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Consolidated Statements of Cash Flows (USD $)
In Thousands, unless otherwise specified
12 Months Ended
Dec. 31, 2012
Dec. 31, 2011
Dec. 31, 2010
Cash flows from operating activities:      
Net income (loss) $ 51,295 $ (1,073) $ 44,208
Adjustments to reconcile net income (loss) to net cash provided by operating activities:      
Depreciation and amortization 20,261 22,776 22,521
Amortization of debt costs 1,737 1,239 471
Provision for doubtful accounts 13,302 11,532 8,746
Deferred income taxes 871 936 178
Share-based compensation 6,303 6,648 8,138
Provision for inventory obsolescence 351 5,463 7,376
Loss on refinancing of credit facility     550
Gain on interest rate swap     (1,254)
Gain on sale of Breg, Inc. (1,345)    
Net gain on sale of vascular operations     (12,019)
Income tax benefit on employee-stock-based awards   (1,737) (2,222)
Other 2,124 4,906 4,216
Changes in operating assets and liabilities, net of effect of dispositions:      
Trade accounts receivable (31,600) (25,818) (14,770)
Inventories (6,692) (13,812) (222)
Escrow receivable 41,537 (32,562) (2,049)
Prepaid expenses and other current assets (6,191) (4,057) (7,214)
Trade accounts payable 5,554 576 (2,863)
Charges related to U.S. Government resolutions (82,500) 88,463  
Other current liabilities (2,842) 3,384 (5,289)
Long-term assets (825) (1,214) (1,625)
Long-term liabilities (135) (869) (4,369)
Net cash provided by operating activities 11,206 64,781 42,508
Cash flows from investing activities:      
Capital expenditures for property, plant and equipment (27,994) (24,965) (25,844)
Capital expenditures for intangible assets (780) (793) (517)
Payment made in connection with acquisition   (5,250)  
Net proceeds from sale of Breg Inc. 153,773    
Net proceeds from the sale of vascular operations     24,215
Net cash provided by (used in) investing activities 124,999 (31,008) (2,146)
Cash flows from financing activities:      
Net proceeds from issuance of common shares 25,586 20,113 7,854
Payment of refinancing fees and debt issuance costs   (758) (4,266)
Repayments of long-term debt (188,695) (7,500) (36,269)
Proceeds from (repayment of) bank borrowings, net (1,297) (2,561) 1,723
Changes in restricted cash 25,799 (24,178) (11,290)
Cash payment for purchase of minority interest in subsidiary   (517)  
Income tax benefit on employee stock-based awards   1,737 2,222
Net cash used in financing activities (138,607) (13,664) (40,026)
Effect of exchange rates changes on cash 250 (463) (103)
Net increase (decrease) in cash and cash equivalents (2,152) 19,646 233
Cash and cash equivalents at the beginning of the year 33,207 13,561 13,328
Cash and cash equivalents at the end of the year 31,055 33,207 13,561
Cash paid during the year for:      
Interest 4,569 17,088 16,032
Income taxes $ 18,268 $ 26,227 $ 29,743