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Borrowings - Narrative (Details) - USD ($)
1 Months Ended 12 Months Ended
Oct. 31, 2017
Aug. 31, 2016
Oct. 31, 2015
Dec. 31, 2018
Dec. 31, 2017
Debt Instrument [Line Items]          
Long term borrowings       $ 38,963,000 $ 38,700,000
Repayment of debt financing       0 1,119,000
Repayment of debt extinguishment       0 29,081,000
Amortization of debt discount       259,000 285,000
Debt covenant minimum cash balance       5,000,000  
SVB and Oxford Term Loan          
Debt Instrument [Line Items]          
Repayment of debt extinguishment $ 1,500,000        
Loss on extinguishment of debt 2,200,000        
Term Loan | SVB and Oxford Term Loan          
Debt Instrument [Line Items]          
Debt face amount   $ 35,200,000.0      
Debt period payment, interest only period   6 months      
Debt period payment, principal and interest period   25 months      
Debt interest stated percentage   11.00%      
Repayment of debt financing 29,100,000        
Amortization of debt discount 700,000        
Term Loan | SVB and Oxford Term Loan | Prime Rate          
Debt Instrument [Line Items]          
Basis spread on variable rate   7.75%      
Term Loan | Pharmakon Term Loan          
Debt Instrument [Line Items]          
Long term borrowings       39,000,000 $ 38,700,000
Debt face amount $ 40,000,000.0        
Debt period payment, interest only period 35 months        
Debt interest stated percentage 11.50%        
Debt issuance costs $ 1,300,000        
Debt closing fee percentage 1.50%        
Debt instrument fee amount $ 600,000        
Debt covenant minimum cash balance $ 5,000,000        
Debt borrowing capacity       $ 10,000,000  
Debt effective percentage       12.30% 12.00%
Term Loan | Pharmakon Term Loan | Prepayment Penalty, 31-48 Months          
Debt Instrument [Line Items]          
Debt prepayment penalty percentage 2.00%        
Term Loan | Pharmakon Term Loan | Prepayment Penalty, 49-60 Months          
Debt Instrument [Line Items]          
Debt prepayment penalty percentage 1.00%        
Line of Credit | Revolving Credit Facility | SVB and Oxford Term Loan          
Debt Instrument [Line Items]          
Line of credit maximum borrowing capacity     $ 4,000,000.0    
Line of credit percent of customer accounts receivable     80.00%    
Line of Credit | Revolving Credit Facility | SVB and Oxford Term Loan | Prime Rate          
Debt Instrument [Line Items]          
Basis spread on variable rate     3.00%