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Goodwill - Additional Information (Detail) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended |
--- | --- | --- | ---
Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018 | Dec. 31, 2018
Non cash impairment charge of goodwill | $ 1,449,215 | $ 0 | $ 1,449,215 | $ 0 |
Goodwill incremental impairment charges |  |  | 147,200 |  |
Goodwill recognition of deferred tax asset |  |  | 147,200 |  |
Accumulated Non cash impairment charge of goodwill | 1,450,000 |  | 1,450,000 |  |
Goodwill | 2,634,874 |  | $ 2,634,874 |  | $ 4,061,439
Anaesthesiology Reporting Unit [Member] |  |  |  |  |
Non cash impairment charge of goodwill | $ 1,300,000 |  |  |  |

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- Definition Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 45 -Paragraph 5 -URI http://asc.fasb.org/extlink&oid=77989000&loc=SL49117168-202975 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 20 -Section 45 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=99380562&loc=d3e13770-109266 + Details
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