0001628280-24-047933 | 10-Q | XBRL Viewer

Debt

9 Months Ended

Sep. 30, 2024

Outstanding debt as of September 30, 2024 and December 31, 2023 consisted of the following (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
2022 Credit Agreement(1)	$	34,125	$	36,792
Total outstanding debt, gross	34,125		36,792
Less: unamortized debt discount and fees	(1,772)		(2,274)
Total outstanding debt	$	32,353	$	34,518

(1)The 2022 Credit Agreement includes final payment fees of $1.8 million.

The first principal payment of $2.5 million with associated fees under the Company's 2022 Credit Agreement (as defined below) was paid in June 2024.

2022 Amended and Restated Credit Agreement

On June 30, 2022, the Company amended and restated its prior debt facility. The amended and restated credit agreement (as amended by Amendment No. 1, dated August 4, 2023, Amendment No. 2, dated November 8, 2023, and Amendment No. 3, dated March 4, 2024, and as further amended from time to time, the "2022 Credit Agreement") is with related parties Deerfield Private Design Fund III, L.P. and Deerfield Partners, L.P. (collectively referred to as “Deerfield” or “Lenders”) and is for an aggregate principal amount of $35.0 million and has a 5-year term. Proceeds from the 2022 Credit Agreement, along with cash on hand, were used to repay the prior debt facility and to pay related fees and expenses.

The 2022 Credit Agreement bears an annual interest of 9% plus the one-month adjusted term Secured Overnight Financing Rate (applying a 2.5% minimum rate). From date of closing, amortization payments are due as follows:

•$2.5 million of the principal due at the end of month 24;

•$7.5 million of the principal due at the end of month 36;

•$10.0 million of the principal due at the end of 48; and

•$15.0 million due at the end of month 60.

The 2022 Credit Agreement is subject to prepayment penalties and provides for final payment fees of an additional $1.8 million due upon prepayment, on the maturity date or upon acceleration.

The 2022 Credit Agreement is secured by a first-priority perfected lien on and security interest in substantially all of the Company’s existing and after-acquired tangible and intangible assets, subject to certain exceptions noted therein.

The 2022 Credit Agreement is subject to certain customary affirmative covenants, representations and warranties and other terms and conditions. It also contains certain customary negative covenants, including, but not limited to, restrictions on the Company’s ability and that of its subsidiaries to merge and consolidate with other companies, incur indebtedness, grant liens or security interests on assets, pay dividends or make other restricted payments, sell or otherwise transfer assets or enter into transactions with affiliates. As of and for the three and nine months ended September 30, 2024, the Company was in compliance with all such covenants.

In addition, the 2022 Credit Agreement includes customary events of default and other provisions that could require all amounts due thereunder to become immediately due and payable, either automatically or at the option of the Lenders, if the Company fails to comply with the terms.

On August 4, 2023, the Company and Deerfield entered into Amendment No. 1, dated August 4, 2023 (“Amendment No.1”) to the 2022 Credit Agreement. Pursuant to Amendment No. 1, the 2022 Credit Agreement was amended to decrease the amount of cash the Company is required to maintain pursuant to the minimum liquidity covenant in the 2022 Credit Agreement to $5,000,000 for a period of 18 months, at which point the amount required under the minimum liquidity covenant shall increase to $20,000,000 (or, if certain conditions are met, $10,000,000), in exchange for a fee paid by the Company.

On November 8, 2023, the Company and Deerfield entered into Amendment No. 2, dated November 8, 2023 (“Amendment No. 2”) to the 2022 Credit Agreement. Pursuant to Amendment No. 2, the 2022 Credit Agreement was amended to, among other things: (i) adjust and increase the amortization schedule such that payments commence on June 30, 2024 and are made 12, 24 and 36 months (i.e., the scheduled maturity date) following June 30, 2024; (ii) limit the business activities the Company may engage in; and (iii) require the Company to maintain a minimum liquidity of $10,000,000 at all times, in exchange for fees paid by the Company.

On March 4, 2024, the Company entered into Waiver and Amendment No. 3 ("Amendment No. 3") to the 2022 Credit Agreement. Previously, on February 16, 2024, Biotronik and VascoMed GmbH (the “Biotronik Parties") filed a Demand for Arbitration (the “Demand") against Acutus with the American Arbitration Association (who notified the Company of the Demand on February 29, 2024), alleging that the Company breached its contractual obligations under five agreements relating to the licensing, manufacturing, distribution and development of medical devices as a result of the wind down of its businesses. Pursuant to Amendment No. 3, Deerfield has agreed to waive any Default or Event of Default (each defined in the 2022 Credit Agreement) that has arisen or may arise in connection with the Demand. In addition, pursuant to Amendment No. 3 among other things, (i) the 2022 Credit Agreement was amended such that (x) a Change in Control (as defined in the 2022 Credit Agreement) under the 2022 Credit Agreement would not be deemed to occur in the event the Company's common stock ceases to be listed on Nasdaq (without a comparable re-listing) (a "Delisting") and (y) exposure incurred in excess of $3.0 million in respect of proceedings in relation to the Demand and/or related proceedings and/or between such parties is deemed an Event of Default (as defined in the 2022 Credit Agreement) under the 2022 Credit Agreement.

In connection with entering into the 2022 Credit Agreement, the Company entered into a warrant purchase agreement (the "2022 Warrant Purchase Agreement") with Deerfield, pursuant to which the Company issued to Deerfield warrants to purchase up to an aggregate 3,779,018 shares of common stock at an exercise price of $1.1114 per warrant share for a period of eight years following issuance (the "2022 Warrants"). On March 4, 2024, the Company entered into an amendment (the “Amendment”) to the 2022 Warrants and 2022 Warrant Purchase Agreement with Deerfield. Pursuant to the Amendment, (i) the 2022 Warrants were amended to remove Deerfield’s option to require the Company to repurchase the 2022 Warrants from

Deerfield upon a Delisting, and modify the volatility rate that would be used to calculate the Black-Scholes value of the 2022 Warrants that would apply to certain other transactions involving the Company pursuant to the 2022 Warrants, and (ii) the Warrant Purchase Agreement was amended to remove the Company obligation to take all commercially reasonable actions necessary to cause the Company’s common stock to remain listed on Nasdaq at all times during the term of the 2022 Warrants.

The 2022 Warrants represent a freestanding financial instrument and are conditionally puttable at the holder’s option upon an event that is outside of the Company’s control. Therefore, the 2022 Warrants are classified as liability pursuant to ASC 480, Distinguishing Liabilities from Equity, initially and subsequently recognized at fair value, with changes in fair value recognized in the condensed consolidated statements of operations and comprehensive income (loss). Refer to Fair Value Measurements in Note 2 - Summary of Significant Accounting Policies and Note 12 - Warrants for more information.

On November 13, 2024, the Company entered into Amendment No. 4 to Amended and Restated Credit Agreement (“Amendment No. 4”) to amend the Amended and Restated Credit Agreement, dated as of June 30, 2022 (as amended, restated, supplemented or otherwise modified from time to time, the “Credit Agreement”), among the Company, the Lenders from time to time party thereto and Wilmington Trust, National Association, as the Administrative Agent.

Pursuant to Amendment No. 4, the Credit Agreement was amended to (i) adjust the amortization schedule of the Credit Agreement such that the $7.5 million installment payment of principal due on June 30, 2025 would be made over three equal installments of $2.5 million on each of June 30, 2025, September 30, 2025 and December 31, 2025 and (ii) increase the exit fee associated with prepayment or repayment of the loans from 5.0% to 6.0% of the principal amount of the loans prepaid or repaid.

Except as amended by Amendment No. 4, the remaining terms of the Credit Agreement remain in full force and effect.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Subsequent Events	9 Months Ended
Subsequent Events	Sep. 30, 2024
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events On November 13, 2024, the Company and Deerfield Partners, L.P. and Deerfield Private Design Fund III, L.P. (collectively, the “Lenders”) entered into Amendment No. 4 to Amended and Restated Credit Agreement (“Amendment No. 4”) to amend the Amended and Restated Credit Agreement, dated as of June 30, 2022 (as amended, restated, supplemented or otherwise modified from time to time, the “Credit Agreement”), among the Company, the Lenders from time to time party thereto and Wilmington Trust, National Association, as the Administrative Agent. Pursuant to Amendment No. 4, the Credit Agreement was amended to (i) adjust the amortization schedule of the Credit Agreement such that the $7.5 million installment payment of principal due on June 30, 2025 would be made over three equal installments of $2.5 million on each of June 30, 2025, September 30, 2025 and December 31, 2025 and (ii) increase the exit fee associated with prepayment or repayment of the loans from 5.0% to 6.0% of the principal amount of the loans prepaid or repaid. Except as amended by Amendment No. 4, the remaining terms of the Credit Agreement remain in full force and effect.

Sale of Business - Narrative (Details) - USD ($)			1 Months Ended		3 Months Ended		9 Months Ended
Sale of Business - Narrative (Details) - USD ($)	Feb. 01, 2023	Jun. 30, 2022	Jan. 31, 2023	Nov. 30, 2022	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of business							$ 13,235,000	$ 17,000,000
Restricted cash					$ 0		0
Gain on sale of business, net					$ 2,435,000	$ 2,648,000	8,096,000	$ 5,927,000
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of business		$ 50,000,000.0	$ 17,000,000.0	$ 20,000,000.0
Indemnity escrow account, amount		$ 4,000,000.0	$ 1,400,000	$ 1,600,000
Indemnity escrow account, term		18 months
Milestone consideration, period	4 years	4 years
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| OEM Earnout
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of business		$ 20,000,000
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Transfer Earnout
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of business		$ 17,000,000
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Medtronic
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Earnout accrued							8,353,000
Gain on sale of business, net							$ 8,096,000
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Year One
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Milestone consideration, royalty percentage	100.00%	100.00%
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Year Two
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Milestone consideration, royalty percentage	75.00%	75.00%
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Year Three
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Milestone consideration, royalty percentage	50.00%	50.00%
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Year Four
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Milestone consideration, royalty percentage	50.00%	50.00%

Property and Equipment, Net - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Property, Plant and Equipment [Abstract]
Depreciation expense	$ 100	$ 200	$ 235	$ 384

Related Party Transactions (Details) - USD ($)		3 Months Ended		9 Months Ended
Related Party Transactions (Details) - USD ($)	Jun. 30, 2022	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Mar. 04, 2024	Dec. 31, 2023
Related Party Transaction [Line Items]
Liability for loan balance		$ 32,353,000		$ 32,353,000			$ 34,518,000
Common stock, shares issued (in shares)		29,912,305		29,912,305			29,912,305
Piggy-back registration rights, period	5 years
Warrant Liability
Related Party Transaction [Line Items]
Class of warrants, exercise price (in dollars per share)	$ 1.1114
Warrant, term	8 years
2022 Credit Agreement \| Senior Term Loan
Related Party Transaction [Line Items]
Face amount						$ 35,000,000.0
Consulting Agreement \| Board of Directors Chairman
Related Party Transaction [Line Items]
Consulting fees incurred for related party, less than		$ 100,000	$ 100,000	$ 100,000	$ 100,000
Credit Agreements \| Related Party \| 2019 Credit Agreement \| Senior Term Loan
Related Party Transaction [Line Items]
Face amount	$ 70,000,000.0
Loan balance, repaid in full	40,000,000.0
Credit Agreements \| Related Party \| 2022 Credit Agreement \| Senior Term Loan
Related Party Transaction [Line Items]
Face amount	$ 35,000,000.0
Long-term debt, term	5 years
Liability for loan balance		32,400,000		32,400,000			$ 34,800,000
Interest expense, debt		$ 1,400,000	$ 1,400,000	$ 4,400,000	$ 4,100,000
Warrants \| Related Party \| Warrant Liability
Related Party Transaction [Line Items]
Common stock, shares issued (in shares)	3,779,018
Class of warrants, exercise price (in dollars per share)	$ 1.1114
Warrant, term	8 years

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Cash flows from operating activities
Net loss	$ (8,141)	$ (47,898)
Less: Loss from discontinued operations	4,916	38,020
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation expense	235	384
Non-cash stock-based compensation expense	459	1,272
Accretion of discounts on marketable securities, net	(28)	(1,318)
Amortization of debt issuance costs	460	325
Amortization of operating lease right-of-use assets	542	513
Gain on sale of business, net	(8,096)	(5,927)
Change in fair value of warrant liability	(107)	(1,478)
Change in fair value of contingent consideration	0	123
Changes in operating assets and liabilities:
Accounts receivable	(3,499)	3,247
Inventory	87	11,567
Employer retention credit receivable	0	4,703
Prepaid expenses and other current assets	286	2,010
Accounts payable	(1,050)	(3,020)
Accrued liabilities	(1,442)	(8,043)
Operating lease liabilities	(532)	(253)
Other long-term liabilities	0	20
Net cash used in operating activities - continuing operations	(15,910)	(5,753)
Net cash used in operating activities - discontinued operations	(11,692)	(39,352)
Net cash used in operating activities	(27,602)	(45,105)
Cash flows from investing activities
Proceeds from sale of business	13,235	17,000
Purchases of available-for-sale marketable securities	0	(38,521)
Sales of available-for-sale marketable securities	500	0
Maturities of available-for-sale marketable securities	2,750	70,250
Purchases of property and equipment	(148)	(1,187)
Net cash provided by investing activities - continuing operations	16,337	47,542
Net cash provided by (used in) investing activities - discontinued operations	339	(207)
Net cash provided by investing activities	16,676	47,335
Cash flows from financing activities
Repayment of debt	(2,625)	0
Proceeds from the exercise of stock options	0	4
Repurchase of common shares to pay employee withholding taxes	0	(35)
Proceeds from employee stock purchase plan	0	25
Payment of contingent consideration	0	(1,923)
Net cash used in financing activities - continuing operations	(2,625)	(1,929)
Net cash used in financing activities - discontinued operations	(41)	(240)
Net cash used in financing activities	(2,666)	(2,169)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(13)	(294)
Net change in cash, cash equivalents and restricted cash	(13,605)	(233)
Cash, cash equivalents and restricted cash, at the beginning of the period	26,200	31,348
Cash, cash equivalents and restricted cash, at the end of the period	12,595	31,115
Supplemental disclosure of cash flow information:
Cash paid for interest	3,394	3,731
Supplemental disclosure of noncash investing and financing activities:
Accounts receivable from sale of business	4,478	6,111
Change in unrealized (gain) on marketable securities	0	(7)
Change in unpaid purchases of property and equipment	$ 0	$ 35

Net Loss Per Common Share

9 Months Ended

Sep. 30, 2024

Earnings Per Share [Abstract]

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 includes the potential impact of the Company’s convertible preferred stock, common stock options, RSUs, RSAs, intended ESPP purchases and warrants when such shares are not anti-dilutive. In accordance with ASC 260, Earnings Per Share, if a Company had discontinued operations, the Company uses income from continuing operations, adjusted for preferred dividends and similar adjustments, as its control number to determine whether potential common shares are dilutive.

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:


	Three Months Ended September 30,		Nine Months Ended September 30,
	2024	2023	2024	2023
	(unaudited)		(unaudited)
Shares issuable upon:
Conversion of Series A Common Equivalent Preferred Stock	6,665,841	6,665,841	6,665,841	6,665,841
Exercise of common stock warrants	4,576,505	4,576,505	4,576,505	4,576,505
Exercise of stock options	—	2,216,938	—	1,098,279
Vesting of RSUs and RSAs	65,832	2,423,022	692,745	2,290,728
Issuance of shares under 2020 ESPP	—	61,361	—	61,361
Total potentially dilutive securities	11,308,178	15,943,667	11,935,091	14,692,714

Sale of Business - Summary of Sale of Discontinued Operation (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on sale of business, net	$ 2,435	$ 2,648	$ 8,096	$ 5,927
Medtronic \| Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Product Net Sales Earnout accrued as of September 30, 2024			8,353
Transaction costs			(257)
Gain on sale of business, net			$ 8,096

Accrued Liabilities (Tables)

9 Months Ended

Sep. 30, 2024

Payables and Accruals [Abstract]

Summary of Accrued Liabilities

Accrued liabilities consisted of the following as of September 30, 2024 and December 31, 2023 (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
Compensation and related expenses	$	1,128	$	2,225
Professional fees	181		378







Other	393		284
Total accrued liabilities	$	1,702	$	2,887

Commitments and Contingencies (Details) $ in Thousands	Oct. 15, 2024 USD ($)	Sep. 30, 2024 USD ($)	Dec. 31, 2023 USD ($)	Jul. 19, 2022 lawsuit	Mar. 23, 2022 lawsuit
Discontinued Operations, Held-for-Sale or Disposed of by Sale
Loss Contingencies [Line Items]
Accrued restructure		$ 2,663	$ 5,649
Loss recognized on classification as held for sale		18,099	$ 16,369
Securities Litigation
Loss Contingencies [Line Items]
Number of class action lawsuits \| lawsuit					2
Number of class action lawsuits consolidated \| lawsuit				2
Biotronik Arbitration \| Subsequent Event
Loss Contingencies [Line Items]
Initial settlement payment	$ 2,600
Percentage of contingent payment upon qualifying asset sale	50.00%
Payment upon change of control involving competitive company, amount	$ 8,000
Percentage of contingent payment upon change of control involving competitive company	5.00%
Percentage of contingent payment upon change of control not involving competitive company	25.00%
Biotronik Arbitration \| Discontinued Operations, Held-for-Sale or Disposed of by Sale
Loss Contingencies [Line Items]
Accrued restructure		2,500
Loss recognized on classification as held for sale		$ 1,700
Biotronik Arbitration \| Maximum \| Subsequent Event
Loss Contingencies [Line Items]
Contingent payment upon change of control involving competitive company	$ 25,000
Aggregate payment upon change of control involving competitive company	$ 25,000

Operating Leases - Narrative (Details)	3 Months Ended		9 Months Ended
Operating Leases - Narrative (Details)	Sep. 30, 2024 USD ($) ft²	Jun. 30, 2024 USD ($) lease	Sep. 30, 2024 USD ($) ft²
Lessee, Lease, Description [Line Items]
Number of subleases \| lease		2
Impairment of the head lease's right-to-use assets \| $		$ 0
Sublease Income \| $	$ 100,000		$ 100,000
Corporate Office Space and Manufacturing Facility
Lessee, Lease, Description [Line Items]
Office space \| ft²	50,800		50,800
Operating lease, renewal term	5 years		5 years
Office Space Zaventem Belgium
Lessee, Lease, Description [Line Items]
Office space \| ft²	3,900		3,900

Warrants

9 Months Ended

Sep. 30, 2024

Warrants and Rights Note Disclosure [Abstract]

Warrants

As of September 30, 2024 and December 31, 2023, the outstanding warrants to purchase the Company’s common stock consisted of the following:


	Exercise Price		Expiration Date	September 30, 2024	December 31, 2023
				(unaudited)
Warrants issued in 2015	$	5.25	1/30/25	3,808	3,808
Warrants issued with 2018 Convertible Notes	$	0.10	6/7/28	346,689	346,689
Warrants issued with 2018 Term Loan	$	16.67	7/31/28	26,998	26,998
Warrants issued with 2019 Credit Agreement	$	16.67	5/20/29	419,992	419,992
Warrants issued with 2022 Credit Agreement	$	1.11	6/30/30	3,779,018	3,779,018
Total Warrants				4,576,505	4,576,505

There was no warrant activity during the nine months ended September 30, 2024.

The Company’s warrants provide the holder the option to purchase a specified number of shares for a specified price within a specified duration or upon the occurrence of a specific event. The holder may exercise the warrant either by cash payment or by 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.

In accordance with ASC 480, the 2022 Warrants are recorded at fair value on the condensed consolidated balance sheets as a warrant liability. Changes in fair value are recognized as a change in fair value of warrant liability in the condensed consolidated statements of operations and comprehensive income (loss). For the nine months ended September 30, 2024, the fair value of the warrant liability decreased $0.1 million.

In connection with the Series A Common Equivalent Preferred Stock Exchange Agreements (as defined below), four warrant holders are limited to exercising their warrants such that following any such exercise, the number of shares of common stock beneficially owned by such holder cannot exceed 4.9% of the outstanding common stock of the Company (two of the holders may, at their option and upon sufficient prior written notice to the Company, increase such percentage to 9.9%). In the event the common share limit has been met and the holder chooses to exercise their warrants, the holder can sell any common stock they hold. Therefore, the amendment to the warrant agreements does not restrict the holder from fully exercising the warrants under the original terms of the warrant agreements.

Summary of Significant Accounting Policies - Narrative (Details)	1 Months Ended	3 Months Ended		9 Months Ended		12 Months Ended
	May 31, 2020	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2024 USD ($) segment	Sep. 30, 2023 USD ($)	Dec. 31, 2022	Dec. 31, 2023 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of operating segment \| segment				1
Number of reportable segments \| segment				1
Restricted cash		$ 0		$ 0
Distribution agreement, term	5 years
Inventory write-down		500,000	$ 300,000	1,100,000	$ 900,000
Allowance for uncollectible accounts		0		0			$ 0
Property and equipment impairment		$ 0	$ 0	$ 0	$ 0
Exercise of common stock warrants \| Significant Unobservable Inputs (Level 3) \| Expected volatility
Summary Of Significant Accounting Policies [Line Items]
Warrants and rights outstanding, measurement input		2.000		2.000
Minimum
Summary Of Significant Accounting Policies [Line Items]
Customers payment period				30 days
Property and equipment, estimated useful lives		3 years		3 years
Maximum
Summary Of Significant Accounting Policies [Line Items]
Customers payment period				60 days
Contracts with customers, expected duration		1 year		1 year
Agreement to produce and sell products, term						4 years
Property and equipment, estimated useful lives		5 years		5 years
Deferred Equipment Agreements \| Minimum
Summary Of Significant Accounting Policies [Line Items]
Term of contract				2 years
Deferred Equipment Agreements \| Maximum
Summary Of Significant Accounting Policies [Line Items]
Term of contract				4 years

Operating Leases - Summary of Quantitative Information About Operating Leases (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Leases [Abstract]
Operating cash flows from operating leases	$ 290	$ 282
Weighted average remaining lease term – operating leases	3 years 2 months 12 days	4 years 2 months 12 days
Weighted average discount rate – operating leases	7.00%	7.00%

Accrued Liabilities

9 Months Ended

Sep. 30, 2024

Payables and Accruals [Abstract]

Accrued Liabilities

Accrued liabilities consisted of the following as of September 30, 2024 and December 31, 2023 (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
Compensation and related expenses	$	1,128	$	2,225
Professional fees	181		378







Other	393		284
Total accrued liabilities	$	1,702	$	2,887

Discontinued Operations, Assets Held for Sale and Restructuring - Summary of Restructuring Activities and Related Accruals (Details) - Discontinued Operations, Held-for-Sale or Disposed of by Sale - USD ($) $ in Thousands	3 Months Ended			9 Months Ended
	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2024
Restructuring Reserve [Roll Forward]
Restructuring reserve, beginning balance	$ 162	$ 1,141	$ 5,649	$ 5,649
Payments	0	(751)	(3,692)
Biotronik Settlement	2,510
Accrual release (non-cash)	(9)	(228)	(816)
Restructuring reserve, ending balance	2,663	162	1,141	2,663
Employee Severance
Restructuring Reserve [Roll Forward]
Restructuring reserve, beginning balance	27	114	3,493	3,493
Payments	0	(78)	(3,194)
Biotronik Settlement	0
Accrual release (non-cash)	(9)	(9)	(185)
Restructuring reserve, ending balance	18	27	114	18
Contract Termination
Restructuring Reserve [Roll Forward]
Restructuring reserve, beginning balance	135	1,027	2,156	2,156
Payments	0	(673)	(498)
Biotronik Settlement	0
Accrual release (non-cash)		(219)	(631)
Restructuring reserve, ending balance	135	135	1,027	135
Other Restructuring
Restructuring Reserve [Roll Forward]
Restructuring reserve, beginning balance	0	0	0	0
Payments	0	0	0
Biotronik Settlement	2,510
Accrual release (non-cash)		0	0
Restructuring reserve, ending balance	$ 2,510	$ 0	$ 0	$ 2,510

Sale of Business (Tables)

9 Months Ended

Sep. 30, 2024

Discontinued Operations and Disposal Groups [Abstract]

Summary of Sale of Discontinued Operation

The major assets and liabilities (at carrying value) associated with discontinued operations included in the Company's consolidated balance sheets are as follows (in thousands):


	September 30, 2024			December 31, 2023
Carrying amounts of major classes of assets included as part of discontinued operations	(unaudited)

Accounts receivable	$	—		$	510
Inventory	12,780			12,780		*
Prepaid expenses and other current assets	897			902		*
Property and equipment, net	4,537			4,871		*
Intangible assets, net	1,416			1,416		*
Other assets	—			—
Less: loss recognized on classification as held for sale	(18,099)		**	(16,369)		*
Total assets of the disposal group classified as discontinued operations in the statement of financial position	$	1,531		$	4,110

* These comprise assets held for sale, at their carrying value of $3.6 million as of December 31, 2023. The Company recorded the loss on classification of held for sale as a valuation allowance on the group of assets held for sale, without allocation to the individual assets within the group.

** At September 30, 2024, an additional valuation allowance of $1.7 million was recorded to reflect an estimate of the additional cost to sell the assets held for sale based on the Biotronik settlement. See further details in Footnote 11, Commitments and Contingencies.

Carrying amounts of major classes of liabilities included as part of discontinued operations

Accounts payable	306			1,892
Accrued restructure	2,663			5,649
Accrued liabilities	—			2,762
Total liabilities of the disposal group classified as discontinued operations in the statement of financial position	$	2,969		$	10,303

The revenues and expenses associated with discontinued operations included in the Company's condensed consolidated statements of operations and comprehensive loss for the three months ended September 30, 2024 were as follows (in thousands):


	Three Months Ended
	September 30, 2024		September 30, 2023
Major line items constituting pretax loss of discontinued operations	(unaudited)		(unaudited)

Revenue	$	—	$	3,178

Cost of products sold	—		(5,445)
Research and development	(15)		(3,899)
Selling, general and administrative	(190)		(5,078)



Restructuring	(2,856)		—
Loss on assets held for sale	(1,730)		—

Loss from discontinued operations before income taxes	(4,791)		(11,244)
Income tax expense	—		75
Net loss from discontinued operations	$	(4,791)	$	(11,319)

Net loss for the three months ended September 30, 2024 is primarily due to an additional restructuring expense of $2.5 million related to the Biotronik settlement and an additional $1.7 million cost related to contingent payment consideration on the sale of assets held for sale per the Biotronik settlement (see Footnote 11, Commitments and Contingencies, for further information), and SG&A expenses related to the wind down of the discontinued operations, offset by recording a credit to stock-based compensation resulting from restructuring termination forfeitures and RSU accelerated vesting modification treatment. (See Footnote 14, Stock-Based Compensation, for further information.)

The revenues and expenses associated with discontinued operations included in the Company's condensed consolidated statements of operations and comprehensive income (loss) for the nine months ended September 30, 2024 were as follows (in thousands):


	Nine Months Ended
	September 30, 2024		September 30, 2023
Major line items constituting pretax loss of discontinued operations	(unaudited)		(unaudited)

Revenue	$	—	$	9,880

Cost of products sold	—		(15,612)
Research and development	197		(14,960)
Selling, general and administrative	(493)		(16,778)



Restructuring	(2,880)		(475)
Loss on assets held for sale	(1,730)		—

Loss from discontinued operations before income taxes	(4,906)		(37,945)
Income tax expense	10		75
Net loss from discontinued operations	$	(4,916)	$	(38,020)

The Company recorded the following amounts for the nine months ended September 30, 2024, resulting in a net gain of $8.1 million related to the sale of business to Medtronic, calculated as the difference between the non-contingent consideration earned, less direct transaction costs (in thousands):


	Nine Months Ended September 30, 2024
	(unaudited)
Product Net Sales Earnout accrued as of September 30, 2024	$	8,353
Transaction costs	(257)
Gain on sale of business, net	$	8,096

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

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+ Details

Summary of Significant Accounting Policies (Policies)	9 Months Ended
Summary of Significant Accounting Policies (Policies)	Sep. 30, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S. GAAP”) for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments necessary for the fair statement of the balances and results for the periods presented. Certain information and note disclosures normally included in the Company’s annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These condensed consolidated financial statement results are not necessarily indicative of results to be expected for the full fiscal year or any future period.
Principles of Consolidation	Principles of Consolidation The condensed consolidated financial statements include the accounts of Acutus Medical, Inc. and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Discontinued Operations	Discontinued Operations In accordance with Accounting Standards Codification ("ASC") 205, Presentation of Financial Statements, under subtopic 205-20 Discontinued Operations, a disposal of a component of an entity or a group of components of an entity is required to be reported as discontinued operations if the disposal represents a strategic shift that has (or will have) a major effect on an entity’s operations and financial results when the components of an entity meets the criteria in paragraph 205-20-45-10. In the period in which the component meets held-for-sale or discontinued operations criteria the major current assets, non-current assets, current liabilities, and non-current liabilities are reported as components of total assets and liabilities separate from those balances of the continuing operations. At the same time, the results of all discontinued operations, less applicable income taxes, are reported as components of net loss separate from the net loss of continuing operations. The strategic shift approved by the Company's board of directors (discussed in Note 1 – Organization and Description of Business, above) met the definition of a discontinued operation as of September 30, 2024 and December 31, 2023. Accordingly, the major current assets, non-current assets, current liabilities, and non-current liabilities are reported as components of total assets and liabilities separate from those balances of the continuing operations as of September 30, 2024 and December 31, 2023, and the operating results of the components disposed are reported as loss from discontinued operations in the accompanying condensed consolidated statements of operations and comprehensive income (loss) for the three- and nine- months ended September 30, 2024 and 2023. For additional information, see Note 3 - Discontinued Operations, Assets Held for Sale and Restructuring.
Use of Estimates and Assumptions	Use of Estimates and Assumptions The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenue, expenses and disclosures of contingent assets and liabilities. These estimates and assumptions are based on current facts, historical experience and various other factors believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities and the recording of revenue and expenses that are not readily apparent from other sources. Actual results could differ from those estimates.
Segments	Segments Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker in making decisions regarding resource allocation and assessing performance. The Company views its operations and manages its business as one operating segment and reportable segment.
Cash and Cash Equivalents and Restricted Cash	Cash and Cash Equivalents and Restricted Cash The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents. All of the Company’s cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in bank deposits and other accounts, the balances of which, at times and as of September 30, 2024 and December 31, 2023, exceeded federally insured limits. Restricted cash consists of (i) deposited cash collateral for the Company’s corporate credit card program and (ii) cash received for the sale of business to Medtronic held in an indemnity escrow account until certain terms of sale are met. Following the termination of the escrow account in accordance with the Asset Purchase Agreement, the amounts in escrow were released. As of September 30, 2024, the Company recorded no restricted cash on the condensed consolidated balance sheet.
Marketable Securities	Marketable Securities The Company’s marketable securities portfolio consists of investments in money market funds, commercial paper, U.S. treasury securities and Yankee debt securities. The Company considers its debt securities to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term or long-term marketable securities based on the maturity date at time of purchase and their availability to meet current operating requirements. Marketable securities that mature in three months or less from the date of purchase are classified as cash equivalents. Marketable securities, excluding cash equivalents, that mature in one year or less are classified as short-term available-for-sale securities and are reported as a component of current assets. Securities that are classified as available-for-sale are measured at fair value with temporary unrealized gains and losses reported in other comprehensive income (loss), and as a component of stockholders’ equity until their disposition or maturity. See “Fair Value Measurements,” below. The Company reviews all available-for-sale securities at each period end to determine if they remain available-for-sale based on the Company’s current intent and ability to sell the security if it is required to do so. Realized gains and losses from the sale of marketable securities, if any, are calculated using the specific-identification method. Marketable securities are subject to a periodic impairment review. The Company may recognize an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investee’s financial condition and the Company’s intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in value judged to be other-than-temporary are included in the Company’s condensed consolidated statements of operations and comprehensive income (loss). The Company did not record any other-than-temporary impairments related to marketable securities in the Company’s condensed consolidated statements of operations and comprehensive income (loss) for the three and nine months ended September 30, 2024 and 2023.
Concentrations of Credit Risk and Off-Balance Sheet Risk	Concentrations of Credit Risk and Off-Balance Sheet Risk Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents, restricted cash, accounts receivable and marketable securities. Cash and restricted cash (if applicable) are maintained in accounts with financial institutions which, at times, may exceed the federal depository insurance coverage of $0.25 million. The Company has not experienced losses on these accounts, and management believes, based upon the quality of the financial institutions, that the credit risk with regard to these deposits is not significant.
Revenue from Contracts with Customers	Revenue from Contracts with Customers The Company accounts for revenue earned from contracts with customers under ASC 606, Revenue from Contracts with Customers (“ASC 606”), and ASC 842, Leases ("ASC 842"). The core principle of ASC 606 is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The following five steps are applied to achieve that core principle: •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. ASC 842 provides guidance on determining whether an agreement contains a lease. ASC 842 defines a lease as a contract, or part of a contract, that conveys the right to control the use of identified property, plant or equipment for a period of time in exchange for consideration. The below description applies to products that are no longer being manufactured and sold by the Company due to the Restructuring. See Note 1 – Organization and Description of Business – Liquidity and Capital Resources, above. Historically, for new customers, the Company had placed its medical diagnostic equipment, the AcQMap System, at customer sites under evaluation agreements and had generated revenue from the sale of disposable products used with the AcQMap System. Disposable products primarily included AcQMap catheters and AcQGuide steerable sheaths. Outside of the United States, the Company also had the Qubic Force Device which generated revenue from the sale of the AcQBlate Force Ablation Catheters. The Company had provided the disposable products in exchange for consideration, which occurred when a customer submitted a purchase order and the Company provided disposables at the agreed upon prices in the invoice. Generally, customers purchased disposable products using separate purchase orders after the equipment had been provided to the customer for free with no binding agreement or requirement to purchase any disposable products. The Company had elected the practical expedient and accounting policy election to account for the shipping and handling as activities to fulfill the promise to transfer the disposable products and not as a separate performance obligation. Additionally, the Company had sold the AcQMap System to customers along with software updates on a when-and-if-available basis, as well as the Qubic Force Device and a transseptal crossing line of products which could be used in a variety of heart procedures and did not need to be accompanied with an AcQMap System or Qubic Force Device. The Company had also entered into deferred equipment agreements that were generally structured such that the Company agreed to provide an AcQMap System at no up-front charge, with title of the device transferring to the customer at the end of the contract term, in exchange for the customer’s commitment to purchase disposables at a specified price over the term of the agreement, which generally ranged from two years to four years. The Company had determined that such deferred equipment agreements included an embedded sales-type lease. The Company had allocated contract consideration under deferred equipment agreements containing fixed annual disposable purchase commitments to the underlying lease and non-lease components at contract inception. The Company had expensed the cost of the device at the inception of the agreement and recorded a financial lease asset equal to the gross consideration allocated to the lease. The lease asset had been reduced by payments for minimum disposable purchases that were allocated to the lease. Lastly, the Company had entered into short-term operating leases for the rental of the AcQMap System after an evaluation. These lease agreements imposed no requirement on the customer to purchase the equipment, and the equipment was not transferred to the customer at the end of the lease term. The short-term nature of the lease agreements did not result in lease payments accumulating to an amount that equaled the value of the equipment nor was the lease term reflective of the economic life of the equipment. The Company’s contracts had primarily included fixed consideration. Generally, there were no discounts, rebates, returns or other forms of variable consideration. Customers were generally required to pay within 30 days to 60 days. The delivery of disposable products were performance obligations satisfied at a point in time. The disposable products were shipped via Free on Board (“FOB”) shipping point or FOB destination. For disposable products that were shipped via FOB shipping point, the customer had the significant risks and rewards of ownership and legal title to the assets when the disposable products left the Company’s shipping facilities, at which point the customer obtained control and thus revenue was recognized at that point in time. Revenue had been recognized on delivery for disposable products shipped via FOB destination. For direct customers, the installation and delivery of the AcQMap System was satisfied at a point in time when the installation was complete, which was when the customer could benefit and had control of the system. For AcQMap System sales sold to Biotronik SE & Co. KG (“Biotronik”), the installation was not a performance obligation as it was performed by Biotronik, and therefore the AcQMap System was satisfied at a point in time when they had control of the system. The Company’s software updates and equipment service performance obligations were satisfied evenly over time as the customer simultaneously received and consumed the benefits of the Company’s performance for these services throughout the service period. The Company had allocated the transaction price to each performance obligation identified in the contract based on the relative standalone selling price (“SSP”). The Company had determined SSP for the purposes of allocating the transaction price to each performance obligation based on the adjusted market assessment approach that maximizes the use of observable inputs, which included, but was not limited to, sales transactions where the specific performance obligations were sold separately, Company listed prices and specific offers to customers. Except for the deferred equipment agreements noted above, the Company’s contracts with customers generally had an expected duration of one year or less, and therefore the Company had elected the practical expedient in ASC 606 to not disclose information about its remaining performance obligations. Any incremental costs to obtain contracts were recorded as selling, general and administrative ("SG&A") expense as incurred due to the short duration of the Company’s contracts. The Company’s contract balances consisted solely of accounts receivable as of September 30, 2024 and December 31, 2023. In May 2020, the Company entered into bi-lateral distribution agreements (the “Bi-Lateral Distribution Agreements”) with Biotronik. Pursuant to the Bi-Lateral Distribution Agreements, the Company obtained a non-exclusive license to distribute a range of Biotronik’s products and accessories in the United States, Canada, China, Hong Kong and multiple Western European countries under the Company’s private label. Moreover, if an investigational device exemption (“IDE”) clinical trial was required for these products to obtain regulatory approval in the United States, or a clinical trial was required for these products to obtain regulatory approval in China, the Company would obtain an exclusive distribution right in such territories for a term of up to five years commencing on the date of regulatory approval if the Company covered the cost of the IDE or other clinical trial and the Company conducted such study within a specified period. Biotronik also agreed to distribute the Company’s products and accessories in Germany, Japan, Mexico, Switzerland and multiple countries in Asia-Pacific, Eastern Europe, the Middle East and South America. The Company also granted Biotronik a co-exclusive right to distribute these products in Hong Kong. Each party would pay to the other party a specified transfer price on the sale of the other party’s products and, accordingly, would earn a distribution margin on the sale of the other party’s products. In February 2024, Biotronik sent a notice to the Company, stating that Biotronik rescinds and terminates the Bi-Lateral Distribution Agreements, effective immediately, based on the alleged repudiation of its contractual obligations under the Bi-Lateral Distribution Agreements. In October 2024, resulting from the Company's Restructuring and the Arbitration that ensued with Biotronik Parties, the Company entered into a Settlement Agreement and Release terminating the Relevant Agreements (except for certain surviving obligations specified therein), settling the Arbitration relating to the Relevant Agreements and releasing and discharging each party of all claims against the other, including any claims that were or could have been asserted in the Arbitration. In 2022, the Company sold its left-heart access transseptal crossing business to Medtronic. In connection with the sale, the Company entered into a distribution agreement (the "Distribution Agreement") with Medtronic, pursuant to which the Company acts as the original equipment manufacturer ("OEM") supplier of these Products. The Company will produce and sell the Products to Medtronic for a period of up to four years. Revenue is recognized when the title to the products are transferred to Medtronic, which occurs when the products are shipped from the Company's facility (or via FOB shipping point). See Note 4 – Sale of Business, below, for further details. As part of the Restructuring, the Company currently focuses exclusively on the manufacturing and distribution of the Products and associated services to Medtronic to continue to generate revenue from such sales and potentially earn the associated earnout payments.
Inventory	Inventory Inventory is stated at the lower of cost (first-in, first-out basis) or net realizable value. The Company recorded write-downs for excess and obsolete inventory of $0.5 million and $0.3 million for the three months ended September 30, 2024 and 2023, respectively, and $1.1 million and $0.9 million for the nine months ended September 30, 2024 and 2023, respectively, based on management’s review of inventories on hand, comparisons to estimated future usage and sales, observed shelf-life and assumptions about the likelihood of obsolescence.
Accounts Receivable	Accounts Receivable Trade accounts receivable are recorded net of allowances for uncollectible accounts. The Company evaluates the collectability of its accounts receivable based on various factors including historical experience, the length of time the receivables are past due and the financial health of the customer. The Company reserves specific receivables if collectability is no longer reasonably assured. Based upon the assessment of these factors, the Company did not record an allowance for uncollectible accounts as of September 30, 2024 or December 31, 2023.
Property and Equipment, Net	Property and Equipment, Net Property and equipment are recorded at cost. Depreciation and amortization are provided using the straight-line method over the estimated useful lives of the related assets, generally three to five years, or, in the case of leasehold improvements, over the lesser of the useful life of the related asset or the lease term.
Impairment of Long-Lived Assets	Impairment of Long-Lived Assets The Company reviews long-lived assets, including property and equipment and finite-lived intangible assets, for impairment whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. An impairment loss is recognized when the asset’s carrying value exceeds the total undiscounted cash flows expected from its use and eventual disposition. The amount of the impairment loss is determined as the excess of the carrying value of the asset over its fair value. For the three and nine months ended September 30, 2024 and 2023, the Company determined that there was no impairment of property and equipment.
Foreign Currency Translation and Transactions	Foreign Currency Translation and Transactions The assets, liabilities and results of operations of Acutus Medical N.V. and Acutus Medical UK Limited are measured using their functional currency, the Euro and British Pound Sterling, respectively, which is the currency of the primary foreign economic environment in which the subsidiaries operate. Upon consolidating these entities with the Company, their assets and liabilities are translated to U.S. dollars at currency exchange rates as of the balance sheet date and their revenues and expenses are translated at the weighted average currency exchange rates during the applicable reporting periods. Translation adjustments resulting from the process of translating the entities’ financial statements are reported in accumulated other comprehensive loss in the condensed consolidated balance sheets and foreign currency translation adjustment in the condensed consolidated statements of operations and comprehensive income (loss).
Lease Property	Lease Property The Company leases office space in Carlsbad, California as its corporate headquarters and for manufacturing operations. Additionally, it leases office space in Zaventem, Belgium for CE Mark compliance. The Company accounts for its lease property under ASC 842. Under this guidance, arrangements meeting the definition of a lease are classified as operating or financing leases, and are recorded on the condensed consolidated balance sheets as both a right-of-use asset and a lease liability, calculated by discounting fixed lease payments over the lease term at the rate implicit in the lease or the Company’s incremental borrowing rate, which is the rate for collateralized borrowings based on the current economic environment, credit history, credit rating, value of leases, currency in which the lease obligation is satisfied, rate sensitivity, lease term and materiality. Lease liabilities are increased by interest and reduced by payments each period, and the right-of-use asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the right-of-use asset results in straight-line rent expense over the lease term. Variable lease expenses are recorded when incurred.
Cost of Products Sold	Cost of Products Sold Cost of products sold includes raw materials, direct labor (including stock-based compensation), manufacturing overhead, shipping and receiving costs and other less significant indirect costs related to the production of the Company’s products.
Research and Development	Research and Development Prior to the Restructuring, the Company was actively engaged in new product research and development efforts. Research and development expenses consisted primarily of salaries and employee-related costs (including stock-based compensation) for personnel directly engaged in research and development activities, clinical trial expenses, equipment costs, material costs, allocated rent and facilities costs and depreciation. Research and development expenses relating to possible future products were expensed as incurred. The Company also accrued and expensed costs for activities associated with clinical trials performed by third parties as incurred. All other costs relative to setting up clinical trial sites were expensed as incurred. Clinical trial site costs related to patient enrollment were accrued as patients were entered into the trials. Following the Restructuring, we have no research and development expense as we discontinued research and development to focus on solely manufacturing and distributing the Products and associated services under our Distribution Agreement with Medtronic.
Selling, General and Administrative	Selling, General and Administrative SG&A expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel in executive, finance and other administrative functions, allocated rent and facilities costs, legal fees relating to intellectual property and corporate matters, professional fees for accounting and consulting services, insurance costs, and additionally, prior to the Restructuring, salaries and employee-related costs for personnel in sales, marketing, and other administrative functions.
Restructuring Expenses	Restructuring Expenses The Company undertook a strategic realignment of resources and corporate restructuring (i.e., the Restructuring), including an organizational workforce reduction and additional cost reduction measures. The Company's restructuring and exit-related charges consisted of severance expenses and related benefit costs for employees affected by the organizational workforce reduction, retention bonuses for certain employees that are assisting with the Restructuring, other restructuring costs and impairment charges in connection with the disposition of certain assets, including inventory, fixed assets and intangibles. Refer to Note 3 - Discontinued Operations, Assets Held for Sale and Restructuring for additional details.
Fair Value Measurements	Fair Value Measurements Financial Instruments Fair value measurements are based on the premise that fair value is an exit price representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the following three-tier fair value hierarchy is used in determining the inputs for measuring fair value: 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. Level 3—Unobservable inputs which are supported by little or no market activity and consist of financial instruments valued using pricing models, discounted cash flow methodologies or similar techniques, as well as instruments for which the determination of fair value requires significant judgment or estimation. Financial instruments measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. Management’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. The use of different assumptions and/or estimation methodologies may have a material effect on estimated fair values. Accordingly, the fair value estimates disclosed or initial amounts recorded may not be indicative of the amount that the Company or holders of the instruments could realize in a current market exchange. There were no transfers made among the three levels in the fair value hierarchy for the three and nine months ended September 30, 2024 and 2023. As of September 30, 2024 and December 31, 2023, the Company’s cash (excluding cash equivalents which are recorded at fair value on a recurring basis), restricted cash, accounts receivable, accounts payable and accrued expenses were carried at cost, which approximates the fair values due to the short-term nature of each instrument. The carrying amount of the Company’s long-term debt approximates fair value due to its variable market interest rate and management’s opinion that current rates and terms that would be available to the Company with the same maturity and security structure would be essentially equivalent to that of the Company’s long-term debt. The fair value of the Company’s money market securities is determined using quoted market prices in active markets for identical assets. The fair value for the available-for-sale marketable securities is determined based on valuation models using inputs that are observable either directly or indirectly (Level 2 inputs) such as quoted prices for similar assets, yield curve, volatility factors, credit spreads, default rates, loss severity, current market and contractual prices for the underlying instruments, broker and dealer quotes, as well as other relevant economic measures.
Stock-Based Compensation	Stock-Based Compensation The Company accounts for all stock-based payments to employees and non-employees, including grants of stock options, restricted stock units ("RSUs"), and restricted stock awards ("RSAs"), to be recognized in the consolidated financial statements based on their respective grant date fair values. The Company estimates the fair value of stock option grants using the Black-Scholes option pricing model. The RSUs and RSAs are valued based on the fair value of the Company’s common stock on the date of grant. The Company expenses stock-based compensation related to stock options, RSUs and RSAs over the requisite service period. All stock-based compensation costs are recorded in cost of products sold, research and development expense or SG&A expense in the condensed consolidated statements of operations and comprehensive income (loss) based upon the respective employee’s or non-employee’s roles within the Company. Forfeitures are recorded as they occur. See Note 14—Stock-Based Compensation for additional details.
Income Taxes	Income Taxes Income taxes are recorded in accordance with ASC 740, Income Taxes (“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the consolidated financial statements or tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse, and net operating loss (“NOL”) carryforwards and research and development tax credit carryforwards. Valuation allowances are provided if, based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized. The Company accounts for uncertain tax positions in accordance with the provisions of ASC 740. When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit would more likely than not be realized assuming examination by the taxing authority. The determination as to whether the tax benefit will more likely than not be realized is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances. To date, there have been no interest or penalties charged in relation to the unrecognized tax benefits.
Warrant Liability	Warrant Liability The Company accounts for certain common stock warrants outstanding as a liability at fair value, determined using the Black-Scholes option pricing model, on the condensed consolidated balance sheets in accordance with ASC 815, Derivatives and Hedging (“ASC 815”). The liability is subject to re-measurement at each reporting period and any change in fair value is recognized in the condensed consolidated statements of operations and comprehensive income (loss). See Note 12—Warrants for additional details.
Business Combinations	Business Combinations The Company accounts for business acquisitions using the acquisition method of accounting based on ASC 805, Business Combinations (“ASC 805”), which requires recognition and measurement of all identifiable assets acquired and liabilities assumed at their fair value as of the date control is obtained. The Company determines the fair value of assets acquired and liabilities assumed based upon its best estimates of the acquisition-date fair value of assets acquired and liabilities assumed in the acquisition. Goodwill is calculated as the excess of the purchase price over the fair value of the net tangible and identifiable intangible assets acquired.
Recently Adopted Accounting Pronouncements	Recently Adopted Accounting Pronouncements The following Accounting Standard Updates ("ASUs") applicable to the Company were effective January 1, 2024: •ASU 2023-07, Segment Reporting •ASU 2022-03, Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions The adoption of the above noted ASUs did not have a material effect on the Company's condensed consolidated financial statements.

Discontinued Operations, Assets Held for Sale and Restructuring

9 Months Ended

Sep. 30, 2024

Discontinued Operations and Disposal Groups [Abstract]

Discontinued Operations, Assets Held for Sale and Restructuring

In November 2023, with approval of the Restructuring, the Company began implementation of its business model shift to solely support the manufacturing and distribution of Medtronic’s left-heart access product portfolio. As part of the Restructuring, the Company no longer manufactures or distributes the AcQMap Mapping System, the AcQMap 3D Mapping Catheter, the AcQBlate Force-Sensing Ablation Catheter, the AcQGuide Max 2.0 Steerable Sheath, and associated accessories. Additionally, the Company has halted any further research and development related to this suite of products.

Discontinued operations comprise those activities that were disposed of during the period, abandoned or which were classified as held for sale at the end of the period and relate to the Company's mapping and ablation businesses, which it began winding down in late 2023, and was substantially completed by the end of the first quarter of 2024.

Assets Held for Sale

The Company considers assets to be held for sale when management approves and commits to a plan to actively market the assets for sale at a reasonable price in relation to its fair value, the assets are available for immediate sale in their present condition, an active program to locate a buyer and other actions required to complete the sale have been initiated, or the sale of the assets is expected to be completed within one year and it is unlikely that significant changes will be made to the plan. Upon designation as held for sale, the Company ceases to record depreciation and amortization expenses and measures the assets at the lower of their carrying value or estimated fair value less costs to sell. At September 30, 2024 and December 31, 2023, assets held for sale are included as non-current assets in the Company’s consolidated balance sheets and the loss recognized on classification of assets held for sale is included in the Company’s restructuring expenses. The assets held for sale were determined to be non-current assets as any proceeds from disposal will be used to pay down the Company's long-term debt.

The major assets and liabilities (at carrying value) associated with discontinued operations included in the Company's consolidated balance sheets are as follows (in thousands):


	September 30, 2024			December 31, 2023
Carrying amounts of major classes of assets included as part of discontinued operations	(unaudited)

Accounts receivable	$	—		$	510
Inventory	12,780			12,780		*
Prepaid expenses and other current assets	897			902		*
Property and equipment, net	4,537			4,871		*
Intangible assets, net	1,416			1,416		*
Other assets	—			—
Less: loss recognized on classification as held for sale	(18,099)		**	(16,369)		*
Total assets of the disposal group classified as discontinued operations in the statement of financial position	$	1,531		$	4,110

* These comprise assets held for sale, at their carrying value of $3.6 million as of December 31, 2023. The Company recorded the loss on classification of held for sale as a valuation allowance on the group of assets held for sale, without allocation to the individual assets within the group.

** At September 30, 2024, an additional valuation allowance of $1.7 million was recorded to reflect an estimate of the additional cost to sell the assets held for sale based on the Biotronik settlement. See further details in Footnote 11, Commitments and Contingencies.

Carrying amounts of major classes of liabilities included as part of discontinued operations

Accounts payable	306			1,892
Accrued restructure	2,663			5,649
Accrued liabilities	—			2,762
Total liabilities of the disposal group classified as discontinued operations in the statement of financial position	$	2,969		$	10,303

Inventory in discontinued operations consisted of the following (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
Raw materials	$	8,020	$	8,020
Work in process	2,211		2,211
Finished goods	2,549		2,549
Total inventory transferred to held for sale	$	12,780	$	12,780

There was no reserve for obsolescence as of September 30, 2024 as management determined that the inventory was unexpired, usable, sellable and above net realizable value. An impairment charge of $0.4 million was taken as of December 31, 2023.

Property and equipment, net, in discontinued operations consisted of the following (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
Furniture and fixtures	$	20	$	20
Laboratory equipment and software	17,569		18,295
Construction in process	1,141		1,141
Total property and equipment	18,730		19,456
Less: accumulated depreciation	(14,193)		(14,585)
Total property and equipment, net, related to discontinued operations	$	4,537	$	4,871

Fixed assets transferred to held for sale are no longer depreciated. There was no depreciation expense recorded for the three and nine months ended September 30, 2024. Depreciation expense was $0.9 million and $3.1 million, respectively for the three and nine months ended September 30, 2023, which is reflected in the loss from discontinued operations in the condensed consolidated statements of operations and comprehensive income (loss). There was no impairment as of September 30, 2024. An impairment charge of $0.6 million was taken as of December 31, 2023. During the three and nine months ended September 30, 2024, net assets held for sale of less than $0.1 million and $0.3 million, respectively, were sold.

Intangibles, net, consist solely of licensed intangible assets acquired from Biotronik relating to the Force Sensing Ablation Catheter, which is part of the Company's operations that it intends to sell. Intangible assets held for sale are no longer amortized. There was no amortization expense recorded for the three and nine months ended September 30, 2024. The Company recorded amortization expense related to the above intangible assets of less than $0.1 million and $0.1 million for the three and nine months ended September 30, 2023, respectively, which is reflected in the loss from discontinued operations in the condensed consolidated statements of operations and comprehensive income (loss).


	Three Months Ended
	September 30, 2024		September 30, 2023
Major line items constituting pretax loss of discontinued operations	(unaudited)		(unaudited)

Revenue	$	—	$	3,178

Cost of products sold	—		(5,445)
Research and development	(15)		(3,899)
Selling, general and administrative	(190)		(5,078)



Restructuring	(2,856)		—
Loss on assets held for sale	(1,730)		—

Loss from discontinued operations before income taxes	(4,791)		(11,244)
Income tax expense	—		75
Net loss from discontinued operations	$	(4,791)	$	(11,319)


	Nine Months Ended
	September 30, 2024		September 30, 2023
Major line items constituting pretax loss of discontinued operations	(unaudited)		(unaudited)

Revenue	$	—	$	9,880

Cost of products sold	—		(15,612)
Research and development	197		(14,960)
Selling, general and administrative	(493)		(16,778)



Restructuring	(2,880)		(475)
Loss on assets held for sale	(1,730)		—

Loss from discontinued operations before income taxes	(4,906)		(37,945)
Income tax expense	10		75
Net loss from discontinued operations	$	(4,916)	$	(38,020)

Net loss for the nine months ended September 30, 2024 is primarily due to additional restructuring expense of $2.5 million related to the Biotronik settlement and an additional $1.7 million cost related to contingent payment consideration on the sale of assets held for sale per the Biotronik arbitration settlement (see Footnote 11, Commitments and Contingencies, for further information), and SG&A expenses related to the wind down of the discontinued operations, offset by recording a credit to

stock-based compensation resulting from restructuring termination forfeitures and RSU accelerated vesting modification treatment. (See Footnote 14, Stock-Based Compensation, for further information.)

For the three and nine months ended September 30, 2024, there were no revenues from discontinued operations.

The following table sets forth the breakdown of the Company’s discontinued operations revenue for disposables and service/other for the three and nine months ended September 30, 2023 (in thousands):


	Three Months Ended		Nine Months Ended
	September 30, 2023		September 30, 2023
Disposables	$	2,845	$	8,632
Service/Other	333		1,248
Total revenue	$	3,178	$	9,880

Prior to the Restructuring, revenue was subject to fluctuation based on the foreign currency in which our products were sold. For the three and nine months ended September 30, 2023, approximately 60% and 60%, respectively, of sales from discontinued operations were sold outside of the United States.

Restructuring Activities

In connection with the strategic decision to wind down the ablation and mapping business, restructuring actions were taken related to this shift in business model, resulting in the realignment of resources, including an organizational workforce reduction and corporate restructure. Restructuring and exit-related charges consisting of severance expenses and related benefit costs for employees affected by the organizational workforce reduction, retention bonuses for certain employees that are assisting with the Restructuring, contract termination costs and other restructuring costs were recorded as restructuring expense, cost of product sold or SG&A expense and are included in the loss from discontinued operations.

The Company identified three major types of restructuring activities related to the disposal of the mapping and ablation businesses. These three types of activities are employee termination costs, contract termination costs, and other costs. Other cost activities had been completed as of December 31, 2023. The restructuring activities related to employee termination and contract termination activities were substantially completed by the end of the first quarter of 2024. However, due to the Biotronik settlement (see Footnote 11, Commitments and Contingencies, for further information), an additional $2.5 million of restructuring expense was accrued related to other restructuring costs. The Company continues to actively market the mapping and ablation businesses to explore opportunities to dispose of the business.

The following summarizes the restructuring activities and their related accruals as of September 30, 2024:


	Employee		Contract
	Termination Costs		Termination Costs		Other Costs		Total

Restructure Accrual Balance at 12/31/2023	$	3,493	$	2,156	$	—	$	5,649
Payments	(3,194)		(498)		—		(3,692)
Accrual release (non-cash)	(185)		(631)		—		(816)
Restructure Accrual Balance at 3/31/2024	$	114	$	1,027	$	—	$	1,141
Payments	(78)		(673)		—		(751)
Accrual release (non-cash)	(9)		(219)		—		(228)
Restructure Accrual Balance at 6/30/2024	$	27	$	135	$	—	$	162
Biotronik Settlement	—		—		2,510		2,510
Payments	—		—		—		—
Accrual release (non-cash)	(9)						(9)
Restructure Accrual Balance at 9/30/2024	$	18	$	135	$	2,510	$	2,663

Sale of Business

On June 30, 2022, the Company completed the First Closing in accordance with the Asset Purchase Agreement with Medtronic, pursuant to which the Company agreed to sell to Medtronic certain transseptal access and sheath assets which make up the Company's left-heart access portfolio (and which comprised the Rhythm Xience product line acquired as part of the Rhythm Xience acquisition). The assets transferred to Medtronic upon the First Closing (the “Assets”) include patents, trademarks, patent and trademark applications, know-how, copyrights, prototypes and other intellectual property owned or licensed by the Company, business records and documents (including regulatory and clinical materials) and manufacturing equipment related to the AcQCross® line of sheath-compatible septal crossing devices, AcQGuide® MINI integrated crossing device and sheath, AcQGuide® FLEX Steerable Introducer with integrated transseptal dilator and needle, and AcQGuide® VUE steerable sheaths (i.e., the Products).

Pursuant to the Asset Purchase Agreement, Medtronic paid $50.0 million at the First Closing, of which $4.0 million was paid into an indemnity escrow account for a period of 18 months following the First Closing to secure indemnification obligations of the Company under the Asset Purchase Agreement, which the Company had recorded as restricted cash on its condensed consolidated balance sheets. Following the termination of the escrow account in accordance with the Asset Purchase Agreement, the amounts in escrow were released. As of September 30, 2024, the Company recorded no restricted cash on the condensed consolidated balance sheet.

The Company is also eligible to receive the following contingent cash consideration pursuant to the Asset Purchase Agreement:

(i) $20.0 million upon the Company’s completion, to the reasonable satisfaction of Medtronic, of certain conditions set forth in the Asset Purchase Agreement relating to the Company becoming a qualified supplier of Medtronic for the Products, including demonstration of ISO 14971:2019 compliance, completion of certain test method validations and compliance with certain other reporting requirements (the “OEM Earnout”);

(ii) $17.0 million upon the earlier of (A) the Second Closing (as defined below) or (B) the Company’s initial submission for CE Mark certification of the Products under the European Union Medical Devices Regulation, to the reasonable satisfaction of a third-party regulatory consultant, subject to certain other conditions as set forth in the Asset Purchase Agreement (the “Transfer Earnout”); and

(iii) amounts equal to 100%, 75%, 50% and 50%, respectively, of quarterly Net Sales (as defined in the Asset Purchase Agreement) from sales of the Products achieved by Medtronic over each year of a four-year period beginning on the first full quarter after Medtronic’s first commercial sale of a Product and achievement of the OEM Earnout.

The $20.0 million OEM Earnout was achieved in October 2022 and payment was received in November 2022, of which $1.6 million was held in escrow and recorded as restricted cash on the condensed consolidated balance sheets. The $17.0 million Transfer Earnout was achieved in December 2022 and payment was received in January 2023, of which $1.4 million was held in escrow and recorded as restricted cash on the condensed consolidated balance sheets. Following the termination of the escrow account in accordance with the Asset Purchase Agreement, all amounts in escrow were released. As of September 30, 2024, the Company recorded no restricted cash on the condensed consolidated balance sheet. During the nine months ended September 30, 2024, $8.4 million was earned (before transaction costs) under item (iii) and recorded as a receivable on the condensed consolidated balance sheet as of September 30, 2024.

With the achievement of the OEM Earnout Conditions (as defined in the Asset Purchase Agreement) and upon notice from Medtronic, Medtronic became the Company's exclusive distributor of the Products under the Distribution Agreement.


	Nine Months Ended September 30, 2024
	(unaudited)
Product Net Sales Earnout accrued as of September 30, 2024	$	8,353
Transaction costs	(257)
Gain on sale of business, net	$	8,096

The net gain on sale will be adjusted in future periods by the contingent consideration, based on the achievement of the predetermined milestones mentioned above. The sale was accounted for as a derecognition of a group of assets that is a

business pursuant to ASC 810 - Consolidation, with the resulting gain classified as operating income within loss from operations on the condensed consolidated statements of operations and comprehensive income (loss). The sale did not represent a strategic shift having a major effect on the Company's operations and financial results and, consequently, did not qualify as a discontinued operation.

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Assets included in:
Available-for-sale securities	$ 0	$ 3,233
Total fair value	11,788	20,144
Liabilities included in:
Total fair value	302	409
Warrant liability
Liabilities included in:
Total fair value	302	409
Money market securities
Assets included in:
Money market securities	11,788	16,911
U.S. treasury securities
Assets included in:
Available-for-sale securities		1,978
Commercial paper
Assets included in:
Available-for-sale securities	0	497
Yankee debt securities
Assets included in:
Available-for-sale securities		758
Quoted Prices in Active Markets for Identical Assets (Level 1)
Assets included in:
Total fair value	11,788	16,911
Liabilities included in:
Total fair value	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Warrant liability
Liabilities included in:
Total fair value	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Money market securities
Assets included in:
Money market securities	11,788	16,911
Quoted Prices in Active Markets for Identical Assets (Level 1) \| U.S. treasury securities
Assets included in:
Available-for-sale securities		0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Commercial paper
Assets included in:
Available-for-sale securities	0	0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Yankee debt securities
Assets included in:
Available-for-sale securities		0
Significant Other Observable Inputs (Level 2)
Assets included in:
Total fair value	0	3,233
Liabilities included in:
Total fair value	0	0
Significant Other Observable Inputs (Level 2) \| Warrant liability
Liabilities included in:
Total fair value	0	0
Significant Other Observable Inputs (Level 2) \| Money market securities
Assets included in:
Money market securities	0	0
Significant Other Observable Inputs (Level 2) \| U.S. treasury securities
Assets included in:
Available-for-sale securities		1,978
Significant Other Observable Inputs (Level 2) \| Commercial paper
Assets included in:
Available-for-sale securities	0	497
Significant Other Observable Inputs (Level 2) \| Yankee debt securities
Assets included in:
Available-for-sale securities		758
Significant Unobservable Inputs (Level 3)
Assets included in:
Total fair value	0	0
Liabilities included in:
Total fair value	302	409
Significant Unobservable Inputs (Level 3) \| Warrant liability
Liabilities included in:
Total fair value	302	409
Significant Unobservable Inputs (Level 3) \| Money market securities
Assets included in:
Money market securities	0	0
Significant Unobservable Inputs (Level 3) \| U.S. treasury securities
Assets included in:
Available-for-sale securities		0
Significant Unobservable Inputs (Level 3) \| Commercial paper
Assets included in:
Available-for-sale securities	$ 0	0
Significant Unobservable Inputs (Level 3) \| Yankee debt securities
Assets included in:
Available-for-sale securities		$ 0

Accrued Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Payables and Accruals [Abstract]
Compensation and related expenses	$ 1,128	$ 2,225
Professional fees	181	378
Other	393	284
Total accrued liabilities	$ 1,702	$ 2,887

Debt (Tables)

9 Months Ended

Sep. 30, 2024

Debt Disclosure [Abstract]

Summary of Outstanding Debt

Outstanding debt as of September 30, 2024 and December 31, 2023 consisted of the following (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
2022 Credit Agreement(1)	$	34,125	$	36,792
Total outstanding debt, gross	34,125		36,792
Less: unamortized debt discount and fees	(1,772)		(2,274)
Total outstanding debt	$	32,353	$	34,518

(1)The 2022 Credit Agreement includes final payment fees of $1.8 million.

- Definition

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.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(22))
-SubTopic 10
-Topic 210
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480566/210-10-S99-1

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-Topic 470
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-Paragraph 69B
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-Section S99
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-Subparagraph (SX 210.12-04(a))
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-Topic 505
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+ Details

Summary of Significant Accounting Policies - Summary of Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Disaggregation of Revenue [Line Items]
Total revenue	$ 5,266	$ 2,060	$ 13,027	$ 4,816
Disposables
Disaggregation of Revenue [Line Items]
Total revenue	5,266	1,862	12,499	4,106
Service/Other
Disaggregation of Revenue [Line Items]
Total revenue	$ 0	$ 198	$ 528	$ 710

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- Definition

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.

+ References

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-Section 50
-Paragraph 41
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+ Details

Summary of Significant Accounting Policies (Tables)

9 Months Ended

Sep. 30, 2024

Accounting Policies [Abstract]

Summary of Disaggregation of Revenue

The following table sets forth the Company’s revenue for disposables, systems and service/other for the three and nine months ended September 30, 2024 and 2023 (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2024		2023		2024		2023
	(unaudited)				(unaudited)
Disposables	$	5,266	$	1,862	$	12,499	$	4,106

Service/Other	—		198		528		710
Total revenue	$	5,266	$	2,060	$	13,027	$	4,816


	Three Months Ended		Nine Months Ended
	September 30, 2023		September 30, 2023
Disposables	$	2,845	$	8,632
Service/Other	333		1,248
Total revenue	$	3,178	$	9,880

Summary of Accounts, Notes, Loans and Financing Receivable

Accounts receivable recorded on the condensed consolidated balance sheets as of September 30, 2024 and December 31, 2023 consists of the following (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
Trade accounts receivable	$	5,492	$	1,993
Earnouts receivable from Medtronic	4,478		9,360
Total accounts receivable	$	9,970	$	11,353

Summary of Fair Value, Liabilities Measured on Recurring Basis

The following tables classify the Company’s financial assets and liabilities measured at fair value on a recurring basis into the fair value hierarchy as of September 30, 2024 and December 31, 2023 (in thousands):


	Fair Value Measurements as of September 30, 2024
	(unaudited)
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets included in:
Cash and cash equivalents
Money market securities	$	11,788	$	—	$	—	$	11,788
Marketable securities at fair value

Commercial paper	—		—		—		—

Total fair value	$	11,788	$	—	$	—	$	11,788

Liabilities included in:
Warrant liability	$	—	$	—	$	302	$	302

Total fair value	$	—	$	—	$	302	$	302


	Fair Value Measurements as of December 31, 2023
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets included in:
Cash and cash equivalents
Money market securities	$	16,911	$	—	$	—	$	16,911
Marketable securities at fair value
U.S. treasury securities	—		1,978		—		1,978
Commercial paper	—		497		—		497
Yankee debt securities	—		758		—		758
Total fair value	$	16,911	$	3,233	$	—	$	20,144

Liabilities included in:
Warrant liability	$	—	$	—	$	409	$	409

Total fair value	$	—	$	—	$	409	$	409

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, 2024 (in thousands):


	Warrant Liability
Balance, December 31, 2023	$	409
Change in fair value	(107)

Balance, September 30, 2024 (unaudited)	$	302

Summary of Weighted-Average Unobservable Inputs to Measure Warranty Liability

The fair value was estimated to be $0.0799 per warrant as of September 30, 2024 and the significant inputs used in the estimation of the fair value were as follows:


			September 30, 2024
			(unaudited)
Risk-free interest rate			3.58%
Expected term in years			5.8
Expected volatility			200.0%

As of September 30, 2024 and December 31, 2023, the outstanding warrants to purchase the Company’s common stock consisted of the following:


	Exercise Price		Expiration Date	September 30, 2024	December 31, 2023
				(unaudited)
Warrants issued in 2015	$	5.25	1/30/25	3,808	3,808
Warrants issued with 2018 Convertible Notes	$	0.10	6/7/28	346,689	346,689
Warrants issued with 2018 Term Loan	$	16.67	7/31/28	26,998	26,998
Warrants issued with 2019 Credit Agreement	$	16.67	5/20/29	419,992	419,992
Warrants issued with 2022 Credit Agreement	$	1.11	6/30/30	3,779,018	3,779,018
Total Warrants				4,576,505	4,576,505

Inventory

9 Months Ended

Sep. 30, 2024

Inventory Disclosure [Abstract]

Inventory

Inventory as of September 30, 2024 and December 31, 2023 consisted of the following (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
Raw materials	$	1,948	$	3,428
Work in process	611		319
Finished goods	1,632		531
Total inventory	$	4,191	$	4,278

Marketable Securities (Tables)

9 Months Ended

Sep. 30, 2024

Investments, Debt and Equity Securities [Abstract]

Summary of Marketable Securities

Marketable securities consisted of the following as of September 30, 2024 and December 31, 2023 (in thousands):

September 30, 2024 (unaudited)

Amortized
Cost

Gross
Unrealized
Gains

Gross
Unrealized
Losses

Fair Value

Available-for-sale securities - short-term:

Commercial paper

—

Total available-for-sale securities - short-term

—

Total available-for-sale securities

—


	December 31, 2023
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term:
U.S. treasury securities	$	1,978	$	—	$	—	$	1,978
Commercial paper	497		—		—		497
Yankee debt securities	758		—		—		758
Total available-for-sale securities - short-term	3,233		—		—		3,233
Total available-for-sale securities	$	3,233	$	—	$	—	$	3,233

- Definition

Tabular disclosure of investment in debt security measured at fair value with change in fair value recognized in other comprehensive income (available-for-sale).

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 320
-SubTopic 10
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-Section 50
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+ Details

Discontinued Operations, Assets Held for Sale and Restructuring - Summary of Inventories in Discontinued Operations (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Raw materials	$ 1,948	$ 3,428
Work in process	611	319
Finished goods	1,632	531
Inventory	4,191	4,278
Discontinued Operations, Held-for-Sale or Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Raw materials	8,020	8,020
Work in process	2,211	2,211
Finished goods	2,549	2,549
Inventory	$ 12,780	$ 12,780

Property and Equipment, Net - Summary of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 4,597	$ 4,449
Less: accumulated depreciation	(3,861)	(3,624)
Property and equipment, net	736	825
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Total property and equipment	432	432
Office equipment
Property, Plant and Equipment [Line Items]
Total property and equipment	1,537	1,537
Laboratory equipment and software
Property, Plant and Equipment [Line Items]
Total property and equipment	1,501	1,494
Leasehold improvements
Property, Plant and Equipment [Line Items]
Total property and equipment	1,086	979
Construction in process
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 41	$ 7

401(k) Retirement Plan	9 Months Ended
401(k) Retirement Plan	Sep. 30, 2024
Retirement Benefits [Abstract]
401(k) Retirement Plan	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 provided no contributions to the 401(k) retirement savings plan for the three and nine months ended September 30, 2024 and 2023.

- Definition

The entire disclosure for retirement benefits.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	5,000,000	5,000,000
Preferred stock, shares issued (in shares)	6,666	6,666
Preferred stock, shares outstanding (in shares)	6,666	6,666
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	260,000,000	260,000,000
Common stock, shares issued (in shares)	29,912,305	29,912,305
Common stock, shares outstanding (in shares)	29,313,667	29,313,667

Discontinued Operations, Assets Held for Sale and Restructuring - Summary of Revenues and Expenses Associated with Discontinued Operations (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Loss from discontinued operations before taxes	$ (4,791,000)	$ (11,244,000)	$ (4,906,000)	$ (37,945,000)
Income tax expense	0	75,000	10,000	75,000
Net loss from discontinued operations	(4,791,000)	(11,319,000)	(4,916,000)	(38,020,000)
Discontinued Operations, Held-for-Sale or Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue	0	3,178,000	0	9,880,000
Cost of products sold	0	(5,445,000)	0	(15,612,000)
Research and development	(15,000)	(3,899,000)	197,000	(14,960,000)
Selling, general and administrative	(190,000)	(5,078,000)	(493,000)	(16,778,000)
Restructuring	(2,856,000)	0	(2,880,000)	(475,000)
Loss on assets held for sale	(1,730,000)	0	(1,730,000)	0
Loss from discontinued operations before taxes	(4,791,000)	(11,244,000)	(4,906,000)	(37,945,000)
Income tax expense	0	75,000	10,000	75,000
Net loss from discontinued operations	$ (4,791,000)	$ (11,319,000)	$ (4,916,000)	$ (38,020,000)

Condensed Consolidated Statements of Operations and Comprehensive Income (Loss) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Statement of Comprehensive Income [Abstract]
Revenue	$ 5,266	$ 2,060	$ 13,027	$ 4,816
Cost of products sold	4,894	3,150	13,019	7,835
Gross profit (loss)	372	(1,090)	8	(3,019)
Operating expenses (income):
Research and development	0	896	0	2,752
Selling, general and administrative	2,318	2,354	7,880	9,502
Change in fair value of contingent consideration	0	0	0	123
Gain on sale of business	(2,435)	(2,648)	(8,096)	(5,927)
Total operating expenses (income)	(117)	602	(216)	6,450
Gain (loss) from operations	489	(1,692)	224	(9,469)
Other income (expense):
Change in fair value of warrant liability	(174)	636	107	1,478
Interest income	153	547	641	2,223
Interest expense	(1,395)	(1,409)	(4,384)	(4,110)
Other revenue	111	0	187	0
Total other expense, net	(1,305)	(226)	(3,449)	(409)
Loss from continuing operations before income taxes	(816)	(1,918)	(3,225)	(9,878)
Net loss from continuing operations	(816)	(1,918)	(3,225)	(9,878)
Discontinued operations:
Loss from discontinued operations before taxes	(4,791)	(11,244)	(4,906)	(37,945)
Income tax expense - discontinued operations	0	75	10	75
Net loss from discontinued operations	(4,791)	(11,319)	(4,916)	(38,020)
Net loss	(5,607)	(13,237)	(8,141)	(47,898)
Other comprehensive loss
Unrealized loss on marketable securities	0	4	0	7
Foreign currency translation adjustment	(15)	(66)	(15)	(91)
Comprehensive loss	$ (5,622)	$ (13,299)	$ (8,156)	$ (47,982)
Net loss per share, basic and diluted:
Loss from continuing operations, basic (in dollars per share)	$ (0.03)	$ (0.07)	$ (0.11)	$ (0.34)
Loss from continuing operations, diluted (in dollars per share)	(0.03)	(0.07)	(0.11)	(0.34)
Loss from discontinued operations, basic (in dollars per share)	(0.16)	(0.39)	(0.17)	(1.31)
Loss from discontinued operations, diluted (in dollars per share)	(0.16)	(0.39)	(0.17)	(1.31)
Net loss per common share, basic (in dollars per share)	(0.19)	(0.45)	(0.27)	(1.65)
Net loss per common share, diluted (in dollars per share)	$ (0.19)	$ (0.45)	$ (0.27)	$ (1.65)
Weighted Average Number of Shares Outstanding, Basic and Diluted [Abstract]
Basic weighted average shares outstanding (in shares)	29,799,241	29,262,768	29,768,208	29,024,353
Diluted weighted average shares outstanding (in shares)	29,799,241	29,262,768	29,768,208	29,024,353

Discontinued Operations, Assets Held for Sale and Restructuring - Summary of Assets and Liabilities Associated with Discontinued Operations (Details) - Discontinued Operations, Held-for-Sale or Disposed of by Sale - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Carrying amounts of major classes of assets included as part of discontinued operations
Accounts receivable	$ 0	$ 510
Inventory	12,780	12,780
Prepaid expenses and other current assets	897	902
Property and equipment, net	4,537	4,871
Intangible assets, net	1,416	1,416
Other assets	0	0
Less: loss recognized on classification as held for sale	(18,099)	(16,369)
Total assets of the disposal group classified as discontinued operations in the statement of financial position	1,531	4,110
Assets held for sale, carrying value		3,600
Carrying amounts of major classes of liabilities included as part of discontinued operations
Accounts payable	306	1,892
Accrued restructure	2,663	5,649
Accrued liabilities	0	2,762
Total liabilities of the disposal group classified as discontinued operations in the statement of financial position	2,969	$ 10,303
Biotronik Arbitration
Carrying amounts of major classes of assets included as part of discontinued operations
Less: loss recognized on classification as held for sale	(1,700)
Carrying amounts of major classes of liabilities included as part of discontinued operations
Accrued restructure	$ 2,500

Inventory (Tables)

9 Months Ended

Sep. 30, 2024

Inventory Disclosure [Abstract]

Summary of Inventory

Inventory as of September 30, 2024 and December 31, 2023 consisted of the following (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
Raw materials	$	1,948	$	3,428
Work in process	611		319
Finished goods	1,632		531
Total inventory	$	4,191	$	4,278

Debt - Narrative (Details)				1 Months Ended
Debt - Narrative (Details)	Nov. 13, 2024 USD ($) payment	Mar. 04, 2024 USD ($)	Jun. 30, 2022 $ / shares shares	Jun. 30, 2024 USD ($)	Sep. 30, 2024 USD ($)	Feb. 16, 2024 agreement	Nov. 08, 2023 USD ($)	Aug. 04, 2023 USD ($)
Deerfield Credit Agreement, Amendment 1
Debt Instrument [Line Items]
Minimum liquidity covenant							$ 10,000,000
Deerfield Credit Agreement, Amendment 3
Debt Instrument [Line Items]
Number of agreements alleged to be breached \| agreement						5
Maximum exposure incurred in proceedings before event of default		$ 3,000,000
Term 1 \| Deerfield Credit Agreement, Amendment 1
Debt Instrument [Line Items]
Minimum liquidity covenant								$ 5,000,000
Minimum liquidity covenant, term								18 months
Term 2 \| Deerfield Credit Agreement, Amendment 1
Debt Instrument [Line Items]
Minimum liquidity covenant								$ 20,000,000
Term 3 \| Deerfield Credit Agreement, Amendment 1
Debt Instrument [Line Items]
Minimum liquidity covenant								$ 10,000,000
Exercise of common stock warrants
Debt Instrument [Line Items]
Class of warrants number of securities called by the warrants or rights (in shares) \| shares			3,779,018
Class of warrants, exercise price (in dollars per share) \| $ / shares			$ 1.1114
Warrant, term			8 years
2022 Credit Agreement \| Senior Term Loan
Debt Instrument [Line Items]
Debt instrument, repaid, principal				$ 2,500,000
Face amount		$ 35,000,000.0
Debt instrument, term		5 years
Variable rate		9.00%
Variable rate, floor		2.50%
Fee amount		$ 1,800,000			$ 1,800,000
Debt Instrument, Variable Interest Rate, Type [Extensible Enumeration]		Secured Overnight Financing Rate (SOFR) [Member]
2022 Credit Agreement \| Senior Term Loan \| Deerfield Credit Agreement, Amendment 3
Debt Instrument [Line Items]
Exit fee percentage		5.00%
2022 Credit Agreement \| Senior Term Loan \| Deerfield Credit Agreement, Amendment 4 \| Subsequent Event
Debt Instrument [Line Items]
Exit fee percentage	6.00%
2022 Credit Agreement \| Senior Term Loan \| End of Month 26
Debt Instrument [Line Items]
Periodic payment principal due		$ 2,500,000
2022 Credit Agreement \| Senior Term Loan \| End of Month 36
Debt Instrument [Line Items]
Periodic payment principal due		7,500,000
2022 Credit Agreement \| Senior Term Loan \| End of Month 36 \| Deerfield Credit Agreement, Amendment 3
Debt Instrument [Line Items]
Debt instrument installment payment		7,500,000
2022 Credit Agreement \| Senior Term Loan \| End of Month 36 \| Deerfield Credit Agreement, Amendment 4 \| Subsequent Event
Debt Instrument [Line Items]
Debt instrument installment payment	$ 2,500,000
Number of periodic payments \| payment	3
2022 Credit Agreement \| Senior Term Loan \| End of Month 48
Debt Instrument [Line Items]
Periodic payment principal due		10,000,000
2022 Credit Agreement \| Senior Term Loan \| End of Month 60
Debt Instrument [Line Items]
Periodic payment principal due		$ 15,000,000

Warrants (Tables)

9 Months Ended

Sep. 30, 2024

Warrants and Rights Note Disclosure [Abstract]

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

The fair value was estimated to be $0.0799 per warrant as of September 30, 2024 and the significant inputs used in the estimation of the fair value were as follows:


			September 30, 2024
			(unaudited)
Risk-free interest rate			3.58%
Expected term in years			5.8
Expected volatility			200.0%

As of September 30, 2024 and December 31, 2023, the outstanding warrants to purchase the Company’s common stock consisted of the following:


	Exercise Price		Expiration Date	September 30, 2024	December 31, 2023
				(unaudited)
Warrants issued in 2015	$	5.25	1/30/25	3,808	3,808
Warrants issued with 2018 Convertible Notes	$	0.10	6/7/28	346,689	346,689
Warrants issued with 2018 Term Loan	$	16.67	7/31/28	26,998	26,998
Warrants issued with 2019 Credit Agreement	$	16.67	5/20/29	419,992	419,992
Warrants issued with 2022 Credit Agreement	$	1.11	6/30/30	3,779,018	3,779,018
Total Warrants				4,576,505	4,576,505

Warrants - Narrative (Details) $ in Thousands	1 Months Ended	3 Months Ended		9 Months Ended
Warrants - Narrative (Details) $ in Thousands	Aug. 31, 2021	Sep. 30, 2024 USD ($) holder	Sep. 30, 2023 USD ($)	Sep. 30, 2024 USD ($) holder	Sep. 30, 2023 USD ($)
Warrants and Rights Note Disclosure [Abstract]
Decrease in fair value of warrant liability \| $		$ (174)	$ 636	$ 107	$ 1,478
Number of warrant holders				4
Maximum percentage of outstanding common stock	0.049			0.049
Number of warrant holders with ability to increase stock ownership percentage after written notice election		2		2
Maximum percentage of outstanding common stock, notice for increase	0.099			0.099

Stock-Based Compensation - Summary of Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
Stock Options
Outstanding at beginning of period (in shares)	1,904,723
Options granted (in shares)	0
Options exercised (in shares)	0
Options forfeited (in shares)	(1,395,921)
Outstanding at end of period (unaudited) (in shares)	508,802	1,904,723
Options vested and exercisable at end of period (unaudited) (in shares)	508,802
Weighted Average Exercise Price
Outstanding at beginning of period (in dollars per share)	$ 1.98
Options granted (in dollars per share)	0
Options exercised (in dollars per share)	0
Options forfeited (in dollars per share)	1.34
Outstanding at end of period (in dollars per share)	3.72	$ 1.98
Options vested and exercisable at end of period (unaudited) (in dollars per share)	$ 3.72
Stock Options Activity, Additional Disclosures
Weighted average remaining contractual life, Outstanding	7 years 7 months 6 days	7 years 9 months 18 days
Weighted average remaining contractual life, Options vested and exercisable at end of period (unaudited)	7 years 7 months 6 days
Aggregate intrinsic value, Outstanding balance at beginning of period	$ 0
Aggregate intrinsic value, Options exercised	0
Aggregate intrinsic value, Outstanding balance at end of period (unaudited)	0	$ 0
Aggregate intrinsic value, Options vested and exercisable at end of period (unaudited)	$ 0

Discontinued Operations, Assets Held for Sale and Restructuring - Summary of Property and Equipment, Net in Discontinued Operations (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	$ 4,597	$ 4,449
Less: accumulated depreciation	(3,861)	(3,624)
Property and equipment, net	736	825
Furniture and fixtures
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	432	432
Laboratory equipment and software
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	1,501	1,494
Construction in process
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	41	7
Discontinued Operations, Held-for-Sale or Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	18,730	19,456
Less: accumulated depreciation	(14,193)	(14,585)
Property and equipment, net	4,537	4,871
Discontinued Operations, Held-for-Sale or Disposed of by Sale \| Furniture and fixtures
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	20	20
Discontinued Operations, Held-for-Sale or Disposed of by Sale \| Laboratory equipment and software
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	17,569	18,295
Discontinued Operations, Held-for-Sale or Disposed of by Sale \| Construction in process
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total property and equipment	$ 1,141	$ 1,141

Cover Page - shares	9 Months Ended
Cover Page - shares	Sep. 30, 2024	Nov. 08, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2024
Document Transition Report	false
Entity File Number	001-39430
Entity Registrant Name	ACUTUS MEDICAL, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	45-1306615
Entity Address, Address Line One	2210 Faraday Ave.
Entity Address, Address Line Two	Suite 100,
Entity Address, City or Town	Carlsbad
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92008
City Area Code	442
Local Phone Number	232-6080
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	AFIB
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		29,912,305
Amendment Flag	false
Document Fiscal Period Focus	Q3
Entity Central Index Key	0001522860
Document Fiscal Year Focus	2024
Current Fiscal Year End Date	--12-31

Stock-Based Compensation

9 Months Ended

Sep. 30, 2024

Share-Based Payment Arrangement [Abstract]

Stock-Based Compensation

2022 Inducement Equity Incentive Plan

The 2022 Inducement Equity Incentive Plan (the “2022 Plan”), which permits the granting of nonstatutory stock options, RSUs, RSAs, stock appreciation rights, performance share units ("PSUs"), performance shares and other equity-based awards to employees, directors and consultants, became effective on March 30, 2022. As of September 30, 2024, 6,000,000 shares of common stock were authorized for issuance under the 2022 Plan, of which 5,958,365 remain available for issuance under the 2022 Plan.

2020 Equity Incentive Plan

The 2020 Equity Incentive Plan (the “2020 Plan”), which permits the granting of nonstatutory stock options, RSAs, RSUs, stock appreciation rights, PSUs, performance shares and other equity-based awards to employees, directors and consultants became effective on August 5, 2020. As of September 30, 2024, 4,431,305 shares of common stock were authorized for issuance under the 2020 Plan. As of September 30, 2024, 5,887,381 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, RSAs, RSUs and other stock-based awards to employees, directors, officers and consultants. As of September 30, 2024, 16,902 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 from future awards under the 2020 Plan.

Stock Options

Stock options granted 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's common stock became publicly traded in August 2020 and lacks company-specific historical and implied volatility information. Therefore, the Company 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.

No stock option awards were granted during the nine months ended September 30, 2024. The following assumptions were used to estimate the fair value of stock options for the nine months ended September 30, 2023:


	Nine Months Ended September 30,
		2023

Risk-free interest rate		3.91% - 4.27%
Expected dividend yield		—
Expected term in years		5.5 - 5.6
Expected volatility		75% - 85%

The Company's stock option activity for the nine months ended September 30, 2024 was as follows:


	Stock Options	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life (in years)	Aggregate Intrinsic Value (in thousands)
Outstanding as of December 31, 2023	1,904,723	$	1.98	7.8	$	—
Options granted	—	—
Options exercised	—	—			$	—
Options forfeited	(1,395,921)	1.34
Outstanding as of September 30, 2024 (unaudited)	508,802	$	3.72	7.6	$	—
Options vested and exercisable as of September 30, 2024 (unaudited)	508,802	$	3.72	7.6	$	—

For options in the money, the aggregate intrinsic value for options outstanding in the above table represents the product of the number of options outstanding multiplied by the difference between the per share fair value of the Company’s common stock on the last day of the fiscal period, which was $0.08 and $0.70 as of September 30, 2024 and December 31, 2023, respectively, and the exercise price. The aggregate intrinsic value for options exercised in the above table represents the product of the number of options exercised multiplied by the difference between the per share fair value of the Company’s stock on the date of exercise and the exercise price. No stock option awards were granted during the nine months ended September 30, 2024. As of September 30, 2024, all outstanding stock options were approved by the Company's board of directors for accelerated vesting, and therefore, the total unrecognized compensation related to unvested stock option awards granted was $0.0 million, which the Company expects to recognize over a weighted-average period of approximately 0.0 years.

Restricted Stock Units (RSUs)

The Company’s RSU activity for the nine months ended September 30, 2024 was as follows:


	Number of Shares	Weighted Average Grant Price
Unvested as of December 31, 2023	2,185,330	$	2.18
Granted	—	—
Forfeited	(1,286,853)	2.51
Vested	(898,477)	1.70
Unvested as of September 30, 2024 (unaudited)	—	$	—

As of September 30, 2024, all outstanding RSUs were approved by the Company's board of directors for accelerated vesting, and therefore, there was $0.0 million of unrecognized compensation related to unvested RSUs.

Total Stock-Based Compensation

The following table summarizes the total stock-based compensation expense for the stock options, PSUs, RSUs, RSAs and ESPP expense recorded in the condensed consolidated statements of operations and comprehensive income (loss) for the three months ended September 30, 2024 and 2023 (in thousands):


	Three Months Ended September 30,				Three Months Ended September 30, 2024				Three Months Ended September 30, 2023
	2024		2023		Continuing Operations		Discontinued Operations		Continuing Operations		Discontinued Operations
	(unaudited)				(unaudited)				(unaudited)
Cost of products sold	$	21	$	146	$	21	$	—	$	—	$	146
Research and development	—		317		—		—		11		306
Selling, general and administrative	107		815		107		—		241		574
Total stock-based compensation	$	128	$	1,278	$	128	$	—	$	252	$	1,026

As noted above during September 2024, the Company's board of directors approved accelerated vesting of the remaining unvested stock options and RSUs. This was considered a Type 1 equity modification. The fair value of the modified awards was determined using the Black-Scholes option pricing model on the date of the modification and the resulting incremental stock-based compensation of less than $0.1 million was recorded as of September 30, 2024, in the Company's condensed consolidated statements of operations.

The following table summarizes the total stock-based compensation expense for the stock options, PSUs, RSUs, RSAs and ESPP expense recorded in the condensed consolidated statements of operations and comprehensive income (loss) for the nine months ended September 30, 2024 and 2023 (in thousands):


	Nine Months Ended September 30,				Nine Months Ended September 30, 2024				Nine Months Ended September 30, 2023
	2024		2023		Continuing Operations		Discontinued Operations		Continuing Operations		Discontinued Operations
	(unaudited)				(unaudited)				(unaudited)
Cost of products sold	$	(89)	$	373	$	53	$	(142)	$	—	$	373
Research and development	(559)		999		—		(559)		36		963
Selling, general and administrative	(617)		3,543		406		(1,023)		1,236		2,307
Total stock-based compensation	$	(1,265)	$	4,915	$	459	$	(1,724)	$	1,272	$	3,643

The employee terminations in conjunction with the Restructuring resulted in the credit to stock-based compensation during the nine months ended September 30, 2024 due to forfeitures being a credit of $1.0 million and Type III equity modifications related to accelerated RSU vesting being a credit of $0.5 million, which was the result of the decline in the Company's stock price. The Type I modifications related to the Company's board of directors approving accelerated vesting on remaining unvested stock options and RSUs resulted in de minimis incremental stock-based compensation (as noted above).

Stockholders’ Equity (Details) $ / shares in Units, $ in Thousands	1 Months Ended			9 Months Ended
	Feb. 29, 2024 shares	Jan. 31, 2024 shares	Aug. 31, 2021 investor $ / shares shares	Sep. 30, 2024 USD ($) $ / shares shares	Sep. 30, 2023 USD ($) shares	Dec. 31, 2023 $ / shares
Class of Stock [Line Items]
Number of investors \| investor			4
Preferred stock, par value (in dollars per share) \| $ / shares				$ 0.001		$ 0.001
Maximum percentage of outstanding common stock			0.049	0.049
Common stock conversion, notice for increase, period			61 days
Maximum percentage of outstanding common stock, notice for increase			0.099	0.099
Stock option exercises (in shares)				0
Proceeds from the exercise of stock options \| $				$ 0	$ 4
Employee stock purchase plan shares issued \| $					$ 25
Accelerated vesting, shares (in shares)	21,250
Restricted Stock Units (RSUs)
Class of Stock [Line Items]
Restricted share award shares issued (in shares)				598,638	686,898
Accelerated vesting, shares (in shares)		88,750
Common Stock
Class of Stock [Line Items]
Conversion of stock, shares converted (in shares)			6,665,841
Stock option exercises (in shares)				0	3,218
Proceeds from the exercise of stock options \| $				$ 0	$ 100
Employee stock purchase plan shares issued (in shares)				0	45,162
Employee stock purchase plan shares issued \| $				$ 0	$ 100
Series A Preferred Stock
Class of Stock [Line Items]
Conversion of stock, shares issued (in shares)			6,666
Preferred stock, par value (in dollars per share) \| $ / shares			$ 0.001
Conversion of stock, option to convert to common stock (in shares)			1,000

Operating Leases

9 Months Ended

Sep. 30, 2024

Leases [Abstract]

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 non-cancelable operating lease that expires on December 31, 2027. 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.

Additionally, the Company leases approximately 3,900 square feet of office space in Zaventem, Belgium under a non-cancelable operating lease that expires on December 31, 2024. 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 Carlsbad and Belgium leases were not impacted by the Restructuring. The Carlsbad office will continue as the corporate headquarters and the facility to manufacture the Products. The Belgium office will continue to facilitate the upkeep of the Company's CE Mark.

During the second quarter of 2024, the Company entered into two subleases with unrelated third parties at the Carlsbad property. The Company was not relieved of its primary obligations under the Carlsbad lease ("head lease") and, therefore, became the intermediate lessor of the subleases. Pursuant to ASC 842, the subleases are operating leases related to property, plant and equipment. The Company determined that the sublease income was more than the remaining lease cost on the head lease, and as such, there was no impairment of the head lease's right-to-use assets. The Company also determined that the head lease did not need to be remeasured as the lease term of the subleases was not longer than the remaining term of the head lease. Additionally, there are no residual value guarantees on the subleases. The Company recorded the sublease income as other revenue in the other income (expense) section of the condensed consolidated statements of operations and comprehensive income (loss). For the three and nine months ended September 30, 2024, sublease income was less than$0.1 million for both periods.

The following table summarizes quantitative information about the Company’s operating leases for the nine months ended September 30, 2024 and 2023 (dollars in thousands):


	Nine Months Ended September 30,
	2024		2023
	(unaudited)
Operating cash flows from operating leases	$	290	$	282

Weighted average remaining lease term – operating leases (in years)	3.2		4.2
Weighted average discount rate – operating leases	7.0%		7.0%

The following table provides the components of the Company’s operating lease expense for the three and nine months ended September 30, 2024 and 2023 (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2024		2023		2024		2023
	(unaudited)				(unaudited)
Operating leases
Operating lease cost	$	256	$	252	$	767	$	755
Variable lease cost	91		81		274		243
Total operating lease expense	$	347	$	333	$	1,041	$	998

As of September 30, 2024, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands):



Three months ending December 31, 2024	$	292
Year ending December 31, 2025	1,151
Year ending December 31, 2026	1,185
Year ending December 31, 2027	1,221
Total	3,849
Less: present value discount	(420)
Operating lease liabilities	$	3,429

Operating Leases

The following table summarizes quantitative information about the Company’s operating leases for the nine months ended September 30, 2024 and 2023 (dollars in thousands):


	Nine Months Ended September 30,
	2024		2023
	(unaudited)
Operating cash flows from operating leases	$	290	$	282

Weighted average remaining lease term – operating leases (in years)	3.2		4.2
Weighted average discount rate – operating leases	7.0%		7.0%

The following table provides the components of the Company’s operating lease expense for the three and nine months ended September 30, 2024 and 2023 (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2024		2023		2024		2023
	(unaudited)				(unaudited)
Operating leases
Operating lease cost	$	256	$	252	$	767	$	755
Variable lease cost	91		81		274		243
Total operating lease expense	$	347	$	333	$	1,041	$	998

As of September 30, 2024, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands):



Three months ending December 31, 2024	$	292
Year ending December 31, 2025	1,151
Year ending December 31, 2026	1,185
Year ending December 31, 2027	1,221
Total	3,849
Less: present value discount	(420)
Operating lease liabilities	$	3,429

Related Party Transactions	9 Months Ended
Related Party Transactions	Sep. 30, 2024
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions Consulting Agreement The Company had a consulting agreement with the former chairman of the Company’s board of directors, which terminated when he stepped down in the first quarter of 2024. The Company recorded no consulting fees and less than $0.1 million of expense related to the agreement for the three months ended September 30, 2024 and 2023, respectively, and less than $0.1 million expense related to the agreement for the nine months ended September 30, 2024 and 2023. Credit Agreements The Company's prior credit agreement (the "2019 Credit Agreement") was between the Company and related parties OrbiMed Royalty Opportunities II, LP and Deerfield Private Design Fund II, L.P., and provided for a loan of up to $70.0 million with a maturity date of May 20, 2024. On June 30, 2022, the loan balance of $40.0 million was repaid in full out of the proceeds of the 2022 Credit Agreement. The 2022 Credit Agreement with related parties Deerfield Private Design Fund III, L.P. and Deerfield Partners, L.P. replaced the 2019 Credit Agreement and provides for an aggregate principal amount of $35.0 million and a maturity date five years from the closing of the loan. Refer to Note 9 - Debt for additional details. The liability for the loan balance related to the 2022 Credit Agreement recorded on the Company's condensed consolidated balance sheets was $32.4 million and $34.8 million as of September 30, 2024 and December 31, 2023, respectively. The Company recorded interest expense related to the debt on the condensed consolidated statement of operations and comprehensive income (loss) of $1.4 million and $1.4 million for the three months ended September 30, 2024 and 2023, respectively, and $4.4 million and $4.1 million for the nine months ended September 30, 2024 and 2023, respectively. Warrants In connection with the 2022 Credit Agreement, the Company entered into the 2022 Warrant Purchase Agreement with Deerfield, pursuant to which the Company issued warrants for the purchase of up to an aggregate 3,779,018 shares of the Company’s common stock at an exercise price of $1.1114 per share for a period of eight years following issuance. Refer to Note 12 - Warrants for additional details. Registration Rights Agreement On June 30, 2022, in connection with the issuance of the 2022 Warrants, the Company also entered into a registration rights agreement (the “Registration Rights Agreement”) with Deerfield, pursuant to which the Company filed a shelf registration statement on Form S-3 with the SEC to register the resale of certain securities held by Deerfield and their affiliates (the “Registrable Securities”). In addition, for a period of five years following the execution of the Registration Rights Agreement, or until all Registrable Securities are registered or no longer subject to restrictions on transfer (whichever is earlier), Deerfield will hold certain “piggy-back” registration rights with respect to registration statements filed during such period. The Company will generally pay all reasonable expenses incidental to its obligations and performance under the Registration Rights Agreement, other than underwriting discounts and commissions and such other charges.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-6

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(g)(3))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(c))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(e))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/850/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-6

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

+ Details

401(k) Retirement Plan (Details) - USD ($)	3 Months Ended		9 Months Ended
401(k) Retirement Plan (Details) - USD ($)	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
401(k) Retirement Plan
Defined Contribution Plan Disclosure [Line Items]
Employer contribution to defined benefit plan	$ 0	$ 0	$ 0	$ 0

Marketable Securities - Summary of Marketable Securities (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Available-for-sale securities - short-term:
Amortized Cost	$ 0	$ 3,233
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	0	3,233
Total available-for-sale securities
Amortized Cost	0	3,233
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	0	3,233
U.S. treasury securities
Available-for-sale securities - short-term:
Amortized Cost		1,978
Gross Unrealized Gains		0
Gross Unrealized Losses		0
Fair Value		1,978
Commercial paper
Available-for-sale securities - short-term:
Amortized Cost	0	497
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	$ 0	497
Yankee debt securities
Available-for-sale securities - short-term:
Amortized Cost		758
Gross Unrealized Gains		0
Gross Unrealized Losses		0
Fair Value		$ 758

Operating Leases - Summary of Components of Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Operating leases
Operating lease cost	$ 256	$ 252	$ 767	$ 755
Variable lease cost	91	81	274	243
Total operating lease expense	$ 347	$ 333	$ 1,041	$ 998

Organization and Description of Business	9 Months Ended
Organization and Description of Business	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Description of Business	Organization and Description of Business Acutus Medical, Inc. (the “Company”) historically designed, manufactured and marketed a range of tools for catheter-based ablation procedures to treat various arrhythmias. Prior to November 2023, the Company’s product portfolio included novel access sheaths, diagnostic and mapping catheters, ablation catheters, mapping and imaging consoles and accessories, as well as supporting algorithms and software programs. In November 2023, the Company’s board of directors approved a strategic realignment of resources and corporate restructuring (the “Restructuring”). The Company began implementation of a shift in its business model to solely support the manufacturing and distribution of Medtronic Inc.’s (“Medtronic”) left-heart access product portfolio, including to potentially earn earnout payments from Medtronic pursuant to its manufacturing and distribution arrangements with Medtronic. As part of the Restructuring, the Company wound down its mapping and ablation businesses and no longer manufactures or distributes the AcQMap Mapping System, the AcQMap 3D Mapping Catheter, the AcQBlate Force-Sensing Ablation Catheter, the AcQGuide Max 2.0 Steerable Sheath or associated accessories, and is exploring strategic alternatives for these businesses (specifically a sale of related assets). The Company substantially completed the Restructuring in the first quarter of 2024. As previously disclosed, The Nasdaq Stock Market, LLC (“Nasdaq”) suspended trading in the Company’s common stock on May 9, 2024, due to noncompliance with Nasdaq Listing Rule 5550(a)(2) and 5550(b). On May 15, 2024, Nasdaq announced that it would formally delist the Company’s common stock that was previously suspended. On May 16, 2024, Nasdaq filed a Form 25 Notification of Delisting with the Securities and Exchange Commission (the “SEC”) to complete the delisting and remove such securities from registration under Section 12(b) of the Exchange Act, and such delisting took effect on May 26, 2024. The deregistration of the Company's common stock under Section 12(b) of the Exchange Act was effective 90 days after the Form 25 filing. On May 9, 2024, the Company’s common stock began trading over the counter on the OTC Pink Market under the trading symbol “AFIB.” The Company was incorporated in the state of Delaware on March 25, 2011, and is located in Carlsbad, California. Liquidity and Capital Resources The Company has limited revenue, and has incurred significant operating losses and negative cash flows from operations since its inception, and if it is unable to realize the expected benefits of the Restructuring, anticipates that it could incur losses for at least the next several years. As of September 30, 2024 and December 31, 2023, the Company had cash, cash equivalents, restricted cash and marketable securities of $12.6 million and $29.4 million, respectively. For the nine months ended September 30, 2024 and 2023, net losses from continuing operations were $3.2 million and $9.9 million, respectively. For the nine months ended September 30, 2024 and 2023, discontinued operations generated net losses of $4.9 million and $38.0 million, respectively. For the nine months ended September 30, 2024 and 2023, net cash used in operating activities from continuing operations was $15.9 million and $5.8 million, respectively, and net cash used in operating activities from discontinued operations was $11.7 million and $39.4 million, respectively. As of September 30, 2024 and December 31, 2023, the Company had an accumulated deficit of $608.1 million and $600.0 million, respectively, and working capital of $12.5 million and $27.3 million, respectively. The Restructuring is intended to reduce the Company’s operating expenses and optimize its cash resources by focusing exclusively on the manufacturing and distribution of the Products (as defined in Note 4 – Sale of Business, below) to Medtronic to continue to generate revenue from such sales in addition to the associated earnout payments discussed further below. Following the Restructuring, the Company's primary uses of capital have been investments in manufacturing and distributing the Products to Medtronic and related expenses, raw materials and supplies, legal and other regulatory expenses, general administrative costs and working capital. On June 30, 2022, Medtronic paid the Company $50.0 million at the first closing (the "First Closing") of the sale of the Company's left-heart access portfolio to Medtronic, of which $4.0 million was paid into an indemnity escrow account for a period of 18 months following the First Closing to secure the Company's indemnification obligations under the asset purchase agreement ("Asset Purchase Agreement") entered into with Medtronic on April 26, 2022. Following the termination of the escrow account in accordance with the Asset Purchase Agreement, the amounts in escrow were released. The OEM Earnout (as defined in Note 4 - Sale of Business, below) under the Asset Purchase Agreement with Medtronic was achieved on October 31, 2022, with $20.0 million paid by Medtronic to the Company in November 2022. Additionally, the Transfer Earnout (as defined in Note 4 - Sale of Business, below) under the Asset Purchase Agreement with Medtronic was achieved on December 21, 2022, with $17.0 million paid by Medtronic to the Company in January 2023. Beginning in February 2023, following Medtronic's first commercial sale of the Products after the Company's achievement of the OEM Earnout (as defined in Note 4 - Sale of Business, below), the Company became eligible to earn amounts equal to 100%, 75%, 50% and 50%, respectively, of quarterly Net Sales (as defined in the Asset Purchase Agreement) of the Products achieved by Medtronic each year over four years. During the nine months ended September 30, 2024, the Company earned $8.4 million in contingent consideration based on Medtronic's Products sales. Management believes the Company’s current cash, cash equivalents and marketable securities are sufficient to fund operations for at least the next 12 months from the date of this filing.

Stock-Based Compensation - 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 (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 128	$ 1,278	$ (1,265)	$ 4,915
Continuing Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	128	0	459	(1,724)
Discontinued Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	252	1,026	1,272	3,643
Cost of products sold
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	21	146	(89)	373
Cost of products sold \| Continuing Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	21	0	53	(142)
Cost of products sold \| Discontinued Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	0	146	0	373
Research and development
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	0	317	(559)	999
Research and development \| Continuing Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	0	0	0	(559)
Research and development \| Discontinued Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	11	306	36	963
Selling, general and administrative
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	107	815	(617)	3,543
Selling, general and administrative \| Continuing Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	107	0	406	(1,023)
Selling, general and administrative \| Discontinued Operations
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation	$ 241	$ 574	$ 1,236	$ 2,307

Discontinued Operations, Assets Held for Sale and Restructuring - Narrative (Details)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2024 USD ($) restructuringActivity	Sep. 30, 2023 USD ($)	Dec. 31, 2023 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Depreciation expense	$ 100,000	$ 200,000	$ 235,000	$ 384,000
Types of restructuring activities \| restructuringActivity			3
Discontinued Operations, Held-for-Sale or Disposed of by Sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Inventory reserve	0		$ 0
Impairment of property and equipment					$ 400,000
Depreciation expense	0	900,000	0	3,100,000
Impairment of property and equipment			0		$ 600,000
Net assets held for sale sold (less than for the three months ended September 30, 2024)	100,000		300,000
Amortization of intangible assets	0	100,000	0	100,000
Restructuring charges	2,510,000
Loss on assets held for sale	1,730,000	0	1,730,000	0
Revenue	0	$ 3,178,000	0	$ 9,880,000
Discontinued Operations, Held-for-Sale or Disposed of by Sale \| Biotronik Arbitration
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Restructuring charges	2,500,000		2,500,000
Loss on assets held for sale	$ 1,700,000		$ 1,700,000
Discontinued Operations, Held-for-Sale or Disposed of by Sale \| Non-US \| Revenue Benchmark \| Geographic Concentration Risk
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Discontinued operation sales (as a percent)		60.00%		60.00%

Marketable Securities - Narrative (Details) - USD ($)	Sep. 30, 2024	Dec. 31, 2023
Investments, Debt and Equity Securities [Abstract]
Marketable securities, short-term	$ 0	$ 3,233,000
Marketable securities, short-term, maturity		1 year
Marketable securities, long-term		$ 0

Summary of Significant Accounting Policies - Summary of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Change in fair value	$ 0	$ 0	$ 0	$ 123
Significant Unobservable Inputs (Level 3) \| Warrant liability
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance at beginning of period			409
Change in fair value			(107)
Balance at end of period (unaudited)	$ 302		$ 302

Operating Leases (Tables)

9 Months Ended

Sep. 30, 2024

Leases [Abstract]

Summary of Quantitative Information About Operating Leases and Components of Lease Cost

The following table summarizes quantitative information about the Company’s operating leases for the nine months ended September 30, 2024 and 2023 (dollars in thousands):


	Nine Months Ended September 30,
	2024		2023
	(unaudited)
Operating cash flows from operating leases	$	290	$	282

Weighted average remaining lease term – operating leases (in years)	3.2		4.2
Weighted average discount rate – operating leases	7.0%		7.0%

The following table provides the components of the Company’s operating lease expense for the three and nine months ended September 30, 2024 and 2023 (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2024		2023		2024		2023
	(unaudited)				(unaudited)
Operating leases
Operating lease cost	$	256	$	252	$	767	$	755
Variable lease cost	91		81		274		243
Total operating lease expense	$	347	$	333	$	1,041	$	998

Summary of Future Minimum Payments Under the Non-cancelable Operating Leases

As of September 30, 2024, future minimum payments under the non-cancelable operating leases under ASC 842 were as follows (in thousands):



Three months ending December 31, 2024	$	292
Year ending December 31, 2025	1,151
Year ending December 31, 2026	1,185
Year ending December 31, 2027	1,221
Total	3,849
Less: present value discount	(420)
Operating lease liabilities	$	3,429

Property and Equipment, Net (Tables)

9 Months Ended

Sep. 30, 2024

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, 2024 and December 31, 2023 (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)

Furniture and fixtures	432		432
Office equipment	1,537		1,537
Laboratory equipment and software	1,501		1,494
Leasehold improvements	1,086		979
Construction in process	41		7
Total property and equipment	4,597		4,449
Less: accumulated depreciation	(3,861)		(3,624)
Property and equipment, net	$	736	$	825

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 12,595	$ 19,170
Marketable securities, short-term	0	3,233
Restricted cash, short-term	0	7,030
Accounts receivable	9,970	11,353
Inventory	4,191	4,278
Prepaid expenses and other current assets	403	678
Current assets of discontinued operations (Note 3)	0	510
Total current assets	27,159	46,252
Noncurrent assets
Property and equipment, net	736	825
Right-of-use assets, net	2,647	3,189
Other assets	94	94
Non-current assets of discontinued operations (Note 3)	1,531	3,600
Total assets	32,167	53,960
Current liabilities:
Accounts payable	1,711	2,761
Accrued liabilities	1,702	2,887
Operating lease liabilities, short-term	897	718
Long-term debt, current portion	7,084	1,864
Warrant liability	302	409
Current liabilities of discontinued operations (Note 3)	2,969	10,303
Total current liabilities	14,665	18,942
Operating lease liabilities, long-term	2,532	3,243
Long-term debt	25,269	32,654
Total liabilities	42,466	54,839
Commitments and contingencies (Note 11)
Stockholders' deficit
Preferred stock, $0.001 par value; 5,000,000 shares authorized as of September 30, 2024 and December 31, 2023; 6,666 shares of preferred stock, designated as Series A Common Equivalent Preferred Stock, are issued and outstanding as of September 30, 2024 and December 31, 2023	0	0
Common stock, $0.001 par value; 260,000,000 shares authorized as of September 30, 2024 and December 31, 2023; 29,912,305 and 29,313,667 shares issued and outstanding as of September 30, 2024 and December 31, 2023, respectively	30	29
Additional paid-in capital	598,670	599,935
Accumulated deficit	(608,118)	(599,977)
Accumulated other comprehensive loss	(881)	(866)
Total stockholders' deficit	(10,299)	(879)
Total liabilities and stockholders' deficit	$ 32,167	$ 53,960

Summary of Significant Accounting Policies - Summary of Accounts Receivable (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable	$ 9,970	$ 11,353
Trade accounts receivable
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable	5,492	1,993
Earnouts receivable from Medtronic
Accounts, Notes, Loans and Financing Receivable [Line Items]
Accounts receivable	$ 4,478	$ 9,360

Stock-Based Compensation (Tables)

9 Months Ended

Sep. 30, 2024

Share-Based Payment Arrangement [Abstract]

Summary of Estimate of the Fair Value of Stock Option

The following assumptions were used to estimate the fair value of stock options for the nine months ended September 30, 2023:


	Nine Months Ended September 30,
		2023

Risk-free interest rate		3.91% - 4.27%
Expected dividend yield		—
Expected term in years		5.5 - 5.6
Expected volatility		75% - 85%

Summary of Stock Option Activity

The Company's stock option activity for the nine months ended September 30, 2024 was as follows:


	Stock Options	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life (in years)	Aggregate Intrinsic Value (in thousands)
Outstanding as of December 31, 2023	1,904,723	$	1.98	7.8	$	—
Options granted	—	—
Options exercised	—	—			$	—
Options forfeited	(1,395,921)	1.34
Outstanding as of September 30, 2024 (unaudited)	508,802	$	3.72	7.6	$	—
Options vested and exercisable as of September 30, 2024 (unaudited)	508,802	$	3.72	7.6	$	—

Summary of RSU Activity

The Company’s RSU activity for the nine months ended September 30, 2024 was as follows:


	Number of Shares	Weighted Average Grant Price
Unvested as of December 31, 2023	2,185,330	$	2.18
Granted	—	—
Forfeited	(1,286,853)	2.51
Vested	(898,477)	1.70
Unvested as of September 30, 2024 (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,				Three Months Ended September 30, 2024				Three Months Ended September 30, 2023
	2024		2023		Continuing Operations		Discontinued Operations		Continuing Operations		Discontinued Operations
	(unaudited)				(unaudited)				(unaudited)
Cost of products sold	$	21	$	146	$	21	$	—	$	—	$	146
Research and development	—		317		—		—		11		306
Selling, general and administrative	107		815		107		—		241		574
Total stock-based compensation	$	128	$	1,278	$	128	$	—	$	252	$	1,026

The following table summarizes the total stock-based compensation expense for the stock options, PSUs, RSUs, RSAs and ESPP expense recorded in the condensed consolidated statements of operations and comprehensive income (loss) for the nine months ended September 30, 2024 and 2023 (in thousands):


	Nine Months Ended September 30,				Nine Months Ended September 30, 2024				Nine Months Ended September 30, 2023
	2024		2023		Continuing Operations		Discontinued Operations		Continuing Operations		Discontinued Operations
	(unaudited)				(unaudited)				(unaudited)
Cost of products sold	$	(89)	$	373	$	53	$	(142)	$	—	$	373
Research and development	(559)		999		—		(559)		36		963
Selling, general and administrative	(617)		3,543		406		(1,023)		1,236		2,307
Total stock-based compensation	$	(1,265)	$	4,915	$	459	$	(1,724)	$	1,272	$	3,643

Subsequent Events (Details) - 2022 Credit Agreement - Senior Term Loan $ in Millions	Nov. 13, 2024 USD ($) payment	Mar. 04, 2024 USD ($)
Deerfield Credit Agreement, Amendment 3
Subsequent Event [Line Items]
Exit fee percentage		5.00%
Deerfield Credit Agreement, Amendment 4 \| Subsequent Event
Subsequent Event [Line Items]
Exit fee percentage	6.00%
End of Month 36 \| Deerfield Credit Agreement, Amendment 3
Subsequent Event [Line Items]
Debt instrument installment payment		$ 7.5
End of Month 36 \| Deerfield Credit Agreement, Amendment 4 \| Subsequent Event
Subsequent Event [Line Items]
Debt instrument installment payment	$ 2.5
Number of periodic payments \| payment	3

Operating Leases - Summary of Future Minimum Payments Under the Non-Cancelable Operating Leases (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Lessee, Operating Lease, Liability, Payment, Due [Abstract]
Three months ending December 31, 2024	$ 292
Year ending December 31, 2025	1,151
Year ending December 31, 2026	1,185
Year ending December 31, 2027	1,221
Total	3,849
Less: present value discount	(420)
Operating lease liabilities	$ 3,429

Summary of Significant Accounting Policies - Summary of Weighted-Average Unobservable Inputs to Measure Warranty Liability (Details) - Significant Unobservable Inputs (Level 3) - Exercise of common stock warrants	Sep. 30, 2024 year $ / shares
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Share price (in usd per share) \| $ / shares	$ 0.0799
Risk-free interest rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants and rights outstanding, measurement input	0.0358
Expected term in years
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants and rights outstanding, measurement input \| year	5.8
Expected volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants and rights outstanding, measurement input	2.000

Property and Equipment, Net

9 Months Ended

Sep. 30, 2024

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

The Company’s property and equipment, net, consisted of the following as of September 30, 2024 and December 31, 2023 (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)

Furniture and fixtures	432		432
Office equipment	1,537		1,537
Laboratory equipment and software	1,501		1,494
Leasehold improvements	1,086		979
Construction in process	41		7
Total property and equipment	4,597		4,449
Less: accumulated depreciation	(3,861)		(3,624)
Property and equipment, net	$	736	$	825

Depreciation expense from continuing operations was $0.1 million and $0.2 million for the three months ended September 30, 2024 and 2023, respectively, and $0.2 million and $0.4 million for the nine months ended September 30, 2024 and 2023, respectively.

Discontinued Operations, Assets Held for Sale and Restructuring - Summary of Company’s Discontinued Operations Revenue (Details) - Discontinued Operations, Held-for-Sale or Disposed of by Sale - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue	$ 0	$ 3,178,000	$ 0	$ 9,880,000
Disposables
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue		2,845,000		8,632,000
Service/Other
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue		$ 333,000		$ 1,248,000

Inventory (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Inventory Disclosure [Abstract]
Raw materials	$ 1,948	$ 3,428
Work in process	611	319
Finished goods	1,632	531
Total inventory	$ 4,191	$ 4,278

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Sep. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Net Loss Per Common Share (Tables)

9 Months Ended

Sep. 30, 2024

Earnings Per Share [Abstract]

Summary of Antidilutive Securities

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:


	Three Months Ended September 30,		Nine Months Ended September 30,
	2024	2023	2024	2023
	(unaudited)		(unaudited)
Shares issuable upon:
Conversion of Series A Common Equivalent Preferred Stock	6,665,841	6,665,841	6,665,841	6,665,841
Exercise of common stock warrants	4,576,505	4,576,505	4,576,505	4,576,505
Exercise of stock options	—	2,216,938	—	1,098,279
Vesting of RSUs and RSAs	65,832	2,423,022	692,745	2,290,728
Issuance of shares under 2020 ESPP	—	61,361	—	61,361
Total potentially dilutive securities	11,308,178	15,943,667	11,935,091	14,692,714

Organization and Description of Business (Details) - USD ($) $ in Thousands			1 Months Ended		3 Months Ended		9 Months Ended
	Feb. 01, 2023	Jun. 30, 2022	Jan. 31, 2023	Nov. 30, 2022	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Subsidiary, Sale of Stock [Line Items]
Cash, cash equivalents, restricted cash and marketable securities					$ 12,600		$ 12,600		$ 29,400
Net losses from continuing operations					816	$ 1,918	3,225	$ 9,878
Loss from discontinued operations					4,791	$ 11,319	4,916	38,020
Net cash used in operating activities - continuing operations							15,910	5,753
Net cash used in operating activities from discontinued operations							11,692	39,352
Accumulated deficit					608,118		608,118		599,977
Working capital					$ 12,500		12,500		$ 27,300
Proceeds from sale of business							13,235	$ 17,000
Contingent consideration received from sales							$ 8,400
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio
Subsidiary, Sale of Stock [Line Items]
Proceeds from sale of business		$ 50,000	$ 17,000	$ 20,000
Indemnity escrow account, amount		$ 4,000	$ 1,400	$ 1,600
Indemnity escrow account, term		18 months
Milestone consideration, period	4 years	4 years
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Year One
Subsidiary, Sale of Stock [Line Items]
Milestone consideration, royalty percentage	100.00%	100.00%
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Year Two
Subsidiary, Sale of Stock [Line Items]
Milestone consideration, royalty percentage	75.00%	75.00%
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Year Three
Subsidiary, Sale of Stock [Line Items]
Milestone consideration, royalty percentage	50.00%	50.00%
Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations \| Left-Heart Access Portfolio \| Year Four
Subsidiary, Sale of Stock [Line Items]
Milestone consideration, royalty percentage	50.00%	50.00%

Summary of Significant Accounting Policies

9 Months Ended

Sep. 30, 2024

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Basis of Presentation

The condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S. GAAP”) for interim financial information and the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and notes required by U.S. GAAP for complete financial statements. In the opinion of management, the condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments necessary for the fair statement of the balances and results for the periods presented. Certain information and note disclosures normally included in the Company’s annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These condensed consolidated financial statement results are not necessarily indicative of results to be expected for the full fiscal year or any future period.

Principles of Consolidation

The condensed consolidated financial statements include the accounts of Acutus Medical, Inc. and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.

Discontinued Operations

In accordance with Accounting Standards Codification ("ASC") 205, Presentation of Financial Statements, under subtopic 205-20 Discontinued Operations, a disposal of a component of an entity or a group of components of an entity is required to be reported as discontinued operations if the disposal represents a strategic shift that has (or will have) a major effect on an entity’s operations and financial results when the components of an entity meets the criteria in paragraph 205-20-45-10. In the period in which the component meets held-for-sale or discontinued operations criteria the major current assets, non-current assets, current liabilities, and non-current liabilities are reported as components of total assets and liabilities separate from those balances of the continuing operations. At the same time, the results of all discontinued operations, less applicable income taxes, are reported as components of net loss separate from the net loss of continuing operations.

The strategic shift approved by the Company's board of directors (discussed in Note 1 – Organization and Description of Business, above) met the definition of a discontinued operation as of September 30, 2024 and December 31, 2023. Accordingly, the major current assets, non-current assets, current liabilities, and non-current liabilities are reported as components of total assets and liabilities separate from those balances of the continuing operations as of September 30, 2024 and December 31, 2023, and the operating results of the components disposed are reported as loss from discontinued operations in the accompanying condensed consolidated statements of operations and comprehensive income (loss) for the three- and nine- months ended September 30, 2024 and 2023. For additional information, see Note 3 - Discontinued Operations, Assets Held for Sale and Restructuring.

Use of Estimates and Assumptions

The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenue, expenses and disclosures of contingent assets and liabilities. These estimates and assumptions are based on current facts, historical experience and various

other factors believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities and the recording of revenue and expenses that are not readily apparent from other sources. Actual results could differ from those estimates.

Segments

Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker in making decisions regarding resource allocation and assessing performance. The Company views its operations and manages its business as one operating segment and reportable segment.

Cash and Cash Equivalents and Restricted Cash

The Company considers all highly liquid investments with maturities of three months or less when purchased to be cash equivalents. All of the Company’s cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in bank deposits and other accounts, the balances of which, at times and as of September 30, 2024 and December 31, 2023, exceeded federally insured limits.

Restricted cash consists of (i) deposited cash collateral for the Company’s corporate credit card program and (ii) cash received for the sale of business to Medtronic held in an indemnity escrow account until certain terms of sale are met. Following the termination of the escrow account in accordance with the Asset Purchase Agreement, the amounts in escrow were released. As of September 30, 2024, the Company recorded no restricted cash on the condensed consolidated balance sheet.

Marketable Securities

The Company’s marketable securities portfolio consists of investments in money market funds, commercial paper, U.S. treasury securities and Yankee debt securities.

The Company considers its debt securities to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term or long-term marketable securities based on the maturity date at time of purchase and their availability to meet current operating requirements. Marketable securities that mature in three months or less from the date of purchase are classified as cash equivalents. Marketable securities, excluding cash equivalents, that mature in one year or less are classified as short-term available-for-sale securities and are reported as a component of current assets.

Securities that are classified as available-for-sale are measured at fair value with temporary unrealized gains and losses reported in other comprehensive income (loss), and as a component of stockholders’ equity until their disposition or maturity. See “Fair Value Measurements,” below. The Company reviews all available-for-sale securities at each period end to determine if they remain available-for-sale based on the Company’s current intent and ability to sell the security if it is required to do so. Realized gains and losses from the sale of marketable securities, if any, are calculated using the specific-identification method.

Marketable securities are subject to a periodic impairment review. The Company may recognize an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investee’s financial condition and the Company’s intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in value judged to be other-than-temporary are included in the Company’s condensed consolidated statements of operations and comprehensive income (loss). The Company did not record any other-than-temporary impairments related to marketable securities in the Company’s condensed consolidated statements of operations and comprehensive income (loss) for the three and nine months ended September 30, 2024 and 2023.

Concentrations of Credit Risk and Off-Balance Sheet Risk

Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents, restricted cash, accounts receivable and marketable securities. Cash and restricted cash (if applicable) are maintained in accounts with financial institutions which, at times, may exceed the federal depository insurance coverage of $0.25 million. The Company has not experienced losses on these accounts, and management believes, based upon the quality of the financial institutions, that the credit risk with regard to these deposits is not significant.

Revenue from Contracts with Customers

The Company accounts for revenue earned from contracts with customers under ASC 606, Revenue from Contracts with Customers (“ASC 606”), and ASC 842, Leases ("ASC 842"). The core principle of ASC 606 is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The following five steps are applied to achieve that core principle:

•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.

ASC 842 provides guidance on determining whether an agreement contains a lease. ASC 842 defines a lease as a contract, or part of a contract, that conveys the right to control the use of identified property, plant or equipment for a period of time in exchange for consideration.

The below description applies to products that are no longer being manufactured and sold by the Company due to the Restructuring. See Note 1 – Organization and Description of Business – Liquidity and Capital Resources, above.

Historically, for new customers, the Company had placed its medical diagnostic equipment, the AcQMap System, at customer sites under evaluation agreements and had generated revenue from the sale of disposable products used with the AcQMap System. Disposable products primarily included AcQMap catheters and AcQGuide steerable sheaths. Outside of the United States, the Company also had the Qubic Force Device which generated revenue from the sale of the AcQBlate Force Ablation Catheters. The Company had provided the disposable products in exchange for consideration, which occurred when a customer submitted a purchase order and the Company provided disposables at the agreed upon prices in the invoice. Generally, customers purchased disposable products using separate purchase orders after the equipment had been provided to the customer for free with no binding agreement or requirement to purchase any disposable products. The Company had elected the practical expedient and accounting policy election to account for the shipping and handling as activities to fulfill the promise to transfer the disposable products and not as a separate performance obligation.

Additionally, the Company had sold the AcQMap System to customers along with software updates on a when-and-if-available basis, as well as the Qubic Force Device and a transseptal crossing line of products which could be used in a variety of heart procedures and did not need to be accompanied with an AcQMap System or Qubic Force Device.

The Company had also entered into deferred equipment agreements that were generally structured such that the Company agreed to provide an AcQMap System at no up-front charge, with title of the device transferring to the customer at the end of the contract term, in exchange for the customer’s commitment to purchase disposables at a specified price over the term of the agreement, which generally ranged from two years to four years. The Company had determined that such deferred equipment agreements included an embedded sales-type lease. The Company had allocated contract consideration under deferred equipment agreements containing fixed annual disposable purchase commitments to the underlying lease and non-lease components at contract inception. The Company had expensed the cost of the device at the inception of the agreement and recorded a financial lease asset equal to the gross consideration allocated to the lease. The lease asset had been reduced by payments for minimum disposable purchases that were allocated to the lease.

Lastly, the Company had entered into short-term operating leases for the rental of the AcQMap System after an evaluation. These lease agreements imposed no requirement on the customer to purchase the equipment, and the equipment was not transferred to the customer at the end of the lease term. The short-term nature of the lease agreements did not result in lease payments accumulating to an amount that equaled the value of the equipment nor was the lease term reflective of the economic life of the equipment.

The Company’s contracts had primarily included fixed consideration. Generally, there were no discounts, rebates, returns or other forms of variable consideration. Customers were generally required to pay within 30 days to 60 days.

The delivery of disposable products were performance obligations satisfied at a point in time. The disposable products were shipped via Free on Board (“FOB”) shipping point or FOB destination. For disposable products that were shipped via FOB shipping point, the customer had the significant risks and rewards of ownership and legal title to the assets when the disposable products left the Company’s shipping facilities, at which point the customer obtained control and thus revenue was recognized at that point in time. Revenue had been recognized on delivery for disposable products shipped via FOB destination.

For direct customers, the installation and delivery of the AcQMap System was satisfied at a point in time when the installation was complete, which was when the customer could benefit and had control of the system. For AcQMap System sales sold to Biotronik SE & Co. KG (“Biotronik”), the installation was not a performance obligation as it was performed by Biotronik, and therefore the AcQMap System was satisfied at a point in time when they had control of the system. The Company’s software updates and equipment service performance obligations were satisfied evenly over time as the customer simultaneously received and consumed the benefits of the Company’s performance for these services throughout the service period.

The Company had allocated the transaction price to each performance obligation identified in the contract based on the relative standalone selling price (“SSP”). The Company had determined SSP for the purposes of allocating the transaction price to each performance obligation based on the adjusted market assessment approach that maximizes the use of observable inputs, which included, but was not limited to, sales transactions where the specific performance obligations were sold separately, Company listed prices and specific offers to customers.

Except for the deferred equipment agreements noted above, the Company’s contracts with customers generally had an expected duration of one year or less, and therefore the Company had elected the practical expedient in ASC 606 to not disclose information about its remaining performance obligations. Any incremental costs to obtain contracts were recorded as selling, general and administrative ("SG&A") expense as incurred due to the short duration of the Company’s contracts. The Company’s contract balances consisted solely of accounts receivable as of September 30, 2024 and December 31, 2023.

In May 2020, the Company entered into bi-lateral distribution agreements (the “Bi-Lateral Distribution Agreements”) with Biotronik. Pursuant to the Bi-Lateral Distribution Agreements, the Company obtained a non-exclusive license to distribute a range of Biotronik’s products and accessories in the United States, Canada, China, Hong Kong and multiple Western European countries under the Company’s private label. Moreover, if an investigational device exemption (“IDE”) clinical trial was required for these products to obtain regulatory approval in the United States, or a clinical trial was required for these products to obtain regulatory approval in China, the Company would obtain an exclusive distribution right in such territories for a term of up to five years commencing on the date of regulatory approval if the Company covered the cost of the IDE or other clinical trial and the Company conducted such study within a specified period. Biotronik also agreed to distribute the Company’s products and accessories in Germany, Japan, Mexico, Switzerland and multiple countries in Asia-Pacific, Eastern Europe, the Middle East and South America. The Company also granted Biotronik a co-exclusive right to distribute these products in Hong Kong. Each party would pay to the other party a specified transfer price on the sale of the other party’s products and, accordingly, would earn a distribution margin on the sale of the other party’s products. In February 2024, Biotronik sent a notice to the Company, stating that Biotronik rescinds and terminates the Bi-Lateral Distribution Agreements, effective immediately, based on the alleged repudiation of its contractual obligations under the Bi-Lateral Distribution Agreements. In October 2024, resulting from the Company's Restructuring and the Arbitration that ensued with Biotronik Parties, the Company entered into a Settlement Agreement and Release terminating the Relevant Agreements (except for certain surviving obligations specified therein), settling the Arbitration relating to the Relevant Agreements and releasing and discharging each party of all claims against the other, including any claims that were or could have been asserted in the Arbitration.

In 2022, the Company sold its left-heart access transseptal crossing business to Medtronic. In connection with the sale, the Company entered into a distribution agreement (the "Distribution Agreement") with Medtronic, pursuant to which the Company acts as the original equipment manufacturer ("OEM") supplier of these Products. The Company will produce and sell the Products to Medtronic for a period of up to four years. Revenue is recognized when the title to the products are transferred to Medtronic, which occurs when the products are shipped from the Company's facility (or via FOB shipping point). See Note 4 – Sale of Business, below, for further details. As part of the Restructuring, the Company currently focuses exclusively on the manufacturing and distribution of the Products and associated services to Medtronic to continue to generate revenue from such sales and potentially earn the associated earnout payments.

The following table sets forth the Company’s revenue for disposables, systems and service/other for the three and nine months ended September 30, 2024 and 2023 (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2024		2023		2024		2023
	(unaudited)				(unaudited)
Disposables	$	5,266	$	1,862	$	12,499	$	4,106

Service/Other	—		198		528		710
Total revenue	$	5,266	$	2,060	$	13,027	$	4,816

For the three and nine months ended September 30, 2024 and 2023, revenue was all U.S.-based.

Inventory

Inventory is stated at the lower of cost (first-in, first-out basis) or net realizable value. The Company recorded write-downs for excess and obsolete inventory of $0.5 million and $0.3 million for the three months ended September 30, 2024 and 2023, respectively, and $1.1 million and $0.9 million for the nine months ended September 30, 2024 and 2023, respectively, based on management’s review of inventories on hand, comparisons to estimated future usage and sales, observed shelf-life and assumptions about the likelihood of obsolescence.

Accounts Receivable

Trade accounts receivable are recorded net of allowances for uncollectible accounts. The Company evaluates the collectability of its accounts receivable based on various factors including historical experience, the length of time the receivables are past due and the financial health of the customer. The Company reserves specific receivables if collectability is no longer reasonably assured. Based upon the assessment of these factors, the Company did not record an allowance for uncollectible accounts as of September 30, 2024 or December 31, 2023.

Accounts receivable recorded on the condensed consolidated balance sheets as of September 30, 2024 and December 31, 2023 consists of the following (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
Trade accounts receivable	$	5,492	$	1,993
Earnouts receivable from Medtronic	4,478		9,360
Total accounts receivable	$	9,970	$	11,353

Property and Equipment, Net

Property and equipment are recorded at cost. Depreciation and amortization are provided using the straight-line method over the estimated useful lives of the related assets, generally three to five years, or, in the case of leasehold improvements, over the lesser of the useful life of the related asset or the lease term.

Impairment of Long-Lived Assets

The Company reviews long-lived assets, including property and equipment and finite-lived intangible assets, for impairment whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. An impairment loss is recognized when the asset’s carrying value exceeds the total undiscounted cash flows expected from its use and eventual disposition. The amount of the impairment loss is determined as the excess of the carrying value of the asset over its fair value. For the three and nine months ended September 30, 2024 and 2023, the Company determined that there was no impairment of property and equipment.

Foreign Currency Translation and Transactions

The assets, liabilities and results of operations of Acutus Medical N.V. and Acutus Medical UK Limited are measured using their functional currency, the Euro and British Pound Sterling, respectively, which is the currency of the primary foreign economic environment in which the subsidiaries operate. Upon consolidating these entities with the Company, their assets and liabilities are translated to U.S. dollars at currency exchange rates as of the balance sheet date and their revenues and expenses are translated at the weighted average currency exchange rates during the applicable reporting periods. Translation adjustments resulting from the process of translating the entities’ financial statements are reported in accumulated other comprehensive loss in the condensed consolidated balance sheets and foreign currency translation adjustment in the condensed consolidated statements of operations and comprehensive income (loss).

Lease Property

The Company leases office space in Carlsbad, California as its corporate headquarters and for manufacturing operations. Additionally, it leases office space in Zaventem, Belgium for CE Mark compliance. The Company accounts for its lease property under ASC 842. Under this guidance, arrangements meeting the definition of a lease are classified as operating or financing leases, and are recorded on the condensed consolidated balance sheets as both a right-of-use asset and a lease liability,

calculated by discounting fixed lease payments over the lease term at the rate implicit in the lease or the Company’s incremental borrowing rate, which is the rate for collateralized borrowings based on the current economic environment, credit history, credit rating, value of leases, currency in which the lease obligation is satisfied, rate sensitivity, lease term and materiality. Lease liabilities are increased by interest and reduced by payments each period, and the right-of-use asset is amortized over the lease term. For operating leases, interest on the lease liability and the amortization of the right-of-use asset results in straight-line rent expense over the lease term. Variable lease expenses are recorded when incurred.

Cost of Products Sold

Cost of products sold includes raw materials, direct labor (including stock-based compensation), manufacturing overhead, shipping and receiving costs and other less significant indirect costs related to the production of the Company’s products.

Research and Development

Prior to the Restructuring, the Company was actively engaged in new product research and development efforts. Research and development expenses consisted primarily of salaries and employee-related costs (including stock-based compensation) for personnel directly engaged in research and development activities, clinical trial expenses, equipment costs, material costs, allocated rent and facilities costs and depreciation.

Research and development expenses relating to possible future products were expensed as incurred. The Company also accrued and expensed costs for activities associated with clinical trials performed by third parties as incurred. All other costs relative to setting up clinical trial sites were expensed as incurred. Clinical trial site costs related to patient enrollment were accrued as patients were entered into the trials.

Following the Restructuring, we have no research and development expense as we discontinued research and development to focus on solely manufacturing and distributing the Products and associated services under our Distribution Agreement with Medtronic.

Selling, General and Administrative

SG&A expenses consist primarily of salaries and employee-related costs (including stock-based compensation) for personnel in executive, finance and other administrative functions, allocated rent and facilities costs, legal fees relating to intellectual property and corporate matters, professional fees for accounting and consulting services, insurance costs, and additionally, prior to the Restructuring, salaries and employee-related costs for personnel in sales, marketing, and other administrative functions.

Restructuring Expenses

The Company undertook a strategic realignment of resources and corporate restructuring (i.e., the Restructuring), including an organizational workforce reduction and additional cost reduction measures. The Company's restructuring and exit-related charges consisted of severance expenses and related benefit costs for employees affected by the organizational workforce reduction, retention bonuses for certain employees that are assisting with the Restructuring, other restructuring costs and impairment charges in connection with the disposition of certain assets, including inventory, fixed assets and intangibles. Refer to Note 3 - Discontinued Operations, Assets Held for Sale and Restructuring for additional details.

Fair Value Measurements

Financial Instruments

Fair value measurements are based on the premise that fair value is an exit price representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the following three-tier fair value hierarchy is used in determining the inputs for measuring fair value:

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.

Level 3—Unobservable inputs which are supported by little or no market activity and consist of financial instruments valued using pricing models, discounted cash flow methodologies or similar techniques, as well as instruments for which the determination of fair value requires significant judgment or estimation.

Financial instruments measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. Management’s assessment of the significance of a particular input to the fair value measurement in its entirety requires judgment and considers factors specific to the asset or liability. The use of different assumptions and/or estimation methodologies may have a material effect on estimated fair values. Accordingly, the fair value estimates disclosed or initial amounts recorded may not be indicative of the amount that the Company or holders of the instruments could realize in a current market exchange. There were no transfers made among the three levels in the fair value hierarchy for the three and nine months ended September 30, 2024 and 2023.

As of September 30, 2024 and December 31, 2023, the Company’s cash (excluding cash equivalents which are recorded at fair value on a recurring basis), restricted cash, accounts receivable, accounts payable and accrued expenses were carried at cost, which approximates the fair values due to the short-term nature of each instrument. The carrying amount of the Company’s long-term debt approximates fair value due to its variable market interest rate and management’s opinion that current rates and terms that would be available to the Company with the same maturity and security structure would be essentially equivalent to that of the Company’s long-term debt.


	Fair Value Measurements as of September 30, 2024
	(unaudited)
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets included in:
Cash and cash equivalents
Money market securities	$	11,788	$	—	$	—	$	11,788
Marketable securities at fair value

Commercial paper	—		—		—		—

Total fair value	$	11,788	$	—	$	—	$	11,788

Liabilities included in:
Warrant liability	$	—	$	—	$	302	$	302

Total fair value	$	—	$	—	$	302	$	302


	Fair Value Measurements as of December 31, 2023
	Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Total
Assets included in:
Cash and cash equivalents
Money market securities	$	16,911	$	—	$	—	$	16,911
Marketable securities at fair value
U.S. treasury securities	—		1,978		—		1,978
Commercial paper	—		497		—		497
Yankee debt securities	—		758		—		758
Total fair value	$	16,911	$	3,233	$	—	$	20,144

Liabilities included in:
Warrant liability	$	—	$	—	$	409	$	409

Total fair value	$	—	$	—	$	409	$	409

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

The fair value for the available-for-sale marketable securities is determined based on valuation models using inputs that are observable either directly or indirectly (Level 2 inputs) such as quoted prices for similar assets, yield curve, volatility factors, credit spreads, default rates, loss severity, current market and contractual prices for the underlying instruments, broker and dealer quotes, as well as other relevant economic measures.

Financial Obligations

The following table presents changes in Level 3 liabilities measured at fair value for the nine months ended September 30, 2024 (in thousands):


	Warrant Liability
Balance, December 31, 2023	$	409
Change in fair value	(107)

Balance, September 30, 2024 (unaudited)	$	302

As of September 30, 2024, the fair value of the common stock warrants was estimated using the Black-Scholes option pricing model. The fair value was estimated to be $0.0799 per warrant as of September 30, 2024 and the significant inputs used in the estimation of the fair value were as follows:


			September 30, 2024
			(unaudited)
Risk-free interest rate			3.58%
Expected term in years			5.8
Expected volatility			200.0%

Expected volatility was set at 200% as agreed upon per the Amendment (as defined below) to the 2022 Warrants and 2022 Warrant Purchase Agreement with Deerfield, entered into by the Company on March 4, 2024. See Note 12—Warrants for additional details.

Stock-Based Compensation

The Company accounts for all stock-based payments to employees and non-employees, including grants of stock options, restricted stock units ("RSUs"), and restricted stock awards ("RSAs"), to be recognized in the consolidated financial statements based on their respective grant date fair values. The Company estimates the fair value of stock option grants using the Black-Scholes option pricing model. The RSUs and RSAs are valued based on the fair value of the Company’s common stock on the date of grant. The Company expenses stock-based compensation related to stock options, RSUs and RSAs over the requisite service period. All stock-based compensation costs are recorded in cost of products sold, research and development expense or SG&A expense in the condensed consolidated statements of operations and comprehensive income (loss) based upon the respective employee’s or non-employee’s roles within the Company. Forfeitures are recorded as they occur. See Note 14—Stock-Based Compensation for additional details.

Income Taxes

Income taxes are recorded in accordance with ASC 740, Income Taxes (“ASC 740”), which provides for deferred taxes using an asset and liability approach. The Company recognizes deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the consolidated financial statements or tax returns. Deferred tax assets and liabilities are determined based on the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse, and net operating loss (“NOL”) carryforwards and research and development tax credit carryforwards. Valuation allowances are provided if, based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized.

The Company accounts for uncertain tax positions in accordance with the provisions of ASC 740. When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit would more likely than not be realized assuming examination by the taxing authority. The determination as to whether the tax benefit will more likely than not be realized is based upon the technical merits of the tax position as well as consideration of the available facts and circumstances. To date, there have been no interest or penalties charged in relation to the unrecognized tax benefits.

Warrant Liability

The Company accounts for certain common stock warrants outstanding as a liability at fair value, determined using the Black-Scholes option pricing model, on the condensed consolidated balance sheets in accordance with ASC 815, Derivatives and Hedging (“ASC 815”). The liability is subject to re-measurement at each reporting period and any change in fair value is recognized in the condensed consolidated statements of operations and comprehensive income (loss). See Note 12—Warrants for additional details.

Business Combinations

The Company accounts for business acquisitions using the acquisition method of accounting based on ASC 805, Business Combinations (“ASC 805”), which requires recognition and measurement of all identifiable assets acquired and liabilities assumed at their fair value as of the date control is obtained. The Company determines the fair value of assets acquired and liabilities assumed based upon its best estimates of the acquisition-date fair value of assets acquired and liabilities assumed in

the acquisition. Goodwill is calculated as the excess of the purchase price over the fair value of the net tangible and identifiable intangible assets acquired.

Recently Adopted Accounting Pronouncements

The following Accounting Standard Updates ("ASUs") applicable to the Company were effective January 1, 2024:

•ASU 2023-07, Segment Reporting

•ASU 2022-03, Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions

The adoption of the above noted ASUs did not have a material effect on the Company's condensed consolidated financial statements.

Stock-Based Compensation - Narrative (Details) - USD ($) $ / shares in Units, $ in Millions		9 Months Ended		12 Months Ended
	Sep. 30, 2024	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Expected dividend yield		0.00%	0.00%
Options granted (in shares)		0
Fair value exercise price to calculate aggregate intrinsic value of options (in dollars per share)		$ 0.08		$ 0.70
Unrecognized compensation related to stock options not vested	$ 0.0	$ 0.0
Share based compensation non vested award period for recognition		0 years
Incremental stock-based compensation (less than)	0.1
Forfeited in period, value		$ 1.0
Restricted Stock Units (RSUs)
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Unrecognized compensation related to restricted stock not vested	$ 0.0	0.0
Share-based payment arrangement, accelerated cost		$ 0.5
2022 Plan
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance (in shares)	6,000,000	6,000,000
Share based payment arrangement number of shares available for issuance (in shares)	5,958,365	5,958,365
2020 Plan
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance (in shares)	4,431,305	4,431,305
Share based payment arrangement number of shares available for issuance (in shares)	5,887,381	5,887,381
2011 Plan
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share based payment arrangement, shares authorized for issuance (in shares)	16,902	16,902
Share based payment arrangement number of shares available for issuance (in shares)	0	0
Share based compensation by share based payments arrangement, remain available for issuance (in shares)		0
Share based compensation by share based payment arrangement stock options vesting term		4 years
Share based compensation by share based payment arrangement stock options contractual term		10 years

Debt - Summary of Outstanding Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Mar. 04, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Long-term debt, gross	$ 34,125		$ 36,792
Less: unamortized debt discount and fees	(1,772)		(2,274)
Total outstanding debt	32,353		34,518
2022 Credit Agreement
Debt Instrument [Line Items]
Long-term debt, gross	34,125		$ 36,792
2022 Credit Agreement \| Senior Term Loan
Debt Instrument [Line Items]
Fee amount	$ 1,800	$ 1,800

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

+ References + Details

Stock-Based Compensation - Summary of RSU Activity (Details) - Restricted Stock Units (RSUs)	9 Months Ended
	Sep. 30, 2024 $ / shares shares
Number of Shares
Unvested balance at beginning of period (in shares) \| shares	2,185,330
Granted (in shares) \| shares	0
Forfeited (in shares) \| shares	(1,286,853)
Vested (in shares) \| shares	(898,477)
Unvested balance at end of period (unaudited) (in shares) \| shares	0
Weighted Average Grant Price
Unvested balance at beginning of period (in dollars per share) \| $ / shares	$ 2.18
Granted (in dollars per share) \| $ / shares	0
Forfeited (in dollars per share) \| $ / shares	2.51
Vested (in dollars per share) \| $ / shares	1.70
Unvested balance at end of period (unaudited) (in dollars per share) \| $ / shares	$ 0

Warrants - Summary of Outstanding Warrants to Purchase the Company's Common Stock (Details) - $ / shares	Sep. 30, 2024	Dec. 31, 2023
Class of Warrant or Right [Line Items]
Warrants outstanding (in shares)	4,576,505	4,576,505
Common Stock \| Warrants issued in 2015
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 5.25
Warrants outstanding (in shares)	3,808	3,808
Common Stock \| Warrants issued with 2018 Convertible Notes
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 0.10
Warrants outstanding (in shares)	346,689	346,689
Common Stock \| Warrants issued with 2018 Term Loan
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 16.67
Warrants outstanding (in shares)	26,998	26,998
Common Stock \| Warrants issued with 2019 Credit Agreement
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 16.67
Warrants outstanding (in shares)	419,992	419,992
Common Stock \| Warrants issued with 2022 Credit Agreement
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 1.11
Warrants outstanding (in shares)	3,779,018	3,779,018

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net loss	$ (5,607)	$ (13,237)	$ (8,141)	$ (47,898)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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+ Details

Stock-Based Compensation - Summary of Estimate of the Fair Value of Stock Option (Details)	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate, minimum		3.91%
Risk-free interest rate, maximum		4.27%
Expected dividend yield	0.00%	0.00%
Expected volatility, minimum		75.00%
Expected volatility, maximum		85.00%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term		5 years 6 months
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term		5 years 7 months 6 days

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Net Loss Per Common Share - Summary of Antidilutive Securities (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	11,308,178	15,943,667	11,935,091	14,692,714
Conversion of Series A Common Equivalent Preferred Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	6,665,841	6,665,841	6,665,841	6,665,841
Exercise of common stock warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	4,576,505	4,576,505	4,576,505	4,576,505
Exercise of stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	0	2,216,938	0	1,098,279
Vesting of RSUs and RSAs
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	65,832	2,423,022	692,745	2,290,728
Issuance of shares under 2020 ESPP
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Shares issuable (in shares)	0	61,361	0	61,361

Stockholders’ Equity	9 Months Ended
Stockholders’ Equity	Sep. 30, 2024
Equity [Abstract]
Stockholders' Equity	Stockholders’ Equity Series A Common Equivalent Preferred Stock In August 2021, the Company entered into exchange agreements (the “Exchange Agreements”) with four investors pursuant to which the investors exchanged 6,665,841 shares of the Company’s common stock for 6,666 shares of a new series of non-voting convertible preferred stock of the Company designated as “Series A Common Equivalent Preferred Stock,” par value $0.001 per share (the "Preferred Stock"). In connection with the issuance of the Preferred Stock pursuant to the Exchange Agreements, on August 23, 2021, the Company filed a Certificate of Designation of Preferences, Rights and Limitations of the Series A Common Equivalent Preferred Stock of the Company with the Secretary of State of the State of Delaware. The Preferred Stock ranks senior to the common stock with respect to rights on the distribution of assets on any voluntary or involuntary liquidation, dissolution or winding up of the affairs of the Company, having a liquidation preference equal to its par value of $0.001 per share. The Preferred Stock will participate equally and ratably on an as-converted basis with the holders of common stock in all cash dividends paid on the common stock. The Preferred Stock is non-voting. Upon election, each holder may convert each share of Preferred Stock into 1,000 shares of common stock, except to the extent that following such conversion the number of shares of common stock held by such holder, its affiliates and any other persons whose beneficial ownership of common stock would be aggregated with such holder’s for purposes of Section 13(d) of the Exchange Act including shares held by any “group” (as defined in Section 13(d) of the Exchange Act and applicable regulations of the SEC of which such holder is a member, but excluding shares beneficially owned by virtue of the ownership of securities or rights to acquire securities that have limitations on the right to convert, exercise or purchase similar to the limitation set forth in the Series A Certificate of Designation, exceeds 4.9% (or, at the election of the holders, OrbiMed Private Investments IV, LP or OrbiMed Royalty Opportunities II, LP, made by delivering at least 61 days advance written notice to the Company of its intention to increase the beneficial ownership cap applicable to such holder, 9.9%) of the total number of shares of common stock then issued and outstanding. Common Stock During the nine months ended September 30, 2024 and 2023, stock options to acquire 0 shares and 3,218 shares, respectively, were exercised for shares of the Company's common stock with proceeds of $0.0 million and less than $0.1 million, respectively. Additionally in relation to the 2020 Employee Stock Purchase Plan (the "2020 ESPP"), during the nine months ended September 30, 2024 and 2023, 0 shares and 45,162 shares, respectively, of common stock were issued for consideration of $0.0 million (as the 2020 ESPP was terminated in November 2023 due to the Restructuring) and less than $0.1 million, respectively. During the nine months ended September 30, 2024 and 2023, the Company issued 598,638 shares and 686,898 shares, respectively, of common stock upon vesting of RSUs, which included RSU accelerated vesting of certain RSU awards of employees terminated due to the Restructuring and 88,750 in accelerated awards in January 2024 and 21,250 in accelerated awards in February 2024, in connection with the departure of certain executive officers due to the Restructuring.

- Definition

The entire disclosure for equity.

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-URI https://asc.fasb.org/1943274/2147481112/505-10-50-14

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-14

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 16
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-16

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-18

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-18

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-18

+ Details

Discontinued Operations, Assets Held for Sale and Restructuring (Tables)

9 Months Ended

Sep. 30, 2024

Discontinued Operations and Disposal Groups [Abstract]

Summary of Sale of Discontinued Operation

The major assets and liabilities (at carrying value) associated with discontinued operations included in the Company's consolidated balance sheets are as follows (in thousands):


	September 30, 2024			December 31, 2023
Carrying amounts of major classes of assets included as part of discontinued operations	(unaudited)

Accounts receivable	$	—		$	510
Inventory	12,780			12,780		*
Prepaid expenses and other current assets	897			902		*
Property and equipment, net	4,537			4,871		*
Intangible assets, net	1,416			1,416		*
Other assets	—			—
Less: loss recognized on classification as held for sale	(18,099)		**	(16,369)		*
Total assets of the disposal group classified as discontinued operations in the statement of financial position	$	1,531		$	4,110

* These comprise assets held for sale, at their carrying value of $3.6 million as of December 31, 2023. The Company recorded the loss on classification of held for sale as a valuation allowance on the group of assets held for sale, without allocation to the individual assets within the group.

** At September 30, 2024, an additional valuation allowance of $1.7 million was recorded to reflect an estimate of the additional cost to sell the assets held for sale based on the Biotronik settlement. See further details in Footnote 11, Commitments and Contingencies.

Carrying amounts of major classes of liabilities included as part of discontinued operations

Accounts payable	306			1,892
Accrued restructure	2,663			5,649
Accrued liabilities	—			2,762
Total liabilities of the disposal group classified as discontinued operations in the statement of financial position	$	2,969		$	10,303


	Three Months Ended
	September 30, 2024		September 30, 2023
Major line items constituting pretax loss of discontinued operations	(unaudited)		(unaudited)

Revenue	$	—	$	3,178

Cost of products sold	—		(5,445)
Research and development	(15)		(3,899)
Selling, general and administrative	(190)		(5,078)



Restructuring	(2,856)		—
Loss on assets held for sale	(1,730)		—

Loss from discontinued operations before income taxes	(4,791)		(11,244)
Income tax expense	—		75
Net loss from discontinued operations	$	(4,791)	$	(11,319)


	Nine Months Ended
	September 30, 2024		September 30, 2023
Major line items constituting pretax loss of discontinued operations	(unaudited)		(unaudited)

Revenue	$	—	$	9,880

Cost of products sold	—		(15,612)
Research and development	197		(14,960)
Selling, general and administrative	(493)		(16,778)



Restructuring	(2,880)		(475)
Loss on assets held for sale	(1,730)		—

Loss from discontinued operations before income taxes	(4,906)		(37,945)
Income tax expense	10		75
Net loss from discontinued operations	$	(4,916)	$	(38,020)


	Nine Months Ended September 30, 2024
	(unaudited)
Product Net Sales Earnout accrued as of September 30, 2024	$	8,353
Transaction costs	(257)
Gain on sale of business, net	$	8,096

Summary of Inventory Transferred to Held For Sale

Inventory in discontinued operations consisted of the following (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
Raw materials	$	8,020	$	8,020
Work in process	2,211		2,211
Finished goods	2,549		2,549
Total inventory transferred to held for sale	$	12,780	$	12,780

Summary of Property, Plant and Equipment, Transferred to Held For Sale

Property and equipment, net, in discontinued operations consisted of the following (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
Furniture and fixtures	$	20	$	20
Laboratory equipment and software	17,569		18,295
Construction in process	1,141		1,141
Total property and equipment	18,730		19,456
Less: accumulated depreciation	(14,193)		(14,585)
Total property and equipment, net, related to discontinued operations	$	4,537	$	4,871

Summary of Disaggregation of Revenue

The following table sets forth the Company’s revenue for disposables, systems and service/other for the three and nine months ended September 30, 2024 and 2023 (in thousands):


	Three Months Ended September 30,				Nine Months Ended September 30,
	2024		2023		2024		2023
	(unaudited)				(unaudited)
Disposables	$	5,266	$	1,862	$	12,499	$	4,106

Service/Other	—		198		528		710
Total revenue	$	5,266	$	2,060	$	13,027	$	4,816


	Three Months Ended		Nine Months Ended
	September 30, 2023		September 30, 2023
Disposables	$	2,845	$	8,632
Service/Other	333		1,248
Total revenue	$	3,178	$	9,880

Summary of Restructuring Reserve by Type of Cost

The following summarizes the restructuring activities and their related accruals as of September 30, 2024:


	Employee		Contract
	Termination Costs		Termination Costs		Other Costs		Total

Restructure Accrual Balance at 12/31/2023	$	3,493	$	2,156	$	—	$	5,649
Payments	(3,194)		(498)		—		(3,692)
Accrual release (non-cash)	(185)		(631)		—		(816)
Restructure Accrual Balance at 3/31/2024	$	114	$	1,027	$	—	$	1,141
Payments	(78)		(673)		—		(751)
Accrual release (non-cash)	(9)		(219)		—		(228)
Restructure Accrual Balance at 6/30/2024	$	27	$	135	$	—	$	162
Biotronik Settlement	—		—		2,510		2,510
Payments	—		—		—		—
Accrual release (non-cash)	(9)						(9)
Restructure Accrual Balance at 9/30/2024	$	18	$	135	$	2,510	$	2,663

- Definition

+ References

+ Details

Condensed Consolidated Statements of Stockholders’ (Deficit) Equity - USD ($) $ in Thousands	Total	Preferred Stock	Common Stock	Additional Paid-in Capital	Accumulated Deficit	Accumulated Other Comprehensive Loss
Preferred stock, beginning balance (in shares) at Dec. 31, 2022		6,666
Balance at beginning of period at Dec. 31, 2022	$ 75,019	$ 0	$ 29	$ 594,173	$ (518,314)	$ (869)
Common stock, beginning balance (in shares) at Dec. 31, 2022			28,554,656
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain (loss) on marketable securities	7					7
Foreign currency translation adjustment	(91)					(91)
Stock option exercises (in shares)			3,218
Stock option exercises	4			4
Stock-based compensation (in shares)			686,898
Stock-based compensation	4,640			4,640
Employee stock purchase plan shares issued (in shares)			45,162
Employee stock purchase plan shares issued	25			25
Net income (loss)	(47,898)				(47,898)
Preferred stock, ending balance (in shares) at Sep. 30, 2023		6,666
Balance at end of period at Sep. 30, 2023	31,706	$ 0	$ 29	598,842	(566,212)	(953)
Common stock, ending balance (in shares) at Sep. 30, 2023			29,289,934
Preferred stock, beginning balance (in shares) at Jun. 30, 2023		6,666
Balance at beginning of period at Jun. 30, 2023	43,741	$ 0	$ 29	597,578	(552,975)	(891)
Common stock, beginning balance (in shares) at Jun. 30, 2023			29,206,570
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain (loss) on marketable securities	4					4
Foreign currency translation adjustment	(66)					(66)
Stock-based compensation (in shares)			83,364
Stock-based compensation	1,264			1,264
Net income (loss)	(13,237)				(13,237)
Preferred stock, ending balance (in shares) at Sep. 30, 2023		6,666
Balance at end of period at Sep. 30, 2023	$ 31,706	$ 0	$ 29	598,842	(566,212)	(953)
Common stock, ending balance (in shares) at Sep. 30, 2023			29,289,934
Preferred stock, beginning balance (in shares) at Dec. 31, 2023	6,666	6,666
Balance at beginning of period at Dec. 31, 2023	$ (879)	$ 0	$ 29	599,935	(599,977)	(866)
Common stock, beginning balance (in shares) at Dec. 31, 2023	29,313,667		29,313,667
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain (loss) on marketable securities	$ 0
Foreign currency translation adjustment	$ (15)					(15)
Stock option exercises (in shares)	0
Stock-based compensation (in shares)			598,638
Stock-based compensation	$ (1,264)		$ 1	(1,265)
Net income (loss)	$ (8,141)				(8,141)
Preferred stock, ending balance (in shares) at Sep. 30, 2024	6,666	6,666
Balance at end of period at Sep. 30, 2024	$ (10,299)	$ 0	$ 30	598,670	(608,118)	(881)
Common stock, ending balance (in shares) at Sep. 30, 2024	29,313,667		29,912,305
Preferred stock, beginning balance (in shares) at Jun. 30, 2024		6,666
Balance at beginning of period at Jun. 30, 2024	$ (4,805)	$ 0	$ 30	598,542	(602,511)	(866)
Common stock, beginning balance (in shares) at Jun. 30, 2024			29,775,630
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Unrealized gain (loss) on marketable securities	0
Foreign currency translation adjustment	(15)					(15)
Stock-based compensation (in shares)			136,675
Stock-based compensation	128			128
Net income (loss)	$ (5,607)				(5,607)
Preferred stock, ending balance (in shares) at Sep. 30, 2024	6,666	6,666
Balance at end of period at Sep. 30, 2024	$ (10,299)	$ 0	$ 30	$ 598,670	$ (608,118)	$ (881)
Common stock, ending balance (in shares) at Sep. 30, 2024	29,313,667		29,912,305

Sale of Business

9 Months Ended

Sep. 30, 2024

Discontinued Operations and Disposal Groups [Abstract]

Sale of Business

Discontinued Operations, Assets Held for Sale and Restructuring

Assets Held for Sale

The major assets and liabilities (at carrying value) associated with discontinued operations included in the Company's consolidated balance sheets are as follows (in thousands):


	September 30, 2024			December 31, 2023
Carrying amounts of major classes of assets included as part of discontinued operations	(unaudited)

Accounts receivable	$	—		$	510
Inventory	12,780			12,780		*
Prepaid expenses and other current assets	897			902		*
Property and equipment, net	4,537			4,871		*
Intangible assets, net	1,416			1,416		*
Other assets	—			—
Less: loss recognized on classification as held for sale	(18,099)		**	(16,369)		*
Total assets of the disposal group classified as discontinued operations in the statement of financial position	$	1,531		$	4,110

* These comprise assets held for sale, at their carrying value of $3.6 million as of December 31, 2023. The Company recorded the loss on classification of held for sale as a valuation allowance on the group of assets held for sale, without allocation to the individual assets within the group.

** At September 30, 2024, an additional valuation allowance of $1.7 million was recorded to reflect an estimate of the additional cost to sell the assets held for sale based on the Biotronik settlement. See further details in Footnote 11, Commitments and Contingencies.

Carrying amounts of major classes of liabilities included as part of discontinued operations

Accounts payable	306			1,892
Accrued restructure	2,663			5,649
Accrued liabilities	—			2,762
Total liabilities of the disposal group classified as discontinued operations in the statement of financial position	$	2,969		$	10,303

Inventory in discontinued operations consisted of the following (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
Raw materials	$	8,020	$	8,020
Work in process	2,211		2,211
Finished goods	2,549		2,549
Total inventory transferred to held for sale	$	12,780	$	12,780

Property and equipment, net, in discontinued operations consisted of the following (in thousands):


	September 30, 2024		December 31, 2023
	(unaudited)
Furniture and fixtures	$	20	$	20
Laboratory equipment and software	17,569		18,295
Construction in process	1,141		1,141
Total property and equipment	18,730		19,456
Less: accumulated depreciation	(14,193)		(14,585)
Total property and equipment, net, related to discontinued operations	$	4,537	$	4,871


	Three Months Ended
	September 30, 2024		September 30, 2023
Major line items constituting pretax loss of discontinued operations	(unaudited)		(unaudited)

Revenue	$	—	$	3,178

Cost of products sold	—		(5,445)
Research and development	(15)		(3,899)
Selling, general and administrative	(190)		(5,078)



Restructuring	(2,856)		—
Loss on assets held for sale	(1,730)		—

Loss from discontinued operations before income taxes	(4,791)		(11,244)
Income tax expense	—		75
Net loss from discontinued operations	$	(4,791)	$	(11,319)


	Nine Months Ended
	September 30, 2024		September 30, 2023
Major line items constituting pretax loss of discontinued operations	(unaudited)		(unaudited)

Revenue	$	—	$	9,880

Cost of products sold	—		(15,612)
Research and development	197		(14,960)
Selling, general and administrative	(493)		(16,778)



Restructuring	(2,880)		(475)
Loss on assets held for sale	(1,730)		—

Loss from discontinued operations before income taxes	(4,906)		(37,945)
Income tax expense	10		75
Net loss from discontinued operations	$	(4,916)	$	(38,020)

stock-based compensation resulting from restructuring termination forfeitures and RSU accelerated vesting modification treatment. (See Footnote 14, Stock-Based Compensation, for further information.)

For the three and nine months ended September 30, 2024, there were no revenues from discontinued operations.


	Three Months Ended		Nine Months Ended
	September 30, 2023		September 30, 2023
Disposables	$	2,845	$	8,632
Service/Other	333		1,248
Total revenue	$	3,178	$	9,880

Restructuring Activities

The following summarizes the restructuring activities and their related accruals as of September 30, 2024:


	Employee		Contract
	Termination Costs		Termination Costs		Other Costs		Total

Restructure Accrual Balance at 12/31/2023	$	3,493	$	2,156	$	—	$	5,649
Payments	(3,194)		(498)		—		(3,692)
Accrual release (non-cash)	(185)		(631)		—		(816)
Restructure Accrual Balance at 3/31/2024	$	114	$	1,027	$	—	$	1,141
Payments	(78)		(673)		—		(751)
Accrual release (non-cash)	(9)		(219)		—		(228)
Restructure Accrual Balance at 6/30/2024	$	27	$	135	$	—	$	162
Biotronik Settlement	—		—		2,510		2,510
Payments	—		—		—		—
Accrual release (non-cash)	(9)						(9)
Restructure Accrual Balance at 9/30/2024	$	18	$	135	$	2,510	$	2,663

Sale of Business

The Company is also eligible to receive the following contingent cash consideration pursuant to the Asset Purchase Agreement:


	Nine Months Ended September 30, 2024
	(unaudited)
Product Net Sales Earnout accrued as of September 30, 2024	$	8,353
Transaction costs	(257)
Gain on sale of business, net	$	8,096

Commitments and Contingencies	9 Months Ended
Commitments and Contingencies	Sep. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Securities Litigation The Company and certain of its current and former officers were named as defendants in two putative securities class action lawsuits filed in the United States District Court for the Southern District of California on February 14, 2022 and March 23, 2022. On July 19, 2022, the court consolidated the two actions, appointed a lead plaintiff and appointed lead counsel for the proposed class. On September 16, 2022, the lead plaintiff filed a consolidated amended complaint. The defendants thereafter filed a motion to dismiss. On September 27, 2023, the court granted the defendant’s motion to dismiss in its entirety, but gave plaintiffs leave to file an amended complaint. On October 27, 2023, the plaintiffs filed a second amended complaint asserting similar claims. The defendants thereafter filed a motion to dismiss. On March 26, 2024, the court granted the defendant’s motion and, on April 29, 2024, dismissed the case and entered judgment. On May 29, 2024, plaintiff filed a notice of appeal. On June 28, 2024, plaintiff voluntarily dismissed the appeal with prejudice, and the Company considers this matter closed. Biotronik Arbitration On October 15, 2024, the Company and Biotronik SE & Co. KG (“Biotronik”) and VascoMed GmbH (“VascoMed”, and together with Biotronik, the “BIO Parties”) entered into a Settlement Agreement and Release (the “Settlement Agreement”) terminating the Relevant Agreements (as defined below) (except for certain surviving obligations specified therein), settling the Arbitration (as defined below) relating to the Relevant Agreements and releasing and discharging each party of all claims against the other, including any claims that were or could have been asserted in the Arbitration. Pursuant to the Settlement Agreement, the Company must pay to Biotronik (i) an initial settlement payment of approximately $2.6 million; (ii) contingent payments of (x) in the event of a Qualifying Asset Sale (as defined in the Settlement Agreement), an amount equal to 50% of the aggregate cash consideration received; (y) in the event of a Change of Control (as defined in the Settlement Agreement) of the Company involving a Competitive Company (as defined in the Settlement Agreement), (A) initial amounts of $8.0 million and 5% of the aggregate upfront consideration received, with the latter not to exceed approximately $25.0 million (“Agreed Upfront Consideration”) and (B) additional amounts if additional consideration is received, up to approximately $25.0 million in aggregate (including the Agreed Upfront Consideration); and (z) in the event of a Change of Control not involving a Competitive Company, with certain exceptions, an amount equal to 25% of the aggregate cash consideration received. At September 30, 2024, the Company recorded $2.5 million in discontinued operations restructuring liability related to the Biotronik settlement. A Qualifying Asset Sale per the Settlement Agreement can be triggered by an asset only sale which is a lower threshold than a business combination. The Company has already designated certain assets as held for sale on its balance sheet (see Footnote 3, Discontinued Operations, Assets Held for Sale and Restructuring, for further details), which such disposal transaction would give rise to a Qualifying Asset Sale but not a Change of Control. The Company determined that the contingent payment as a result of a potential Qualifying Asset Sale represents an additional cost to sell. As such, the Company adjusted its valuation allowance against the assets held for sale by $1.7 million, based on the formula prescribed in the Settlement Agreement, to account for the contingent payment to the BIO Parties. However, a definitive offer for the assets held for sale has not been received, and, as such, it is reasonably possible that the contingent payment amount could differ from the amount recorded. With regard to a Change of Control event, the Company determined a Change of Control event cannot be considered probable and, therefore, should not be accrued until such transaction has occurred.

Marketable Securities

9 Months Ended

Sep. 30, 2024

Investments, Debt and Equity Securities [Abstract]

Marketable Securities

Marketable securities consisted of the following as of September 30, 2024 and December 31, 2023 (in thousands):

September 30, 2024 (unaudited)

Amortized
Cost

Gross
Unrealized
Gains

Gross
Unrealized
Losses

Fair Value

Available-for-sale securities - short-term:

Commercial paper

—

Total available-for-sale securities - short-term

—

Total available-for-sale securities

—


	December 31, 2023
	Amortized Cost		Gross Unrealized Gains		Gross Unrealized Losses		Fair Value
Available-for-sale securities - short-term:
U.S. treasury securities	$	1,978	$	—	$	—	$	1,978
Commercial paper	497		—		—		497
Yankee debt securities	758		—		—		758
Total available-for-sale securities - short-term	3,233		—		—		3,233
Total available-for-sale securities	$	3,233	$	—	$	—	$	3,233

As of December 31, 2023, the Company’s available-for-sale securities classified as short-term of $3.2 million mature in 1 year or less and there were none held long-term.