CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash flows from operating activities:
Net loss	$ (36,256)	$ (15,191)	$ (11,985)
Reconciliation of net loss to net cash provided by (used in) operating activities:
Depreciation of fixed assets	2,579	1,711	946
Gain on sale of assets	(20)	0	0
Provision for write down of inventory	1,363	2,132	1,400
Provision for bad debt	452	1,767	327
Issuance of stock to consultant	102	0	189
Stock based compensation	1,970	3,295	2,999
Amortization of debt costs and debt discount	9,226	9,586	8,427
Amortization of intangibles	3,096	2,930	2,833
Deferred income taxes	73	0	0
Foreign currency exchange loss (gain)	3,371	(7,719)	936
Partial extinguishment of 3.75% senior notes	4,235	0	0
Extinguishment of 2021 term loan	1,315	0	0
Loss on impairment of intangible assets	1,924	113	16
Changes in operating assets and liabilities:
Accounts receivable	(4,047)	5,964	(7,936)
Inventories	(1,877)	(5,275)	(5,042)
Prepaid expenses and other current receivables	224	(748)	3,427
Other assets	(26)	192	667
Accounts payable and accrued expenses	(3,405)	1,641	2,825
Deferred income	2,426	0	(476)
Net cash (used in) provided by operating activities	(13,275)	398	(447)
Cash flows from investing activities:
Capital expenditures	(25,332)	(40,429)	(16,655)
Disposal of fixed assets	38	0	0
Product acquisition costs, net	0	0	(3,421)
Net cash used in investing activities	(25,294)	(40,429)	(20,076)
Cash flows from financing activities:
Proceeds from 2021 revolver	15,000	0	0
Repayment of 2021 term loan, net	(25,550)	0	0
Debt issuance costs	(6,239)	0	0
Repurchase of 3.75% senior notes	(53,123)	0	0
Proceeds from exercise of common stock options and warrants	251	269	96
Principal payments on capital lease obligations	(6)	0	(70)
Payment (recovery) from stockholder, net	0	0	(36)
Net cash provided by (used in) financing activities	25,333	269	(10)
Effect of exchange rate on cash, cash equivalents and restricted cash	(860)	446	(301)
Net decrease in cash, cash equivalents and restricted cash	(13,236)	(39,762)	(20,533)
Cash, cash equivalents and restricted cash at beginning of year	27,165	66,481	87,315
Cash, cash equivalents and restricted cash at end of year	13,069	27,165	66,481
Supplemental Cash flow information:
Cash payments for interest	7,340	5,391	5,393
Cash payments for income taxes	89	126	113
Non cash investing and financing transactions:
Acquisition of capital expenditures in accounts payable and accrued expenses	568	3,186	1,805
Capitalized stock compensation in capital expenditures	96	127	91
Issuance of stock to consultant	102	0	189
2021 Term Loan
Cash flows from financing activities:
Proceeds from term loan	25,000	0	0
2023 Term Loan
Cash flows from financing activities:
Proceeds from term loan	$ 70,000	$ 0	$ 0