Accrued Expenses (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Payables and Accruals [Abstract]
Professional fees	$ 2,153	$ 546
Payroll	1,908	1,580
Inventory and supplies	1,809	58
Interest expense	1,042	240
Rebates	714	83
Medicaid and Medicare	383	1,487
Clinical Studies	334	596
Royalties	222	856
Capital expenditures	275	1,947
Wholesaler Fees	203	0
Income Tax	45	58
Other	754	650
Accrued Liabilities	$ 9,842	$ 8,101