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Condensed Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2021
Mar. 31, 2020
Operating Activities:    
Net (loss) income $ (29,698) $ 37,583
Non-cash items included in net loss:    
Remeasurement of derivative instruments 7,268 (9,752)
Stock-based compensation 9,536 9,043
Amortization 6,699 10,267
Depreciation 6,079 6,796
Amortization of operating lease assets 5,389 3,136
Remeasurement of Respicardia investment and loan (4,640) 0
Amortization of debt issuance costs 4,409 543
Remeasurement of contingent consideration to fair value 453 (17,283)
Deferred tax expense (benefit) 37 (22,884)
Other 673 (1,968)
Changes in operating assets and liabilities:    
Accounts receivable, net (3,372) 24,336
Inventories (2,900) (12,513)
Other current and non-current assets 26,820 (15,948)
Accounts payable and accrued current and non-current liabilities (1,858) (1,792)
Taxes payable (3,337) 0
Litigation provision liability (2,078) (115,609)
Net cash provided by (used in) operating activities 19,480 (106,045)
Investing Activities:    
Purchases of property, plant and equipment (8,220) (8,597)
Purchase of investments (1,800) (3,000)
Proceeds from asset sales 162 834
Other 0 (322)
Net cash used in investing activities (9,858) (11,085)
Financing Activities:    
Payment of contingent consideration (4,387) (4,604)
Shares repurchased from employees for minimum tax withholding (3,740) (3,997)
Change in short-term borrowing, net (643) (2,477)
Proceeds from long-term debt obligations 0 162,899
Proceeds from short term borrowings (maturities greater than 90 days) 0 46,115
Closing adjustment payment for sale of CRM business 0 (14,891)
Other 442 48
Net cash (used in) provided by financing activities (8,328) 183,093
Effect of exchange rate changes on cash and cash equivalents (1,587) (1,277)
Net (decrease) increase in cash and cash equivalents (293) 64,686
Cash and cash equivalents at beginning of period 252,832 61,137
Cash and cash equivalents at end of period $ 252,539 $ 125,823