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Goodwill and Intangible Assets
6 Months Ended
Jun. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill and Intangible Assets

6.   Goodwill and Intangible Assets. The change in the carrying amount of goodwill for the six-month period ended June 30, 2023 is detailed as follows (in thousands):

    

2023

Goodwill balance at January 1

$

359,821

Effect of foreign exchange

 

410

Additions and adjustments as the result of acquisitions

 

21,536

Goodwill balance at June 30

$

381,767

Total accumulated goodwill impairment losses aggregated $8.3 million as of June 30, 2023 and December 31, 2022. We did not have any goodwill impairments for the six-month periods ended June 30, 2023 and 2022. The total goodwill balances as of June 30, 2023 and December 31, 2022 were related to our cardiovascular segment.

Other intangible assets at June 30, 2023 and December 31, 2022 consisted of the following (in thousands):

June 30, 2023

Gross Carrying

Accumulated

Net Carrying

    

Amount

    

Amortization

    

Amount

Patents

$

30,451

$

(11,732)

$

18,719

Distribution agreements

 

3,250

 

(2,817)

 

433

License agreements

 

11,139

 

(7,832)

 

3,307

Trademarks

 

35,129

 

(19,215)

 

15,914

Customer lists

 

40,333

 

(32,822)

 

7,511

Total

$

120,302

$

(74,418)

$

45,884

December 31, 2022

Gross Carrying

Accumulated

Net Carrying

    

Amount

    

Amortization

    

Amount

Patents

$

29,445

$

(10,203)

$

19,242

Distribution agreements

 

3,250

 

(2,715)

 

535

License agreements

 

11,109

 

(7,250)

 

3,859

Trademarks

 

30,221

 

(17,863)

 

12,358

Customer lists

 

34,105

 

(31,749)

 

2,356

Total

$

108,130

$

(69,780)

$

38,350

Aggregate amortization expense for the three and six-month periods ended June 30, 2023 was $13.4 million and $25.7 million, respectively. Aggregate amortization expense for the three and six-month periods ended June 30, 2022 was $12.1 million and $24.2 million, respectively.

We evaluate long-lived assets, including amortizing intangible assets, for impairment whenever events or changes in circumstances indicate that their carrying amounts may not be recoverable. We perform the impairment analysis at the asset group for which the lowest level of identifiable cash flows is largely independent of the cash flows of other assets and liabilities. We determine the fair value of our amortizing assets based on estimated future cash flows discounted back to their present value using a discount rate that reflects the risk profiles of the underlying activities. During the three and six-month periods ended June 30, 2023, we did not identify indicators of impairment in any intangible assets based on our qualitative assessment.

During the six-month period ended June 30, 2022, we identified indicators of impairment associated with certain acquired intangible assets based on our qualitative assessment, which led us to complete an interim quantitative impairment assessment. The primary indicator of impairment was our planned divestiture of the STD Pharmaceutical Products Limited (“STD Pharmaceutical”) business acquired in our August 2019 acquisition of Fibrovein Holdings Limited. On April 30, 2022, we completed the divestiture of Fibrovein Holdings Limited, in exchange for the termination of our obligations arising from the acquisition transaction in August 2019 and the purchaser’s agreement to make potential future payments upon a qualifying disposition of the STD Pharmaceutical business. We recorded an impairment charge for the carrying value of $1.7 million of intangible assets during the six months ended June 30, 2022, all of which pertained to our cardiovascular segment.

Estimated amortization expense for developed technology and other intangible assets for the next five years consisted of the following as of June 30, 2023 (in thousands):

    

Estimated Amortization Expense

Remaining 2023

$

32,085

2024

 

59,732

2025

 

57,701

2026

46,963

2027

 

43,768