Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Cash flows from operating activities:
Net loss	$ (32,477)	$ (32,594)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	2,502	2,210
Provision for doubtful accounts	758	70
Provision for inventory obsolescence	1,512	(93)
Share-based compensation	4,534	5,174
Loss from disposal of property and equipment	152	75
Unrealized foreign currency loss, net	5,043	2,890
Change in fair value of derivative instruments	(442)	(2,843)
Change in fair value of contingent consideration	(304)	(567)
Amortization of debt discount	1,232	2,056
Changes in operating assets and liabilities:
Accounts receivable	3,291	(5,279)
Inventory	(1,722)	(2,007)
Prepaid expenses and other current assets	1,043	(2,949)
Other assets	(30)	(3)
Accounts payable	(3,267)	3,683
Accrued liabilities	1,725	3,964
Other liabilities	506	256
Net cash used in operating activities	(15,944)	(25,957)
Cash flows from investing activities:
Purchases of property and equipment	(2,136)	(5,623)
Cash used in asset acquisitions	(1,652)	(767)
Cost incurred for intangible assets	(647)	(17)
Net cash used in investing activities	(4,435)	(6,407)
Cash flows from financing activities:
Borrowings under Madryn credit agreement, net of issuance costs	0	24,748
Repayments on capital leases	(224)	(264)
Proceeds from issuance of ordinary shares, net of issuance costs	63,855	0
Cash used to repurchase warrants	0	(2,261)
Proceeds from stock option exercises	566	278
Proceeds from warrant exercises	0	58
Tax payments related to shares withheld upon vesting of restricted stock	(65)	(135)
Net cash provided by financing activities	64,132	22,424
Effect of exchange rate changes on cash	23	(140)
Net (decrease)/increase in cash	43,776	(10,080)
Cash at beginning of period	37,655	52,639
Cash at end of period	81,431	42,559
Supplemental disclosures:
Cash paid for interest	5,213	4,192
Cash paid for income taxes	2	201
Supplemental disclosures of non-cash investing and financing activities:
Unpaid balance for property and equipment	252	540
Assets acquired under capital leases	0	69
Issuance of common stock, net of underwriters’ discount and issuance costs	618	630
Equity consideration in an asset acquisition	0	337
Inventory acquired in an asset acquisition	1,009	1,257
Intangible assets acquired in an asset acquisition	138	0
Consideration payable related to asset acquisition	$ 818	$ 1,234