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Fair Value Measurement (Notes)
 12 Months Ended
Dec. 31, 2024
Fair Value Disclosures [Abstract]  
Fair Value Disclosures [Text Block] FAIR VALUE MEASUREMENTS
Fair value is the price that would be received from selling an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. Fair value is estimated by applying the following hierarchy, which prioritizes the inputs used to measure fair value into three levels and bases the categorization within the hierarchy upon the lowest level of input that is available and significant to the fair value measurement:

•Level 1: quoted prices in active markets for identical assets or liabilities;
•Level 2: inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices in active markets for similar assets or liabilities, quoted prices for identical or similar assets or liabilities in markets that are not active, or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities; or
•Level 3: unobservable inputs that are supported by little or no market activity and that are significant to the fair values of the assets or liabilities.

Contingent earn-out liabilities
In August 2021, we entered into an agreement with one of our international distributors whereby that distributor would not compete with us in a specific territory for a three-year period that ended September 2024. The terms of the agreement included a contingent earn-out payment. The contingent earn-out payment could not exceed $6.0 million and was to be earned based on certain revenue targets over a twelve-month measurement period determined by the highest four consecutive quarters commencing over a two-year period starting on the closing date of the agreement and provided that the distributor is in compliance with its obligations under the agreement. The estimated fair value of the contingent earn-out was calculated using a probability-weighted cash flow model based on historical revenue streams and the likelihood that the revenue targets will be met. As of December 31, 2023, the earn-out measurement period ended. The fair value of the contingent earn-out was determined to be $3.4 million and was paid out in the first quarter of 2024.

In November 2021, we acquired a small foreign infusion systems supplier. Total consideration for the acquisition includes a potential earn-out payment of up to $2.5 million, consisting of (i) a cash payment of $1.0 million contingent on the achievement of certain revenue targets for the annual period ending December 31, 2022 and, separately, (ii) a cash payment of $1.5 million contingent on obtaining certain product-related regulatory certifications by May 26, 2024. As of December 31, 2022, the measurement period related to the contingent earn-out based on certain revenue targets ended and based on the actual revenue achieved during the measurement period, the fair value of the contingent earn-out was determined to be zero as the minimum threshold for earning the earn-out was not met. As of December 31, 2024, the earn-out measurement period related to certain product-related regulatory certifications had ended and the product-related regulatory certification had not been achieved, accordingly, the estimated fair value for the contingent consideration was reduced to zero.

In 2022, we acquired Smiths Medical with a combination of cash consideration and share consideration issued at closing. Total consideration for the acquisition included a potential earn-out payment of $100.0 million in cash contingent on our common stock achieving a certain volume-weighted average price (the "Price Targets") from the closing date to either the third or fourth anniversary of closing and provided Smiths beneficially owns at least 50.0% of the shares of common stock issued at closing at the time the Price Target is achieved. The initial estimated fair value of the earn-out was determined to be $53.5 million using a Monte Carlo simulation model. The model utilized several assumptions including volatility and the risk-free interest rate. The assumed volatility is based on the average of the historical volatility of our common stock price and the implied volatility of certain at-the-money traded options. The risk-free interest rate is equal to the yield on U.S. Treasury securities at constant maturity for the period commensurate with the term of the earn-out. At each reporting date subsequent to the acquisition, we remeasured the earn-out liability and recognized any changes in its fair value in our consolidated statements of operations. If the probability of achieving the Price Targets during their respective measurement periods was significantly greater than initially anticipated, the realization of an additional liability and related expense would have had a significant impact on our consolidated financial statements in the period recognized. As of December 31, 2023, the estimated fair value of the contingent earn-out was $4.0 million. During 2024, Smiths sold all of their remaining shares of common stock of ICU Medical, Inc. The sale of these shares rendered Smiths unable to achieve the contingent consideration based on certain price targets during the third and fourth anniversary of closing as Smiths no longer met the required minimum beneficial ownership percentage. Accordingly, the valuation of the contingent earn-out liability as of December 31, 2024 was zero.

Our contingent earn-out liabilities are separately stated on our consolidated balance sheets.

The following table provides a reconciliation of our Level 3 earn-out liabilities measured at estimated fair value based on an initial valuation and updated quarterly for the years ended December 31, 2024, 2023 and 2022 (in thousands):
Earn-out Liability
Contingent earn-out liability, January 1, 2022$2,589 
Acquisition date fair value estimate of earn-out(1)
55,158 
Change in fair value of contingent earn-out (included in income from operations as a separate line item)(2)
(32,091)
Currency translation(84)
Contingent earn-out liability, December 31, 202225,572 
Change in fair value of contingent earn-out (included in income from operations as a separate line item)(3
(16,247)
Other(4)
(496)
Transfer of Mediverse earn-out liability into Level 2(5)
(3,379)
Currency translation41 
Contingent earn-out liability, December 31, 20235,491 
Change in fair value of contingent earn-out (included in income from operations as a separate line item)(6)
(5,399)
Currency translation(92)
Contingent earn-out liability, December 31, 2024$— 
_______________________________
(1)    $53.5 million relates to our acquisition of Smiths Medical and $1.6 million relates to our acquisition of a small foreign infusions systems supplier in the fourth quarter of 2021 (see Note 2: Acquisitions).
(2)     Primarily relates to the change in fair value of our Smiths Medical earn-out and an adjustment to reduce to zero a contingent earn-out issued as part of the 2021 acquisition of a small foreign infusion systems supplier. The contingent earn-out was not earned based on our determination that the threshold target was not met.
(3)     Primarily relates to the change in fair value of our Smiths Medical earn-out.
(4)    Primarily relates to the reclassification to accrued liabilities of a holdback liability not subject to unobservable inputs when determining the fair market value.
(5)    The Mediverse earn-out was transferred out of Level 3 and into Level 2 in the fourth quarter of 2023 when the amount of the actual payment was known, and subsequently settled during first quarter of 2024.
(6)    Relates to the change in fair value of our Smiths Medical earn-out and the earn-out with one of our small foreign infusion systems suppliers, both of which were written down to zero as of December 31, 2024.
    
The following table provides quantitative information about Level 3 inputs for fair value measurement of our earn-out liabilities related to Smiths Medical:

Smiths Medical Earn-out
As of
December 31, 2023
Simulation Input
Volatility47.00 %
Risk-Free Rate4.18 %
Investments, Foreign Currency Contracts and Interest Rate Contracts    

Our investments historically consist of corporate, government bonds and U.S. treasury securities. The fair value of our corporate and government bonds are estimated using observable market-based inputs such as quoted prices, interest rates and yield curves or Level 2 inputs. The fair value of our U.S. treasury securities are based on quoted market prices in active markets and are included in the Level 1 fair value hierarchy.

The fair value of our Level 2 forward currency contracts is estimated using observable market inputs such as known notional value amounts, spot and forward exchange rates. These inputs relate to liquid, heavily traded currencies with active markets which are available for the full term of the derivative.

The fair value of our Level 2 interest rate swaps is estimated using a pricing model that reflects the terms of the contracts, including the period to maturity, and relies on observable market inputs such as known notional value amounts and USD interest rate curves.
Other than the Mediverse earn-out liability described above, there were no transfers between levels in 2024 or 2023.
    
Our assets and liabilities measured at fair value on a recurring basis consisted of the following (Level 1, 2 and 3 inputs as defined above) (in thousands): 
 Fair value measurements as of December 31, 2024
 Total carrying
value		Quoted prices
in active
markets for
identical
assets (level 1)		Significant
other
observable
inputs (level 2)		Significant
unobservable
inputs (level 3)
Assets:
Foreign exchange forwards:
Prepaid expenses and other current assets$6,716 $— $6,716 $— 
Interest rate contracts:
Prepaid expenses and other current assets11,038 — 11,038 — 
Other assets5,724 — 5,724 — 
Total Assets$23,478 $— $23,478 $— 
Liabilities:
Foreign exchange contracts:
Accrued liabilities$7,391 $— $7,391 $— 
Total Liabilities$7,391 $— $7,391 $— 
  
 Fair value measurements as of December 31, 2023
 Total carrying
value		Quoted prices
in active
markets for
identical
assets (level 1)		Significant
other
observable
inputs (level 2)		Significant
unobservable
inputs (level 3)
Assets:
Available-for-sale debt securities:
Short-term corporate bonds$501 $— $501 $— 
Foreign exchange forwards:
Prepaid expenses and other current assets6,785 — 6,785 — 
Other assets673 — 673 — 
Interest rate contracts:
Prepaid expenses and other current assets23,065 — 23,065 — 
Other assets4,876 — 4,876 — 
Total Assets$35,900 $— $35,900 $— 
Liabilities:
Contingent earn-out liability-ST$4,879 $3,379 $1,500 
Contingent earn-out liability - LT3,991 $— — $3,991 
Foreign exchange contracts:
Accrued liabilities2,590 — 2,590 — 
Other long-term liabilities240 — 240 — 
Total Liabilities$11,700 $— $6,209 $5,491