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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($)
6 Months Ended
Jun. 30, 2020
Jun. 30, 2019
Operating activities:    
Net loss $ (36,527,000) $ (25,404,000)
Adjustments to reconcile net loss to net cash used in operating activities:    
Depreciation and amortization 5,056,000 3,430,000
Stock-based compensation 8,143,000 3,963,000
Amortization of debt discount and debt issuance costs 2,376,000 1,033,000
Amortization of right-of-use asset 527,000 441,000
Provision for doubtful accounts 22,000 122,000
Provision for excess and obsolete inventory 3,434,000 4,123,000
Deferred income tax benefit   2,000
Beneficial conversion feature from convertible notes   242,000
Loss on disposal of instruments 144,000 66,000
Accretion to contingent consideration   289,000
Loss on extinguishment of debt 1,555,000  
Changes in operating assets and liabilities:    
Accounts receivable, net (3,657,000) 1,330,000
Inventories, net (10,047,000) (7,963,000)
Prepaid expenses and other current assets (1,061,000) 285,000
Other assets   126,000
Other long-term assets   (2,690,000)
Accrued expenses and other (2,549,000) 1,201,000
Accounts payable 5,883,000 4,322,000
Lease liability (644,000) 2,639,000
Other long-term liabilities (2,800,000) (2,199,000)
Net cash used in operating activities (30,145,000) (14,642,000)
Investing activities:    
Purchases of property and equipment (6,978,000) (3,717,000)
Net cash used in investing activities (6,978,000) (3,717,000)
Financing activities:    
Proceeds from sale of common stock, net 1,379,000 1,401,000
Borrowings under lines of credit 42,455,000 54,220,000
Repayments under lines of credit (56,615,000) (54,488,000)
Principal payments on capital lease obligations (18,000) (12,000)
Proceeds from issuance of term debt, net 33,921,000 9,700,000
Principal payments on term loan and notes payable (24,000) (3,045,000)
Net cash provided by financing activities 21,098,000 7,776,000
Effect of exchange rate changes on cash 75,000 99,000
Net decrease in cash (15,950,000) (10,484,000)
Cash at beginning of period, including discontinued operations 47,113,000 29,054,000
Cash at end of period, including discontinued operations 31,163,000 18,570,000
Supplemental disclosure of cash flow information:    
Cash paid for interest 3,534,000 2,714,000
Cash paid for income taxes 166,000 102,000
Supplemental disclosure of noncash investing and financing activities:    
Common stock warrants issued with term loan draw 2,986,000 13,664,000
Purchases of property and equipment in accounts payable $ 2,290,000 2,221,000
SafeOp Surgical, Inc.    
Supplemental disclosure of noncash investing and financing activities:    
Common stock issued for achievement of SafeOp contingent consideration   $ 2,889,000