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Income Taxes (Tables)
12 Months Ended
Dec. 31, 2021
Income Tax Disclosure [Abstract]  
Schedule Of Components Of Loss Before Income Tax
The components of loss before income taxes for the years ended twelve months ended December 31, are as follows: 
Loss Before Income Taxes:202120202019
Ireland$(36,631)$(27,205)$(50,134)
U.S.(56,687)22,335 10,401 
France173 (212)1,151 
Total loss before income taxes$(93,145)$(5,082)$(38,582)
Schedule Of Income Tax (Benefit) Provision
The income tax benefit consists of the following for the years ended December 31:  

 Income Tax Benefit:202120202019
Current:   
U.S. - Federal$— $(12,810)$— 
U.S. - State60 20 97 
Total current60 (12,790)97 
Deferred:   
Ireland— — (1,256)
U.S. - Federal(15,876)680 (4,093)
U.S. - State— — (104)
Total deferred(15,876)680 (5,453)
Income tax benefit$(15,816)$(12,110)$(5,356)
Schedule of Effective Income Tax Rate Reconciliation The reconciliation between income taxes at the statutory rate and the Company’s benefit for income taxes is as follows for the years ended December 31: 
 Reconciliation to Effective Income Tax Rate:202120202019
Income tax benefit - at statutory tax rate$(11,642)$(636)$(4,823)
Differences in international tax rates(8,950)1,755 (1,218)
Nondeductible changes in fair value of contingent consideration— 988 121 
Intercompany asset transfer— — (8,190)
Change in valuation allowances4,296 4,231 7,379 
Nondeductible share-based compensation645 1,060 1,039 
Hospital Products sale— (9,328)— 
Unrealized tax benefits239 (274)(261)
State and local taxes (net of federal)60 20 (7)
Change in U.S. tax law— (9,124)— 
Nondeductible interest expense2,173 1,728 982 
Orphan drug and R&D tax credit(1,524)(2,793)— 
Other(1,113)263 (378)
Income tax benefit - at effective income tax rate$(15,816)$(12,110)$(5,356)
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 Activity202120202019
Balance at January 1: $3,143 $6,465 $5,315 
Increases for tax positions of prior years— — 2,416 
Statute of limitations expiration— — (1,266)
Settlements— (3,322)— 
Balance at December 31: $3,143 $3,143 $6,465 
Schedule of Deferred Tax Assets and Liabilities The net deferred tax assets (liabilities) at December 31, 2021 and 2020 resulted from the following temporary differences: 
 Net Deferred Tax Assets and Liabilities: 20212020
Deferred tax assets:  
Net operating loss carryforwards$35,990 $31,302 
Orphan drug and R&D tax credit4,964 2,793 
Share-based compensation4,108 2,626 
Amortization3,429 3,701 
Other662 423 
Gross deferred tax assets49,153 40,845 
Deferred tax liabilities:  
Other(925)(890)
Prepaid expenses(75)(75)
Gross deferred tax liabilities(1,000)(965)
Less: valuation allowances(24,025)(21,624)
Net deferred tax assets $24,128 $18,256