securities, Available-for-sale, Unrealized Loss	0	0
Short-term investment securities		1,313	2,314
Long-term investment securities			516
US Treasury Securities
Debt Securities, Available-for-sale [Line Items]
Debt Securities, Available-for-sale, Amortized Cost, Current			1,412
Debt Securities, Available-for-sale, Unrealized Loss	0
Short-term investment securities			1,412
US Government Debt Securities
Debt Securities, Available-for-sale [Line Items]
Debt Securities, Available-for-sale, Amortized Cost, Current		499	498
Debt Securities, Available-for-sale, Unrealized Loss	$ 0	0
Short-term investment securities		$ 499	$ 498		$ 498
[1]December 31, 2022 balances were derived from audited consolidated financial statements.

Equity Method Investments (Deta

Equity Method Investments (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Equity Securities without Readily Determinable Fair Value [Line Items]
Equity Method Investment, Aggregate Cost	$ 3,300
Equity Method Investments	$ 3,161	$ 3,178
Non Public Company
Equity Securities without Readily Determinable Fair Value [Line Items]
Equity Method Investment, Ownership Percentage	20%

Prepaids and Other Current As_3

Prepaids and Other Current Assets Prepaids and Other Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Prepaid Expense and Other Assets [Abstract]
Other Prepaid Expense, Current	$ 24,967	$ 21,635
Prepaid vendor expenses	1,305	3,052
Deferred Costs and Other Assets	6,432	2,395
Prepaid insurance and property taxes	7,987	16,322
Prepaid Taxes	2,618	3,546
Deferred tax charge	4,984	3,830
Deposit Assets	1,233	1,329
Other Assets, Current	3,022	3,532
Prepaid expenses and other current assets	95,783	88,932	[1]
Prepaid Expenses and Other Current Assets [Member]
Prepaid Expense and Other Assets [Abstract]
Foreign Currency Contract, Asset, Fair Value Disclosure	11,533	4,860
Interest Rate Derivative Assets, at Fair Value	31,702	28,431
Derivative [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	$ 11,533	$ 4,860
[1]December 31, 2022 balances were derived from audited consolidated financial statements.

Other Assets Noncurrent(Details

Other Assets Noncurrent(Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Derivative [Line Items]
Derivative Asset, Noncurrent	$ 18,126	$ 26,847
Lessor, Operating Lease, Payments to be Received	28,091	27,086
Spare parts	41,245	38,498
Equity Method Investments	3,161	3,178
Debt Issuance Costs, Noncurrent, Net	4,297	5,156
Finance Lease, Right-of-Use Asset	3,019	2,598
Derivative Asset, Noncurrent	18,126	26,847
Other Assets, Miscellaneous, Noncurrent	2,918	2,193
OTHER ASSETS	99,960	105,462	[1]
Interest Rate Swap
Derivative [Line Items]
Derivative Asset, Noncurrent	17,229	26,753
Derivative Asset, Noncurrent	$ 17,229	$ 26,753
[1]December 31, 2022 balances were derived from audited consolidated financial statements.

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Inventory Disclosure [Abstract]
Inventory, Raw Materials, Net of Reserves	$ 298,441	$ 286,964
Inventory, Work in Process, Net of Reserves	73,110	73,795
Inventory, Finished Goods, Net of Reserves	403,718	335,250
Total	$ 775,269	$ 696,009	[1]
[1]December 31, 2022 balances were derived from audited consolidated financial statements.

Property and Equipment (Details

Property and Equipment (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 1,191,307	$ 1,162,557
Accumulated depreciation	(574,767)	(526,444)
Net property and equipment	616,540	636,113	[1]
Machinery and Equipment, Gross	449,210	414,811
Furniture and Fixtures, Gross	30,309	29,876
Construction in Progress, Gross	127,795	152,909
Land, Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	276,062	274,063
Molds [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	79,845	77,203
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	120,805	115,214
Instruments Placed with Customers [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 107,281	$ 98,481
[1]December 31, 2022 balances were derived from audited consolidated financial statements.

Property and Equipment Text (De

Property and Equipment Text (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Property, Plant and Equipment [Abstract]
Depreciation	$ 24.4	$ 24.9	$ 47.8	$ 46.4

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets Goodwill Table (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Dec. 31, 2022	[1]
Goodwill and Intangible Assets Disclosure [Abstract]
GOODWILL	$ 1,464,478	$ 1,449,258
Goodwill, Foreign Currency Translation Gain (Loss)	$ 15,220
[1]December 31, 2022 balances were derived from audited consolidated financial statements.

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets Intangibles Table (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Assets, Gross	$ 1,213,724	$ 1,202,911
Finite-Lived Intangible Assets, Accumulated Amortization	318,915	251,951
Finite-Lived Intangible Assets, Net	894,809	950,960
Indefinite-lived Intangible Assets (Excluding Goodwill)	35,021	31,806
Intangible Assets, Gross (Excluding Goodwill)	1,248,745	1,234,717
INTANGIBLE ASSETS, net	$ 929,830	$ 982,766	[1]
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Asset, Useful Life	10 years	10 years
Finite-Lived Intangible Assets, Gross	$ 31,434	$ 29,998
Finite-Lived Intangible Assets, Accumulated Amortization	19,588	18,610
Finite-Lived Intangible Assets, Net	$ 11,846	$ 11,388
Customer Contracts [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Asset, Useful Life	12 years	12 years
Finite-Lived Intangible Assets, Gross	$ 9,975	$ 10,026
Finite-Lived Intangible Assets, Accumulated Amortization	6,586	6,443
Finite-Lived Intangible Assets, Net	$ 3,389	$ 3,583
Customer-Related Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Asset, Useful Life	8 years	8 years
Finite-Lived Intangible Assets, Gross	$ 552,419	$ 546,935
Finite-Lived Intangible Assets, Accumulated Amortization	136,133	101,556
Finite-Lived Intangible Assets, Net	$ 416,286	$ 445,379
Trademarks [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Asset, Useful Life	1 year	1 year
Finite-Lived Intangible Assets, Gross	$ 5,425	$ 5,425
Finite-Lived Intangible Assets, Accumulated Amortization	5,425	5,425
Finite-Lived Intangible Assets, Net	$ 0	$ 0
Trade Names [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Asset, Useful Life	15 years	15 years
Finite-Lived Intangible Assets, Gross	$ 18,248	$ 18,251
Finite-Lived Intangible Assets, Accumulated Amortization	6,555	5,959
Finite-Lived Intangible Assets, Net	$ 11,693	$ 12,292
Developed Technology Rights [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Asset, Useful Life	10 years	10 years
Finite-Lived Intangible Assets, Gross	$ 587,123	$ 583,176
Finite-Lived Intangible Assets, Accumulated Amortization	138,278	108,708
Finite-Lived Intangible Assets, Net	$ 448,845	$ 474,468
Noncompete Agreements [Member]
Finite-Lived Intangible Assets [Line Items]
Finite-Lived Intangible Asset, Useful Life	3 years	3 years
Finite-Lived Intangible Assets, Gross	$ 9,100	$ 9,100
Finite-Lived Intangible Assets, Accumulated Amortization	6,350	5,250
Finite-Lived Intangible Assets, Net	$ 2,750	$ 3,850
[1]December 31, 2022 balances were derived from audited consolidated financial statements.

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets Text (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization of Intangible Assets	$ 33,100,000	$ 41,600,000	$ 65,400,000	$ 73,300,000

Goodwill and Intangible Asset_6

Goodwill and Intangible Assets 5-Year Amortization (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Finite-Lived Intangible Assets, Amortization Expense, Next Twelve Months	$ 66,435
Finite-Lived Intangible Assets, Amortization Expense, Next Twelve Months	132,106
Finite-Lived Intangible Assets, Amortization Expense, Year Two	124,565
Finite-Lived Intangible Assets, Amortization Expense, Year Four	123,879
Finite-Lived Intangible Assets, Amortization Expense, Year Five	117,818
Finite-Lived Intangible Assets, Amortization Expense, Year Five	109,154
Finite-Lived Intangible Assets, Amortization Expense, after Year Five	220,852
Finite-Lived Intangible Assets, Net	$ 894,809	$ 950,960

Accrued Liabilities (Details)

Accrued Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022		Jan. 06, 2022
Accrued Liabilities [Abstract]
Salaries and benefits	$ 55,701	$ 44,304
Incentive compensation	27,578	30,254
Operating Lease, Liability, Current	19,187	18,169
Sales taxes	6,043	5,844
Restructuring accrual	4,771	5,923
UnfavorablecontractliabilityST	27,686	30,838
Accrued other taxes	3,960	5,794
Accrued Professional Fees	6,730	5,317
Legal accrual	2,667	3,137
Distribution Fees	14,041	17,063
Warranties and returns	3,530	3,097
Field service corrective action	28,684	24,517
Accrued freight	14,820	17,988
Derivative Liability, Current	3,806	1,847
Other	655	6,999
Accrued liabilities	254,508	242,769	[1]
Liability, Defined Benefit Plan, Current	2,331	2,928
Accrued audit fees	7,031	6,279
Derivative [Line Items]
Derivative Liability, Current	3,806	1,847
Product Liability Contingency [Line Items]
Product Liability Accrual, Component Amount	47,400			$ 55,100
Interest Payable	716	1,033
accrued research and development	2,211	3,538
Accrued liability Italy payment scheme	22,360	7,900
Contra AR - Italy Payment Scheme		12,100
Foreign Exchange
Accrued Liabilities [Abstract]
Derivative Liability, Current	3,806	1,847
Derivative [Line Items]
Derivative Liability, Current	$ 3,806	$ 1,847
[1]December 31, 2022 balances were derived from audited consolidated financial statements.

Accrued Liabilities Long-term l

Accrued Liabilities Long-term liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022	Jan. 06, 2022
Accrued Liabilities [Abstract]
Operating Lease, Liability, Noncurrent	$ 59,875	$ 60,916
Accrued Employee Benefits	5,084	5,314
Accrued Rent	930	997
Derivative Liability, Noncurrent	105	167
Finance Lease, Liability, Noncurrent	2,134	1,855
Other Accrued Liabilities, Noncurrent	3,630	3,489
OTHER LONG-TERM LIABILITIES	109,858	114,104
Product Liability Accrual, Component Amount	47,400		$ 55,100
Product Liability Contingency [Line Items]
Product Liability Accrual, Component Amount	47,400		$ 55,100
Contract with Customer, Liability, Noncurrent	15,356	16,239
Derivative [Line Items]
Derivative Liability, Noncurrent	105	167
Long Term
Accrued Liabilities [Abstract]
Product Liability Accrual, Component Amount	22,849	25,294
Product Liability Contingency [Line Items]
Product Liability Accrual, Component Amount	$ 22,849	$ 25,294

Income Taxes Effective tax rate

Income Taxes Effective tax rate (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Business Acquisition, Contingent Consideration [Line Items]
Change in fair value of contingent earn-out	$ 4,016	$ (27,194)	$ 3,316	$ (27,194)
Share-based Payment Arrangement, Expense, Tax Benefit	900	$ 0	$ 200	2,600
contingent consideration, tax expense	$ 0			$ 0
Effective Income Tax Rate	57%	56%	46%	36%
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent			21%	21%
Share-based Payment Arrangement, Expense, Tax Benefit	$ 900	$ 0	$ 200	$ 2,600
contingent consideration, tax expense	0			$ 0
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	6,000		6,000
SmithsMedical
Business Acquisition, Contingent Consideration [Line Items]
Change in fair value of contingent earn-out	$ 4,000		$ 3,300

Long-Term Obligations (Details)

Long-Term Obligations (Details) - USD ($) $ in Thousands	3 Months Ended
	Jun. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
TotalSeniorSecuredCreditFacility	$ 2,200,000
Long-term Debt, Gross	1,662,813
Revolver Sub limits	50,000
Debt Issuance Costs, Gross	37,800
Leverage Ratio Calculation Ceiling Subtracted Amount	500,000
Term Loan A
Debt Instrument [Line Items]
Proceeds from Issuance of Debt	850,000
Long-term Debt, Gross	823,438	$ 834,000
Debt Issuance Costs, Gross	15,800
Long-term Debt	$ 834,200
Debt Instrument, Maturity Date	Jan. 06, 2027
Term Loan B
Debt Instrument [Line Items]
Proceeds from Issuance of Debt	$ 850,000
Long-term Debt, Gross	839,375	$ 843,625
Debt Issuance Costs, Gross	13,400
Long-term Debt	$ 836,600
Debt Instrument, Maturity Date	Jan. 06, 2029
Revolving Credit Facility
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 500,000
Debt Issuance Costs, Gross	$ 8,600

Long-Term Obligations Interest

Long-Term Obligations Interest Rate Terms (Details)	3 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Interest Percentage Added to Federal Funds Rate	0.0050
Interest Percentage Added to Base Rate	0.0100
Ter SOFR Interest Rate % Adjustment for Base Rate Loans	0.0010
Line of Credit Facility, Commitment Fee Percentage	0.25%
Applicable Margin Based on Leverage Ratio [Line Items]
Line of Credit Facility, Commitment Fee Percentage	0.25%
Maximum [Member]
Debt Disclosure [Abstract]
Term SOFR Adjustment Interest Rate Adjustment Term SOFR Loans	0.0025
Applicable Margin Based on Leverage Ratio [Line Items]
Term SOFR Adjustment Interest Rate Adjustment Term SOFR Loans	0.0025
Minimum [Member]
Debt Disclosure [Abstract]
Term SOFR Adjustment Interest Rate Adjustment Term SOFR Loans	0.0010
Applicable Margin Based on Leverage Ratio [Line Items]
Term SOFR Adjustment Interest Rate Adjustment Term SOFR Loans	0.0010
greaterthan 4to1
Debt Disclosure [Abstract]
Line of Credit Facility, Commitment Fee Percentage	0.35%
Applicable Margin Based on Leverage Ratio [Line Items]
Line of Credit Facility, Commitment Fee Percentage	0.35%
lessthan4to1butgreaterthan3to1
Debt Disclosure [Abstract]
Line of Credit Facility, Commitment Fee Percentage	0.30%
Applicable Margin Based on Leverage Ratio [Line Items]
Line of Credit Facility, Commitment Fee Percentage	0.30%
lessthanorequal3to1butgreaterthan2point5to1
Debt Disclosure [Abstract]
Line of Credit Facility, Commitment Fee Percentage	0.25%
Applicable Margin Based on Leverage Ratio [Line Items]
Line of Credit Facility, Commitment Fee Percentage	0.25%
lessthanorequalto2point5to1butgreaterthan2to1
Debt Disclosure [Abstract]
Line of Credit Facility, Commitment Fee Percentage	0.20%
Applicable Margin Based on Leverage Ratio [Line Items]
Line of Credit Facility, Commitment Fee Percentage	0.20%
lessthanorequalto2to1
Debt Disclosure [Abstract]
Line of Credit Facility, Commitment Fee Percentage	0.15%
Applicable Margin Based on Leverage Ratio [Line Items]
Line of Credit Facility, Commitment Fee Percentage	0.15%
Term Loan A
Debt Disclosure [Abstract]
Applicable Margin Base Rate Loans	0.0075
Applicable Margin Term SOFR Loans	0.0175
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin Base Rate Loans	0.0075
Applicable Margin Term SOFR Loans	0.0175
Term Loan A | greaterthan 4to1
Debt Disclosure [Abstract]
Applicable Margin Base Rate Loans	0.0125
Applicable Margin Term SOFR Loans	0.0225
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin Base Rate Loans	0.0125
Applicable Margin Term SOFR Loans	0.0225
Term Loan A | lessthan4to1butgreaterthan3to1
Debt Disclosure [Abstract]
Applicable Margin Base Rate Loans	0.0100
Applicable Margin Term SOFR Loans	0.0200
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin Base Rate Loans	0.0100
Applicable Margin Term SOFR Loans	0.0200
Term Loan A | lessthanorequal3to1butgreaterthan2point5to1
Debt Disclosure [Abstract]
Applicable Margin Base Rate Loans	0.0075
Applicable Margin Term SOFR Loans	0.0175
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin Base Rate Loans	0.0075
Applicable Margin Term SOFR Loans	0.0175
Term Loan A | lessthanorequalto2point5to1butgreaterthan2to1
Debt Disclosure [Abstract]
Applicable Margin Base Rate Loans	0.0050
Applicable Margin Term SOFR Loans	0.0150
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin Base Rate Loans	0.0050
Applicable Margin Term SOFR Loans	0.0150
Term Loan A | lessthanorequalto2to1
Debt Disclosure [Abstract]
Applicable Margin Base Rate Loans	0.0025
Applicable Margin Term SOFR Loans	0.0125
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin Base Rate Loans	0.0025
Applicable Margin Term SOFR Loans	0.0125
Term Loan B
Debt Disclosure [Abstract]
Applicable Margin Base Rate Loans	0.015
Applicable Margin Term SOFR Loans	0.025
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin Base Rate Loans	0.015
Applicable Margin Term SOFR Loans	0.025
Term Loan B | greaterthan2point75to1
Debt Disclosure [Abstract]
Applicable Margin Base Rate Loans	0.0150
Applicable Margin Term SOFR Loans	0.0250
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin Base Rate Loans	0.0150
Applicable Margin Term SOFR Loans	0.0250
Term Loan B | lessthan2point75to1
Debt Disclosure [Abstract]
Applicable Margin Base Rate Loans	0.0125
Applicable Margin Term SOFR Loans	0.0225
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin Base Rate Loans	0.0125
Applicable Margin Term SOFR Loans	0.0225

Long-Term Obligations Terminate

Long-Term Obligations Terminated Credit Agreement (Details) $ in Millions	6 Months Ended
	Jun. 30, 2023 USD ($)
Debt Disclosure [Abstract]
Line of Credit Facility, Maximum Borrowing Capacity	$ 150
Line of Credit Facility, Expiration Date	Nov. 08, 2022

Long-Term Obligations Table (De

Long-Term Obligations Table (Details) - USD ($)	3 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 1,662,813,000
Line of Credit Facility, Fair Value of Amount Outstanding	0		$ 0
Debt Instrument, Unamortized Discount (Premium) and Debt Issuance Costs, Net	(21,718,000)		(24,262,000)
Debt, Long-term and Short-term, Combined Amount	1,641,095,000		1,653,363,000
Debt, Current	40,375,000		29,688,000
Long-term Debt, Excluding Current Maturities	1,600,720,000		1,623,675,000
Revolving Credit Facility
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 500,000,000
Debt Instrument, Interest Rate During Period	0%	0%
Term Loan A
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 823,438,000		834,000,000
Debt Instrument, Unamortized Discount (Premium) and Debt Issuance Costs, Net	$ 10,900,000
Debt Instrument, Interest Rate During Period	7.52%	3.99%
Term Loan B
Debt Instrument [Line Items]
Long-term Debt, Gross	$ 839,375,000		$ 843,625,000
Debt Instrument, Unamortized Discount (Premium) and Debt Issuance Costs, Net	$ 10,800,000
Debt Instrument, Interest Rate During Period	7.86%	4.61%

Long-Term Obligations Schedule

Long-Term Obligations Schedule of Maturities (Details) $ in Thousands	Jun. 30, 2023 USD ($)
LOng-Term Obligations Disclosure [Abstract]
Long-Term Debt, Maturity, Remainder of Fiscal Year	$ 14,875
Long-Term Debt, Maturity, Year One	51,000
Long-Term Debt, Maturity, Year Two	51,000
Long-Term Debt, Maturity, Year Three	72,250
Long-Term Debt, Maturity, Year Four	672,563
Long-Term Debt, Maturity, Year Five	8,500
Long-Term Debt, Maturity, after Year Five	792,625
Long-term Debt, Gross	$ 1,662,813

Long-Term Obligations Interes_2

Long-Term Obligations Interest Expense (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Debt Disclosure [Abstract]
Interest Expense, Debt, Excluding Amortization	$ 30,836,000	$ 12,622,000	$ 60,099,000	$ 22,639,000
Amortization of Debt Issuance Costs and Discounts	1,703,000	1,799,000	3,404,000	3,442,000
Line of Credit Facility, Commitment Fee Amount	383,000	309,000	751,000	661,000
Interest Expense, Debt	$ 32,922,000	$ 14,730,000	$ 64,254,000	$ 26,742,000

Long-Term Obligations Principal

Long-Term Obligations Principal Payment (Details)	3 Months Ended	6 Months Ended
	Jun. 30, 2022 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2022 USD ($)
Debt Disclosure [Abstract]
Term A principal payment % First 2 Years		0.0250
Term A Principal Payment % Year 3 and 4		0.0500
Term A Principal Payment % in Year 5		0.0750
Term Loan B Principal Payment %		0.0025
Debt Instrument, Periodic Payment, Principal	$ 16,000,000	$ 14,800,000	$ 18,100,000

Commitments and Contingencies C

Commitments and Contingencies Contingency (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2023	Jan. 06, 2022
Business Acquisition, Contingent Consideration [Line Items]
Contingent Consideration, Gross ST	$ 1,000
Contingent Consideration, Gross LT	1,500
Product Liability Accrual, Component Amount	47,400	$ 47,400	$ 55,100
SmithsMedical
Business Acquisition, Contingent Consideration [Line Items]
contingent consideration gross	100,000
Business Combination, Contingent Consideration, Liability	22,600	22,600	$ 53,500
Foreign Infusion System Supplier
Business Acquisition, Contingent Consideration [Line Items]
contingent consideration gross	2,500
Business Combination, Contingent Consideration, Liability	1,500	1,500
International Distributor
Business Acquisition, Contingent Consideration [Line Items]
contingent consideration gross		6,000
Business Combination, Contingent Consideration, Liability	$ 4,300	$ 4,300

Collaborative and Other Arran_2

Collaborative and Other Arrangements (Details) $ in Millions	Jun. 30, 2023 USD ($)
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Purchase Commitment, Remaining Minimum Amount Committed	$ 29.6

Equity (Details)

Equity (Details) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2023 USD ($)	Jun. 30, 2023 USD ($) shares	Jun. 30, 2022 USD ($) shares
Equity [Abstract]
Treasury Stock Purchase Plan	$ 100,000	$ 100,000
Stock Repurchase Program, Remaining Authorized Repurchase Amount	$ 100,000	$ 100,000
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation | shares		54,371	44,759
Payment, Tax Withholding, Share-based Payment Arrangement		$ 8,718	$ 10,438
Smiths Group Ownership % Acquisition Shares Issued	0.105	0.105
Smiths Group Ownership % Required for Board Representation	0.050

Equity Accumulated Other Compre

Equity Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022		Dec. 31, 2021
Accumulated Other Comprehensive Income (Loss) [Line Items]
Accumulated other comprehensive loss	$ (48,794)	$ (61,603)	$ (92,275)	$ (628)	$ (48,794)	$ (92,275)	$ (80,978)	[1]	$ (19,269)
Other Comprehensive Income (Loss), before Reclassifications, Net of Tax	20,710	24,839	(89,546)	20,851
Reclassification from Accumulated Other Comprehensive Income, Current Period, Net of Tax	(7,901)	(5,464)	(2,101)	(2,210)
Other Comprehensive income (loss), net of Tax	12,809	19,375	(91,647)	18,641	32,184	(73,006)
Accumulated Foreign Currency Adjustment Attributable to Parent [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Accumulated other comprehensive loss	(90,421)	(97,990)	(123,796)	(23,991)	(90,421)	(123,796)	(122,973)		(19,045)
Other Comprehensive Income (Loss), before Reclassifications, Net of Tax	7,569	24,983	(99,805)	(4,946)
Reclassification from Accumulated Other Comprehensive Income, Current Period, Net of Tax	0	0	0	0
Other Comprehensive income (loss), net of Tax	7,569	24,983	(99,805)	(4,946)
Accumulated Net Gain (Loss) from Cash Flow Hedges Attributable to Parent [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Accumulated other comprehensive loss	40,476	35,202	31,479	23,335	40,476	31,479	40,779		(237)
Other Comprehensive Income (Loss), before Reclassifications, Net of Tax	13,175	(113)	10,245	25,782
Reclassification from Accumulated Other Comprehensive Income, Current Period, Net of Tax	(7,901)	(5,464)	(2,101)	(2,210)
Other Comprehensive income (loss), net of Tax	5,274	(5,577)	8,144	23,572
Accumulated Defined Benefit Plans Adjustment Attributable to Parent [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Accumulated other comprehensive loss	1,151	1,185	42	28	$ 1,151	$ 42	$ 1,216		$ 13
Other Comprehensive Income (Loss), before Reclassifications, Net of Tax	(34)	(31)	14	15
Reclassification from Accumulated Other Comprehensive Income, Current Period, Net of Tax	0	0	0	0
Other Comprehensive income (loss), net of Tax	$ (34)		$ 14	$ 15
Other Comprehensive (Income) Loss, Defined Benefit Plan, after Tax and Reclassification Adjustment, Attributable to Parent		$ (31)
[1]December 31, 2022 balances were derived from audited consolidated financial statements.

Transfers and Servicing (Detail

Transfers and Servicing (Details) $ in Millions	3 Months Ended	6 Months Ended
	Jun. 30, 2023 USD ($)	Jun. 30, 2023 USD ($)
Transfers and Servicing [Abstract]
Transfer of Financial Assets Accounted for as Sales, Cash Proceeds Received for Assets Derecognized, Amount	$ 59.3	$ 59.3
Proceeds from Sale and Collection of Receivables		288.6
Cash Remitted to Purchaser		231
Accounts Receivable, Sale		290.3
Gain (Loss) on Sale of Accounts Receivable	0.9	1.7
Financing Receivable, Revolving	$ 150	$ 150

Subsequent Events (Details)

Subsequent Events (Details) - USD ($) $ in Millions	6 Months Ended	12 Months Ended
	Jun. 30, 2023	Dec. 31, 2022
Subsequent Events [Abstract]
Historic product revenue related to revenue at risk	$ 7.2	$ 37.6