0001564590-20-053665 | 10-Q | XBRL Viewer

Property Plant And Equipment [Abstract]

Lessor Sales-Type Leases

Note 6—Lessor Sales-Type Leases

The Company recognizes revenue and costs, as well as a lease receivable, at the time embedded sales-type leases within its deferred equipment agreements commence. Lease revenue related to sales-type leases for each of the three and nine months ended September 30, 2020 was $0.7 million and is included within revenue in the accompanying condensed consolidated statements of operations and comprehensive loss. There was no lease revenue for the three and nine months ended September 30, 2019. Costs related to embedded leases within the Company’s deferred equipment agreements are included in cost of products sold in the accompanying condensed consolidated statements of operations and comprehensive loss.

The Company has a short-term lease receivable of $0.3 million and a long-term lease receivable of $0.4 million included in prepaid expenses and other current assets and other assets, respectively, as of September 30, 2020. There was no lease receivable as of December 31, 2019.

As of September 30, 2020, estimated future maturities of customer sales-type lease receivables for each of the following years are as follows (in thousands):

Three months ending December 31, 2020	$	68
Year ending December 31, 2021		273
Year ending December 31, 2022		254
Year ending December 31, 2023		46
Year ending December 31, 2024		27
Lease receivable	$	668

Property and Equipment, Net

9 Months Ended

Sep. 30, 2020

Property and Equipment, Net

Note 7—Property and Equipment, Net

The Company’s property and equipment, net, consisted of the following as of September 30, 2020 and December 31, 2019 (in thousands):

	September 30,			December 31,
	2020			2019
	(unaudited)
Medical diagnostic equipment	$	10,155		$	5,492
Furniture and fixtures		388			159
Office equipment		1,391			1,321
Laboratory equipment and software		3,409			2,807
Leasehold improvements		600			507
Construction in process		141			306
Total property and equipment		16,084			10,592
Less: accumulated depreciation		(6,144	)		(6,165	)
Property and equipment, net	$	9,940		$	4,427

Property and equipment includes certain medical diagnostic equipment, AcQMap Systems, located at customer premises. The Company retains the ownership of the equipment and has the right to remove the equipment if it is not being used according to expectations.

Depreciation expense was $0.8 million and $0.5 million for the three months ended September 30, 2020 and 2019, respectively, and $1.8 million and $1.7 million for the nine months ended September 30, 2020 and 2019, respectively.

Goodwill and Intangible Assets

9 Months Ended

Sep. 30, 2020

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

Note 8—Goodwill and Intangible Assets

The table below summarizes goodwill and intangible assets activities as of September 30, 2020 and December 31, 2019 (in thousands):

	Goodwill		Intangible Assets
Balance at December 31, 2019	$	12,026	$	4,110
Amortization expense		—		(330	)
Balance at September 30, 2020 (unaudited)	$	12,026	$	3,780

	Estimated Useful	Weighted Average Remaining
	Life (in years)	Life (in years)		Intangible Assets		Accumulated Amortization			September 30, 2020
									(unaudited)
Developed technology	10		8.8	$	4,200	$	(495	)	$	3,705
Trademarks and trade names	0.5	—			60		(60	)		—
Customer-related intangible	5	3.75			100		(25	)		75
Total				$	4,360	$	(580	)	$	3,780

	Estimated Useful	Weighted Average Remaining
	Life (in years)	Life (in years)	Intangible Assets		Accumulated Amortization			December 31, 2019
Developed technology	10	9.5	$	3,600	$	(180	)	$	3,420
In-process technology	indefinite			600		—			600
Trademarks and trade names	0.5	—		60		(60	)		—
Customer-related intangible	5	4.5		100		(10	)		90
Total			$	4,360	$	(250	)	$	4,110

Acquired in-process technology was classified as an indefinite-lived intangible asset until the receipt of FDA approval for the technology in January 2020. Once the FDA approval was received, the in-process technology was reclassified as developed technology and amortization began. The Company recorded amortization expense related to the above intangible assets of $0.1 million and $0.1 million for the three months ended September 30, 2020 and 2019, respectively, and $0.3 million and $0.1 million for the nine months ended September 30, 2020 and 2019, respectively.

The following table shows the remaining amortization expense associated with amortizable intangible assets as of September 30, 2020 (in thousands):

	Developed Technology		Customer- Related Intangible		Total Amortization
Three months ending December 31, 2020	$	105	$	5	$	110
Year ending December 31, 2021		420		20		440
Year ending December 31, 2022		420		20		440
Year ending December 31, 2023		420		20		440
Year ending December 31, 2024		420		10		430
Thereafter		1,920		—		1,920
Total	$	3,705	$	75	$	3,780

Accrued Liabilities

9 Months Ended

Sep. 30, 2020

Payables And Accruals [Abstract]

Accrued Liabilities

Note 9—Accrued Liabilities

Accrued liabilities consisted of the following as of September 30, 2020 and December 31, 2019 (in thousands):

	September 30,		December 31,
	2020		2019
	(unaudited)
Payroll and related expenses	$	5,083	$	3,785
Professional fees		290		188
Deferred revenue		290		311
Sales and use tax		140		151
Biotronik Asset Acquisition - accrued purchase price		—		5,000
Other		697		641
Total accrued liabilities	$	6,500	$	10,076

Debt

9 Months Ended

Sep. 30, 2020

Debt Disclosure [Abstract]

Debt

Note 10—Debt

Outstanding debt as of September 30, 2020 and December 31, 2019 consisted of the following (in thousands):

	September 30,			December 31,
	2020			2019
	(unaudited)
2019 Credit Agreement ⁽¹⁾	$	44,550		$	44,550
Total debt, gross		44,550			44,550
Less: Unamortized debt discount and fees		(5,788	)		(6,306	)
Total long-term debt	$	38,762		$	38,244

(1)	The 2019 Credit Agreement includes final payment fees of $4.6 million.

2019 Credit Agreement

On May 20, 2019, the Company entered into a Credit Agreement (the “2019 Credit Agreement”). The 2019 Credit Agreement provided the Company with a senior term loan facility in aggregate principal amount of $70.0 million, of which the Company borrowed $40.0 million upon closing. Of the remaining amount of the facility, $10.0 million was available for borrowing by the Company on or prior to June 30, 2020 and $20.0 million is available for borrowing by the Company on or prior to December 31, 2020, in each case subject to the achievement of specified trailing revenue levels. The Company did not achieve the trailing revenue levels to draw the $10.0 million by June 30, 2020 but the $20.0 million remains available for borrowing on or prior to December 31, 2020 if the specified trailing revenue levels are met. The 2019 Credit Agreement bears interest per annum at 7.75% plus LIBOR for such interest period and the principal amount of term loans outstanding under the 2019 Credit Agreement is due on May 20, 2024. The 2019 Credit Agreement provides for final payment fees of an additional $4.6 million that are due upon prepayment or on the maturity date or upon acceleration.

Upon the occurrence and during an event of default, which includes but is not limited to payment default, covenant default or the occurrence of a material adverse change, the lenders may declare all outstanding principal and accrued and unpaid interest immediately due and payable, all unfunded commitments would be terminated, there would be an increase in the applicable interest rate by 10.0% per annum, and the lenders would be entitled to exercise their other rights and remedies provided for under the 2019 Credit Agreement. Additionally, the lenders may request repayment of a portion of obligations outstanding under the 2019 Credit Agreement to the extent of the Company’s receipt of any (i) net casualty proceeds or (ii) net asset sales proceeds, as defined. These acceleration and early payment features are an embedded derivative that is separately measured from the loan host instrument and classified with the loan host instrument.

In connection with the issuance of the 2019 Credit Agreement, the Company issued liability-classified warrants with a fair value of $0.9 million to purchase 419,992 shares of Series C convertible preferred stock at $16.67 per share. These warrants were subsequently automatically converted into warrants to purchase an equal number of shares of the Company’s Series D convertible preferred stock at a price of $16.67 per share.

The initial recognition of the warrant liability and direct fees of $1.2 million and final payment fees of $4.6 million for the 2019 Credit Agreement resulted in a discount of $6.7 million, which is being amortized to interest expense over the term of the 2019 Credit Agreement using the effective interest method.

The Company’s obligations under the 2019 Credit Agreement are secured by substantially all of its assets, including its intellectual property, and is guaranteed by Acutus NV. The 2019 Credit Agreement contains customary affirmative and negative covenants, including with respect to the Company’s ability to enter into fundamental transactions, incur additional indebtedness, grant liens, pay any dividend or make any distributions to its holders, make investments and merge or consolidate with any other person or engage in transactions with its affiliates, but does not include any financial covenants, other than a minimum liquidity requirement. As of and for the nine months ended September 30, 2020 and 2019, the Company was in compliance with all such covenants.

2019 Convertible Notes

On May 20, 2019, the Company sold and issued $37.0 million in aggregate principal amount of convertible promissory notes (the “2019 Convertible Notes”). The 2019 Convertible Notes bore interest at 13% per annum and were due on December 31, 2019. The 2019 Convertible Notes, including accrued interest, automatically converted into preferred stock at the lowest price per share paid by a cash investor in a qualified equity financing of at least $23.0 million (excluding the principal of any debt that is cancelled or converted into preferred stock in the equity financing), which occurred on June 12, 2019. In accordance with ASC 480, Distinguishing Liabilities from Equity, the 2019 Convertible Notes were recorded as share-settled debt at fair value. As the 2019 Convertible Notes converted to Series D convertible preferred stock on June 12, 2019, the initial proceeds of $37.0 million is the fair value and the settlement value of the 2019 Convertible Notes.

Operating Leases

9 Months Ended

Sep. 30, 2020

Commitments And Contingencies Disclosure [Abstract]

Operating Leases

Note 11—Operating Leases

The Company leases approximately 50,800 square feet of office space for its corporate headquarters and manufacturing facility in Carlsbad, California under a noncancelable operating lease that expires on December 31, 2022. The lease is subject to variable charges for common area maintenance and other costs that are determined annually based on actual costs. The base rent is subject to an annual increase each year. The Company has a renewal option for an additional five-year term upon the expiration date of the lease, which has been excluded from the calculation of the right-of-use asset as it is not reasonably certain to be exercised.

The Company also leases approximately 3,900 square feet of office space in Zaventem, Belgium under a noncancelable operating lease that expires on December 31. 2021. The lease is subject to variable charges that are determined annually for common area maintenance and other costs based on actual costs, and base rent is subject to an annual increase each year based on an index rate. The Company has a renewal option for an additional three-year term upon the expiration date of the lease, which has been included in the calculation of the right-of-use asset as it is reasonably certain to be exercised.

The following table summarizes quantitative information about the Company’s operating leases for the nine months ended September 30, 2020 and 2019 (dollars in thousands):

	Nine Months Ended September 30,
	2020			2019
	(unaudited)
Operating cash flows from operating leases	$	760		$	725
Right-of-use assets exchanged for operating lease liabilities	$	—		$	2,978
Weighted average remaining lease term – operating leases (in years)		1.7			2.2
Weighted average discount rate – operating leases		7.0	%		7.0	%

The following table provides the components of the Company’s lease cost (in thousands):

	Three Months Ended September 30,				Nine Months Ended September 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
Operating leases
Operating lease cost	$	216	$	216	$	648	$	648
Variable lease cost		73		65		238		169
Total rent expense	$	289	$	281	$	886	$	817

As of September 30, 2020, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands):

Three months ending December 31, 2020	$	253
Year ending December 31, 2021		1,044
Year ending December 31, 2022		1,074
Year ending December 31, 2023		51
Year ending December 31, 2024		51
Total		2,473
Less: present value discount		(201	)
Operating lease liabilities	$	2,272

Commitments and Contingencies

9 Months Ended

Sep. 30, 2020

Commitments and Contingencies

Note 12—Commitments and Contingencies

The Company is not a party to any material legal proceedings and is not aware of any pending or threatened claims. From time to time however, the Company may be subject to various legal proceedings and claims that arise in the ordinary course of its business activities.

Warrants

9 Months Ended

Sep. 30, 2020

Warrants And Rights Note Disclosure [Abstract]

Warrants

Note 13—Warrants

As of September 30, 2020 and December 31, 2019, the outstanding warrants to purchase the Company’s common stock were comprised of the following:

	Equity Upon
	Exercise				September 30,		December 31,
	(After Conversion)	Exercise Price		Expiration Date	2020		2019
					(unaudited)
Warrants issued in 2015	Common Stock	$	5.25	1/30/25		7,616		7,616
Warrants issued with 2018 Convertible Notes	Common Stock	$	0.10	6/7/28		501,946		501,946
Warrants issued with 2018 Term Loan	Common Stock	$	16.67	7/31/28		26,998		26,998
Warrants issued with 2019 Credit Agreement	Common Stock	$	16.67	5/20/29		419,992		419,992
Total Warrants						956,552		956,552

The Company has no warrant activity for the nine months ended September 30, 2020. The remaining weighted average contractual life is 7.7 years as of September 30, 2020.

Warrants Classified as Liabilities

During 2019, in connection with the Company’s entry into the 2019 Credit Agreement, the Company issued warrants to purchase 419,992 shares of its Series C convertible preferred stock with an exercise price of $16.67 per share. These warrants were subsequently automatically converted into warrants to purchase an equal number of shares of the Company’s Series D convertible preferred stock at a price of $16.67 per share. During 2018, in connection with the issuance of the 2018 Convertible Notes and the 2018 Term Loan, the Company issued ten-year warrants to purchase 501,946 shares of common stock with an exercise price of $0.10 per share and 26,998 shares of Series C convertible preferred stock with an exercise price of $16.67 per share, respectively. The warrants for Class C convertible preferred stock were subsequently automatically converted into warrants to purchase an equal number of shares of the Company’s Series D convertible preferred stock at a price of $16.67 per share. On August 10, 2020, in connection with the closing of the IPO, the warrants to purchase 446,990 shares of Series D convertible preferred stock were automatically converted to an equal number of warrants to purchase common stock at an exercise price of $16.67 per share.

The Company’s warrants provide the holder the option to purchase a specified number of shares for a specified price. The holder may exercise the warrant in cash or exercise pursuant to a cashless exercise whereby a calculated number of shares are withheld upon exercise to satisfy the exercise price. The warrants do not provide the holder any voting rights until the warrants are exercised.

Prior to the IPO, in accordance with ASC 815, other than the warrants issued in 2015, the warrants were recorded as liabilities at fair value at the issuance date. Changes in the fair value were recognized in change in fair value of warrant liability and embedded derivative in the condensed consolidated statements of operations and comprehensive loss at the end of each reporting period. On August 10, 2020, in connection with the closing of the IPO, the warrants recorded as liabilities no longer met the definition of a derivative. Accordingly, the fair value of the common and preferred stock warrant liability of $14.5 million was reclassified to stockholders’ equity (deficit) in the condensed consolidated balance sheet.

Warrants Classified as Equity

In accordance with ASC 815, the warrants issued in 2015 do not meet the definition of a derivative and are classified in stockholders’ equity (deficit) in the condensed consolidated balance sheets.

Convertible Preferred Stock

9 Months Ended

Sep. 30, 2020

Temporary Equity [Abstract]

Convertible Preferred Stock

Note 14—Convertible Preferred Stock

In February 2020, the Company issued 119,993 shares of its Series D convertible preferred stock with an implied value of $2.2 million in connection with a contingent consideration payment related to the Rhythm Xience Acquisition.

In February 2020, the Company issued 273,070 shares of its Series D convertible preferred stock with an implied value of $5.0 million for the stock issuance portion of the purchase consideration of the Biotronik Asset Acquisition.

On August 10, 2020, in connection with the closing of the IPO, all of the 391,210 shares of Series A, 3,088,444 shares of Series B, 4,499,921 shares of Series C and 8,593,360 shares of Series D convertible preferred stock, respectively, automatically converted into an equal number of shares of common stock.

Redemption

The convertible preferred stock was not unconditionally redeemable at the option of the holder thereof. However, the convertible preferred stock was contingently redeemable upon certain liquidation events. As redemption by the holders was not solely within the control of the Company, all of the outstanding convertible preferred stock was classified as temporary equity in the condensed consolidated balance sheets, prior to the conversion to common stock on August 10, 2020.

Dividends

The holders of shares of convertible preferred stock were entitled to receive dividends, out of any assets legally available therefore, prior and in preference to any declaration or payment of any dividend on the common stock of the Company, at the applicable dividend rate, payable on a pro rata, pari passu basis when, as and if declared by the Company’s board of directors. The dividend rate was $0.68 per annum for each share of Series A convertible preferred stock, $1.07 per annum for each share of Series B convertible preferred stock and $1.36 per annum for each share of Series C convertible preferred stock and Series D convertible preferred stock, as adjusted. The dividend rights were not cumulative.

Liquidation

The holders of the Series D convertible preferred stock were entitled to receive a liquidation preference prior to any distribution to the holders of Series A convertible preferred stock, Series B convertible preferred stock and Series C convertible preferred stock (collectively the “Junior Preferred Stock”) and the holders of common stock, in the amount of the original issue price plus declared but unpaid dividends on such shares (the “Series D Liquidation Preference”). The holders of the Junior Preferred Stock were entitled to receive a liquidation preference prior to any distribution to the holders of common stock, after payment of the Series D Liquidation Preference, in the amount of the applicable original issue price plus declared but unpaid dividends on such shares.

Conversion

Each share of preferred stock was convertible, at the option of the holder thereof, at any time after the date of issuance of such share, into such number of fully paid and nonassessable shares of the Company’s common stock as was determined by dividing the original issue price, as adjusted, for such series by the applicable conversion price for such series in effect on the date the certificate is surrendered for conversion. The initial conversion price per share for each series of convertible preferred stock was the original issue price applicable to such series as follows:

Series	Conversion Price
Series A convertible preferred stock	$	8.295
Series B convertible preferred stock	$	13.370
Series C convertible preferred stock	$	16.667
Series D convertible preferred stock	$	16.667

Each share of convertible preferred stock was automatically convertible into fully-paid, non-assessable shares of common stock at the conversion rate at the time in effect for such series of preferred stock immediately upon: (i) the date, or the occurrence of an event, specified by vote or written consent or agreement of the requisite investors; or (ii) the closing of the sale of shares of common stock to the public, at a price of at least $50.00 per share, as adjusted, in a firm-commitment underwritten public offering pursuant to an effective registration statement under the Securities Act of 1933, as amended, resulting in at least $50.0 million of net proceeds to the Company. As noted above, on August 10, 2020, all shares of Series A, Series B, Series C and Series D convertible preferred stock were converted into common stock.

Stockholders’ Equity (Deficit)

9 Months Ended

Sep. 30, 2020

Equity [Abstract]

Stockholders’ Equity (Deficit)

Note 15—Stockholders’ Equity (Deficit)

On August 10, 2020, the Company issued 10,147,058 shares of common stock in its IPO, which included 1,323,529 shares of common stock issued upon the underwriters’ exercise in full of an option to purchase, at the public offering price less underwriting discounts and commissions, up to an additional 1,323,529 shares. The price to the public for each share was $18.00. The Company received gross proceeds of $182.6 million from the IPO. Net of underwriting discounts and commission and other offering expenses, the Company received net proceeds of $166.3 million from the IPO.

On August 10, 2020, in connection with the closing of the IPO, the Company filed an amended and restated certificate of incorporation (the “A&R Certificate”) with the Secretary of State of the State of Delaware. The A&R Certificate amended and restated the Company’s authorized shares of common stock to 260,000,000 and authorized shares of undesignated preferred stock to 5,000,000.

As of December 31, 2019, the Company’s Amended and Restated Certificate of Incorporation authorized the issuance of 220,000,000 shares of common stock, $0.001 par value per share. Each share of common stock is entitled to one voting right. Common stock owners are entitled to dividends when funds are legally available and declared by the Board.

During the nine months ended September 30, 2020 and 2019, stock options to acquire 92,223 and 15,921 shares, respectively, were exercised for shares of common stock. The Company received approximately $0.4 million and $0.1 million for the exercise price of the stock options for the nine months ended September 30, 2020 and 2019, respectively.

Stock-Based Compensation

9 Months Ended

Sep. 30, 2020

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Stock-Based Compensation

Note 16—Stock-Based Compensation

2020 Equity Incentive Plan

The 2020 Equity Incentive Plan (“2020 Plan”) which permits the granting of nonstatutory stock options, restricted stock, restricted stock units, stock appreciation rights, performance units, performance shares and other equity-based awards to employees, directors and consultants became effective on August 5, 2020. As of September 30, 2020, 2,191,600 shares of common stock were authorized for issuance under the 2020 Plan and 1,101,996 shares remain available for issuance under the 2020 Plan.

2011 Equity Incentive Plan

The Company’s 2011 Equity Incentive Plan (the “2011 Plan”) permits the granting of incentive stock options, non-statutory stock options, restricted stock, restricted stock units and other stock-based awards to employees, directors, officers and consultants. As of September 30, 2020, 2,823,333 shares of common stock were authorized for issuance under the 2011 Plan and no shares remain available for issuance under the 2011 Plan. No additional awards will be granted under the 2011 Plan. Shares that become available for issuance from the outstanding awards under the 2011 Plan due to forfeiture, or otherwise, will become available for issuance of future awards under the 2020 Plan.

Stock Options

The stock options generally vest over four years and have a ten-year contractual term. The fair value of each employee and non-employee stock option grant is estimated on the date of grant using the Black-Scholes option pricing model. The Company became publicly traded in August 2020 and lacks company-specific historical and implied volatility information. Therefore, it estimates its expected stock volatility based on the historical volatility of a set of publicly traded peer companies. Due to the lack of historical exercise history, the expected term of the Company’s stock options has been determined using the “simplified” method for awards. The risk-free interest rate is determined by reference to the U.S. Treasury yield curve in effect at the time of grant of the award for time periods approximately equal to the expected term of the award. Expected dividend yield is zero based on the fact that the Company has never paid cash dividends and does not expect to pay any cash dividends in the foreseeable future.

The following assumptions were used to estimate the fair value of stock option for the nine months ended September 30, 2020 and 2019:

	Nine Months Ended September 30,
	2020		2019
	(unaudited)
Risk-free interest rate	0.4% - 0.9%		1.6% - 2.1%
Expected dividend yield	—		—
Expected term in years		7.0	6.4 - 10.0
Expected volatility	70% - 80%		80%

The following table summarizes stock option activity during the nine months ended September 30, 2020:

	Stock Options			Weighted Average Exercise Price		Weighted Average Remaining Contractual Life (in years)		Aggregate Intrinsic Value (in thousands)
Outstanding as of December 31, 2019		2,041,205		$	9.52		7.7	$	7,857
Options granted		1,746,415			16.69
Option exercised		(139,597	)		7.24
Options forfeited		(231,678	)		11.91
Outstanding as of September 30, 2020 (unaudited)		3,416,345		$	13.12		8.2	$	57,110
Options vested and exercisable as of September 30, 2020 (unaudited)		1,310,459		$	9.22		6.5	$	26,974

The aggregate intrinsic value in the above table is calculated as the difference between the fair value of the Company’s common stock as of September 30, 2020 and the exercise price of the stock options. The weighted average grant date fair value per share for the stock option awards granted during the nine months ended September 30, 2020 was $11.49. As of September 30, 2020, the total unrecognized compensation related to unvested stock option awards granted was $29.1 million, which the Company expects to recognize over a weighted average period of approximately 3.0 years.

Performance-Based Restricted Stock Units and Restricted Stock Units

In June 2019, the Company granted 567,509 PSUs, with a grant date fair value of $13.37. Vesting of the PSUs was dependent upon the satisfaction of both a service condition and a performance condition, which is an IPO or a change of control. The Company began recording compensation expense related to the PSUs upon the declaration of the Company’s IPO becoming effective on August 5, 2020, as the performance conditions were satisfied. The compensation expense was determined using the original grant date fair value and is being recognized over the remaining service period.

The Company’s PSU and RSU activity for the nine months ended September 30, 2020 was as follows:

	Number of Shares			Weighted Average Grant Price
Unvested as of December 31, 2019		567,509		$	13.37
Granted		215,846			18.35
Forfeited		(1,388	)		18.00
Vested		(285,375	)		13.37
Unvested as of September 30, 2020 (unaudited)		496,592		$	15.52

Restricted Stock

The Company’s RSA activity for the nine months ended September 30, 2020 was as follows:

	Number of Shares			Weighted Average Grant Price
Unvested as of December 31, 2019		—		$	—
Granted		32,921			16.55
Vested		(32,921	)		16.55
Unvested as of September 30, 2020 (unaudited)		—		$	—

The following table summarizes the total stock-based compensation expense for the stock options, PSUs, RSUs and RSAs recorded in the condensed consolidated statements of operations and comprehensive loss for the three and nine months ended September 30, 2020 and 2019 (in thousands):

	Three Months Ended September 30,				Nine Months Ended September 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
Cost of products sold	$	126	$	56	$	292	$	162
Research and development		319		179		697		471
Selling, general and administrative		5,929		577		8,283		1,541
Total stock-based compensation	$	6,374	$	812	$	9,272	$	2,174

Employee Stock Purchase Plan

The 2020 Employee Stock Purchase Plan (“2020 ESPP”), which permits employees to purchase shares of the Company’s common stock, became effective on August 10, 2020 and 387,063 shares of common stock were authorized for sale under the 2020 ESPP. As of September 30, 2020, there were no purchase of shares under the 2020 ESPP.

Net Loss Per Common Share

9 Months Ended

Sep. 30, 2020

Earnings Per Share [Abstract]

Net Loss Per Common Share

Note 17—Net Loss Per Common Share

Basic net loss per common share is computed by dividing net loss attributable to common stockholders by the weighted average number of shares of common stock outstanding for the period. Diluted net loss per common share excludes the potential impact of the Company’s convertible preferred stock, common stock options and warrants because their effect would be anti-dilutive due to the Company’s net loss. Since the Company had a net loss in the periods presented, basic and diluted net loss per common share are the same.

The table below provides potentially dilutive securities not included in the calculation of the diluted net loss per common share because to do so would be anti-dilutive:

	Nine Months Ended September 30,
Shares issuable upon:	2020		2019
Conversion of Series A Preferred Stock		—		391,210
Conversion of Series B Preferred Stock		—		3,088,444
Conversion of Series C Preferred Stock		—		4,499,921
Conversion of Series D Preferred Stock		—		6,418,437
Exercise of stock options		3,416,345		1,751,616
Exercise of common stock warrants		956,552		509,562
Exercise of preferred stock warrants		—		446,990
Vesting of PSUs and RSUs		496,592		—
Total		4,869,489		17,106,180

For the nine months ended September 30, 2019, the PSUs are not included in the above table as awards with performance conditions are not included in the calculation of diluted earnings per share until the performance conditions for the PSU are considered probable.

401(k) Retirement Plan

9 Months Ended

Sep. 30, 2020

Compensation And Retirement Disclosure [Abstract]

401(k) Retirement Plan

Note 18—401(k) Retirement Plan

The Company has a 401(k) retirement savings plan that provides retirement benefits to substantially all full-time U.S. employees. Eligible employees may contribute a percentage of their annual compensation, subject to Internal Revenue Service limitations. The Company did not provide any contributions to the 401(k) retirement savings plan for the nine months ended September 30, 2020 and 2019.

The entire disclosure for retirement benefits.

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 715
-SubTopic 20
-Section 55
-Paragraph 17
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Related Party Transactions

Related Party Transactions

9 Months Ended

Sep. 30, 2020

Note 19—Related Party Transactions

The Company licenses certain patent rights from a former director and shareholder. The license agreement provides for royalty payments to the shareholder of 3% of net product sales, as defined in the agreement. Royalties earned prior to the director’s resignation were $22,000 and $10,000 for the three months ended September 30, 2020 and 2019, respectively, and $61,000 and $32,000 for the nine months ended September 30, 2020 and 2019, respectively. Additionally, the former director and shareholder also works for one of the Company’s customers and can significantly influence the customer to purchase the Company’s product. Prior to the director’s resignation, the Company recorded sales to this customer of $8,000 and $50,000 for the three months ended September 30, 2020 and 2019, respectively, and $0.5 million and $0.2 million for the nine months ended September 30, 2020 and 2019, respectively.

The Company has a consulting agreement with a director and chairman of the Company’s board of directors. The Company recorded $55,000 and $81,000 for the three months ended September 30, 2020 and 2019, respectively, and $0.1 million and $0.2 million for the nine months ended September 30, 2020 and 2019, respectively, in SG&A expense in the condensed consolidated statements of operations and comprehensive loss, for the consulting services. With the completion of the IPO, the performance condition was satisfied for certain performance stock units granted to the director and chairman of the Company’s board of directors. The Company recorded $4.0 million of stock-based compensation expense for these awards for the three and nine months ended September 30, 2020 in SG&A expense in the condensed consolidated statements of operations and comprehensive loss.

The Company had a consulting agreement with an officer of the Company in the prior year. The Company recorded $93,000 for the three months ended September 30, 2019, and $0.3 million for the nine months ended September 30, 2019 in SG&A expense in the condensed consolidated statements of operations and comprehensive loss, for the consulting services.

The Company had a consulting arrangement with a current director and officer of the Company, prior to his full-time employment. The Company recorded $0.2 million and $0.4 million for the three and nine months ended September 30, 2019, respectively, in SG&A expense in the condensed consolidated statements of operations and comprehensive loss, for the consulting services.

Multiple preferred stock shareholders entered into the 2018 and 2019 Convertible Notes that also contained detached warrants. Additionally, Orbimed Royalty Opportunities II, LP and Deerfield Private Design Fund II, L.P. entered into the 2019 Credit Agreement with the Company in 2019 for a total of $70.0 million, with $40.0 million being drawn as of September 30, 2020. The Company recorded $1.4 million and $1.4 million for the three months ended September 30, 2020 and 2019, respectively, and $4.1 million and $2.1 million for the nine months ended September 30, 2020 and 2019, respectively, in interest expense related to these debt agreements.

Summary of Significant Accounting Policies (Policies)

9 Months Ended

Sep. 30, 2020

Accounting Policies [Abstract]

Basis of Presentation

Principles of Consolidation

Use of Estimates and Assumptions

Segments

Cash and Cash Equivalents and Restricted Cash

	September 30,		December 31,
	2020		2019
	(unaudited)
Cash and cash equivalents	$	58,302	$	9,452
Restricted cash		150		150
Total cash, cash equivalents and restricted cash	$	58,452	$	9,602

Marketable Securities

Concentrations of Credit Risk and Off-Balance Sheet Risk

Revenue from Contracts with Customers

•

Step 1: Identify the contract with the customer.

•

Step 2: Identify the performance obligations in the contract.

•

Step 3: Determine the transaction price.

•

Step 4: Allocate the transaction price to the performance obligations in the contract.

•

Step 5: Recognize revenue when, or as, the company satisfies a performance obligation.

The following table sets forth the Company’s revenue for disposables and systems/service for the three and nine months ended September 30, 2020 and 2019 (in thousands):

	Three Months Ended September 30,				Nine Months Ended September 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
Disposables	$	2,179	$	643	$	4,358	$	2,155
Systems		965		—		1,485		—
Service/Other		29		3		47		12
Total	$	3,173	$	646	$	5,890	$	2,167

The following table provides revenue by geographic location for the three and nine months ended September 30, 2020 and 2019 (in thousands):

	Three Months Ended September 30,				Nine Months Ended September 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
United States	$	1,867	$	147	$	3,195	$	603
Europe		1,306		499		2,695		1,564
Total Revenue	$	3,173	$	646	$	5,890	$	2,167

Inventory

Accounts Receivable

Property and Equipment, Net

Intangible Assets

Goodwill

Impairment of Long-Lived Assets

Foreign Currency Translation and Transactions

Lessee Leases

Cost of Products Sold

Research and Development

Selling, General and Administrative

Fair Value Measurements

Level 1—Quoted prices in active markets for identical assets or liabilities.

Level 2—Observable inputs other than Level 1 prices for similar assets or liabilities that are directly or indirectly observable in the marketplace.

	Fair Value Measured at September 30, 2020 (unaudited)
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at September 30, 2020
Assets included in:
Cash and cash equivalents
Money market securities	$	53,063	$	—	$	—	$	53,063
Marketable securities at fair value
Corporate debt securities		—		31,455		—		31,455
U.S. treasury securities		—		14,361		—		14,361
Commercial paper		—		53,926		—		53,926
Asset-backed securities		—		8,789		—		8,789
Total fair value	$	53,063	$	108,531	$	—	$	161,594

Liabilities included in:
Contingent consideration	$	—	$	—	$	7,600	$	7,600
Total fair value	$	—	$	—	$	7,600	$	7,600

	Fair Value Measured at December 31, 2019
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at December 31, 2019
Assets included in:
Cash and cash equivalents
Money market securities	$	8,901	$	—	$	—	$	8,901
Marketable securities at fair value
Corporate debt securities		—		28,224		—		28,224
Asset-backed securities		—		17,121		—		17,121
U.S. treasury securities		—		5,032		—		5,032
Commercial paper		—		11,974		—		11,974
Total fair value	$	8,901	$	62,351	$	—	$	71,252

Liabilities included in:
Contingent consideration	$	—	$	—	$	13,900	$	13,900
Common and preferred stock warrant liability		—		—		8,919		8,919
Total fair value	$	—	$	—	$	22,819	$	22,819

The fair value of the Company’s money market funds is determined using quoted market prices in active markets for identical assets.

The following table presents changes in Level 3 liabilities measured at fair value for the nine months ended September 30, 2020 (in thousands):

	Common and Preferred Stock Warrant Liability			Contingent Consideration			Total
Balance, December 31, 2019	$	8,919		$	13,900		$	22,819
Payment of contingent consideration		—			(2,636	)		(2,636	)
Issuance of preferred stock for contingent consideration		—			(2,197	)		(2,197	)
Reclassification of warrant liability to stockholders' equity		(14,474	)		—			(14,474	)
Change in fair value		5,555			(1,466	)		4,089
Balance, September 30, 2020 (unaudited)	$	—		$	7,600		$	7,600

	August 10,	December 31,
	2020	2019
	(unaudited)
Risk-free interest rate	0.39%	1.59% - 1.60%
Expected dividend yield	—	—
Contractual term in years	7.8 - 8.8	0.7 - 1.0
Expected volatility	65.0%	60.0% - 110.5%

	September 30, 2020	December 31, 2019
	(unaudited)
Risk-free interest rate	0.20%	1.60%
Expected term in years	1.0 - 2.0	1.0 - 2.0
Expected volatility	20.4%	11.8%

Stock-Based Compensation

Income Taxes

Warrant Liability

Asset Acquisitions (Research and Development—License Acquired)

Business Combinations

Accounting Pronouncements to Be Adopted

Summary of Significant Accounting Policies (Tables)

9 Months Ended

Sep. 30, 2020

Accounting Policies [Abstract]

Summary of Cash and Cash Equivalents and Restricted Cash

The following table reconciles cash, cash equivalents and restricted cash in the condensed consolidated balance sheets to the totals shown on the condensed consolidated statements of cash flows (in thousands):

	September 30,		December 31,
	2020		2019
	(unaudited)
Cash and cash equivalents	$	58,302	$	9,452
Restricted cash		150		150
Total cash, cash equivalents and restricted cash	$	58,452	$	9,602

Summary of Disaggregation of Revenue

The following table sets forth the Company’s revenue for disposables and systems/service for the three and nine months ended September 30, 2020 and 2019 (in thousands):

	Three Months Ended September 30,				Nine Months Ended September 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
Disposables	$	2,179	$	643	$	4,358	$	2,155
Systems		965		—		1,485		—
Service/Other		29		3		47		12
Total	$	3,173	$	646	$	5,890	$	2,167

Summary of Revenue from External Customers by Geographic Areas

The following table provides revenue by geographic location for the three and nine months ended September 30, 2020 and 2019 (in thousands):

	Three Months Ended September 30,				Nine Months Ended September 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
United States	$	1,867	$	147	$	3,195	$	603
Europe		1,306		499		2,695		1,564
Total Revenue	$	3,173	$	646	$	5,890	$	2,167

Summary of Fair Value, Liabilities Measured on Recurring Basis

	Fair Value Measured at September 30, 2020 (unaudited)
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at September 30, 2020
Assets included in:
Cash and cash equivalents
Money market securities	$	53,063	$	—	$	—	$	53,063
Marketable securities at fair value
Corporate debt securities		—		31,455		—		31,455
U.S. treasury securities		—		14,361		—		14,361
Commercial paper		—		53,926		—		53,926
Asset-backed securities		—		8,789		—		8,789
Total fair value	$	53,063	$	108,531	$	—	$	161,594

Liabilities included in:
Contingent consideration	$	—	$	—	$	7,600	$	7,600
Total fair value	$	—	$	—	$	7,600	$	7,600

	Fair Value Measured at December 31, 2019
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value at December 31, 2019
Assets included in:
Cash and cash equivalents
Money market securities	$	8,901	$	—	$	—	$	8,901
Marketable securities at fair value
Corporate debt securities		—		28,224		—		28,224
Asset-backed securities		—		17,121		—		17,121
U.S. treasury securities		—		5,032		—		5,032
Commercial paper		—		11,974		—		11,974
Total fair value	$	8,901	$	62,351	$	—	$	71,252

Liabilities included in:
Contingent consideration	$	—	$	—	$	13,900	$	13,900
Common and preferred stock warrant liability		—		—		8,919		8,919
Total fair value	$	—	$	—	$	22,819	$	22,819

Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation

The following table presents changes in Level 3 liabilities measured at fair value for the nine months ended September 30, 2020 (in thousands):

	Common and Preferred Stock Warrant Liability			Contingent Consideration			Total
Balance, December 31, 2019	$	8,919		$	13,900		$	22,819
Payment of contingent consideration		—			(2,636	)		(2,636	)
Issuance of preferred stock for contingent consideration		—			(2,197	)		(2,197	)
Reclassification of warrant liability to stockholders' equity		(14,474	)		—			(14,474	)
Change in fair value		5,555			(1,466	)		4,089
Balance, September 30, 2020 (unaudited)	$	—		$	7,600		$	7,600

Weighted average unobservable inputs to measure contingent consideration

The weighted average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the common and preferred stock warrant liability as of August 10, 2020 (date of conversion to equity classified warrants) and December 31, 2019 were as follows:

	August 10,	December 31,
	2020	2019
	(unaudited)
Risk-free interest rate	0.39%	1.59% - 1.60%
Expected dividend yield	—	—
Contractual term in years	7.8 - 8.8	0.7 - 1.0
Expected volatility	65.0%	60.0% - 110.5%

Weighted-average unobservable inputs to measure contingent consideration

The weighted average (in aggregate) significant unobservable inputs (Level 3 inputs) used in measuring the contingent consideration from the acquisition of Rhythm Xience as of September 30, 2020 and December 31, 2019 were as follows:

	September 30, 2020	December 31, 2019
	(unaudited)
Risk-free interest rate	0.20%	1.60%
Expected term in years	1.0 - 2.0	1.0 - 2.0
Expected volatility	20.4%	11.8%

Asset Acquisition and Business Combination (Tables)

9 Months Ended

Sep. 30, 2020

Business Combination Recognized Identifiable Assets Acquired Goodwill And Liabilities Assumed Net [Abstract]

Summary of Purchase Price Allocation To The Assets Acquired and Liabilities Assumed

The following table summarizes the allocation of the purchase price to the assets acquired and liabilities assumed for the Rhythm Xience Acquisition (in thousands):

Accounts receivable, net	$	3
Prepaid expenses and other current assets		8
Property and equipment, net		3
Intangible assets		4,360
Goodwill		12,026
Contingent consideration		(13,400	)
Cash consideration	$	3,000

Marketable Securities (Tables)

9 Months Ended

Sep. 30, 2020

Available For Sale Securities Fair Value To Amortized Cost Basis [Abstract]

Summary of Marketable Securities

Marketable securities consisted of the following as of September 30, 2020 and December 31, 2019 (in thousands):

	September 30, 2020 (unaudited)
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses			Fair Value
Available-for-sale securities - short-term:
Corporate debt securities	$	31,459	$	—	$	(4	)	$	31,455
U.S. treasury securities		14,362		—		(1	)		14,361
Commercial paper		53,926		—		—			53,926
Total available-for-sale securities - short-term		99,747		—		(5	)		99,742

Asset-backed securities, long-term		8,789				—			8,789
Total available-for-sale securities	$	108,536	$	—	$	(5	)	$	108,531

	December 31, 2019
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term:
Corporate debt securities	$	28,204	$	20	$	—	$	28,224
Asset-backed securities		17,108		13		—		17,121
U.S. treasury securities		5,020		12		—		5,032
Commercial paper		11,974		—		—		11,974
Total available-for-sale securities	$	62,306	$	45	$	—	$	62,351

Inventory (Tables)

9 Months Ended

Sep. 30, 2020

Inventory Disclosure [Abstract]

Summary of Inventory

Inventory as of September 30, 2020 and December 31, 2019 consisted of the following (in thousands):

	September 30,		December 31,
	2020		2019
	(unaudited)
Raw materials	$	5,980	$	5,492
Work in process		864		1,605
Finished goods		4,088		1,327
Total inventory	$	10,932	$	8,424

Lessor Sales-Type Leases (Tables)

9 Months Ended

Sep. 30, 2020

Estimated Future Maturities of Customer Sales-Type Lease Receivables

As of September 30, 2020, estimated future maturities of customer sales-type lease receivables for each of the following years are as follows (in thousands):

Three months ending December 31, 2020	$	68
Year ending December 31, 2021		273
Year ending December 31, 2022		254
Year ending December 31, 2023		46
Year ending December 31, 2024		27
Lease receivable	$	668

Property and Equipment, Net (Tables)

9 Months Ended

Sep. 30, 2020

Property Plant And Equipment [Abstract]

Summary of Property and Equipment, Net

The Company’s property and equipment, net, consisted of the following as of September 30, 2020 and December 31, 2019 (in thousands):

	September 30,			December 31,
	2020			2019
	(unaudited)
Medical diagnostic equipment	$	10,155		$	5,492
Furniture and fixtures		388			159
Office equipment		1,391			1,321
Laboratory equipment and software		3,409			2,807
Leasehold improvements		600			507
Construction in process		141			306
Total property and equipment		16,084			10,592
Less: accumulated depreciation		(6,144	)		(6,165	)
Property and equipment, net	$	9,940		$	4,427

Goodwill and Intangible Assets (Tables)

9 Months Ended

Sep. 30, 2020

Goodwill And Intangible Assets Disclosure [Abstract]

Summary Of Goodwill And Intangible Assets Activities

The table below summarizes goodwill and intangible assets activities as of September 30, 2020 and December 31, 2019 (in thousands):

	Goodwill		Intangible Assets
Balance at December 31, 2019	$	12,026	$	4,110
Amortization expense		—		(330	)
Balance at September 30, 2020 (unaudited)	$	12,026	$	3,780

Summary of Finite and Indefinite Lived Intangible Assets

	Estimated Useful	Weighted Average Remaining
	Life (in years)	Life (in years)		Intangible Assets		Accumulated Amortization			September 30, 2020
									(unaudited)
Developed technology	10		8.8	$	4,200	$	(495	)	$	3,705
Trademarks and trade names	0.5	—			60		(60	)		—
Customer-related intangible	5	3.75			100		(25	)		75
Total				$	4,360	$	(580	)	$	3,780

	Estimated Useful	Weighted Average Remaining
	Life (in years)	Life (in years)	Intangible Assets		Accumulated Amortization			December 31, 2019
Developed technology	10	9.5	$	3,600	$	(180	)	$	3,420
In-process technology	indefinite			600		—			600
Trademarks and trade names	0.5	—		60		(60	)		—
Customer-related intangible	5	4.5		100		(10	)		90
Total			$	4,360	$	(250	)	$	4,110

Summary Of Remaining Amortization Expense

The following table shows the remaining amortization expense associated with amortizable intangible assets as of September 30, 2020 (in thousands):

	Developed Technology		Customer- Related Intangible		Total Amortization
Three months ending December 31, 2020	$	105	$	5	$	110
Year ending December 31, 2021		420		20		440
Year ending December 31, 2022		420		20		440
Year ending December 31, 2023		420		20		440
Year ending December 31, 2024		420		10		430
Thereafter		1,920		—		1,920
Total	$	3,705	$	75	$	3,780

Accrued Liabilities (Tables)	9 Months Ended
Accrued Liabilities (Tables)	Sep. 30, 2020
Payables And Accruals [Abstract]
Summary Of Accrued Liabilities	Error extracting Word content

Debt (Tables)

9 Months Ended

Sep. 30, 2020

Debt Instruments [Abstract]

Summary Of Outstanding Debt

Outstanding debt as of September 30, 2020 and December 31, 2019 consisted of the following (in thousands):

	September 30,			December 31,
	2020			2019
	(unaudited)
2019 Credit Agreement ⁽¹⁾	$	44,550		$	44,550
Total debt, gross		44,550			44,550
Less: Unamortized debt discount and fees		(5,788	)		(6,306	)
Total long-term debt	$	38,762		$	38,244

(1)	The 2019 Credit Agreement includes final payment fees of $4.6 million.

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02.22)
-URI http://asc.fasb.org/extlink&oid=120391452&loc=d3e13212-122682

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 1A
-URI http://asc.fasb.org/extlink&oid=119993939&loc=d3e28541-108399

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 6
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21506-112644

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08.(e),(f))
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Operating Leases (Tables)

9 Months Ended

Sep. 30, 2020

Summary Of Quantitative Information About Operating Leases

The following table summarizes quantitative information about the Company’s operating leases for the nine months ended September 30, 2020 and 2019 (dollars in thousands):

	Nine Months Ended September 30,
	2020			2019
	(unaudited)
Operating cash flows from operating leases	$	760		$	725
Right-of-use assets exchanged for operating lease liabilities	$	—		$	2,978
Weighted average remaining lease term – operating leases (in years)		1.7			2.2
Weighted average discount rate – operating leases		7.0	%		7.0	%

Summary Of Components Of Lease Cost

The following table provides the components of the Company’s lease cost (in thousands):

	Three Months Ended September 30,				Nine Months Ended September 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
Operating leases
Operating lease cost	$	216	$	216	$	648	$	648
Variable lease cost		73		65		238		169
Total rent expense	$	289	$	281	$	886	$	817

Summary Of Future Minimum Payments Under The Non-cancelable Operating Leases

As of September 30, 2020, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands):

Three months ending December 31, 2020	$	253
Year ending December 31, 2021		1,044
Year ending December 31, 2022		1,074
Year ending December 31, 2023		51
Year ending December 31, 2024		51
Total		2,473
Less: present value discount		(201	)
Operating lease liabilities	$	2,272

Warrants (Tables)

9 Months Ended

Sep. 30, 2020

Warrants And Rights Note Disclosure [Abstract]

Schedule of Outstanding Warrants to Purchase the Company's Common Stock

As of September 30, 2020 and December 31, 2019, the outstanding warrants to purchase the Company’s common stock were comprised of the following:

	Equity Upon
	Exercise				September 30,		December 31,
	(After Conversion)	Exercise Price		Expiration Date	2020		2019
					(unaudited)
Warrants issued in 2015	Common Stock	$	5.25	1/30/25		7,616		7,616
Warrants issued with 2018 Convertible Notes	Common Stock	$	0.10	6/7/28		501,946		501,946
Warrants issued with 2018 Term Loan	Common Stock	$	16.67	7/31/28		26,998		26,998
Warrants issued with 2019 Credit Agreement	Common Stock	$	16.67	5/20/29		419,992		419,992
Total Warrants						956,552		956,552

Convertible Preferred Stock (Tables)

9 Months Ended

Sep. 30, 2020

Temporary Equity [Abstract]

Schedule of Initial Conversion Price per Share for each Series of Convertible Preferred Stock

The initial conversion price per share for each series of convertible preferred stock was the original issue price applicable to such series as follows:

Series	Conversion Price
Series A convertible preferred stock	$	8.295
Series B convertible preferred stock	$	13.370
Series C convertible preferred stock	$	16.667
Series D convertible preferred stock	$	16.667

Stock-Based Compensation (Tables)

9 Months Ended

Sep. 30, 2020

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Schedule of Estimate of the Fair Value of Stock Option

The following assumptions were used to estimate the fair value of stock option for the nine months ended September 30, 2020 and 2019:

	Nine Months Ended September 30,
	2020		2019
	(unaudited)
Risk-free interest rate	0.4% - 0.9%		1.6% - 2.1%
Expected dividend yield	—		—
Expected term in years		7.0	6.4 - 10.0
Expected volatility	70% - 80%		80%

Summary of Stock Option Activity

The following table summarizes stock option activity during the nine months ended September 30, 2020:

	Stock Options			Weighted Average Exercise Price		Weighted Average Remaining Contractual Life (in years)		Aggregate Intrinsic Value (in thousands)
Outstanding as of December 31, 2019		2,041,205		$	9.52		7.7	$	7,857
Options granted		1,746,415			16.69
Option exercised		(139,597	)		7.24
Options forfeited		(231,678	)		11.91
Outstanding as of September 30, 2020 (unaudited)		3,416,345		$	13.12		8.2	$	57,110
Options vested and exercisable as of September 30, 2020 (unaudited)		1,310,459		$	9.22		6.5	$	26,974

Schedule of PSU and RSA Activity

The Company’s PSU and RSU activity for the nine months ended September 30, 2020 was as follows:

	Number of Shares			Weighted Average Grant Price
Unvested as of December 31, 2019		567,509		$	13.37
Granted		215,846			18.35
Forfeited		(1,388	)		18.00
Vested		(285,375	)		13.37
Unvested as of September 30, 2020 (unaudited)		496,592		$	15.52

Schedule of RSA Activity

The Company’s RSA activity for the nine months ended September 30, 2020 was as follows:

	Number of Shares			Weighted Average Grant Price
Unvested as of December 31, 2019		—		$	—
Granted		32,921			16.55
Vested		(32,921	)		16.55
Unvested as of September 30, 2020 (unaudited)		—		$	—

Summary of the Total Stock-Based Compensation Expense for the Stock Options, PSUs and RSAs Recorded in the Condensed Consolidated Statements of Operations and Comprehensive Loss

	Three Months Ended September 30,				Nine Months Ended September 30,
	2020		2019		2020		2019
	(unaudited)				(unaudited)
Cost of products sold	$	126	$	56	$	292	$	162
Research and development		319		179		697		471
Selling, general and administrative		5,929		577		8,283		1,541
Total stock-based compensation	$	6,374	$	812	$	9,272	$	2,174

Net Loss Per Common Share (Tables)

9 Months Ended

Sep. 30, 2020

Earnings Per Share [Abstract]

Summary of Calculation of the Diluted Net Loss per Common Share

The table below provides potentially dilutive securities not included in the calculation of the diluted net loss per common share because to do so would be anti-dilutive:

	Nine Months Ended September 30,
Shares issuable upon:	2020		2019
Conversion of Series A Preferred Stock		—		391,210
Conversion of Series B Preferred Stock		—		3,088,444
Conversion of Series C Preferred Stock		—		4,499,921
Conversion of Series D Preferred Stock		—		6,418,437
Exercise of stock options		3,416,345		1,751,616
Exercise of common stock warrants		956,552		509,562
Exercise of preferred stock warrants		—		446,990
Vesting of PSUs and RSUs		496,592		—
Total		4,869,489		17,106,180

Organization and Description of Business - Additional Information (Detail) $ / shares in Units, $ in Thousands			9 Months Ended
	Aug. 10, 2020 USD ($) $ / shares shares	Jul. 28, 2020	Sep. 30, 2020 USD ($) shares	Dec. 31, 2019 USD ($) shares
Date of incorporation			Mar. 25, 2011
Reverse stock split			common stock and convertible preferred stock on a 9.724-for-one basis
Reverse stock split ratio		9.724
Share price \| $ / shares	$ 18.00
Proceeds from issuance of common stock upon IPO, net of issuance costs \| $	$ 166,300		$ 166,286
Common stock shares outstanding	26,719,993		27,826,408	695,902
Accumulated deficit \| $			$ (331,613)	$ (259,034)
Working capital deficit \| $			$ 159,500	$ 50,500
Series A Convertible Preferred Stock [Member]
Conversion of stock shares converted	391,210
Series B Convertible Preferred Stock [Member]
Conversion of stock shares converted	3,088,444
Series C Convertible Preferred Stock [Member]
Conversion of stock shares converted	4,499,921
Series D Convertible Preferred Stock [Member]
Shares issued during the period,shares			273,070
Conversion of stock shares converted	8,593,360
Class of warrants number of securities called by the warrants or rights	446,990
Exercise price of each warrant \| $ / shares	$ 16.67
IPO [Member]
Shares issued during the period,shares	10,147,058
Proceeds from issuance of common stock upon IPO, net of issuance costs \| $	$ 166,300
Over-Allotment Option [Member]
Shares issued during the period,shares	1,323,529
Over-Allotment Option [Member] \| Maximum [Member]
Shares issued during the period,shares	1,323,529

Summary of Significant Accounting Policies - Additional information (Detail)	3 Months Ended		9 Months Ended
	Sep. 30, 2020 USD ($)	Sep. 30, 2019 USD ($)	Sep. 30, 2020 USD ($) Segment ReportingUnit	Sep. 30, 2019 USD ($)	Aug. 10, 2020 $ / shares	Dec. 31, 2019 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of operating segment \| Segment			1
Other-than-temporary impairments related to marketable securities			$ 0	$ 0
Cash, FDIC insured amount	$ 250,000		250,000
Inventory Write-down	37,000	$ 300,000	100,000	500,000
Allowance for uncollectible accounts	0		$ 0			$ 0
Number of reporting unit \| ReportingUnit			1
Impairment of property and equipment or intangible assets	0	$ 0	$ 0	$ 0
Interest or penalties charged in relation to the unrecognized tax benefits	$ 0		$ 0
IPO [Member]
Summary Of Significant Accounting Policies [Line Items]
Share price \| $ / shares					$ 18.00
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Customers payment period			30 days
Property and equipment, estimated useful lives			3 years
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Customers payment period			60 days
Contracts with customers, expected duration	1 year		1 year
Property and equipment, estimated useful lives			5 years
Deferred Equipment Agreements [Member]
Summary Of Significant Accounting Policies [Line Items]
Cash, FDIC insured amount			$ 0
Deferred Equipment Agreements [Member] \| Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Contract term			2 years
Deferred Equipment Agreements [Member] \| Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Contract term			4 years

Summary of Significant Accounting Policies - Summary of Cash and Cash Equivalents and Restricted Cash (Detail) - USD ($) $ in Thousands	Sep. 30, 2020	Dec. 31, 2019	Sep. 30, 2019	Dec. 31, 2018
Accounting Policies [Abstract]
Cash and cash equivalents	$ 58,302	$ 9,452
Restricted cash	150	150
Total cash, cash equivalents and restricted cash	$ 58,452	$ 9,602	$ 34,345	$ 9,775

Summary of Significant Accounting Policies - Summary of Disaggregation of Revenue (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	$ 3,173	$ 646	$ 5,890	$ 2,167
Disposables [Member]
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	2,179	643	4,358	2,155
Systems [Member]
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	965		1,485
Product and Service, Other [Member]
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	$ 29	$ 3	$ 47	$ 12

Amount, including tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value-added and excise.

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Summary of Significant Accounting Policies - Summary of Revenue from External Customers by Geographic Areas (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	$ 3,173	$ 646	$ 5,890	$ 2,167
United States [Member]
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	1,867	147	3,195	603
Europe [Member]
Summary Of Significant Accounting Policies [Line Items]
Total Revenue	$ 1,306	$ 499	$ 2,695	$ 1,564