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Income Taxes (Tables) | 12 Months Ended
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Dec. 31, 2020
Income Tax Disclosure [Abstract] |
Schedule Of Components Of Loss Before Income Tax | The components of (loss) income before income taxes for the years ended twelve months ended December 31, are as follows:
(Loss) Income Before Income Taxes: |  | 2020 |  | 2019 |  | 2018
Ireland |  | $ | (27,205) |  |  | $ | (50,134) |  |  | $ | (42,604) |
U.S. |  | 22,335 |  |  | 10,401 |  |  | (70,340) |
France |  | (212) |  |  | 1,151 |  |  | (253) |
Total loss before income taxes |  | $ | (5,082) |  |  | $ | (38,582) |  |  | $ | (113,197) |
Schedule Of Income Tax (Benefit) Provision | The income tax (benefit) provision consists of the following for the years ended December 31:
Income Tax (Benefit) Provision: |  | 2020 |  | 2019 |  | 2018
Current: |  |  |  |  |  |
U.S. - Federal |  | $ | (12,810) |  |  | $ | — |  |  | $ | — |
U.S. - State |  | 20 |  |  | 97 |  |  | 330 |
Total current |  | (12,790) |  |  | 97 |  |  | 330 |
Deferred: |  |  |  |  |  |
Ireland |  | — |  |  | (1,256) |  |  | — |
U.S. - Federal |  | 680 |  |  | (4,093) |  |  | (19,503) |
U.S. - State |  | — |  |  | (104) |  |  | 1,280 |
Total deferred |  | 680 |  |  | (5,453) |  |  | (18,223) |
Income tax benefit |  | $ | (12,110) |  |  | $ | (5,356) |  |  | $ | (17,893) |
Schedule of Effective Income Tax Rate Reconciliation | The reconciliation between income taxes at the statutory rate and the Company’s benefit for income taxes is as follows for the years ended December 31:
Reconciliation to Effective Income Tax Rate: |  | 2020 |  | 2019 |  | 2018
Statutory tax rate |  | 12.5 | % |  | 12.5 | % |  | 12.5 | %
Differences in international tax rates |  | (34.5) | % |  | 3.2 | % |  | 8.0 | %
Nondeductible changes in fair value of contingent consideration |  | (19.4) | % |  | (0.3) | % |  | 4.0 | %
Intercompany asset transfer |  | — | % |  | 21.2 | % |  | — | %
Change in valuation allowances |  | (83.3) | % |  | (19.1) | % |  | (5.3) | %
Nondeductible stock-based compensation |  | (20.9) | % |  | (2.7) | % |  | (1.3) | %
Hospital Products sale |  | 183.5 | % |  | — | % |  | — | %
Unrealized tax benefits |  | 5.4 | % |  | 0.7 | % |  | (1.3) | %
State and local taxes (net of federal) |  | (0.4) | % |  | — | % |  | (0.3) | %
Change in U.S. tax law |  | 179.5 | % |  | — | % |  | (0.2) | %
Nondeductible interest expense |  | (34.0) | % |  | (2.5) | % |  | (1.1) | %
Orphan drug and R&D tax credit |  | 55.0 | % |  | — | % |  | — | %
Other |  | (5.1) | % |  | 0.9 | % |  | 0.7 | %
Effective income tax rate |  | 238.3 | % |  | 13.9 | % |  | 15.7 | %
Income tax benefit - at statutory tax rate |  | $ | (636) |  |  | $ | (4,823) |  |  | $ | (14,149) |
Differences in international tax rates |  | 1,755 |  |  | (1,218) |  |  | (9,039) |
Nondeductible changes in fair value of contingent consideration |  | 988 |  |  | 121 |  |  | (4,559) |
Intercompany asset transfer |  | — |  |  | (8,190) |  |  | — |
Change in valuation allowances |  | 4,231 |  |  | 7,379 |  |  | 5,998 |
Nondeductible stock-based compensation |  | 1,060 |  |  | 1,039 |  |  | 1,499 |
Hospital Products sale |  | (9,328) |  |  | — |  |  | — |
Unrecognized tax benefits |  | (274) |  |  | (261) |  |  | 1,440 |
State and local taxes (net of federal) |  | 20 |  |  | (7) |  |  | 299 |
Change in U.S. tax law |  | (9,124) |  |  | — |  |  | 274 |
Nondeductible interest expense |  | 1,728 |  |  | 982 |  |  | 1,269 |
Orphan drug and R&D tax credit |  | (2,793) |  |  | — |  |  | — |
Other |  | 263 |  |  | (378) |  |  | (925) |
Income tax benefit - at effective income tax rate |  | $ | (12,110) |  |  | $ | (5,356) |  |  | $ | (17,893) |
Summary of Unrecognized Tax Benefits | The following table summarizes the activity related to the Company’s unrecognized tax benefits for the twelve months ended December 31:
Unrecognized Tax Benefit Activity |  | 2020 |  | 2019 |  | 2018
Balance at January 1: |  | $ | 6,465 |  |  | $ | 5,315 |  |  | $ | 3,954 |
Additions based on tax positions related to the current year |  | — |  |  | — |  |  | 1,087 |
Increases for tax positions of prior years |  | — |  |  | 2,416 |  |  | 274 |
Statute of limitations expiration |  | — |  |  | (1,266) |  |  | — |
Settlements |  | (3,322) |  |  | — |  |  | — |
Balance at December 31: |  | $ | 3,143 |  |  | $ | 6,465 |  |  | $ | 5,315 |
Schedule of Deferred Tax Assets and Liabilities | The net deferred tax assets (liabilities) at December 31, 2020 and 2019 resulted from the following temporary differences:
Net Deferred Tax Assets and Liabilities: |  | 2020 |  | 2019
Deferred tax assets: |  |  |  |
Net operating loss carryforwards |  | $ | 31,302 |  |  | $ | 30,275 |
Amortization |  | 3,701 |  |  | 11,602 |
Stock based compensation |  | 2,626 |  |  | 3,577 |
Accounts receivable |  | — |  |  | 53 |
Fair value contingent consideration |  | — |  |  | 264 |
Orphan drug and R&D tax credit |  | 2,793 |  |  | — |
Other |  | 423 |  |  | 901 |
Gross deferred tax assets |  | 40,845 |  |  | 46,672 |
Deferred tax liabilities: |  |  |  |
Amortization |  | — |  |  | (172) |
Prepaid expenses |  | (75) |  |  | (35) |
Other |  | (890) |  |  | — |
Gross deferred tax liabilities |  | (965) |  |  | (207) |
Less: valuation allowances |  | (21,624) |  |  | (17,038) |
Net deferred tax assets |  | $ | 18,256 |  |  | $ | 29,427 |

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