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Acquisition and Other Expense
9 Months Ended
Sep. 30, 2020
Acquisition and Other Expense [Abstract]  
Acquisition and Other Expense Acquisition and Other Expense
Acquisition and other expense consist of the following, which are included in cost of sales, selling and administrative expense or other expense depending on the nature of the charge:

Three Months Ended September 30,Nine Months Ended September 30,
 2020201920202019
Plant underutilization costs$— $— $6,586 $— 
Product rationalization costs - inventory— — 2,169 — 
Restructuring costs— — 1,087 — 
Manufacturing consolidation costs606 1,430 3,993 1,430 
Acquisition and integration costs796 171 2,253 1,335 
Acquisition and other expense included in cost of sales$1,402 $1,601 $16,088 $2,765 
Restructuring and related costs$1,009 $— $3,133 $— 
Product rationalization costs - field inventory— — 2,095 — 
Acquisition and integration costs — 1,490 1,192 11,196 
Acquisition and other expense included in selling and administrative expense$1,009 $1,490 $6,420 $11,196 
Debt refinancing costs included in other expense$— $— $— $3,904 
During the nine months ended September 30, 2020, we recorded a $6.6 million charge to cost of sales related to plant underutilization due to abnormally low production as a result of decreased sales caused by the COVID-19 pandemic.

During nine months ended September 30, 2020, we performed an analysis of our product lines and determined certain catalog numbers, principally related to capital equipment, would be discontinued and consolidated into existing product offerings. We consequently recorded a $2.2 million charge to cost of sales to write-off inventory of the discontinued products.
In addition, we incurred $2.1 million in costs related to the write-off of field inventory used for customer demonstration and evaluation of the discontinued products which we charged to selling and administrative expense.

During the nine months ended September 30, 2020, we incurred $1.1 million in restructuring costs related to a voluntary separation arrangement with employees as a result of the COVID-19 pandemic which were charged to cost of sales based on the job function of the affected employees. Substantially all of the costs associated with the voluntary separation arrangement were paid during the third quarter.

During the three and nine months ended September 30, 2020, we incurred $0.6 million and $4.0 million, respectively, in costs related to the consolidation of certain manufacturing operations which were charged to cost of sales. These costs related to winding down operations at certain locations and moving production lines to other facilities. During the three and nine months ended September 30, 2019, we incurred $1.4 million in costs related to the consolidation of certain manufacturing operations. These costs mainly related to severance and were charged to cost of sales.

During the three and nine months ended September 30, 2020, we recognized costs for inventory step-up adjustments and other costs related to a previous acquisition of $0.8 million and $2.3 million, respectively. During the three and nine months ended September 30, 2019, we incurred costs of $0.2 million and $1.3 million, respectively, for inventory adjustments associated with the acquisition of Buffalo Filter as further described in Note 3. These costs were charged to cost of sales.

During the three and nine months ended September 30, 2020, we recorded charges of $1.0 million and $2.3 million respectively, related to the restructuring of our Orthopedic sales force which was charged to selling and administrative expense. The charges for Orthopedic sales force restructuring consist primarily of termination payments to distributors made in exchange for ongoing assistance to transition to employee-based sales representatives.

During the nine months ended September 30, 2020, we recorded $0.8 million in restructuring charges principally related to a voluntary separation arrangement with employees as a result of the COVID-19 pandemic which were charged to selling and administrative expense based on the nature of the costs and function of the affected employees. Substantially all of the costs associated with the voluntary separation arrangement were paid during the third quarter.

During the nine months ended September 30, 2020, we incurred $1.2 million in severance and integration costs mainly related to the Buffalo Filter acquisition. During the three and nine months ended September 30, 2019, we incurred $1.5 million and $11.2 million, respectively, in costs associated with the acquisition of Buffalo Filter as further described in Note 3. These costs include investment banking fees in the first quarter of 2019, and, consulting fees, legal fees, severance and integration related costs in the three and nine months ended September 30, 2019. These costs were included in selling and administrative expense.

During the nine months ended September 30, 2019, we incurred a $3.6 million charge related to commitment fees paid to certain of our lenders, which provided a financing commitment for the Buffalo Filter acquisition and recorded a loss on the early extinguishment of debt of $0.3 million in conjunction with the sixth amended and restated senior credit agreement.

During the third quarter of 2020, we sold a vacant facility for $3.2 million that was classified as an asset held for sale at the end of the second quarter of 2020.