Document and Entity Information - USD ($)	12 Months Ended
Document and Entity Information - USD ($)	Dec. 31, 2015	Feb. 24, 2016	Jun. 30, 2015
Document Information [Abstract]
Entity Registrant Name	MERIT MEDICAL SYSTEMS INC
Entity Central Index Key	0000856982
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Document Type	10-K
Document Period End Date	Dec. 31, 2015
Document Fiscal Year Focus	2015
Document Fiscal Period Focus	FY
Amendment Flag	false
Entity Common Stock, Shares Outstanding		44,266,986
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Public Float			$ 911,939,002

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
CURRENT ASSETS:
Cash and cash equivalents	$ 4,177	$ 7,355
Trade receivables — net of allowance for uncollectible accounts — 2015 — $1,297 and 2014 — $893	70,292	72,717
Employee receivables	217	173
Other receivables	6,799	7,507
Inventories	105,999	91,773
Prepaid expenses	5,634	5,012
Prepaid income taxes	2,955	1,273
Deferred income tax assets	7,025	6,375
Income tax refund receivables	905	155
Total current assets	204,003	192,340
PROPERTY AND EQUIPMENT:
Land and land improvements	19,307	16,830
Buildings	136,595	130,447
Manufacturing equipment	158,775	145,022
Furniture and fixtures	39,301	35,201
Leasehold improvements	27,561	16,096
Construction-in-progress	26,292	21,858
Total property and equipment	407,831	365,454
Less accumulated depreciation	(140,053)	(121,283)
Property and equipment — net	267,778	244,171
OTHER ASSETS:
Goodwill	184,472	184,464
Deferred income tax assets	0	9
Other assets	13,121	15,873
Total other assets	306,947	310,654
TOTAL	778,728	747,165
CURRENT LIABILITIES:
Trade payables	37,977	29,810
Accrued expenses	37,846	33,826
Current portion of long-term debt	10,000	10,000
Advances from employees	589	381
Income taxes payable	1,498	1,413
Total current liabilities	87,910	75,430
LONG-TERM DEBT	197,593	214,490
DEFERRED INCOME TAX LIABILITIES	10,985	6,385
LIABILITIES RELATED TO UNRECOGNIZED TAX BENEFITS	768	1,353
DEFERRED COMPENSATION PAYABLE	8,500	8,635
DEFERRED CREDITS	2,721	2,891
OTHER LONG-TERM OBLIGATIONS	4,148	2,722
Total liabilities	$ 312,625	$ 311,906
COMMITMENTS AND CONTINGENCIES (Notes 2, 7, 8, 9 and 13)
STOCKHOLDERS’ EQUITY:
Preferred stock — 5,000 shares authorized as of December 31, 2015 and 2014; no shares issued
Common stock, no par value; shares authorized — 2015 and 2014 - 100,000; issued and outstanding as of December 31, 2015 - 44,267 and December 31, 2014 - 43,614	$ 197,826	$ 187,709
Retained earnings	273,764	249,962
Accumulated other comprehensive loss	(5,487)	(2,412)
Total stockholders’ equity	466,103	435,259
TOTAL	778,728	747,165
Developed technology — net of accumulated amortization — 2015 — $38,497 and 2014 — $27,982
OTHER ASSETS:
Intangible Assets	69,861	79,172
Other — net of accumulated amortization — 2015 — $26,603 and 2014 — $22,480
OTHER ASSETS:
Intangible Assets	$ 39,493	$ 31,136

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
CURRENT ASSETS:
Trade receivables, allowances	$ 1,297	$ 893
STOCKHOLDERS’ EQUITY:
Preferred stock shares authorized (in shares)	5,000,000	5,000,000
Preferred stock shares issued (in shares)	0	0
Common stock par value (in USD per share)
Common stock shares authorized (in shares)	100,000,000	100,000,000
Common stock shares issued (in shares)	44,267,000	43,614,000
Common stock shares outstanding (in shares)	44,267,000	43,614,000
Other
OTHER ASSETS:
Intangibles, accumulated amortization	$ 26,603	$ 22,480
Developed technology
OTHER ASSETS:
Intangibles, accumulated amortization	$ 38,497	$ 27,982

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Income Statement [Abstract]
NET SALES	$ 542,149	$ 509,689	$ 449,049
COST OF SALES	306,368	284,467	254,682
GROSS PROFIT	235,781	225,222	194,367
OPERATING EXPENSES:
Selling, general and administrative	156,348	147,894	128,642
Research and development	40,810	36,632	33,886
Intangible asset impairment charges	0	1,102	8,089
Contingent consideration expense (benefit)	80	(572)	(4,094)
Acquired in-process research and development	1,000	0	0
Total operating expenses	198,238	185,056	166,523
INCOME FROM OPERATIONS	37,543	40,166	27,844
OTHER INCOME (EXPENSE):
Interest income	272	217	255
Interest expense	(6,229)	(8,829)	(8,044)
Other income (expense) — net	(386)	18	(216)
Other expense — net	(6,343)	(8,594)	(8,005)
INCOME BEFORE INCOME TAXES	31,200	31,572	19,839
INCOME TAX EXPENSE	7,398	8,598	3,269
NET INCOME	$ 23,802	$ 22,974	$ 16,570
EARNINGS PER COMMON SHARE:
Basic (in dollars per share)	$ 0.54	$ 0.53	$ 0.39
Diluted (in dollars per share)	$ 0.53	$ 0.53	$ 0.39
AVERAGE COMMON SHARES:
Basic (in shares)	44,036	43,143	42,607
Diluted (in shares)	44,511	43,409	42,884

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Statement of Comprehensive Income [Abstract]
Net income	$ 23,802	$ 22,974	$ 16,570
Unrealized gain on marketable securities:
Interest rate swap	(571)	(630)	2,992
Less income tax benefit (expense)	222	245	(1,164)
Foreign currency translation adjustment	(3,037)	(3,160)	292
Less income tax benefit	311	190	5
Total other comprehensive income (loss)	(3,075)	(3,355)	2,125
Total comprehensive income	$ 20,727	$ 19,619	$ 18,695

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References + Details

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Retained Earnings	Accumulated Other Comprehensive Income (Loss)
Beginning balance at Dec. 31, 2012	$ 381,577	$ 172,341	$ 210,418	$ (1,182)
Beginning balance (in shares) at Dec. 31, 2012		42,489
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	16,570		16,570
Other comprehensive income	2,125			2,125
Excess tax benefits from stock-based compensation	259	$ 259
Stock-based compensation expense	1,467	1,467
Options exercised	3,733	$ 3,733
Options exercised (in shares)		413
Issuance of common stock under Employee Stock Purchase Plans	448	$ 448
Issuance of common stock under Employee Stock Purchase Plans (in shares)		37
Shares surrendered in exchange for payment of payroll tax liabilities	(21)	$ (21)
Shares surrendered in exchange for payment of payroll tax liabilities (in shares)		(48)
Shares surrendered in exchange for the exercise of stock options	(452)	$ (452)
Shares surrendered in exchange for the exercise of stock options (in shares)		(45)
Ending balance at Dec. 31, 2013	405,706	$ 177,775	226,988	943
Ending balance (in shares) at Dec. 31, 2013		42,846
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	22,974		22,974
Other comprehensive income	(3,355)			(3,355)
Excess tax benefits from stock-based compensation	576	$ 576
Stock-based compensation expense	1,460	1,460
Options exercised	9,638	$ 9,638
Options exercised (in shares)		878
Issuance of common stock under Employee Stock Purchase Plans	450	$ 450
Issuance of common stock under Employee Stock Purchase Plans (in shares)		33
Shares surrendered in exchange for payment of payroll tax liabilities	(249)	$ (249)
Shares surrendered in exchange for payment of payroll tax liabilities (in shares)		(16)
Shares surrendered in exchange for the exercise of stock options	(1,941)	$ (1,941)
Shares surrendered in exchange for the exercise of stock options (in shares)		(127)
Ending balance at Dec. 31, 2014	$ 435,259	$ 187,709	249,962	(2,412)
Ending balance (in shares) at Dec. 31, 2014	43,614	43,614
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	$ 23,802		23,802
Other comprehensive income	(3,075)			(3,075)
Excess tax benefits from stock-based compensation	2,124	$ 2,124
Stock-based compensation expense	2,243	2,243
Options exercised	$ 10,029	$ 10,029
Options exercised (in shares)	858	858
Issuance of common stock under Employee Stock Purchase Plans	$ 441	$ 441
Issuance of common stock under Employee Stock Purchase Plans (in shares)		23
Shares surrendered in exchange for payment of payroll tax liabilities	(918)	$ (918)
Shares surrendered in exchange for payment of payroll tax liabilities (in shares)		(43)
Shares surrendered in exchange for the exercise of stock options	(3,802)	$ (3,802)
Shares surrendered in exchange for the exercise of stock options (in shares)		(185)
Ending balance at Dec. 31, 2015	$ 466,103	$ 197,826	$ 273,764	$ (5,487)
Ending balance (in shares) at Dec. 31, 2015	44,267	44,267

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 23,802	$ 22,974	$ 16,570
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	37,425	35,929	32,542
Losses (gains) on sales and/or abandonment of property and equipment	(23)	916	177
Write-off of patents and intangible assets	141	1,427	8,208
Acquired in-process research and development	1,000	0	0
Amortization of deferred credits	(171)	(175)	(139)
Amortization of long-term debt issuance costs	987	987	845
Deferred income taxes	3,450	3,870	1,359
Excess tax benefits from stock-based compensation	(2,124)	(576)	(259)
Stock-based compensation expense	2,243	1,460	1,467
Changes in operating assets and liabilities, net of effects from acquisitions:
Trade receivables	(5,872)	(13,599)	(6,445)
Employee receivables	(52)	46	(53)
Other receivables	387	(3,042)	(609)
Inventories	(13,113)	(9,396)	2,334
Prepaid expenses	(696)	(58)	(758)
Prepaid income taxes	(1,788)	(41)	18
Income tax refund receivables	(784)	11	1,267
Other assets	(362)	(1,388)	(1,806)
Trade payables	14,766	5,326	(5)
Accrued expenses	5,656	6,137	(276)
Advances from employees	217	142	(277)
Income taxes payable	2,199	1,083	255
Liabilities related to unrecognized tax benefits	536	(76)	(520)
Deferred compensation payable	(135)	802	1,877
Other long-term obligations	1,769	566	(4,399)
Total adjustments	45,656	30,351	34,803
Net cash provided by operating activities	69,458	53,325	51,373
Capital expenditures for:
Property and equipment	(50,959)	(34,181)	(59,505)
Intangible assets	(1,956)	(1,714)	(1,617)
Proceeds from sale-leaseback transactions	2,017	5,521	24,000
Proceeds from the sale of property and equipment	1,247	98	113
Cash paid in acquisitions, net of cash acquired	(12,368)	(5,927)	(31,600)
Net cash used in investing activities	(62,019)	(36,203)	(68,609)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of common stock	6,668	8,146	3,729
Proceeds from issuance of long-term debt	152,375	144,018	176,764
Payments on long-term debt	(169,272)	(169,392)	(165,477)
Proceeds from industrial assistant grants	0	0	389
Excess tax benefits from stock-based compensation	2,124	576	259
Long-term debt issuance costs	0	0	(798)
Contingent payments related to acquisitions	(1,212)	(67)	(77)
Payment of taxes related to an exchange of common stock	(918)	(249)	(21)
Net cash provided by (used in) financing activities	(10,235)	(16,968)	14,768
EFFECT OF EXCHANGE RATES ON CASH	(382)	(258)	208
NET DECREASE IN CASH AND CASH EQUIVALENTS	(3,178)	(104)	(2,260)
CASH AND CASH EQUIVALENTS:
Beginning of year	7,355	7,459	9,719
End of year	4,177	7,355	7,459
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION
Interest (net of capitalized interest of $325, $389 and $1,038 respectively)	6,273	9,014	7,877
Income taxes	3,409	3,289	735
SUPPLEMENTAL DISCLOSURES OF NON-CASH INVESTING AND FINANCING ACTIVITIES
Property and equipment purchases in accounts payable	3,199	2,896	4,055
Receivable due for sale of equipment	0	1,256	0
Cost method investment converted to intangible asset in acquisition in lieu of additional cash payment	1,010	0	0
Acquisition purchases in accrued expenses and other long-term obligations	1,300	1,000	350
Merit common stock surrendered (185, 127 and 45 shares, respectively) in exchange for exercise of stock options	$ 3,802	$ 1,941	$ 452

Organization and Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2015

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Organization and Summary of Significant Accounting Policies

ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Organization. Merit Medical Systems, Inc. (“Merit,” “we,” or “us”) designs, develops, manufactures and markets single-use medical products for interventional and diagnostic procedures. For financial reporting purposes, we report our operations in two operating segments: cardiovascular and endoscopy. Our cardiovascular segment consists of cardiology and radiology devices which assist in diagnosing and treating coronary arterial disease, peripheral vascular disease and other non-vascular diseases; embolotherapeutic products; and cardiac rhythm management and electrophysiology ("CRM/EP") devices. Our endoscopy segment consists of gastroenterology and pulmonology medical devices which assist in the palliative treatment of expanding esophageal, tracheobronchial and biliary strictures caused by malignant tumors.

We manufacture our products in plants located in the United States, Mexico, The Netherlands, Ireland, France and Brazil. We export sales to dealers and have direct sales forces in the United States, Western Europe and China (see Note 12). Our consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America. The following is a summary of the more significant of such policies.

Use of Estimates in Preparing Financial Statements. The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

Principles of Consolidation. The consolidated financial statements include our wholly owned subsidiaries. Intercompany balances and transactions have been eliminated.

Cash and Cash Equivalents. For purposes of the statements of cash flows, we consider interest bearing deposits with an original maturity date of three months or less to be cash equivalents.

Receivables. The allowance for uncollectible accounts receivable is based on our historical bad debt experience and on management’s evaluation of our ability to collect individual outstanding balances.

Inventories. We value our inventories at the lower of cost, determined on a first-in, first-out method, or market value. Market value for raw materials is based on replacement costs. Inventory costs include material, labor and manufacturing overhead. We review inventories on hand at least quarterly and record provisions for estimated excess, slow moving and obsolete inventory, as well as inventory with a carrying value in excess of net realizable value. The regular and systematic inventory valuation reviews include a current assessment of future product demand, historical experience and product expiration.

Goodwill and Intangible Assets. We test goodwill balances as of July 1 for impairment on an annual basis during the third quarter, or whenever impairment indicators arise. We utilize several reporting units in evaluating goodwill for impairment. We assess the estimated fair value of reporting units using a combination of a market-based approach with a guideline public company method and a discounted cash flow method. If the carrying amount of a reporting unit exceeds the fair value of the reporting unit, an impairment charge is recognized in an amount equal to the excess of the carrying amount of the reporting unit goodwill over the implied fair value of that goodwill.

We evaluate the recoverability of intangible assets periodically and take into account events or circumstances that warrant revised estimates of useful lives or that indicate that impairment exists. All of our intangible assets are subject to amortization. Intangible assets are amortized on a straight-line basis, except for customer lists, which are generally amortized on an accelerated basis, over the following useful lives:



Customer lists	5	-	15 years
Developed technology	8	-	15 years
Distribution agreements	3	-	12 years
License agreements and trademarks	4	-	15 years
Covenants not to compete	3	-	10 years
Patents	17 years
Royalty agreements	5 years

Long-Lived Assets. We periodically review the carrying amount of our long-lived assets for impairment. An asset is considered impaired when estimated future cash flows are less than the carrying amount of the asset. In the event the carrying amount of such asset is not considered recoverable, the asset is adjusted to its fair value. Fair value is generally determined based on discounted future cash flow. There were no impairments of long-lived assets during the years ended December 31, 2015, 2014 and 2013, except as noted in Note 4.

Property and Equipment. Property and equipment is stated at the historical cost of construction or purchase. Construction costs include interest costs capitalized during construction. Maintenance and repairs of property and equipment are charged to operations as incurred. Leasehold improvements are amortized over the lesser of the base term of the lease or estimated life of the leasehold improvements. Construction-in-process consists of new buildings and various production equipment being constructed internally and externally. Assets in construction-in-process will commence depreciating once the asset has been placed in service. Depreciation is computed using the straight-line method over estimated useful lives as follows:



Buildings	40 years
Manufacturing equipment	4	-	20 years
Furniture and fixtures	3	-	20 years
Land improvements	10	-	20 years
Leasehold improvements	4	-	25 years

Depreciation expense related to property and equipment for the years ended December 31, 2015, 2014 and 2013 was approximately $22.6 million, $21.0 million, and $18.4 million, respectively.

Deferred Compensation. We have a deferred compensation plan that permits certain management employees to defer a portion of their salary until the future. We established a Rabbi trust to finance obligations under the plan with corporate-owned variable life insurance contracts. The cash surrender value totaled approximately $8.8 million and $9.0 million at December 31, 2015 and 2014, respectively, which is included in other assets in our consolidated balance sheets. We have recorded a deferred compensation payable of approximately $8.5 million and $8.6 million at December 31, 2015 and 2014, respectively, to reflect the liability to our employees under this plan.

Other Assets. Other assets consist of our deferred compensation plan cash surrender value discussed above, unamortized debt issuance costs, two investments in privately-held companies accounted for at cost, a long-term income tax refund receivable, and deposits related to various leases.

Deferred Credits. Deferred credits consist of grant money received from the Irish government. Grant money is received for a percentage of expenditures on eligible property and equipment, specific research and development projects and costs of hiring and training employees. Amounts related to the acquisition of property and equipment are amortized as a reduction of depreciation expense over the lives of the corresponding property and equipment.

Revenue Recognition. We sell our single-use disposable medical products through a direct sales force in the U.S., and through OEM relationships, custom procedure tray manufacturers and a combination of direct sales force and independent distributors in international markets. Revenues from these customers are recognized when all of the following have occurred: (i) persuasive evidence of an arrangement exists, (ii) delivery has occurred or services have been rendered, (iii) the price is fixed or determinable and (iv) the ability to collect is reasonably assured. These criteria are generally satisfied at the time of shipment when risk of loss and title passes to the customer. We have certain written agreements with group purchasing organizations to sell our products to participating hospitals. These agreements have destination shipping terms which require us to defer the recognition of a sale until the product has arrived at the participating hospitals. We reserve for sales returns, including returns related to defective products, as a reduction in net sales, based on our historical experience. We also offer sales rebates and discounts to purchasing groups. These reserves are recorded as a reduction in net sales and are not considered material to our consolidated statements of income for the years ended December 31, 2015, 2014 and 2013. In addition, we invoice our customers for taxes assessed by governmental authorities such as sales tax and value added taxes. We present these taxes on a net basis.

Shipping and Handling. We bill our customers for shipping and handling charges, which are included in net sales for the applicable period, and the corresponding shipping and handling expense is reported in cost of sales.

Cost of Sales. We include product costs (i.e. material, direct labor and overhead costs), shipping and handling expense, medical device excise tax, product royalty expense, developed technology amortization expense, production-related depreciation expense and product license agreement expense in cost of sales.

Research and Development. Research and development costs are expensed as incurred.

Income Taxes. We utilize an asset and liability approach for financial accounting and reporting for income taxes. Deferred income taxes are provided for temporary differences in the basis of assets and liabilities as reported for financial statement and income tax purposes. Deferred income taxes reflect the tax effects of net operating loss and tax credit carryovers and temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. Realization of certain deferred tax assets is dependent upon future earnings, if any. We make estimates and judgments in determining the need for a provision for income taxes, including the estimation of our taxable income for each full fiscal year.

Earnings per Common Share. Net income per common share is computed by both the basic method, which uses the weighted average number of our common shares outstanding, and the diluted method, which includes the dilutive common shares from stock options and warrants, as calculated using the treasury stock method.

Fair Value Measurements. The fair value of a financial instrument is the amount that could be received upon the sale of an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. Financial assets are marked to bid prices and financial liabilities are marked to offer prices. Fair value measurements do not include transaction costs. A fair value hierarchy is used to prioritize the quality and reliability of the information used to determine fair values. Categorization within the fair value hierarchy is based on the lowest level of input that is significant to the fair value measurement. The fair value hierarchy is defined into the following three categories:

Level 1: Quoted market prices in active markets for identical assets or liabilities.

Level 2: Observable market-based inputs or inputs that are corroborated by market data.

Level 3: Unobservable inputs that are not corroborated by market data.

Stock-Based Compensation. We recognize the fair value compensation cost relating to share-based payment transactions in accordance with Accounting Standards Codification (“ASC”) 718, Compensation — Stock Compensation. Under the provisions of ASC 718, share-based compensation cost is measured at the grant date, based on the fair value of the award and is recognized over the employee’s requisite service period, which is generally the vesting period. The fair value of our stock options is estimated using a Black-Scholes option valuation model. Stock-based compensation expense for the years ended December 31, 2015, 2014 and 2013 was approximately $2.2 million, $1.5 million and $1.5 million, respectively.

Concentration of Credit Risk. Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash and cash equivalents and accounts receivable. We provide credit, in the normal course of business, primarily to hospitals and independent third-party custom procedure tray manufacturers and distributors. We perform ongoing credit evaluations of our customers and maintain allowances for potential credit losses. Sales to our single largest customer approximated 3%, 3% and 3% of total sales for the years ended December 31, 2015, 2014 and 2013, respectively.

Foreign Currency. The financial statements of our foreign subsidiaries are measured using local currencies as the functional currency, with the exception of Ireland and Mexico which each use the U.S. Dollar as its functional currency. Assets and liabilities are translated into U.S. Dollars at year-end rates of exchange and results of operations are translated at average rates for the year. Gains and losses resulting from these translations are included in accumulated other comprehensive income (loss) as a separate component of stockholders’ equity. Foreign currency transactions denominated in a currency other than the entity’s functional currency are included in determining net income for the period. Such foreign currency transaction gains and losses have not been significant for purposes of our financial reporting.

Derivatives. We use forward contracts to mitigate our exposure to volatility in foreign exchange rates, and we use an interest rate swap to hedge changes in the benchmark interest rate related to our Credit Agreement described in Note 7. All derivatives are recognized in the consolidated balance sheets at fair value. Classification of each hedging instrument is based upon whether the maturity of the instrument is less than or greater than 12 months. We do not purchase or hold derivative financial instruments for speculative or trading purposes (see Note 8).

Accumulated Other Comprehensive Income (Loss). As of December 31, 2015, accumulated other comprehensive income (loss) included approximately $1,000 (net of tax of $(1,000)) related to an interest rate swap and ($5.5) million (net of tax of $513,000) related to foreign currency translation. As of December 31, 2014, accumulated other comprehensive income (loss) included approximately $350,000 (net of tax of $(223,000)) related to an interest rate swap and ($2.8) million (net of tax of $202,000) related to foreign currency translation.

Recently Issued Financial Accounting Standards. In November 2015, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") 2015-17, Income Taxes (Topic 740): Balance Sheet Classification of Deferred Taxes, which will require deferred tax assets and deferred tax liabilities to be presented as noncurrent within a classified balance sheet. The ASU simplifies the current guidance which requires an entity to separate deferred income tax liabilities and assets into current and noncurrent amounts in a classified balance sheet. The current requirement that deferred tax assets and liabilities of a tax-paying component of an entity be offset and presented as a single amount is not affected. The ASU is effective for financial statements issued for annual periods beginning after December 15, 2016, and interim periods within those annual periods. Earlier application is permitted for all entities as of the beginning of an interim or annual reporting period. We do not presently anticipate that the adoption of this standard will have a material impact on our financial statements.

In September 2015, the FASB issued ASU 2015-16, Simplifying the Accounting for Measurement-Period Adjustments, which eliminates the requirement to retrospectively account for measurement-period adjustments. This standard is effective for our financial statements issued for fiscal years beginning after December 15, 2015, and interim periods within those fiscal years. Early adoption is permitted for financial statements that have not been previously issued. We intend to apply the new guidance on a prospective basis. We do not presently anticipate that the adoption of this standard will have a material impact on our financial statements.

In August 2015, the FASB issued ASU 2015-15, Presentation and Subsequent Measurement of Debt Issuance Costs Associated With Line-of-Credit Arrangements - Amendments to SEC Paragraphs Pursuant to Staff Announcement at June 18, 2015 EITF Meeting, to clarify that given the absence of authoritative guidance within ASU No. 2015-03 for debt issuance costs related to the line-of-credit arrangements, such costs may be presented as an asset and subsequently amortized ratably over the term of the line-of-credit arrangement. We do not presently expect the adoption of this update to have a material effect on our consolidated financial statements.

In July 2015, the FASB issued ASU 2015-11, Simplifying the Measurement of Inventory. This standard requires that inventory be measured at the lower of cost or net realizable value. Net realizable value is the estimated selling price in the ordinary course of business, less reasonably predictable costs of completion, disposal, and transportation. Inventory measured using last-in, first-out or the retail inventory method are excluded from the scope of this update which is effective for fiscal years beginning after December 15, 2016, and interim periods within those fiscal years. We do not anticipate that the implementation of ASU 2015-11 will have a material impact on our consolidated financial statements.

In April 2015, the FASB issued ASU 2015-03, Simplifying the Presentation of Debt Issuance Costs, which requires debt issuance costs to be presented in the balance sheet as a direct deduction from the associated debt liability. This standard is effective for our financial statements issued for fiscal years beginning after December 15, 2015, and interim periods within those fiscal years. Early adoption is permitted for financial statements that have not been previously issued. The new guidance will be applied on a retrospective basis. We do not presently anticipate that the adoption of this standard will have a material impact on our financial statements.

In May 2014, the FASB issued authoritative guidance amending the FASB Accounting Standards Codification and creating a new Topic 606, Revenue from Contracts with Customers. The new guidance clarifies the principles for recognizing revenue and develops a common revenue standard for U.S. GAAP applicable to revenue transactions. This guidance provides that an entity should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. The existing industry guidance will be eliminated when the new guidance becomes effective and annual disclosures will be substantially revised. Additional disclosures will also be required under the new standard. In July 2015, the FASB approved a proposal that extended the required implementation date one year to the first quarter of 2018 but also would permit companies to adopt the standard at the original effective date of 2017. Implementation may be either through retrospective application to each period from the first quarter of 2016 or with a cumulative effect adjustment upon adoption in 2018. We are assessing the impact this new standard is anticipated to have on our consolidated financial statements.

Acquisitions

12 Months Ended

Dec. 31, 2015

Business Combinations [Abstract]

Acquisitions

ACQUISITIONS

On December 4, 2015, we entered into a license agreement with a medical device company for the right to manufacture and sell certain percutaneous transluminal angioplasty balloon catheter products. As of December 31, 2015, we had paid $500,000 in connection with the agreement. We are obligated to pay an additional $1.5 million if certain milestones set forth in the license agreement are reached. We accounted for the transaction as an asset purchase and intend to amortize the asset over a period of 12 years.

On September 29, 2015, we entered into a license agreement with Blockade Medical, LLC, a Delaware limited liability company ("Blockade"), for rights to manufacture, market and sell a set of endovascular embolization products. As part of the agreement, we paid $1.7 million during the year ended December 31, 2015 and, in lieu of any additional payment, we converted the cost method investment in Blockade of $1.0 million we had previously recorded, toward the purchase price of the license. As of December 31, 2015, we recorded $2.7 million to a license agreement intangible asset, which we intend to amortize over ten years.

On August 19, 2015, we purchased 116,279 shares of Series A Preferred Stock of Xablecath, Inc., a Delaware corporation ("Xablecath"), for an aggregate price of approximately $300,000. Our ownership interest Xablecath is approximately 14% and is accounted for at cost. Xablecath is developing an over-the-wire crossing catheter.

On July 17, 2015, we entered into an asset purchase agreement with LeMatire Vascular, Inc., a Delaware corporation ("LeMaitre"), for rights to the Unballoon® non-occlusive modeling catheter. We accounted for the transaction as an asset purchase. The full purchase price of $400,000 was paid as of December 31, 2015, and the purchase price was recorded as a developed technology intangible asset, which we intend to amortize over a period of 10 years.

On July 14, 2015, we entered into an asset purchase agreement with Quellent, LLC, a California limited liability company ("Quellent"), for superabsorbent pad technology. The purchase price for the asset was $1.0 million, payable in two installments. We accounted for this acquisition as a business combination. The first payment of $500,000 was paid as of December 31, 2015, and the second payment of $500,000 was recorded as an accrued liability as of December 31, 2015. We also recorded $270,000 of contingent consideration related to royalties payable to Quellent pursuant to this agreement. The sales and results of operations related to this acquisition have been included in our cardiovascular segment since the acquisition date and were not material. The purchase price was allocated as follows: $1.21 million to a developed technology intangible asset and $60,000 to goodwill as of December 31, 2015. We intend to amortize the developed technology intangible asset over 13 years. The pro forma consolidated results of operations are not presented, as we do not deem the pro forma effect of the transaction to be material.

On July 1, 2015, we entered into an agreement with Catch Medical, LLC, a Utah limited liability company ("Catch Medical"), to purchase rights to a steerable snare. We expensed the full purchase price of $1.0 million to in-process research and development during the year ended December 31, 2015, because the initial costs of in-process research and development acquired in this asset purchase do not have an alternative future use. These costs include payments incurred prior to regulatory approval in connection with acquired research and development projects that provide rights to develop, manufacture, market and sell products. During the year ended December 31, 2015, we paid cash of $200,000 and recorded $200,000 as a current liability for the portion that will be due in less than a year. We also recorded $600,000 as a long-term obligation for the portion that will be due in over a year.

On July 1, 2015, we entered into a license agreement with Distal Access, LLC, a Utah limited liability company ("Distal"), for guidewire controller technology. We made a payment of $3.5 million upon the closing of the agreement during the year ended December 31, 2015. We accounted for this acquisition as an asset purchase. We recorded the purchase price to a license agreement intangible asset of $3.5 million, which we intend to amortize over a period of six years.

On March 26, 2015, we entered into an asset purchase agreement with Teleflex Incorporated, a Delaware corporation ("Teleflex"). We accounted for the transaction as an asset purchase. During the year ended December 31, 2015, we paid $400,000 to acquire the asset, which we recorded as a customer list intangible asset. We will be obligated to pay an additional $400,000 if Teleflex meets certain obligations under the agreement, which will be recorded to the customer list intangible asset at that time. We intend to amortize the asset over a period of five years.

On January 6, 2015, we amended a distribution and patent sublicense agreement with Catheter Connections, Inc., a Utah corporation ("CathConn"), which we had originally entered into on August 21, 2012 for CathConn's MaleCap Solo technology. The amendment provides exclusive rights for certain aspects of CathConn's DualCap disinfecting cap technology. We paid CathConn an additional $250,000 in January 2015. The purchase price was allocated to a distribution agreement for $250,000, which we intend to amortize over ten years.

On November 25, 2014, we entered into a marketing, distribution, and license agreement with a medical device company for the right to market and distribute certain introducer shaft products. During the year ended December 31, 2014, we paid $624,800 in connection with this agreement. During the year ended December 31, 2015, we paid an additional $1.1 million as a milestone related to 510(k) clearance was achieved. We are obligated to pay an additional €500,000 if certain milestones set forth in the agreement are reached. We accounted for the transaction as an asset purchase. We recorded the amount paid as a license agreement asset, which we intend to amortize over a period of ten years.

On August 8, 2014, we entered into a license agreement and a distribution agreement with a medical device company for the right to manufacture and sell certain percutaneous transluminal angioplasty balloon catheter products. As of December 31, 2014, we had paid $3.0 million and recorded an additional $1.0 million obligation to accrued liabilities in connection with these two agreements. During 2015, we paid $3.5 million, which included the amount that was accrued as of December 31, 2014 and the amount related to the achievement of certain milestones under the agreements. As of December 31, 2015, we had paid all obligations under these two agreements. We accounted for the transaction as an asset purchase. Of the purchase price paid as of December 31, 2015, $200,000 was allocated to a distribution agreement asset, which we are amortizing over a period of three years, and $6.3 million was allocated to a license agreement asset, which we intend to amortize over a period of 12 years.

On July 15, 2014, we entered into a purchase agreement to acquire certain assets from a limited liability company. In connection with this agreement, we paid approximately $752,000. The primary assets acquired from this entity were manufacturing and export licenses. We accounted for the transaction as an asset purchase. We recorded the amount paid on the closing date as a license agreement asset, which we intend to amortize over a period of ten years.

On May 8, 2014, we purchased 737,628 shares of the common stock of G Medix, Inc., a Minnesota corporation ("G Medix"), for an aggregate price of approximately $1.8 million. Our purchase of the G Medix shares, which represents an ownership interest in G Medix of approximately 19%, has been accounted for at cost. We made a refundable advance to G Medix of $350,000 in 2013 that was credited against the final purchase amount, resulting in $1.45 million of cash purchase price paid to G Medix during 2014. G Medix develops catheter-based therapeutic devices.

On December 20, 2013, we acquired a license to sell our Hepasphere products in China. We paid $700,000 to purchase the license, $350,000 of which was included in accrued liabilities at December 31, 2013. The purchase price was allocated to a license agreement for $700,000, which we are amortizing over four years.

On October 4, 2013, we acquired certain assets contemplated by an Asset Purchase Agreement we executed with Datascope Corp. ("Datascope"), a Delaware corporation. The primary assets we acquired consist of the Safeguard® Pressure Assisted Device, which assists in obtaining and maintaining hemostasis after a femoral procedure, and the Air-Band™ Radial Compression Device, which is indicated to assist hemostasis of the radial artery puncture site while maintaining visibility. We accounted for this acquisition as a business combination. We made a payment of approximately $27.5 million to acquire these assets. Acquisition-related costs during the year ended December 31, 2013, which were included in selling, general, and administrative expenses in the accompanying consolidated statements of income, were not material. The results of operations related to this acquisition have been included in our cardiovascular segment since the acquisition date. During the year ended December 31, 2013, our net sales of Datascope products were approximately $1.6 million. It is not practical to separately report the earnings related to the Datascope acquisition, as we cannot split out sales costs related to Datascope products, principally because our sales representatives are selling multiple products (including Datascope products) in the cardiovascular business segment. The total purchase price was allocated as follows (in thousands):



Assets Acquired
Inventories	$	478
Intangibles
Developed technology	18,200
Customer lists	390
Trademarks	320
Goodwill	8,112

Total assets acquired	$	27,500

With respect to the Datascope assets, we are amortizing developed technology over ten years and customer lists on an accelerated basis over six years. While U.S. trademarks can be renewed indefinitely, we currently estimate that we will generate cash flow from the acquired trademarks for a period of 15 years from the acquisition date. The total weighted-average amortization period for these acquired intangible assets is ten years.

On October 4, 2013, we acquired certain assets contemplated by an Asset Purchase Agreement with Radial Assist, LLC ("Radial Assist"), a Georgia limited liability company. The primary assets we acquired consist of the Rad Board, Rad BoardXtra, Rad Trac, and Rad Rest devices. The Rad Board is designed to provide a larger work space for physicians and an area for patients to rest their arms during radial procedures. The Rad Board Xtra is designed to work in conjunction with the Rad Board by extending the usable work space and allowing for a 90-degree perpendicular extension of the arm for physicians who prefer doing procedures at a 90-degree angle. The Rad Trac is also designed to be used with the Rad Board and facilitates placement and removal of the Rad Board with the patient still on the table. The Rad Rest is a disposable, single-use product designed to stabilize the arm by ergonomically supporting the elbow, forearm and wrist during radial procedures. We accounted for this acquisition as a business combination. We made a payment of approximately $2.5 million to acquire these assets. Acquisition-related costs during the year ended December 31, 2013, which were included in selling, general, and administrative expenses in the accompanying consolidated statements of income, were not material. The results of operations related to this acquisition have been included in our cardiovascular segment since the acquisition date. During the year ended December 31, 2013, our net sales of Radial Assist products were approximately $191,000. It is not practical to separately report the earnings related to the Radial Assist acquisition, as we cannot split out sales costs related to Radial Assist products, principally because our sales representatives are selling multiple products (including Radial Assist products) in the cardiovascular business segment. The total purchase price was allocated as follows (in thousands):



Assets Acquired
Inventories	$	16
Intangibles
Developed technology	1,520
Customer lists	20
Trademarks	40
Goodwill	904

Total assets acquired	$	2,500

With respect to the Radial Assist assets, we are amortizing developed technology over ten years and customer lists on an accelerated basis over six years. While U.S. trademarks can be renewed indefinitely, we currently estimate that we will generate cash flow from the acquired trademarks for a period of 15 years from the acquisition date. The total weighted-average amortization period for these acquired intangible assets is 10.07 years.

In connection with our Datascope and Radial Assist acquisitions, we paid approximately $798,000 in long-term debt issuance costs to Wells Fargo Bank related to the amendment of our Credit Agreement (see Note 7). These costs consist primarily of loan origination fees that we are amortizing over the remaining contract term of our Credit Agreement, which matures December 19, 2017.

On September 10, 2013, we entered into a license agreement with a medical device company for the exclusive rights to sell certain biocompatible gloves, instrument cleaners, and surgical wipes. Upon signing, we paid $250,000 for the use of the license. We paid an additional $250,000 during the year ended December 31, 2015 after 30 days of our first commercial sale of the product. The purchase price was allocated to a license agreement for $500,000, which we intend to amortize over ten years.

The following table summarizes our consolidated results of operations for the year ended December 31, 2013, as well as unaudited pro forma consolidated results of operations as though the Datascope acquisition had occurred on January 1, 2012 (in thousands, except per common share amounts):



	2013
	As Reported		Pro Forma
Net sales	$	449,049	$	454,333
Net income	16,570		17,112
Earnings per common share:
Basic	$	0.39	$	0.40
Diluted	$	0.39	$	0.40

The unaudited pro forma information set forth above is for informational purposes only and includes adjustments related to the step-up of acquired inventories, amortization expense related to acquired intangible assets, and interest expense on long-term debt. The pro forma information should not be considered indicative of actual results that would have been achieved if the Datascope acquisition had occurred on January 1, 2012, or results that may be obtained in any future period. The pro forma consolidated results of operations do not include the Radial Assist acquisition, as we do not deem the pro forma effect of the transaction to be material.

The goodwill arising from the acquisitions discussed above consists largely of the synergies and economies of scale we hope to achieve from combining the acquired assets and operations with our historical operations (see Note 4). The goodwill recognized from these acquisitions is expected to be deductible for income tax purposes.

- Definition

The entire disclosure for a business combination (or series of individually immaterial business combinations) completed during the period, including background, timing, and recognized assets and liabilities. The disclosure may include leverage buyout transactions (as applicable).

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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-Section 50
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Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
-SubTopic 10
-Section 50
-Paragraph 4
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Reference 3: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 4: http://www.xbrl.org/2003/role/presentationRef
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-Name Accounting Standards Codification
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Reference 5: http://www.xbrl.org/2003/role/presentationRef
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Reference 6: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 7: http://www.xbrl.org/2003/role/presentationRef
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-Name Accounting Standards Codification
-Topic 805
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-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=56956791&loc=d3e4845-128472

Reference 8: http://www.xbrl.org/2003/role/presentationRef
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Reference 10: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
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Reference 13: http://www.xbrl.org/2003/role/presentationRef
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-Name Accounting Standards Codification
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Reference 14: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
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Reference 15: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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-URI http://asc.fasb.org/extlink&oid=35744584&loc=d3e6996-128479

+ Details

Inventories

12 Months Ended

Dec. 31, 2015

Inventory Disclosure [Abstract]

Inventories

INVENTORIES

Inventories at December 31, 2015 and 2014, consisted of the following (in thousands):



	2015		2014
Finished goods	$	59,170	$	50,000
Work-in-process	8,540		7,680
Raw materials	38,289		34,093

Total	$	105,999	$	91,773

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2015

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

GOODWILL AND INTANGIBLE ASSETS

The changes in the carrying amount of goodwill for the years ended December 31, 2015 and 2014, are as follows (in thousands):



	2015			2014
Goodwill balance at January 1	$	184,464		$	184,505
Effect of foreign exchange	(52		)	(41		)
Additions as the result of acquisitions	60			—
Goodwill balance at December 31	$	184,472		$	184,464

As of December 31, 2015, we had recorded $8.3 million of accumulated goodwill impairment charges. All of the goodwill balance as of December 31, 2015 and 2014 is related to our cardiovascular segment.

Other intangible assets at December 31, 2015 and 2014, consisted of the following (in thousands):



	2015
	Gross Carrying Amount		Accumulated Amortization			Net Carrying Amount
Patents	$	12,014	$	(2,595	)	$	9,419
Distribution agreements	5,626		(2,853		)	2,773
License agreements	19,109		(2,438		)	16,671
Trademarks	7,259		(2,554		)	4,705
Covenants not to compete	1,028		(873		)	155
Customer lists	20,793		(15,023		)	5,770
Royalty agreements	267		(267		)	—

Total	$	66,096	$	(26,603	)	$	39,493



	2014
	Gross Carrying Amount		Accumulated Amortization			Net Carrying Amount
Patents	$	10,199	$	(2,196	)	$	8,003
Distribution agreements	5,376		(2,285		)	3,091
License agreements	8,995		(1,823		)	7,172
Trademarks	7,298		(2,079		)	5,219
Covenants not to compete	1,029		(636		)	393
Customer lists	20,452		(13,194		)	7,258
Royalty agreements	267		(267		)	—

Total	$	53,616	$	(22,480	)	$	31,136

Aggregate amortization expense for the years ended December 31, 2015, 2014 and 2013 was approximately $14.8 million, $14.9 million and $14.2 million, respectively.

We evaluate long-lived assets, including amortizing intangible assets, for impairment whenever events or changes in circumstances indicate that their carrying amounts may not be recoverable. We perform the impairment analysis at the asset group for which the lowest level of identifiable cash flows are largely independent of the cash flows of other assets and liabilities. We compared the carrying value of the amortizing intangible assets acquired in our January 2012 acquisition of Ostial to the undiscounted cash flows expected to result from the asset group and determined that the carrying amount was not recoverable. We then determined the fair value of the amortizing assets related to the Ostial acquisition based on estimated future cash flows discounted back to their present value using a discount rate that reflects the risk profiles of the underlying activities. Some of the factors that influenced our estimated cash flows were slower than anticipated sales growth in the products acquired from our Ostial acquisition and uncertainty about future sales growth. The excess of the carrying value compared to the fair value was recognized as an intangible asset impairment charge. We did not record any impairment charges during the year ended December 31, 2015. During the third quarter of 2014 and 2013, we recorded an impairment charge for Ostial of approximately $1.1 million and $8.1 million, respectively, which was offset by approximately $874,000 and $3.8 million of fair value reductions to the related contingent consideration liability.

Estimated amortization expense for the developed technology and other intangible assets for the next five years consists of the following as of December 31, 2015 (in thousands):



Year Ending December 31
2016	$	15,659
2017	15,515
2018	14,982
2019	14,640
2020	13,807

- Definition

The entire disclosure for the aggregate amount of goodwill and a description of intangible assets, which may include (a) for amortizable intangible assets (also referred to as finite-lived intangible assets), the carrying amount, the amount of any significant residual value, and the weighted-average amortization period, (b) for intangible assets not subject to amortization (also referred to as indefinite-lived intangible assets), the carrying amount, and (c) the amount of research and development assets acquired and written off in the period, including the line item in the income statement in which the amounts written off are aggregated, if not readily apparent from the income statement. Also discloses (a) for amortizable intangibles assets in total and by major class, the gross carrying amount and accumulated amortization, the total amortization expense for the period, and the estimated aggregate amortization expense for each of the five succeeding fiscal years, (b) for intangible assets not subject to amortization the carrying amount in total and by major class, and (c) for goodwill, in total and for each reportable segment, the changes in the carrying amount of goodwill during the period (including the aggregate amount of goodwill acquired, the aggregate amount of impairment losses recognized, and the amount of goodwill included in the gain (loss) on disposal of a reporting unit). If any part of goodwill has not been allocated to a reportable segment, discloses the unallocated amount and the reasons for not allocating. For each impairment loss recognized related to an intangible asset (excluding goodwill), discloses: (a) a description of the impaired intangible asset and the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method for determining fair value, (c) the caption in the income statement or the statement of activities in which the impairment loss is aggregated, and (d) the segment in which the impaired intangible asset is reported. For each goodwill impairment loss recognized, discloses: (a) a description of the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method of determining the fair value of the associated reporting unit, and (c) if a recognized impairment loss is an estimate not finalized and the reasons why the estimate is not final. May also disclose the nature and amount of any significant adjustments made to a previous estimate of an impairment loss.

+ References + Details

Income Taxes

12 Months Ended

Dec. 31, 2015

Income Tax Disclosure [Abstract]

Income Taxes

INCOME TAXES

For the years ended December 31, 2015, 2014 and 2013, income before income taxes is broken out between U.S. and foreign-sourced operations and consisted of the following (in thousands):



	2015		2014		2013
Domestic	$	9,470	$	16,961	$	5,435
Foreign	21,730		14,611		14,404

Total	$	31,200	$	31,572	$	19,839

The components of the provision for income taxes for the years ended December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



	2015			2014			2013

Current expense (benefit):
Federal	$	(17	)	$	1,316		$	(747	)
State	747			768			333
Foreign	3,218			2,644			2,324

Total current expense	3,948			4,728			1,910

Deferred expense (benefit):
Federal	3,250			4,078			1,089
State	294			(119		)	278
Foreign	(94		)	(89		)	(8		)

Total deferred expense	3,450			3,870			1,359

Total income tax expense	$	7,398		$	8,598		$	3,269

The difference between the income tax expense reported and amounts computed by applying the statutory federal rate of 35.0% to pretax income for the years ended December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



	2015			2014			2013

Computed federal income tax expense at statutory rate of 35%	$	10,920		$	11,050		$	6,943
State income taxes	698			438			397
Tax credits	(1,019		)	(888		)	(1,385		)
Foreign tax rate differential	(3,564		)	(1,958		)	(2,374		)
Uncertain tax positions	536			(76		)	(520		)
Deferred compensation insurance assets	182			(81		)	(358		)
Other — including the effect of graduated rates	(355		)	113			566

Total income tax expense	$	7,398		$	8,598		$	3,269

Deferred income tax assets and liabilities at December 31, 2015 and 2014, consisted of the following temporary differences and carry-forward items (in thousands):



	2015			2014

Deferred income tax assets:
Allowance for uncollectible accounts receivable	$	531		$	366
Accrued compensation expense	5,534			5,492
Inventory differences	2,043			2,401
Net operating loss carryforwards	11,434			13,542
Deferred revenue	118			87
Stock-based compensation expense	2,532			2,479
Uncertain tax positions	—			284
Federal research and development credit carryforward	2,355			1,413
Foreign Tax Credits	600			1,374
Other	5,754			4,173
Total deferred income tax assets	30,901			31,611

Deferred income tax liabilities:
Prepaid expenses	(841		)	(708		)
Property and equipment	(24,467		)	(23,298		)
Intangible assets	(6,495		)	(4,853		)
Other	(1,077		)	(1,150		)
Total deferred income tax liabilities	(32,880		)	(30,009		)
Valuation allowance	(1,981		)	(1,603		)
Net deferred income tax assets (liabilities)	$	(3,960	)	$	(1	)

Reported as:
Deferred income tax assets - Current	$	7,025		$	6,375
Deferred income tax assets - Long-term	—			9
Deferred income tax liabilities - Current	—			—
Deferred income tax liabilities - Long-term	(10,985		)	(6,385		)

Net deferred income tax liabilities	$	(3,960	)	$	(1	)

The long-term deferred income tax balances are not netted as they represent deferred amounts applicable to different taxing jurisdictions. Deferred income tax balances reflect the temporary differences between the carrying amounts of assets and liabilities and their tax bases and are stated at enacted tax rates expected to be in effect when taxes are actually paid or recovered. The valuation allowance is primarily related to state credit carryforwards and capital losses for which we believe it is more likely than not that the deferred tax assets will not be realized. The valuation allowance increased by approximately $378,000, $240,000, and $138,000 during the years ended December 31, 2015, 2014 and 2013, respectively.

We have not provided U.S. deferred income taxes or foreign withholding taxes on the undistributed earnings of certain foreign subsidiaries that are intended to be reinvested indefinitely in operations outside the United States. It is not practical to estimate the amount of additional taxes that might be payable on such undistributed earnings.

As of December 31, 2015 and 2014, we had U.S federal net operating loss carryforwards of approximately $32.7 million and $38.7 million, respectively. These net operating loss carryforwards, which expire at various dates through 2030, are subject to an annual limitation under Internal Revenue Code Section 382. We anticipate that we will utilize the net operating loss carryforwards over the next 11 years. We utilized a total of approximately $6.0 million and $13.5 million in U.S. federal net operating loss carryforwards during the year ended December 31, 2015 and 2014, respectively.

As of December 31, 2015, we had $0 of non-U.S. net operating loss carryforwards. As of December 31, 2014, we had non-U.S. net operating loss carryforwards of approximately $53,000, which have no expiration date. Non-U.S. net operating loss carryforwards utilized during 2015 and 2014 were not material.

We are subject to income taxes in the United States and numerous foreign jurisdictions. Significant judgment is required in determining our worldwide provision for income taxes and recording the related assets and liabilities. In the ordinary course of our business, there are many transactions and calculations where the ultimate tax determination is uncertain. In our opinion, we have made adequate provisions for income taxes for all years subject to audit. We are no longer subject to U.S. federal, state, and local income tax examinations by tax authorities for years before 2012. In foreign jurisdictions, we are no longer subject to income tax examinations for years before 2009.

Although we believe our estimates are reasonable, the final outcomes of these matters may be different from those which we have reflected in our historical income tax provisions and accruals. Such differences could have a material effect on our income tax provision and operating results in the period in which we make such determination.

The total liability for unrecognized tax benefits at December 31, 2015, including interest and penalties, was approximately $2.2 million, of which approximately $2.2 million would favorably impact our effective tax rate if recognized. Approximately $1.4 million of the total liability at December 31, 2015 was presented as a reduction to non-current deferred income tax assets on our consolidated balance sheet. The total liability for unrecognized tax benefits at December 31, 2014, including interest and penalties, was approximately $1.9 million, of which approximately $1.6 million would favorably impact our effective tax rate if recognized. Approximately $563,000 of the total liability at December 31, 2014 was presented as a reduction to non-current deferred income tax assets on our consolidated balance sheet. As of December 31, 2015 and 2014, we had accrued approximately $187,000 and $181,000 respectively, in total interest and penalties related to unrecognized tax benefits. We account for interest and penalties for unrecognized tax benefits as part of our income tax provision. During the years ended December 31, 2015 and 2014, we added interest and penalties of approximately $6,000 and $42,000, respectively, to our liability for unrecognized tax benefits. During the year ended December 31, 2013, we removed interest and penalties of approximately$22,000 from our liability for unrecognized tax benefits. It is reasonably possible that within the next 12 months the total liability for unrecognized tax benefits may increase, net of potential decreases due to the expiration of statutes of limitation, up to $400,000 .

A reconciliation of the beginning and ending amount of liabilities associated with uncertain tax benefits for the years ended December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



Tabular Roll-forward	2015			2014			2013

Unrecognized tax benefits, opening balance	$	1,736		$	2,129		$	2,776
Gross increases in tax positions taken in a prior year	187			142			107
Gross increases in tax positions taken in the current year	763			309			236
Lapse of applicable statute of limitations	(704		)	(844		)	(990		)
Unrecognized tax benefits, ending balance	$	1,982		$	1,736		$	2,129

The tabular roll-forward ending balance does not include interest and penalties related to unrecognized tax benefits.

Revolving Credit Facility and Long-Term Debt

12 Months Ended

Dec. 31, 2015

Debt Disclosure [Abstract]

Revolving Credit Facility and Long-Term Debt

REVOLVING CREDIT FACILITY AND LONG-TERM DEBT

We entered into an Amended and Restated Credit Agreement, dated December 19, 2012, with the lenders who are or may become party thereto (collectively, the "Lenders") and Wells Fargo Bank, National Association ("Wells Fargo"), as administrative agent for the Lenders, which was amended on October 4, 2013 by a First Amendment to the Amended and Restated Credit Agreement by and among Merit, certain subsidiaries of Merit, the Lenders and Wells Fargo as administrative agent for the Lenders (as amended, the "Credit Agreement"). Pursuant to the terms of the Credit Agreement, the Lenders have agreed to make revolving credit loans up to an aggregate amount of $215 million. The Lenders also made a term loan in the amount of $100 million, repayable in quarterly installments in the amounts provided in the Credit Agreement until the maturity date of December 19, 2017, at which time the term and revolving credit loans, together with accrued interest thereon, will be due and payable. In addition, certain mandatory prepayments are required to be made upon the occurrence of certain events described in the Credit Agreement. Wells Fargo has agreed, upon satisfaction of certain conditions, to make swingline loans from time to time through the maturity date in amounts equal to the difference between the amounts actually loaned by the Lenders and the aggregate revolving credit commitment. The Credit Agreement is collateralized by substantially all of our assets. At any time prior to the maturity date, we may repay any amounts owing under all revolving credit loans, term loans, and all swingline loans in whole or in part, subject to certain minimum thresholds, without premium or penalty, other than breakage costs.

The term loan and any revolving credit loans made under the Credit Agreement bear interest, at our election, at either (i) the base rate (described below) plus 0.25% (subject to adjustment if the Consolidated Total Leverage Ratio, as defined in the Credit Agreement, is at or greater than 2.25 to 1), (ii) the London Inter-Bank Offered Rate (“LIBOR”) Market Index Rate (as defined in the Credit Agreement) plus 1.25% (subject to adjustment if the Consolidated Total Leverage Ratio, as defined in the Credit Agreement, is at or greater than 2.25 to 1), or (iii) the LIBOR Rate (as defined in the Credit Agreement) plus 1.25% (subject to adjustment if the Consolidated Total Leverage Ratio, as defined in the Credit Agreement, is at or greater than 2.25 to 1). Initially, the term loan and revolving credit loans under the Credit Agreement bear interest, at our election, at either (x) the base rate plus 1.00%, (y) the LIBOR Market Index Rate, plus 2.00%, or (z) the LIBOR Rate plus 2.00%. Swingline loans bear interest at the LIBOR Market Index Rate plus 1.25% (subject to adjustment if the Consolidated Total Leverage Ratio, as defined in the Credit Agreement, is at or greater than 2.25 to 1). Initially, swingline loans bear interest at the LIBOR Market Index Rate plus 2.00%. Interest on each loan featuring the base rate or the LIBOR Market Index Rate is due and payable on the last business day of each calendar month; interest on each loan featuring the LIBOR Rate is due and payable on the last day of each interest period selected by us when selecting the LIBOR Rate as the benchmark for interest calculation. For purposes of the Credit Agreement, the base rate means the highest of (i) the prime rate (as announced by Wells Fargo), (ii) the federal funds rate plus 0.50%, and (iii) LIBOR for an interest period of one month plus 1.00%. Our obligations under the Credit Agreement and all loans made thereunder are fully secured by a security interest in our assets pursuant to a separate collateral agreement entered into in conjunction with the Credit Agreement.

The Credit Agreement contains customary covenants, representations and warranties and other terms customary for revolving credit loans of this nature. In this regard, the Credit Agreement requires us to not, among other things, (a) permit the Consolidated Total Leverage Ratio (as defined in the Credit Agreement) to be greater than 4.75 to 1 through the end of 2013, no more than 4.00 to 1 as of the fiscal quarter ending March 31, 2014, no more than 3.75 to 1 as of the fiscal quarter ending June 30, 2014, no more than 3.50 to 1 as of the fiscal quarter ending September 30, 2014, no more than 3.25 to 1 as of the fiscal quarter ending December 31, 2014, no more than 3.00 to 1 as of any fiscal quarter ending during 2015, no more than 2.75 to 1 as of any fiscal quarter ending during 2016, and no more than 2.50 to 1 as of any fiscal quarter ending thereafter; (b) for any period of four consecutive fiscal quarters, permit the ratio of Consolidated EBITDA (as defined in the Credit Agreement and subject to certain adjustments) to Consolidated Fixed Charges (as defined in the Credit Agreement) to be less than 1.75 to 1; (c) subject to certain adjustments, permit Consolidated Net Income (as defined in the Credit Agreement) for certain periods to be less than $0; or (d) subject to certain conditions and adjustments, permit the aggregate amount of all Facility Capital Expenditures (as defined in the Credit Agreement) in any fiscal year beginning in 2013 to exceed $30 million. Additionally, the Credit Agreement contains various negative covenants with which we must comply, including, but not limited to, limitations respecting: the incurrence of indebtedness, the creation of liens or pledges on our assets, mergers or similar combinations or liquidations, asset dispositions, the repurchase or redemption of equity interests or debt, the issuance of equity, the payment of dividends and certain distributions, the entry into related party transactions and other provisions customary in similar types of agreements. As of December 31, 2015, we were in compliance with all covenants set forth in the Credit Agreement.

We had originally entered into an unsecured credit agreement, dated September 30, 2010, with certain lenders who were or became party thereto and Wells Fargo, as administrative agent for the lenders. Pursuant to the terms of that credit agreement, the lenders agreed to make revolving credit loans up to an aggregate amount of $175 million. Wells Fargo also agreed to make swingline loans from time to time through the maturity date of September 10, 2015 in amounts equal to the difference between the amount actually loaned by the lenders and the aggregate credit agreement. The unsecured credit agreement was amended and restated as of December 19, 2012, as the Credit Agreement.

In summary, principal balances under our long-term debt as of December 31, 2015 and 2014, consisted of the following (in thousands):



	2015		2014
Term loan	$	64,962	$	82,500
Revolving credit loans	142,631		141,990
Total long-term debt	207,593		224,490
Less current portion	10,000		10,000
Long-term portion	$	197,593	$	214,490

Future minimum principal payments on our long-term debt as of December 31, 2015, are as follows (in thousands):



Years Ending	Future Minimum
December 31	Principal Payments
2016	10,000
2017	197,593
Total future minimum principal payments	$	207,593

As of December 31, 2015, we had outstanding borrowings of approximately $207.6 million under the Credit Agreement, with available borrowings of approximately $32.4 million, based on the leverage ratio in the terms of the Credit Agreement. Our interest rate as of December 31, 2015 was a fixed rate of 2.48% on $135.0 million as a result of an interest rate swap (see Note 8), a variable floating rate of 1.74% on $65.8 million and a variable floating rate of 2.12% on approximately $6.8 million. Our interest rate as of December 31, 2014 was a fixed rate of 2.98% on $140.0 million as a result of an interest rate swap, variable floating rate of 2.17% on $84.3 million and a variable floating rate of 2.26% on approximately $174,000.

Derivatives	12 Months Ended
Derivatives	Dec. 31, 2015
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivatives	DERIVATIVES General. Our earnings and cash flows are subject to fluctuations due to changes in interest rates and foreign currency exchange rates, and we seek to mitigate a portion of these risks by entering into derivative contracts. The derivatives we use are an interest rate swap and foreign currency forward contracts. We recognize derivatives as either assets or liabilities at fair value in the accompanying consolidated balance sheets, regardless of whether or not hedge accounting is applied. We report cash flows arising from our hedging instruments consistent with the classification of cash flows from the underlying hedged items. Accordingly, cash flows associated with our derivative programs are classified as operating activities in the accompanying consolidated statements of cash flows. We formally document, designate and assess the effectiveness of transactions that receive hedge accounting initially and on an ongoing basis. Changes in the fair value of derivatives that qualify for hedge accounting treatment are recorded, net of applicable taxes, in accumulated other comprehensive income (loss), a component of stockholders’ equity in the accompanying consolidated balance sheets. For the ineffective portions of qualifying hedges, the change in fair value is recorded through earnings in the period of change. Changes in the fair value of derivatives not designated as cash flow hedges are recorded in earnings throughout the term of the derivative instrument. Interest Rate Swap. A portion of our debt bears interest at variable interest rates and therefore, we are subject to variability in the cash paid for interest expense. In order to mitigate a portion of this risk, we use a hedging strategy to reduce the variability of cash flows in the interest payments associated with a portion of the variable-rate debt outstanding under our Credit Agreement that is solely due to changes in the benchmark interest rate. On December 19, 2012, we entered into a pay-fixed, receive-variable interest rate swap having an initial notional amount of $150 million with Wells Fargo to fix the one-month LIBOR rate at 0.98%. The variable portion of the interest rate swap is tied to the one-month LIBOR rate (the benchmark interest rate). The interest rates under both the interest rate swap and the underlying debt reset, the swap is settled with the counterparty, and interest is paid, on a monthly basis. The notional amount of the interest rate swap is reduced quarterly by 50% of the minimum principal payment due under the terms of our Credit Agreement. The interest rate swap is scheduled to expire on December 19, 2017. At December 31, 2015 and 2014, our interest rate swap qualified as a cash flow hedge. The fair value of our interest rate swap at December 31, 2015 was an asset of approximately $2,000, which was partially offset by approximately $1,000 in deferred taxes. The fair value of our interest rate swap at December 31, 2014 was an asset of approximately $573,000, which was offset by approximately $223,000 in deferred taxes. During the years ended December 31, 2015, 2014 and 2013, the amount reclassified from accumulated other comprehensive income to earnings due to hedge effectiveness were included in interest expense in the accompanying consolidated statements of income and were not material. Foreign Currency Forward Contracts. We forecast our net exposure to various currencies and enter into foreign currency forward contracts to mitigate that exposure. As of December 31, 2015, we entered into foreign currency forward contracts for the Euro (EUR), British Pound (GBP), Chinese Yuan Renminbi (CNY), Mexican Peso (MXN), Brazilian Real (BRL), and Australian Dollar (AUD). On November 25, 2015, we forecasted a net exposure for December 31, 2015 (representing the difference between EUR, GBP, CNY, MXN, BRL, and AUD-denominated receivables and EUR, GBP, CNY, MXN, BRL, and AUD-denominated payables) of approximately 1.7 million EUR, 610,000 GBP, 38.4 million CNY, 32.0 million MXN, 1.5 million BRL, and 830,000 AUD. In order to partially offset such risks, on November 25, 2015 we entered into short-term forward contracts for the EUR, GBP, CNY, MXN, BRL, and AUD with notional amounts of approximately 1.7 million EUR, 610,000 GBP, 38.4 million CNY, 32.0 million MXN, 1.5 million BRL, and 830,000 AUD. On November 28, 2014, we forecasted a net exposure for December 31, 2014 (representing the difference between EUR and GBP-denominated receivables and EUR and GBP-denominated payables) of approximately 899,000 EUR and 572,000 GBP. In order to partially offset such risks at November 28, 2014, we entered into short-term forward contracts for the EUR and GBP with notional amounts of approximately 899,000 EUR and 572,000 GBP. We enter into similar transactions at various times during the year to partially offset exchange rate risks we bear throughout the year. These contracts are marked to market at each month-end. The fair value of our open positions at December 31, 2015 and 2014 was not material. On October 23, 2015, we entered into a foreign currency forward contract to partially offset the currency risk related to an intercompany loan denominated in CNY. The loan matures and the forward contract is deliverable on September 16, 2016. The notional amount of the forward contract is approximately 46.3 million CNY. This contract is marked to market at each month-end. The fair value of our open position at December 31, 2015 was a liability of approximately $278,000. During the years ended December 31, 2015, 2014 and 2013, we recorded a net gain (loss) on all foreign currency transactions of approximately $(400,000), $36,000 and $(202,000), respectively, which is included in other income in the accompanying consolidated statements of income.

- Definition

The entire disclosure for derivative instruments and hedging activities including, but not limited to, risk management strategies, non-hedging derivative instruments, assets, liabilities, revenue and expenses, and methodologies and assumptions used in determining the amounts.

+ References

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+ Details

Commitments and Contingencies

12 Months Ended

Dec. 31, 2015

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

COMMITMENTS AND CONTINGENCIES

We are obligated under non-terminable operating leases for manufacturing facilities, finished good distribution, office space and equipment. Total rental expense on these operating leases and on our manufacturing and office building for the years ended December 31, 2015, 2014 and 2013, approximated $10.7 million, $8.1 million and $5.5 million, respectively.

The future minimum lease payments for operating leases as of December 31, 2015, consisted of the following (in thousands):



Years Ending	Operating
December 31	Leases

2016	$	9,168
2017	7,961
2018	7,205
2019	7,110
2020	5,027
Thereafter	37,320

Total minimum lease payments	$	73,791

Sale-Leaseback. During the year ended December 31, 2015, we entered into sale and leaseback transactions to finance certain production equipment for $2.0 million. During the year ended December 31, 2014, we entered into sale and leaseback transactions to finance certain production equipment for $5.5 million. The lease agreements from the sale and leaseback transactions are accounted for as operating leases. Under the terms of the lease agreement, we have agreed to operate and maintain the equipment. The lease term is seven years. During the year ended December 31, 2013, we entered into a sale and leaseback transaction with a third-party lessor for the sale and leaseback of our Pearland, Texas facility for $24.0 million. The lease agreement from this sale and leaseback transaction is accounted for as an operating lease. Under the terms of the lease agreement, we have agreed to operate and maintain the building. The lease term is 19.8 years. Payments under the lease agreement are fixed. The lease agreement contains standard termination events, including termination upon a breach of our obligation to make rental payments and upon any other material breach of obligations under the lease, and standard maintenance and return condition provisions.

Irish Government Development Agency Grants. As of December 31, 2015, we had entered into several grant agreements with the Irish Government Development Agency. We have recorded the grants related to research and development projects and costs of hiring and training employees as a reduction of operating expenses for the years ended December 31, 2015, 2014 and 2013 in the amounts of approximately $0, $0 and $1.2 million, respectively. Grants related to the acquisition of property and equipment purchased in Ireland are amortized as a reduction to depreciation expense over lives corresponding to the depreciable lives of such property and equipment. The balance of deferred credits related to such grants as of December 31, 2015 and 2014, was approximately $2.7 million and $2.9 million, respectively. During the years ended December 31, 2015, 2014 and 2013, approximately $171,000, $175,000 and $139,000, respectively, of the deferred credit was amortized as a reduction of operating expenses.

We have committed to repay the Irish government for grants received if we cease production in Ireland prior to the expiration of the grant liability period. The grant liability period is usually between five and eight years from the last claim made on a grant. As of December 31, 2015, the total amount of grants that could be subject to refund was approximately $3.9 million, and the remaining grant liability period was three years. Our management does not currently believe we will have to repay any of these grant monies, as we have no current intention of ceasing operations in Ireland.

Litigation. In the ordinary course of business, we are involved in various claims and litigation matters. These claims and litigation matters may include actions involving product liability, intellectual property, contractual, and employment matters. We do not believe that any such actions are likely to be, individually or in the aggregate, material to our business, financial condition, results of operations or liquidity. However, in the event of unexpected further developments, it is possible that the ultimate resolution of these matters, or other similar matters, if unfavorable, may be materially adverse to our business, financial condition, results of operations or liquidity. Legal costs for these matters such as outside counsel fees and expenses are charged to expense in the period incurred.

Earnings Per Common Share (EPS)

12 Months Ended

Dec. 31, 2015

Earnings Per Share, Basic and Diluted [Abstract]

Earnings Per Common Share (EPS)

EARNINGS PER COMMON SHARE (EPS)

The computation of weighted average shares outstanding and the basic and diluted earnings per common share for the following periods consisted of the following (in thousands, except per share amounts):



	Net Income		Shares	Per Share Amount
Year ended December 31, 2015:
Basic EPS	$	23,802	44,036	$	0.54
Effect of dilutive stock options and warrants			475

Diluted EPS	$	23,802	44,511	$	0.53

Year ended December 31, 2014:
Basic EPS	$	22,974	43,143	$	0.53
Effect of dilutive stock options and warrants			266

Diluted EPS	$	22,974	43,409	$	0.53

Year ended December 31, 2013:
Basic EPS	$	16,570	42,607	$	0.39
Effect of dilutive stock options and warrants			277

Diluted EPS	$	16,570	42,884	$	0.39

For the years ended December 31, 2015, 2014 and 2013, approximately 423,000, 1,292,000 and 1,823,000, respectively, of stock options were not included in the computation of diluted earnings per share because their effect would have been anti-dilutive.

Employee Stock Purchase Plan Stock Options and Warrants

12 Months Ended

Dec. 31, 2015

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Employee Stock Purchase Plan Stock Options and Warrants

EMPLOYEE STOCK PURCHASE PLAN STOCK OPTIONS AND WARRANTS.

Our stock-based compensation primarily consists of the following plans:

2006 Long-Term Incentive Plan. In May 2006, our Board of Directors adopted and our shareholders approved, the Merit Medical Systems, Inc. 2006 Long-Term Incentive Plan (the “2006 Incentive Plan”). The 2006 Incentive Plan provides for the granting of stock options, stock appreciation rights, restricted stock, stock units (including restricted stock units) and performance awards. Options may be granted to directors, officers, outside consultants and key employees and may be granted upon such terms and such conditions as the Compensation Committee of our Board of Directors determines. Options will typically vest on an annual basis over a three to five year life (or one year if performance based) with a contractual life of seven years. As of December 31, 2015, a total of approximately 2.5 million shares remained available to be issued under the 2006 Incentive Plan.

Employee Stock Purchase Plan. We have a non-qualified Employee Stock Purchase Plan (“ESPP”), which has an expiration date of June 30, 2026. As of December 31, 2015, the total number of shares of Common Stock that remained available to be issued under our non-qualified plan was approximately 233,000 shares. ESPP participants purchase shares on a quarterly basis at a price equal to 95% of the market price of the Common Stock at the end of the applicable offering period.

Stock-Based Compensation Expense. The stock-based compensation expense before income tax expense for the years ended December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



	2015		2014		2013
Cost of goods sold	$	398	$	198	$	145
Research and development	122		69		87
Selling, general, and administrative	1,723		1,193		1,235
Stock-based compensation expense before taxes	$	2,243	$	1,460	$	1,467

We recognize stock-based compensation expense (net of a forfeiture rate) for those awards which are expected to vest on a straight-line basis over the requisite service period. We estimate the forfeiture rate based on our historical experience and expectations about future forfeitures. As of December 31, 2015, the total remaining unrecognized compensation cost related to non-vested stock options, net of expected forfeitures, was approximately $5.9 million and is expected to be recognized over a weighted average period of 3.4 years.

In applying the Black-Scholes methodology to the option grants, the fair value of our stock-based awards granted were estimated using the following assumptions for the periods indicated below:



	2015			2014			2013
Risk-free interest rate	1.53%	-	1.66%	1.53%	-	1.97%	0.65%	-	1.16%
Expected option life	5.0			5.0	-	5.5 years	4.2	-	6.0 years
Expected dividend yield	—%			—%			—%
Expected price volatility	33.72%	-	35.11%	34.52%	-	36.90%	34.08%	-	41.67%

The average risk-free interest rate is determined using the U.S. Treasury rate in effect as of the date of grant, based on the expected term of the stock option. We determine the expected term of the stock options using the historical exercise behavior of employees. The expected price volatility was determined using a weighted average of daily historical volatility of our stock price over the corresponding expected option life and implied volatility based on recent trends of the daily historical volatility. For options with a vesting period, compensation expense is recognized on a straight-line basis over the service period, which corresponds to the vesting period. Compensation expense is recognized immediately for options that are fully vested on the date of grant. During the years ended December 31, 2015, 2014 and 2013, approximately 618,000, 666,000 and 348,000 stock-based compensation grants were made, respectively, for a total fair value of approximately $3.7 million, $2.8 million and $1.4 million, net of estimated forfeitures, respectively.

The table below presents information related to stock option activity for the years ended December 31, 2015, 2014 and 2013 (in thousands):



	2015		2014		2013
Total intrinsic value of stock options exercised	$	7,548	$	3,505	$	1,649
Cash received from stock option exercises	6,227		7,697		3,281
Excess tax benefit from the exercise of stock options	2,124		576		259

Changes in stock options for the year ended December 31, 2015, consisted of the following (shares and intrinsic value in thousands):



	Number of Shares		Weighted Average Exercise Price		Remaining Contractual Term (in years)	Intrinsic Value
2015:
Beginning balance	2,791		$	12.59
Granted	618		18.16
Exercised	(858	)	11.63
Forfeited/expired	(143	)	14.38
Outstanding at December 31	2,408		14.25		4.3	$	10,752
Exercisable	2,329		14.23		4.3	10,461
Ending vested and expected to vest	992		13.34		2.9	5,206

The weighted average grant-date fair value of options granted during the years ended December 31, 2015, 2014 and 2013 was $5.98, $4.27 and $5.31, respectively.

The following table summarizes information about stock options outstanding at December 31, 2015 (shares in thousands):



				Options Outstanding				Options Exercisable
Range of Exercise				Number Outstanding	Weighted Average Remaining Contractual Life (in years)	Weighted Average Exercise Price		Number Exercisable	Weighted Average Exercise Price
$	9.95	-	$12.91	671	5.20	$	11.82	187	$	11.85
$	13.14	-	$13.16	216	3.36	13.15		129	13.15
$	13.75	-	$13.75	638	2.61	13.75		511	13.75
$	13.77	-	$21.98	883	5.19	16.76		165	13.92
$	9.95	-	$21.98	2,408				992

Segment Reporting and Foreign Operations

12 Months Ended

Dec. 31, 2015

Segment Reporting [Abstract]

Segment Reporting and Foreign Operations

SEGMENT REPORTING AND FOREIGN OPERATIONS

We report our operations in two operating segments: cardiovascular and endoscopy. Our cardiovascular segment consists of cardiology and radiology medical device products which assist in diagnosing and treating coronary artery disease, peripheral vascular disease and other non-vascular diseases and includes embolization devices and CRM/EP devices. Our endoscopy segment consists of gastroenterology and pulmonology medical device products which assist in the palliative treatment of expanding esophageal, tracheobronchial and biliary strictures caused by malignant tumors. We evaluate the performance of our operating segments based on operating income (loss). Listed below are the sales by business segment for the years ended December 31, 2015, 2014 and 2013 (in thousands):



	% Change		2015		% Change		2014		% Change		2013

Cardiovascular
Stand-alone devices	8	%	$	155,414	15	%	$	143,712	10	%	$	125,445
Custom kits and procedure trays	5	%	116,368		7	%	111,076		10	%	103,700
Inflation devices	1	%	73,373		10	%	72,538		(4	)%	66,182
Catheters	11	%	96,833		17	%	87,550		16	%	75,131
Embolization devices	3	%	45,025		31	%	43,855		(1	)%	33,395
CRM/EP	3	%	33,902		17	%	32,975		1,359	%	28,271
Total	6	%	520,915		14	%	491,706		14	%	432,124

Endoscopy
Endoscopy devices	18	%	21,234		6	%	17,983		7	%	16,925

Total	6	%	$	542,149	14	%	$	509,689	14	%	$	449,049

During the years ended December 31, 2015, 2014 and 2013, we had foreign sales of approximately $214.0 million, $198.3 million and $165.8 million, respectively, or approximately 39%, 39% and 37%, respectively, of total sales, primarily in China, Japan, Germany, France, the United Kingdom and Russia. Foreign sales are attributed based on location of the customer receiving the product.

Our long-lived assets by geographic area at December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



	2015		2014		2013
United States	$	186,389	$	177,627	$	178,130
Ireland	48,896		49,708		50,274
Other foreign countries	32,493		16,836		14,866
Total	$	267,778	$	244,171	$	243,270

Financial information relating to our reportable operating segments and reconciliations to the consolidated totals for the years ended December 31, 2015, 2014 and 2013, are as follows (in thousands):



	2015			2014			2013
Revenues
Cardiovascular	$	520,915		$	491,706		$	432,124
Endoscopy	21,234			17,983			16,925
Total revenues	542,149			509,689			449,049

Operating expenses
Cardiovascular	187,492			175,152			157,479
Endoscopy	10,746			9,904			9,044
Total operating expenses	198,238			185,056			166,523

Operating income (loss)
Cardiovascular	34,052			38,601			26,597
Endoscopy	3,491			1,565			1,247
Total operating income	37,543			40,166			27,844

Total other expense - net	(6,343		)	(8,594		)	(8,005		)
Income tax expense	7,398			8,598			3,269

Net income	$	23,802		$	22,974		$	16,570

Total assets by business segment at December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



	2015		2014		2013
Cardiovascular	$	767,952	$	734,940	$	716,659
Endoscopy	10,776		12,225		11,624
Total	$	778,728	$	747,165	$	728,283

Total depreciation and amortization by business segment for the years ended December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



	2015		2014		2013

Cardiovascular	$	36,474	$	34,975	$	31,594
Endoscopy	951		954		948
Total	$	37,425	$	35,929	$	32,542

Total capital expenditures for property and equipment by business segment for the years ended December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



	2015		2014		2013

Cardiovascular	$	50,927	$	33,660	$	59,421
Endoscopy	32		521		84
Total	$	50,959	$	34,181	$	59,505

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
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-Name Accounting Standards Codification
-Topic 280
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Reference 2: http://www.xbrl.org/2003/role/presentationRef
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Reference 3: http://www.xbrl.org/2003/role/presentationRef
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Reference 7: http://www.xbrl.org/2003/role/presentationRef
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Reference 8: http://www.xbrl.org/2003/role/presentationRef
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+ Details

Royalty Agreements	12 Months Ended
Royalty Agreements	Dec. 31, 2015
Royalty Agreements [Abstract]
Royalty Agreements	ROYALTY AGREEMENTS During 2010, in connection with our acquisition of BioSphere, we entered into a running royalty agreement as part of a partnership between BioSphere and L’Assistance Publique-Hôpitaux de Paris, referred to as “AP-HP,” pursuant to which AP-HP has granted us the exclusive license to use two United States patents and their foreign counterparts that we jointly own with AP-HP relating to microspheres. We are required to pay to AP-HP a royalty on the commercial sale of any products that incorporate technology covered by the subject patents. We may sublicense these exclusive rights under the agreement only with the prior written consent of AP-HP, which consent cannot be unreasonably withheld. Under the terms of the royalty agreement, our exclusive license extends for both (i) the term of jointly owned U.S. and foreign counterpart patents and (ii) as long as the products and specialties implementing the patents are marketed. BioSphere filed patent applications which, if issued, will expire in approximately January 2031. The royalty rate in the agreement is 5.0% of net sales until the patents expire, and 2.5% of net sales thereafter as long as the product is sold. We paid or accrued approximately $1.5 million, $1.5 million and $1.3 million in royalty payments to AP-HP for the years ended December 31, 2015, 2014 and 2013, respectively. See Note 2 for a discussion of additional future royalty commitments related to acquisitions.

Employee Benefit Plans	12 Months Ended
Employee Benefit Plans	Dec. 31, 2015
Defined Contribution Pension and Other Postretirement Plans Disclosure [Abstract]
Employee Benefit Plans	EMPLOYEE BENEFIT PLANS We have a contributory 401(k) savings and profit sharing plan (the “Plan”) covering all U.S. full-time employees who are at least 18 years of age. The Plan has a 90-day minimum service requirement. We may contribute, at our discretion, matching contributions based on the employees’ compensation. Contributions we made to the Plan for the years ended December 31, 2015, 2014 and 2013, totaled approximately $2.0 million, $1.8 million and $429,000, respectively. We have defined contribution plans covering some of our foreign employees. We contribute between 2% and 32% of the employee’s compensation for certain foreign non-management employees, and between 2% and 32% of the employee’s compensation for certain foreign management employees. Contributions made to these plans for the years ended December 31, 2015, 2014 and 2013, totaled approximately $893,000, $912,000 and $748,000, respectively.

Quarterly Results of Operations (Unaudited)

12 Months Ended

Dec. 31, 2015

Quarterly Financial Information Disclosure [Abstract]

Quarterly Results of Operations (Unaudited)

QUARTERLY RESULTS OF OPERATIONS (UNAUDITED)

Quarterly data for the years ended December 31, 2015 and 2014 consisted of the following (in thousands, except per share amounts):



	Quarter Ended
	March 31		June 30		September 30		December 31
2015
Net sales	$	129,577	$	138,082	$	136,086	$	138,404
Gross profit	55,383		60,886		59,205		60,307
Income from operations	8,704		12,242		8,547		8,050
Income tax expense	2,289		3,122		1,842		145
Net income	5,174		7,401		4,818		6,409
Basic earnings per common share	0.12		0.17		0.11		0.14
Diluted earnings per common share	0.12		0.17		0.11		0.14

2014
Net sales	$	119,236	$	128,865	$	128,808	$	132,780
Gross profit	52,043		55,624		57,421		60,134
Income from operations	6,489		7,384		12,076		14,217
Income tax expense	1,063		1,366		2,489		3,680
Net income	2,823		3,716		7,764		8,671
Basic earnings per common share	0.07		0.09		0.18		0.20
Diluted earnings per common share	0.07		0.09		0.18		0.20

Basic and diluted earnings per share are computed independently for each of the quarters presented. Therefore, the sum of the quarterly amounts may not equal the total computed for the year.

Fair Value Measurements

12 Months Ended

Dec. 31, 2015

Fair Value Disclosures [Abstract]

Fair Value Measurements

FAIR VALUE MEASUREMENTS

Our financial assets and (liabilities) carried at fair value measured on a recurring basis as of December 31, 2015 and 2014, consisted of the following (in thousands):



				Fair Value Measurements Using
	Total Fair			Quoted prices in		Significant other			Significant
	Value at			active markets		observable inputs			Unobservable inputs
Description	December 31, 2015			(Level 1)		(Level 2)			(Level 3)

Interest rate contracts (1)	$	2		$	—	$	2		$	—
Foreign currency contracts (2)	$	(278	)	$	—	$	(278	)	$	—

				Fair Value Measurements Using
	Total Fair			Quoted prices in		Significant other			Significant
	Value at			active markets		observable inputs			Unobservable inputs
Description	December 31, 2014			(Level 1)		(Level 2)			(Level 3)

Interest rate contracts (1)	$	573		$	—	$	573		$	—

(1) The fair value of the interest rate contracts is determined using Level 2 fair value inputs and is recorded as other assets in the Consolidated Balance Sheets.

(2) The fair value of the foreign currency contracts is determined using Level 2 fair value inputs and is recorded as accrued expenses in the Consolidated Balance Sheets.

Certain of our business combinations involve the potential for the payment of future contingent consideration, generally based on a percentage of future product sales or upon attaining specified future revenue milestones. See Note 2 for further information regarding these acquisitions. The contingent consideration liability is re-measured at the estimated fair value at each reporting period with the change in fair value recognized within operating expenses in the accompanying consolidated statements of income. We measure the initial liability and re-measure the liability on a recurring basis using Level 3 inputs as defined under authoritative guidance for fair value measurements. Changes in the fair value of our contingent consideration liability during the years ended December 31, 2015 and 2014, consisted of the following (in thousands):



	2015			2014
Beginning balance	$	1,886		$	2,526
Contingent consideration liability recorded as the result of acquisitions (see Note 2)	270			—
Fair value adjustments recorded to income during the period	80			(572		)
Contingent payments made	(1,212		)	(68		)
Ending balance	$	1,024		$	1,886

The recurring Level 3 measurement of our contingent consideration liability includes the following significant unobservable inputs at December 31, 2015 and 2014 (amount in thousands):



Contingent consideration liability	Fair value at December 31, 2015		Valuation technique	Unobservable inputs	Range
Revenue-based payments	$	874	Discounted cash flow	Discount rate	5% - 15%
			Discounted cash flow	Probability of milestone payment	100%
				Projected year of payments	2016-2028

Other payments	$	150	Discounted cash flow	Discount rate	—%
			Discounted cash flow	Probability of milestone payment	100%
				Projected year of payments	2016

Contingent consideration liability	Fair value at December 31, 2014		Valuation technique	Unobservable inputs	Range
Revenue-based payments	$	1,610	Discounted cash flow	Discount rate	1% - 14%
			Discounted cash flow	Probability of milestone payment	90%
				Projected year of payments	2015-2028

Other payments	$	276	Discounted cash flow	Discount rate	5%
			Discounted cash flow	Probability of milestone payment	100%
				Projected year of payments	2015-2016

The contingent consideration liability is re-measured to fair value each reporting period using projected revenues, discount rates, probabilities of payment, and projected payment dates. Projected contingent payment amounts are discounted back to the current period using a discounted cash flow model. Projected revenues are based on our most recent internal operational budgets and long-range strategic plans. Increases (decreases) in discount rates and the time to payment may result in lower (higher) fair value measurements. A decrease in the probability of any milestone payment may result in lower fair value measurements. An increase (decrease) in either the discount rate or the time to payment, in isolation, may result in a significantly lower (higher) fair value measurement.

Our determination of the fair value of the contingent consideration liability could change in future periods based upon our ongoing evaluation of these significant unobservable inputs. We intend to record any such change in fair value to operating expenses in our consolidated statements of income. As of December 31, 2015, approximately $775,000 was included in other long-term obligations and $249,000 was included in accrued expenses in our consolidated balance sheet. As of December 31, 2014, approximately $803,000 was included in other long-term obligations and $1.1 million was included in accrued expenses in our consolidated balance sheet. The cash paid to settle the contingent consideration liability recognized at fair value as of the acquisition date (including measurement-period adjustments) has been reflected as a cash outflow from financing activities in the accompanying consolidated statements of cash flows.

During the years ended December 31, 2015, 2014 and 2013, we had losses of approximately $141,000, $1.4 million, and $8.2 million, respectively, related to the measurement of non-financial assets at fair value on a nonrecurring basis subsequent to their initial recognition.

The carrying amount of cash and cash equivalents, receivables, and trade payables approximates fair value because of the immediate, short-term maturity of these financial instruments. The carrying amount of long-term debt approximates fair value, as determined by borrowing rates estimated to be available to us for debt with similar terms and conditions. The fair value of assets and liabilities whose carrying value approximates fair value is determined using Level 2 inputs, with the exception of cash and cash equivalents, which are Level 1 inputs.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Subsequent Events	12 Months Ended
Subsequent Events	Dec. 31, 2015
Subsequent Events [Abstract]
Subsequent Events	SUBSEQUENT EVENTS We have evaluated whether any subsequent events have occurred from December 31, 2015 to the time of filing of this report that would require disclosure in the consolidated financial statements. We note the following two events below. Third Amendment to Amended and Restated Credit Agreement On February 3, 2016, we entered into a Third Amendment to Amended and Restated Credit Agreement (the “Amendment”), by and among Merit, certain subsidiaries of Merit, the lenders who are party to the Amendment and Wells Fargo, as administrative agent for those lenders. The Amendment sets forth the terms and conditions upon which Merit, Wells Fargo and the other parties to the Amendment have agreed to amend our Credit Agreement. Among other provisions, the Amendment provides for an increase in our borrowing capacity under our Credit Agreement by $50 million. The Credit Agreement, after giving effect to the Amendment (the “Amended Credit Agreement”), sets forth the agreement of the lenders who are party to the Amendment to make revolving credit loans to us in an aggregate amount of $225 million on the terms and subject to the conditions set forth in the Amended Credit Agreement. Those lenders have previously made a term loan to us in the amount of $100 million, repayable in quarterly installments in the amounts provided in the Amended Credit Agreement until the maturity date of December 19, 2017, at which time the term loan, together with accrued interest thereon, is required to be paid in full. In addition, certain mandatory prepayments are required to be made upon the occurrence of certain events described in the Amended Credit Agreement. Wells Fargo has agreed to make “Swingline” loans from time to time through the maturity date of December 19, 2017 in amounts equal to the difference between the amounts actually loaned by the Lenders and the aggregate revolving credit commitment, on the terms and subject to the conditions set forth in the Amended Credit Agreement. HeRO® Acquisition On February 4, 2016, we purchased the HeRO®Graft device and other related assets from CryoLife, Inc., a developer of medical devices based in Kennesaw, GA. The purchase price was $18.5 million. We are currently evaluating the accounting treatment of this purchase, as well as performing the valuation of the assets acquired and the related purchase price allocation.

Schedule II - Valuation and qualifying accounts

12 Months Ended

Dec. 31, 2015

Valuation and Qualifying Accounts [Abstract]

Schedule II - Valuation and qualifying accounts

(2) Financial Statement Schedule.

— Schedule II - Valuation and qualifying accounts

Years Ended December 31, 2015, 2014 and 2013

(In thousands)



Description	Balance at Beginning of Year		Additions Charged to Costs and Expenses (a)		Deduction (b)	Balance at End of Year

ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:

2013	(892	)	(376	)	428	(840	)
2014	(840	)	(83	)	30	(893	)
2015	(893	)	(607	)	203	(1,297	)

(a) We record a bad debt provision based upon historical experience and a review of individual customer balances.

(b) When an individual customer balance becomes impaired and is deemed uncollectible, a deduction is made against the allowance for uncollectible accounts.

Years Ended December 31, 2015, 2014 and 2013

(In thousands)



Description	Balance at Beginning of Year		Additions Charged to Costs and Expenses (c)		Deduction	Balance at End of Year

TAX VALUATION ALLOWANCE:

2013	(1,225	)	(138	)	—	(1,363	)
2014	(1,363	)	(240	)	—	(1,603	)
2015	(1,603	)	(378	)	—	(1,981	)

(c) We record a valuation allowance against a deferred tax asset when it is determined that it is more likely than not that the deferred tax asset will not be realized.

Organization and Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2015

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Use of Estimates in Preparing Financial Statements

Principles of Consolidation

Principles of Consolidation. The consolidated financial statements include our wholly owned subsidiaries. Intercompany balances and transactions have been eliminated.

Cash and Cash Equivalents

Cash and Cash Equivalents. For purposes of the statements of cash flows, we consider interest bearing deposits with an original maturity date of three months or less to be cash equivalents.

Receivables

Inventories

Goodwill and Intangible Assets



Customer lists	5	-	15 years
Developed technology	8	-	15 years
Distribution agreements	3	-	12 years
License agreements and trademarks	4	-	15 years
Covenants not to compete	3	-	10 years
Patents	17 years
Royalty agreements	5 years

Long-Lived Assets

Property and Equipment



Buildings	40 years
Manufacturing equipment	4	-	20 years
Furniture and fixtures	3	-	20 years
Land improvements	10	-	20 years
Leasehold improvements	4	-	25 years

Deferred Compensation

Other Assets

Deferred Credits

Revenue Recognition

Shipping and Handling Cost

Cost of Sales

Research and Development

Research and Development. Research and development costs are expensed as incurred.

Income Taxes

Earnings per Common Share

Fair Value Measurements

Level 1: Quoted market prices in active markets for identical assets or liabilities.

Level 2: Observable market-based inputs or inputs that are corroborated by market data.

Level 3: Unobservable inputs that are not corroborated by market data.

Stock-Based Compensation

Concentration of Credit Risk

Foreign Currency

Derivatives

Recently Issued Financial Accounting Standards

Organization and Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2015

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Intangible Assets

Intangible assets are amortized on a straight-line basis, except for customer lists, which are generally amortized on an accelerated basis, over the following useful lives:



Customer lists	5	-	15 years
Developed technology	8	-	15 years
Distribution agreements	3	-	12 years
License agreements and trademarks	4	-	15 years
Covenants not to compete	3	-	10 years
Patents	17 years
Royalty agreements	5 years

Property and Equipment

Depreciation is computed using the straight-line method over estimated useful lives as follows:



Buildings	40 years
Manufacturing equipment	4	-	20 years
Furniture and fixtures	3	-	20 years
Land improvements	10	-	20 years
Leasehold improvements	4	-	25 years

Acquisitions (Tables)

12 Months Ended

Dec. 31, 2015

Business Combinations [Abstract]

Schedule of Recognized Identified Assets Acquired and Liabilities Assumed

The total purchase price was allocated as follows (in thousands):



Assets Acquired
Inventories	$	478
Intangibles
Developed technology	18,200
Customer lists	390
Trademarks	320
Goodwill	8,112

Total assets acquired	$	27,500

The total purchase price was allocated as follows (in thousands):



Assets Acquired
Inventories	$	16
Intangibles
Developed technology	1,520
Customer lists	20
Trademarks	40
Goodwill	904

Total assets acquired	$	2,500

Business Acquisition, Pro Forma Information



	2013
	As Reported		Pro Forma
Net sales	$	449,049	$	454,333
Net income	16,570		17,112
Earnings per common share:
Basic	$	0.39	$	0.40
Diluted	$	0.39	$	0.40

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2015

Goodwill and Intangible Assets Disclosure [Abstract]

Changes in carrying amount of goodwill

The changes in the carrying amount of goodwill for the years ended December 31, 2015 and 2014, are as follows (in thousands):



	2015			2014
Goodwill balance at January 1	$	184,464		$	184,505
Effect of foreign exchange	(52		)	(41		)
Additions as the result of acquisitions	60			—
Goodwill balance at December 31	$	184,472		$	184,464

Other intangible assets

Other intangible assets at December 31, 2015 and 2014, consisted of the following (in thousands):



	2015
	Gross Carrying Amount		Accumulated Amortization			Net Carrying Amount
Patents	$	12,014	$	(2,595	)	$	9,419
Distribution agreements	5,626		(2,853		)	2,773
License agreements	19,109		(2,438		)	16,671
Trademarks	7,259		(2,554		)	4,705
Covenants not to compete	1,028		(873		)	155
Customer lists	20,793		(15,023		)	5,770
Royalty agreements	267		(267		)	—

Total	$	66,096	$	(26,603	)	$	39,493



	2014
	Gross Carrying Amount		Accumulated Amortization			Net Carrying Amount
Patents	$	10,199	$	(2,196	)	$	8,003
Distribution agreements	5,376		(2,285		)	3,091
License agreements	8,995		(1,823		)	7,172
Trademarks	7,298		(2,079		)	5,219
Covenants not to compete	1,029		(636		)	393
Customer lists	20,452		(13,194		)	7,258
Royalty agreements	267		(267		)	—

Total	$	53,616	$	(22,480	)	$	31,136

Estimated amortization expense

Estimated amortization expense for the developed technology and other intangible assets for the next five years consists of the following as of December 31, 2015 (in thousands):



Year Ending December 31
2016	$	15,659
2017	15,515
2018	14,982
2019	14,640
2020	13,807

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2015

Income Tax Disclosure [Abstract]

Schedule of Income before Income Tax, Domestic and Foreign

For the years ended December 31, 2015, 2014 and 2013, income before income taxes is broken out between U.S. and foreign-sourced operations and consisted of the following (in thousands):



	2015		2014		2013
Domestic	$	9,470	$	16,961	$	5,435
Foreign	21,730		14,611		14,404

Total	$	31,200	$	31,572	$	19,839

Schedule of Components of Income Tax Expense (Benefit)

The components of the provision for income taxes for the years ended December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



	2015			2014			2013

Current expense (benefit):
Federal	$	(17	)	$	1,316		$	(747	)
State	747			768			333
Foreign	3,218			2,644			2,324

Total current expense	3,948			4,728			1,910

Deferred expense (benefit):
Federal	3,250			4,078			1,089
State	294			(119		)	278
Foreign	(94		)	(89		)	(8		)

Total deferred expense	3,450			3,870			1,359

Total income tax expense	$	7,398		$	8,598		$	3,269

Schedule of Effective Income Tax Rate Reconciliation



	2015			2014			2013

Computed federal income tax expense at statutory rate of 35%	$	10,920		$	11,050		$	6,943
State income taxes	698			438			397
Tax credits	(1,019		)	(888		)	(1,385		)
Foreign tax rate differential	(3,564		)	(1,958		)	(2,374		)
Uncertain tax positions	536			(76		)	(520		)
Deferred compensation insurance assets	182			(81		)	(358		)
Other — including the effect of graduated rates	(355		)	113			566

Total income tax expense	$	7,398		$	8,598		$	3,269

Schedule of Deferred Tax Assets and Liabilities

Deferred income tax assets and liabilities at December 31, 2015 and 2014, consisted of the following temporary differences and carry-forward items (in thousands):



	2015			2014

Deferred income tax assets:
Allowance for uncollectible accounts receivable	$	531		$	366
Accrued compensation expense	5,534			5,492
Inventory differences	2,043			2,401
Net operating loss carryforwards	11,434			13,542
Deferred revenue	118			87
Stock-based compensation expense	2,532			2,479
Uncertain tax positions	—			284
Federal research and development credit carryforward	2,355			1,413
Foreign Tax Credits	600			1,374
Other	5,754			4,173
Total deferred income tax assets	30,901			31,611

Deferred income tax liabilities:
Prepaid expenses	(841		)	(708		)
Property and equipment	(24,467		)	(23,298		)
Intangible assets	(6,495		)	(4,853		)
Other	(1,077		)	(1,150		)
Total deferred income tax liabilities	(32,880		)	(30,009		)
Valuation allowance	(1,981		)	(1,603		)
Net deferred income tax assets (liabilities)	$	(3,960	)	$	(1	)

Reported as:
Deferred income tax assets - Current	$	7,025		$	6,375
Deferred income tax assets - Long-term	—			9
Deferred income tax liabilities - Current	—			—
Deferred income tax liabilities - Long-term	(10,985		)	(6,385		)

Net deferred income tax liabilities	$	(3,960	)	$	(1	)

Summary of Income Tax Contingencies



Tabular Roll-forward	2015			2014			2013

Unrecognized tax benefits, opening balance	$	1,736		$	2,129		$	2,776
Gross increases in tax positions taken in a prior year	187			142			107
Gross increases in tax positions taken in the current year	763			309			236
Lapse of applicable statute of limitations	(704		)	(844		)	(990		)
Unrecognized tax benefits, ending balance	$	1,982		$	1,736		$	2,129

Revolving Credit Facility and Long-Term Debt (Tables)

12 Months Ended

Dec. 31, 2015

Debt Disclosure [Abstract]

Schedule of Long-term Debt Instruments

In summary, principal balances under our long-term debt as of December 31, 2015 and 2014, consisted of the following (in thousands):



	2015		2014
Term loan	$	64,962	$	82,500
Revolving credit loans	142,631		141,990
Total long-term debt	207,593		224,490
Less current portion	10,000		10,000
Long-term portion	$	197,593	$	214,490

Schedule of Maturities of Long-term Debt

Future minimum principal payments on our long-term debt as of December 31, 2015, are as follows (in thousands):



Years Ending	Future Minimum
December 31	Principal Payments
2016	10,000
2017	197,593
Total future minimum principal payments	$	207,593

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02.22)
-URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682

Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=6928386&loc=d3e21475-112644

Reference 3: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 470
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=6479336&loc=d3e64711-112823

Reference 4: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08.(e),(f))
-URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690

Reference 5: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 55
-Paragraph 8
-URI http://asc.fasb.org/extlink&oid=34725769&loc=d3e28878-108400

Reference 6: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 8
-URI http://asc.fasb.org/extlink&oid=6928386&loc=d3e21538-112644

Reference 7: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 6
-URI http://asc.fasb.org/extlink&oid=6928386&loc=d3e21506-112644

Reference 8: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 1A
-URI http://asc.fasb.org/extlink&oid=6451184&loc=d3e28541-108399

Reference 9: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=6451184&loc=d3e28551-108399

Reference 10: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 7
-URI http://asc.fasb.org/extlink&oid=6928386&loc=d3e21521-112644

+ Details

Earnings Per Common Share (EPS) (Tables)

12 Months Ended

Dec. 31, 2015

Earnings Per Share, Basic and Diluted [Abstract]

Schedule of Earnings Per Share, Basic and Diluted



	Net Income		Shares	Per Share Amount
Year ended December 31, 2015:
Basic EPS	$	23,802	44,036	$	0.54
Effect of dilutive stock options and warrants			475

Diluted EPS	$	23,802	44,511	$	0.53

Year ended December 31, 2014:
Basic EPS	$	22,974	43,143	$	0.53
Effect of dilutive stock options and warrants			266

Diluted EPS	$	22,974	43,409	$	0.53

Year ended December 31, 2013:
Basic EPS	$	16,570	42,607	$	0.39
Effect of dilutive stock options and warrants			277

Diluted EPS	$	16,570	42,884	$	0.39

Employee Stock Purchase Plan Stock Options and Warrants (Tables)

12 Months Ended

Dec. 31, 2015

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Schedule of Employee Service Share-based Compensation, Allocation of Recognized Period Costs

The stock-based compensation expense before income tax expense for the years ended December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



	2015		2014		2013
Cost of goods sold	$	398	$	198	$	145
Research and development	122		69		87
Selling, general, and administrative	1,723		1,193		1,235
Stock-based compensation expense before taxes	$	2,243	$	1,460	$	1,467

Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions

In applying the Black-Scholes methodology to the option grants, the fair value of our stock-based awards granted were estimated using the following assumptions for the periods indicated below:



	2015			2014			2013
Risk-free interest rate	1.53%	-	1.66%	1.53%	-	1.97%	0.65%	-	1.16%
Expected option life	5.0			5.0	-	5.5 years	4.2	-	6.0 years
Expected dividend yield	—%			—%			—%
Expected price volatility	33.72%	-	35.11%	34.52%	-	36.90%	34.08%	-	41.67%

Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested and Expected to Vest, Outstanding and Exercisable

The table below presents information related to stock option activity for the years ended December 31, 2015, 2014 and 2013 (in thousands):



	2015		2014		2013
Total intrinsic value of stock options exercised	$	7,548	$	3,505	$	1,649
Cash received from stock option exercises	6,227		7,697		3,281
Excess tax benefit from the exercise of stock options	2,124		576		259

Schedule of Share-based Compensation, Stock Options, Activity

Changes in stock options for the year ended December 31, 2015, consisted of the following (shares and intrinsic value in thousands):



	Number of Shares		Weighted Average Exercise Price		Remaining Contractual Term (in years)	Intrinsic Value
2015:
Beginning balance	2,791		$	12.59
Granted	618		18.16
Exercised	(858	)	11.63
Forfeited/expired	(143	)	14.38
Outstanding at December 31	2,408		14.25		4.3	$	10,752
Exercisable	2,329		14.23		4.3	10,461
Ending vested and expected to vest	992		13.34		2.9	5,206

Schedule of Share-based Compensation, Shares Authorized under Stock Option Plans, by Exercise Price Range

The following table summarizes information about stock options outstanding at December 31, 2015 (shares in thousands):



				Options Outstanding				Options Exercisable
Range of Exercise				Number Outstanding	Weighted Average Remaining Contractual Life (in years)	Weighted Average Exercise Price		Number Exercisable	Weighted Average Exercise Price
$	9.95	-	$12.91	671	5.20	$	11.82	187	$	11.85
$	13.14	-	$13.16	216	3.36	13.15		129	13.15
$	13.75	-	$13.75	638	2.61	13.75		511	13.75
$	13.77	-	$21.98	883	5.19	16.76		165	13.92
$	9.95	-	$21.98	2,408				992

Segment Reporting and Foreign Operations (Tables)

12 Months Ended

Dec. 31, 2015

Segment Reporting [Abstract]

Revenue from External Customers by Products and Services

Listed below are the sales by business segment for the years ended December 31, 2015, 2014 and 2013 (in thousands):



	% Change		2015		% Change		2014		% Change		2013

Cardiovascular
Stand-alone devices	8	%	$	155,414	15	%	$	143,712	10	%	$	125,445
Custom kits and procedure trays	5	%	116,368		7	%	111,076		10	%	103,700
Inflation devices	1	%	73,373		10	%	72,538		(4	)%	66,182
Catheters	11	%	96,833		17	%	87,550		16	%	75,131
Embolization devices	3	%	45,025		31	%	43,855		(1	)%	33,395
CRM/EP	3	%	33,902		17	%	32,975		1,359	%	28,271
Total	6	%	520,915		14	%	491,706		14	%	432,124

Endoscopy
Endoscopy devices	18	%	21,234		6	%	17,983		7	%	16,925

Total	6	%	$	542,149	14	%	$	509,689	14	%	$	449,049

Schedule of Revenue from External Customers and Long-Lived Assets, by Geographical Areas

Our long-lived assets by geographic area at December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



	2015		2014		2013
United States	$	186,389	$	177,627	$	178,130
Ireland	48,896		49,708		50,274
Other foreign countries	32,493		16,836		14,866
Total	$	267,778	$	244,171	$	243,270

Schedule of Segment Reporting Information, by Segment

Financial information relating to our reportable operating segments and reconciliations to the consolidated totals for the years ended December 31, 2015, 2014 and 2013, are as follows (in thousands):



	2015			2014			2013
Revenues
Cardiovascular	$	520,915		$	491,706		$	432,124
Endoscopy	21,234			17,983			16,925
Total revenues	542,149			509,689			449,049

Operating expenses
Cardiovascular	187,492			175,152			157,479
Endoscopy	10,746			9,904			9,044
Total operating expenses	198,238			185,056			166,523

Operating income (loss)
Cardiovascular	34,052			38,601			26,597
Endoscopy	3,491			1,565			1,247
Total operating income	37,543			40,166			27,844

Total other expense - net	(6,343		)	(8,594		)	(8,005		)
Income tax expense	7,398			8,598			3,269

Net income	$	23,802		$	22,974		$	16,570

Total depreciation and amortization by business segment for the years ended December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



	2015		2014		2013

Cardiovascular	$	36,474	$	34,975	$	31,594
Endoscopy	951		954		948
Total	$	37,425	$	35,929	$	32,542

Total capital expenditures for property and equipment by business segment for the years ended December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



	2015		2014		2013

Cardiovascular	$	50,927	$	33,660	$	59,421
Endoscopy	32		521		84
Total	$	50,959	$	34,181	$	59,505

Reconciliation of Assets from Segment to Consolidated

Total assets by business segment at December 31, 2015, 2014 and 2013, consisted of the following (in thousands):



	2015		2014		2013
Cardiovascular	$	767,952	$	734,940	$	716,659
Endoscopy	10,776		12,225		11,624
Total	$	778,728	$	747,165	$	728,283

Quarterly Results of Operations (Unaudited) (Tables)

12 Months Ended

Dec. 31, 2015

Quarterly Financial Information Disclosure [Abstract]

Schedule of Quarterly Financial Information

Quarterly data for the years ended December 31, 2015 and 2014 consisted of the following (in thousands, except per share amounts):



	Quarter Ended
	March 31		June 30		September 30		December 31
2015
Net sales	$	129,577	$	138,082	$	136,086	$	138,404
Gross profit	55,383		60,886		59,205		60,307
Income from operations	8,704		12,242		8,547		8,050
Income tax expense	2,289		3,122		1,842		145
Net income	5,174		7,401		4,818		6,409
Basic earnings per common share	0.12		0.17		0.11		0.14
Diluted earnings per common share	0.12		0.17		0.11		0.14

2014
Net sales	$	119,236	$	128,865	$	128,808	$	132,780
Gross profit	52,043		55,624		57,421		60,134
Income from operations	6,489		7,384		12,076		14,217
Income tax expense	1,063		1,366		2,489		3,680
Net income	2,823		3,716		7,764		8,671
Basic earnings per common share	0.07		0.09		0.18		0.20
Diluted earnings per common share	0.07		0.09		0.18		0.20

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2015

Fair Value Disclosures [Abstract]

Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis

Our financial assets and (liabilities) carried at fair value measured on a recurring basis as of December 31, 2015 and 2014, consisted of the following (in thousands):



				Fair Value Measurements Using
	Total Fair			Quoted prices in		Significant other			Significant
	Value at			active markets		observable inputs			Unobservable inputs
Description	December 31, 2015			(Level 1)		(Level 2)			(Level 3)

Interest rate contracts (1)	$	2		$	—	$	2		$	—
Foreign currency contracts (2)	$	(278	)	$	—	$	(278	)	$	—

				Fair Value Measurements Using
	Total Fair			Quoted prices in		Significant other			Significant
	Value at			active markets		observable inputs			Unobservable inputs
Description	December 31, 2014			(Level 1)		(Level 2)			(Level 3)

Interest rate contracts (1)	$	573		$	—	$	573		$	—

(1) The fair value of the interest rate contracts is determined using Level 2 fair value inputs and is recorded as other assets in the Consolidated Balance Sheets.

(2) The fair value of the foreign currency contracts is determined using Level 2 fair value inputs and is recorded as accrued expenses in the Consolidated Balance Sheets.

Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation

Changes in the fair value of our contingent consideration liability during the years ended December 31, 2015 and 2014, consisted of the following (in thousands):



	2015			2014
Beginning balance	$	1,886		$	2,526
Contingent consideration liability recorded as the result of acquisitions (see Note 2)	270			—
Fair value adjustments recorded to income during the period	80			(572		)
Contingent payments made	(1,212		)	(68		)
Ending balance	$	1,024		$	1,886

Fair Value Inputs, Liabilities, Quantitative Information

The recurring Level 3 measurement of our contingent consideration liability includes the following significant unobservable inputs at December 31, 2015 and 2014 (amount in thousands):



Contingent consideration liability	Fair value at December 31, 2015		Valuation technique	Unobservable inputs	Range
Revenue-based payments	$	874	Discounted cash flow	Discount rate	5% - 15%
			Discounted cash flow	Probability of milestone payment	100%
				Projected year of payments	2016-2028

Other payments	$	150	Discounted cash flow	Discount rate	—%
			Discounted cash flow	Probability of milestone payment	100%
				Projected year of payments	2016

Contingent consideration liability	Fair value at December 31, 2014		Valuation technique	Unobservable inputs	Range
Revenue-based payments	$	1,610	Discounted cash flow	Discount rate	1% - 14%
			Discounted cash flow	Probability of milestone payment	90%
				Projected year of payments	2015-2028

Other payments	$	276	Discounted cash flow	Discount rate	5%
			Discounted cash flow	Probability of milestone payment	100%
				Projected year of payments	2015-2016

Organization and Summary of Significant Accounting Policies - Intangible Assets (Details)		12 Months Ended
	Dec. 20, 2013	Dec. 31, 2015
License agreements
Finite-Lived Intangible Assets [Line Items]
Useful life	4 years
Patents
Finite-Lived Intangible Assets [Line Items]
Useful life		17 years
Royalty agreements
Finite-Lived Intangible Assets [Line Items]
Useful life		5 years
Minimum \| Customer lists
Finite-Lived Intangible Assets [Line Items]
Useful life		5 years
Minimum \| Developed technology
Finite-Lived Intangible Assets [Line Items]
Useful life		8 years
Minimum \| Distribution agreements
Finite-Lived Intangible Assets [Line Items]
Useful life		3 years
Minimum \| License agreements
Finite-Lived Intangible Assets [Line Items]
Useful life		4 years
Minimum \| Covenant not to compete
Finite-Lived Intangible Assets [Line Items]
Useful life		3 years
Maximum \| Customer lists
Finite-Lived Intangible Assets [Line Items]
Useful life		15 years
Maximum \| Developed technology
Finite-Lived Intangible Assets [Line Items]
Useful life		15 years
Maximum \| Distribution agreements
Finite-Lived Intangible Assets [Line Items]
Useful life		12 years
Maximum \| License agreements
Finite-Lived Intangible Assets [Line Items]
Useful life		15 years
Maximum \| Covenant not to compete
Finite-Lived Intangible Assets [Line Items]
Useful life		10 years

Organization and Summary of Significant Accounting Policies - Property and Equipment (Details) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Impairment of PPE	$ 0	$ 0	$ 0
Property, Plant and Equipment [Line Items]
Depreciation	$ 22,600,000	$ 21,000,000	$ 18,400,000
Building
Property, Plant and Equipment [Line Items]
Useful life	40 years
Minimum \| Manufacturing equipment
Property, Plant and Equipment [Line Items]
Useful life	4 years
Minimum \| Furniture and fixtures
Property, Plant and Equipment [Line Items]
Useful life	3 years
Minimum \| Land improvements
Property, Plant and Equipment [Line Items]
Useful life	10 years
Minimum \| Leasehold improvements
Property, Plant and Equipment [Line Items]
Useful life	4 years
Maximum \| Manufacturing equipment
Property, Plant and Equipment [Line Items]
Useful life	20 years
Maximum \| Furniture and fixtures
Property, Plant and Equipment [Line Items]
Useful life	20 years
Maximum \| Land improvements
Property, Plant and Equipment [Line Items]
Useful life	20 years
Maximum \| Leasehold improvements
Property, Plant and Equipment [Line Items]
Useful life	25 years

Organization and Summary of Significant Accounting Policies - Deferred Compensation (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Cash surrender value of life insurance	$ 8,800	$ 9,000
Deferred compensation cost	$ 8,500	$ 8,635

Organization and Summary of Significant Accounting Policies - Stock Based Compensation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Allocated share-based compensation	$ 2,243	$ 1,460	$ 1,467

Organization and Summary of Significant Accounting Policies - Concentration of Credit Risk (Details)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Accounting Policies [Abstract]
Concentration for largest customer	3.00%	3.00%	3.00%

Organization and Summary of Significant Accounting Policies - Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Accumulated other comprehensive income (loss), interest rate swaps, net of tax	$ 1	$ 350
Accumulated other comprehensive income (loss), interest rate swap, tax benefit	(1)	(223)
Accumulated other comprehensive income (loss) related to foreign currency translation, net of tax	(5,500)	(2,800)
Accumulated other comprehensive income (loss), foreign currency translation, tax benefit	$ 513	$ 202

Acquisitions - Purchase Price Allocation (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013	Oct. 04, 2013
Business Acquisition [Line Items]
Goodwill	$ 184,472	$ 184,464	$ 184,505
Datascope
Business Acquisition [Line Items]
Inventories				$ 478
Goodwill				8,112
Total assets acquired				27,500
Radial Assist
Business Acquisition [Line Items]
Inventories				16
Goodwill				904
Total assets acquired				2,500
Developed technology \| Datascope
Business Acquisition [Line Items]
Intangibles				18,200
Developed technology \| Radial Assist
Business Acquisition [Line Items]
Intangibles				1,520
Customer lists \| Datascope
Business Acquisition [Line Items]
Intangibles				390
Customer lists \| Radial Assist
Business Acquisition [Line Items]
Intangibles				20
Trademarks \| Datascope
Business Acquisition [Line Items]
Intangibles				320
Trademarks \| Radial Assist
Business Acquisition [Line Items]
Intangibles				$ 40

Acquisitions - Pro Forma Consolidated Results (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Business Combinations [Abstract]
Revenues	$ 138,404	$ 136,086	$ 138,082	$ 129,577	$ 132,780	$ 128,808	$ 128,865	$ 119,236	$ 542,149	$ 509,689	$ 449,049
Sales, Pro Forma											454,333
Net income	$ 6,409	$ 4,818	$ 7,401	$ 5,174	$ 8,671	$ 7,764	$ 3,716	$ 2,823	$ 23,802	$ 22,974	16,570
Net income, Pro Forma											$ 17,112
EARNINGS PER COMMON SHARE:
Basic (in dollars per share)	$ 0.14	$ 0.11	$ 0.17	$ 0.12	$ 0.20	$ 0.18	$ 0.09	$ 0.07	$ 0.54	$ 0.53	$ 0.39
Earnings per common share: basic, Pro Forma (in dollars per share)											0.40
Diluted (in dollars per share)	$ 0.14	$ 0.11	$ 0.17	$ 0.12	$ 0.20	$ 0.18	$ 0.09	$ 0.07	$ 0.53	$ 0.53	0.39
Earnings per common share: diluted, Pro Forma (in dollars per share)											$ 0.40

Acquisitions - Narrative (Details) € in Thousands																1 Months Ended		12 Months Ended
Acquisitions - Narrative (Details) € in Thousands	Dec. 04, 2015 USD ($)	Sep. 29, 2015 USD ($)	Jul. 17, 2015	Jul. 14, 2015 USD ($)	Jul. 01, 2015 USD ($)	Mar. 26, 2015 USD ($)	Nov. 25, 2014 EUR (€)	Aug. 08, 2014 USD ($)	Jul. 15, 2014 USD ($)	May. 08, 2014 USD ($) shares	Dec. 20, 2013 USD ($)	Dec. 20, 2013 USD ($)	Oct. 04, 2013 USD ($)	Sep. 10, 2013 USD ($)	Aug. 21, 2012 USD ($)	Jan. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)	Dec. 31, 2013 USD ($)	Aug. 19, 2015 USD ($) shares
Business Acquisition [Line Items]
Payments to acquire intangible assets																		$ 1,956,000	$ 1,714,000	$ 1,617,000
Goodwill acquired																		60,000	0
Acquired in-process research and development																		1,000,000	0	0
Cash paid in acquisitions, net of cash acquired																		12,368,000	5,927,000	31,600,000
Accrued expenses																	$ 33,826,000	37,846,000	33,826,000
Payments for debt issuance costs																		0	0	798,000
Wells Fargo Credit Agreement
Business Acquisition [Line Items]
Payments for debt issuance costs													$ 798,000
Xablecath Inc.
Business Acquisition [Line Items]
Number of units acquired \| shares																					116,279
Cost method investment																					$ 300,000
Percent owned																					14.00%
Quellent, LLC
Business Acquisition [Line Items]
Payments to acquire intangible assets																		500,000
Consideration paid				$ 1,000,000
Accrued purchase obligation																		500,000
Noncurrent contingent consideration																		270,000
Goodwill acquired																		60,000
GMedix
Business Acquisition [Line Items]
Number of units acquired \| shares										737,628
Percent owned										19.00%
Payments to acquire investment										$ 1,800,000
Cash paid in acquisitions, net of cash acquired																			1,450,000	350,000
Datascope
Business Acquisition [Line Items]
Cash paid to acquire business													$ 27,500,000
Income since acquisition date																				1,600,000
Weighted average useful life													10 years
Radial Assist
Business Acquisition [Line Items]
Cash paid to acquire business													$ 2,500,000
Income since acquisition date																				$ 191,000
Weighted average useful life													10 years 27 days
License agreements
Business Acquisition [Line Items]
Payments to acquire intangible assets											$ 700,000
Useful life												4 years
Intangible Assets																	7,172,000	16,671,000	7,172,000
Accrued expenses											350,000	$ 350,000
Finite-lived intangible assets											$ 700,000	$ 700,000					8,995,000	19,109,000	8,995,000
Developed technology
Business Acquisition [Line Items]
Intangible Assets																	79,172,000	69,861,000	79,172,000
Developed technology \| Quellent, LLC
Business Acquisition [Line Items]
Useful life				13 years
Intangible Assets																		1,210,000
Developed technology \| Datascope
Business Acquisition [Line Items]
Useful life													10 years
Developed technology \| Radial Assist
Business Acquisition [Line Items]
Useful life													10 years
Customer Lists
Business Acquisition [Line Items]
Intangible Assets																	7,258,000	5,770,000	7,258,000
Finite-lived intangible assets																	20,452,000	20,793,000	20,452,000
Customer Lists \| Datascope
Business Acquisition [Line Items]
Useful life													6 years
Customer Lists \| Radial Assist
Business Acquisition [Line Items]
Useful life													6 years
Distribution agreements
Business Acquisition [Line Items]
Intangible Assets																	3,091,000	2,773,000	3,091,000
Finite-lived intangible assets																	5,376,000	5,626,000	5,376,000
Trademarks
Business Acquisition [Line Items]
Intangible Assets																	5,219,000	4,705,000	5,219,000
Finite-lived intangible assets																	7,298,000	7,259,000	7,298,000
Trademarks \| Datascope
Business Acquisition [Line Items]
Useful life													15 years
Trademarks \| Radial Assist
Business Acquisition [Line Items]
Useful life													15 years
Medical Company 1 \| License agreements
Business Acquisition [Line Items]
Payments to acquire intangible assets	$ 500,000
Useful life	12 years
Medical Company 1 \| Additional Payments for License Agreement Milestone \| License agreements
Business Acquisition [Line Items]
Potential payments on license agreement	$ 1,500,000
Blockade Medical LLC
Business Acquisition [Line Items]
License agreements																		2,700,000
Blockade Medical LLC \| License agreements
Business Acquisition [Line Items]
Useful life		10 years
LeMaitre Vascular, Inc. \| Developed technology
Business Acquisition [Line Items]
Payments to acquire intangible assets																		400,000
Useful life			10 years
Catch Medical, LLC
Business Acquisition [Line Items]
Payments to acquire intangible assets																		200,000
Accrued purchase obligation																		200,000
Acquired in-process research and development					$ 1,000,000
Long term purchase obligations																		600,000
Distal Access, LLC \| License agreements
Business Acquisition [Line Items]
Payments to acquire intangible assets																		3,500,000
Useful life					6 years
Intangible Assets					$ 3,500,000
Teleflex Incorporated
Business Acquisition [Line Items]
Future payments under agreement						$ 400,000
Teleflex Incorporated \| Customer Lists
Business Acquisition [Line Items]
Payments to acquire intangible assets																		400,000
Useful life						5 years
Catheter Connections, Inc. \| Distribution agreements
Business Acquisition [Line Items]
Payments to acquire intangible assets																$ 250,000
Useful life															10 years
Intangible Assets															$ 250,000
Medical Company 2
Business Acquisition [Line Items]
Payments to acquire intangible assets																	$ 624,800	1,100,000
Contingent liability \| €							€ 500
Medical Company 2 \| License agreements
Business Acquisition [Line Items]
Useful life							10 years
Medical Company 3
Business Acquisition [Line Items]
Payments to acquire intangible assets																		3,500,000	$ 3,000,000
Liabilities incurred																		1,000,000
Medical Company 3 \| License agreements
Business Acquisition [Line Items]
Useful life								12 years
Intangible assets								$ 6,300,000
Medical Company 3 \| Distribution agreements
Business Acquisition [Line Items]
Useful life								3 years
Intangible assets								$ 200,000
Limited Liability Company
Business Acquisition [Line Items]
Payments to acquire investment									$ 752,000
Limited Liability Company \| License agreements
Business Acquisition [Line Items]
Useful life									10 years
Medical Company 4 \| License agreements
Business Acquisition [Line Items]
Payments to acquire intangible assets														$ 250,000				250,000
Useful life														10 years
Finite-lived intangible assets																		$ 500,000
Number of days accrued liability due after first commercial sale														30 days
Cost-method Investments \| Blockade Medical LLC
Business Acquisition [Line Items]
Other consideration paid		$ 1,000,000
Loans Receivable \| Blockade Medical LLC
Business Acquisition [Line Items]
Other consideration paid		$ 1,700,000

Inventories (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Inventory Disclosure [Abstract]
Finished goods	$ 59,170	$ 50,000
Work-in-process	8,540	7,680
Raw materials	38,289	34,093
Total	$ 105,999	$ 91,773

Goodwill and Intangible Assets - Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Goodwill [Roll Forward]
Goodwill balance at January 1	$ 184,464	$ 184,505
Effect of foreign exchange	(52)	(41)
Additions as the result of acquisitions	60	0
Goodwill balance at December 31	$ 184,472	$ 184,464

Goodwill and Intangible Assets - Other Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014	Dec. 20, 2013
Other
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 66,096	$ 53,616
Accumulated Amortization	(26,603)	(22,480)
Net Carrying Amount	39,493	31,136
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	12,014	10,199
Accumulated Amortization	(2,595)	(2,196)
Net Carrying Amount	9,419	8,003
Distribution agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	5,626	5,376
Accumulated Amortization	(2,853)	(2,285)
Net Carrying Amount	2,773	3,091
License agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	19,109	8,995	$ 700
Accumulated Amortization	(2,438)	(1,823)
Net Carrying Amount	16,671	7,172
Trademarks
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	7,259	7,298
Accumulated Amortization	(2,554)	(2,079)
Net Carrying Amount	4,705	5,219
Covenants not to compete
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,028	1,029
Accumulated Amortization	(873)	(636)
Net Carrying Amount	155	393
Customer lists
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	20,793	20,452
Accumulated Amortization	(15,023)	(13,194)
Net Carrying Amount	5,770	7,258
Royalty agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	267	267
Accumulated Amortization	(267)	(267)
Net Carrying Amount	$ 0	$ 0

Goodwill and Intangible Assets - Future Amortization Expense (Details) $ in Thousands	Dec. 31, 2015 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2016	$ 15,659
2017	15,515
2018	14,982
2019	14,640
2020	$ 13,807

Goodwill and Intangible Assets - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Finite-Lived Intangible Assets [Line Items]
Accumulated impairment loss			$ 8,300
Aggregate amortization expense			14,800	$ 14,900	$ 14,200
Intangible asset impairment charges			$ 0	$ 1,102	$ 8,089
Ostial Solutions, LLC
Finite-Lived Intangible Assets [Line Items]
Intangible asset impairment charges	$ 1,100	$ 8,100
Contingent consideration benefit	$ 874	$ 3,800

Income Taxes - Domestic and Foreign (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Income Tax Disclosure [Abstract]
Domestic									$ 9,470	$ 16,961	$ 5,435
Foreign									21,730	14,611	14,404
INCOME BEFORE INCOME TAXES	$ 8,050	$ 8,547	$ 12,242	$ 8,704	$ 14,217	$ 12,076	$ 7,384	$ 6,489	$ 31,200	$ 31,572	$ 19,839

Income Taxes - Components of Income Tax Expense (Benefit) (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Current expense (benefit):
Federal									$ (17)	$ 1,316	$ (747)
State									747	768	333
Foreign									3,218	2,644	2,324
Total current expense									3,948	4,728	1,910
Deferred expense (benefit):
Federal									3,250	4,078	1,089
State									294	(119)	278
Foreign									(94)	(89)	(8)
Total deferred expense									3,450	3,870	1,359
Total income tax expense	$ 145	$ 1,842	$ 3,122	$ 2,289	$ 3,680	$ 2,489	$ 1,366	$ 1,063	$ 7,398	$ 8,598	$ 3,269

Income Taxes - Effective Income Tax Rate Reconciliation (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Income Tax Disclosure [Abstract]
Computed federal income tax expense at statutory rate of 35%									$ 10,920	$ 11,050	$ 6,943
State income taxes									698	438	397
Tax credits									(1,019)	(888)	(1,385)
Foreign tax rate differential									(3,564)	(1,958)	(2,374)
Uncertain tax positions									536	(76)	(520)
Deferred compensation insurance assets									182	(81)	(358)
Other — including the effect of graduated rates									(355)	113	566
Total income tax expense	$ 145	$ 1,842	$ 3,122	$ 2,289	$ 3,680	$ 2,489	$ 1,366	$ 1,063	$ 7,398	$ 8,598	$ 3,269

Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Deferred income tax assets:
Allowance for uncollectible accounts receivable	$ 531	$ 366
Accrued compensation expense	5,534	5,492
Inventory differences	2,043	2,401
Net operating loss carryforwards	11,434	13,542
Deferred revenue	118	87
Stock-based compensation expense	2,532	2,479
Uncertain tax positions	0	284
Federal research and development credit carryforward	2,355	1,413
Foreign Tax Credits	600	1,374
Other	5,754	4,173
Total deferred income tax assets	30,901	31,611
Deferred income tax liabilities:
Prepaid expenses	(841)	(708)
Property and equipment	(24,467)	(23,298)
Intangible assets	(6,495)	(4,853)
Other	(1,077)	(1,150)
Total deferred income tax liabilities	(32,880)	(30,009)
Valuation allowance	(1,981)	(1,603)
Total deferred income tax liabilities	(3,960)	(1)
Reported as:
Deferred income tax assets - Current	7,025	6,375
Deferred income tax assets - Long-term	0	9
Deferred income tax liabilities - Current	0	0
Deferred income tax liabilities - Long-term	(10,985)	(6,385)
Total deferred income tax liabilities	$ (3,960)	$ (1)

Income Taxes - Summary of Income Tax Contingencies (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Unrecognized tax benefits, opening balance	$ 1,736	$ 2,129	$ 2,776
Gross increases in tax positions taken in a prior year	187	142	107
Gross increases in tax positions taken in the current year	763	309	236
Lapse of applicable statute of limitations	(704)	(844)	(990)
Unrecognized tax benefits, ending balance	$ 1,982	$ 1,736	$ 2,129

Income Taxes - Narrative (Details) - USD ($)	12 Months Ended
Income Taxes - Narrative (Details) - USD ($)	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Federal statutory rate	35.00%	35.00%	35.00%
Increase in valuation allowance	$ 378,000	$ 240,000	$ 138,000
U.S federal net operating loss carryforwards	$ 32,700,000	38,700,000
Period to utilize the net operating loss carryforwards	11 years
NOL carryforward used in period	$ 6,000,000	13,500,000
Foreign operating loss carryforwards	0	53,000
Unrecognized tax benefts including interest and penalties	2,200,000	1,900,000
Unrecognized tax benefits that would impact effective rate	2,200,000	1,600,000
Reduction in valuation allowance	1,400,000	563,000
Accrued interest and penalties	187,000	181,000
Income tax penalties and interest expense	6,000	$ 42,000	$ 22,000
Maximum
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Estimated change in unrecognized tax benefit in next twelve months, lower bound	$ 400,000

Accrued Expenses (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Payables and Accruals [Abstract]
Payroll taxes	$ 2,369	$ 1,931
Payroll	4,971	4,086
Bonuses	5,283	7,301
Commissions	790	980
Vacation	7,748	6,753
Royalties	1,499	1,497
Value-added tax	1,797	1,555
Other accrued expenses	13,389	9,723
Total	$ 37,846	$ 33,826

Revolving Credit Facility and Long-Term Debt - Narrative (Details)		12 Months Ended
	Dec. 19, 2012 USD ($) quarter	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)	Oct. 04, 2013 USD ($)	Sep. 30, 2010 USD ($)
Credit Agreement
Line of Credit Facility [Line Items]
Maximum consolidated total leverage ratio, quarter ending December 31, 2013 requirement	4.75
Maximum consolidated total leverage ratio, quarter ending March 31, 2014 requirement	4.00
Maximum consolidated total leverage ratio, quarter ending June 30, 2014 requirement	3.75
Maximum consolidated total leverage ratio, quarter ending September 30, 2014 requirement	3.50
Maximum consolidated total leverage ratio, quarter ending December 31, 2014 requirement	3.25
Maximum consolidated total leverage ratio, year ending 2015 requirement	3
Maximum consolidated total leverage ratio, year ending 2016 requirement	2.75
Maximum consolidated total leverage ratio, year subsequent to 2016 requirement	2.5
Number of consecutive quarters for EBITDA to fixed charges ratio covenants \| quarter	4
Minimum consolidated EBITDA to fixed charges ratio	1.75
Maximum consolidated net income	$ 0
Maximum facility capital expenditures in the next 12 months	$ 30,000,000
Amount outstanding on line of credit		$ 207,600,000
Remaining borrowing capacity on line of credit		$ 32,400,000
Fixed interest rate percent		2.4825%	2.98%
Debt subject to fixed interest rate		$ 135,000,000	$ 140,000,000
Base Rate \| Credit Agreement
Line of Credit Facility [Line Items]
Spread on variable rate loans	1.00%	0.25%
Minimum consolidated total leverage ratio		2.25
London Interbank Offered Rate (LIBOR) Market Index Rate \| Credit Agreement
Line of Credit Facility [Line Items]
Spread on variable rate loans	2.00%	1.25%
Minimum consolidated total leverage ratio		2.25
London Interbank Offered Rate (LIBOR) \| Credit Agreement
Line of Credit Facility [Line Items]
Spread on variable rate loans	2.00%	1.25%
Calculation of base rate		1.00%
Minimum consolidated total leverage ratio		2.25
Federal Funds Rate \| Credit Agreement
Line of Credit Facility [Line Items]
Calculation of base rate		0.50%
Variable Rate 1 \| Credit Agreement
Line of Credit Facility [Line Items]
Variable interest rate percent		1.74%	2.17%
Debt subject to variable interest rate		$ 65,800,000	$ 84,300,000
Variable Rate 2 \| Credit Agreement
Line of Credit Facility [Line Items]
Variable interest rate percent		2.12%	2.26%
Debt subject to variable interest rate		$ 6,800,000	$ 200,000
Revolving Credit Facility \| Credit Agreement
Line of Credit Facility [Line Items]
Maximum borrowing capacity				$ 215,000,000
Revolving Credit Facility \| Wells Fargo
Line of Credit Facility [Line Items]
Maximum borrowing capacity					$ 175,000,000
Term Loan \| Credit Agreement
Line of Credit Facility [Line Items]
Maximum borrowing capacity	$ 100,000,000
Bridge Loan \| Base Rate \| Credit Agreement
Line of Credit Facility [Line Items]
Minimum consolidated total leverage ratio		2.25
Bridge Loan \| London Interbank Offered Rate (LIBOR) Market Index Rate \| Credit Agreement
Line of Credit Facility [Line Items]
Spread on variable rate loans	2.00%	1.25%

Revolving Credit Facility and Long-Term Debt - Principal Balances under Long-term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Line of Credit Facility [Line Items]
Total long-term debt	$ 207,593	$ 224,490
Less current portion	10,000	10,000
Long-term portion	197,593	214,490
Term Loan
Line of Credit Facility [Line Items]
Total long-term debt	64,962	82,500
Revolving Credit Facility
Line of Credit Facility [Line Items]
Total long-term debt	$ 142,631	$ 141,990

Revolving Credit Facility and Long-Term Debt - Future Minimum Payments on Long-term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Debt Disclosure [Abstract]
2016	$ 10,000
2017	197,593
Total long-term debt	$ 207,593	$ 224,490

Derivatives - Narrative (Details) € in Thousands, £ in Thousands, AUD in Thousands, ¥ in Millions, MXN in Millions, BRL in Millions		12 Months Ended
	Dec. 19, 2012 USD ($)	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)	Dec. 31, 2013 USD ($)	Nov. 25, 2015 EUR (€)	Nov. 25, 2015 CNY (¥)	Nov. 25, 2015 MXN	Nov. 25, 2015 GBP (£)	Nov. 25, 2015 BRL	Nov. 25, 2015 AUD	Oct. 23, 2015 CNY (¥)	Nov. 28, 2014 EUR (€)	Nov. 28, 2014 GBP (£)
Derivative [Line Items]
Foreign Currency Derivative Instruments Not Designated as Hedging Instruments, Liability at Fair Value		$ 278,000
Interest rate asset		2,000	$ 573,000
Accumulated other comprehensive income (loss), interest rate swap, tax benefit		(1,000)	(223,000)
Gain (loss) on derivatives not designated as hedging instruments		$ (400,000)	$ 36,000	$ (202,000)
Interest rate swap
Derivative [Line Items]
Notional amount of derivative	$ 150,000,000
Fixed rate	0.9825%
Quarterly reduction of notional amount	50.00%
Foreign currency forward contracts
Derivative [Line Items]
Notional amount of derivative					€ 1,700	¥ 38.4	MXN 32.0	£ 610	BRL 1.5	AUD 830	¥ 46.3	€ 899	£ 572

Commitments and Contingencies - Schedule of Future Minimum Rental Payments for Operating Leases (Details) $ in Thousands	Dec. 31, 2015 USD ($)
Commitments and Contingencies Disclosure [Abstract]
2016	$ 9,168
2017	7,961
2018	7,205
2019	7,110
2020	5,027
Thereafter	37,320
Total minimum lease payments	$ 73,791

Commitments and Contingencies - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Other Commitments [Line Items]
Rent expense	$ 10,700	$ 8,100	$ 5,500
Proceeds from sale-leaseback transactions	2,017	$ 5,521	$ 24,000
Term of lease		7 years	19 years 10 months
Training and hiring grants from Ireland	0	$ 0	$ 1,200
Deferred credits	2,700	2,900
Property, plant, and equipment grants from Ireland	171	$ 175	$ 139
Irish grants refundable if operations discontinued	$ 3,900
Remaining grant liability period	3 years
Minimum
Other Commitments [Line Items]
Grant period	5 years
Maximum
Other Commitments [Line Items]
Grant period	8 years

Earnings Per Common Share (EPS) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Earnings Per Share, Basic and Diluted [Abstract]
Net income, basic									$ 23,802	$ 22,974	$ 16,570
Basic (in shares)									44,036	43,143	42,607
Basic (in dollars per share)	$ 0.14	$ 0.11	$ 0.17	$ 0.12	$ 0.20	$ 0.18	$ 0.09	$ 0.07	$ 0.54	$ 0.53	$ 0.39
Effect of dilutive stock options and warrants (in shares)									475	266	277
Net income, diluted									$ 23,802	$ 22,974	$ 16,570
Diluted (in shares)									44,511	43,409	42,884
Diluted (in dollars per share)	$ 0.14	$ 0.11	$ 0.17	$ 0.12	$ 0.20	$ 0.18	$ 0.09	$ 0.07	$ 0.53	$ 0.53	$ 0.39
Antidilutive securities excluded from EPS (in shares)									423	1,292	1,823

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

+ References + Details

Employee Stock Purchase Plan Stock Options and Warrants - Narrative (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Compensation cost not yet recognized	$ 5.9
Compensation cost not yet recognized, period of recognition	3 years 4 months 10 days
Options granted in period (in shares)	618	666	348
Fair value of options, net of forfeitures	$ 3.7	$ 2.8	$ 1.4
Options granted in period, weighted average grant date fair value (in dollars per share)	$ 5.98	$ 4.27	$ 5.31
2006 Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for grant (in shares)	2,500
Employee Stock Purchase Plan Qualified
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for grant (in shares)	233
Purchase price for ESPP, percent of market price	95.00%
Stock Options \| 2006 Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Option contractual life	7 years
Stock Options \| Minimum \| 2006 Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	3 years
Stock Options \| Maximum \| 2006 Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	5 years
Performance Shares \| 2006 Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	1 year

Employee Stock Purchase Plan Stock Options and Warrants - Allocation of Recognized Period Costs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	$ 2,243	$ 1,460	$ 1,467
Cost of goods sold
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	398	198	145
Research and development
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	122	69	87
Selling, general, and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	$ 1,723	$ 1,193	$ 1,235

Employee Stock Purchase Plan Stock Options and Warrants - Fair Value Calculation Assumptions (Details)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate, minimum	1.53%	1.53%	0.65%
Risk-free interest rate, maximum	1.66%	1.97%	1.16%
Expected option life	5 years
Expected dividend yield	0.00%	0.00%	0.00%
Expected price volatility, minimum	33.72%	34.52%	34.08%
Expected price volatility, maximum	35.11%	36.90%	41.67%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected option life		5 years	4 years 2 months 12 days
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected option life		5 years 6 months	6 years

Employee Stock Purchase Plan Stock Options and Warrants - Stock Option Activity (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2015
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Total intrinsic value of stock options exercised	$ 7,548	$ 3,505	$ 1,649
Cash received from stock option exercises	6,227	7,697	3,281
Excess tax benefit from the exercise of stock options	$ 2,124	$ 576	$ 259
Number of Shares
Beginning balance (in shares)	2,791
Granted (in shares)	618
Exercised (in shares)	(858)
Forfeited/expired (in shares)	(143)
Outstanding at December 31 (in shares)	2,408	2,791
Exercisable (in shares)				2,329
Ending vested and expected to vest (in shares)				992
Weighted Average Exercise Price
Beginning balance (in dollars per share)	$ 14.25	$ 12.59		$ 14.25
Granted (in dollars per share)	18.16
Exercised (in dollars per share)	11.63
Forfeited/expired (in dollars per share)	14.38
Outstanding at December 31 (in dollars per share)	$ 14.25	$ 12.59
Exercisable (in dollars per share)				14.23
Ending vested and expected to vest (in dollars per share)				$ 13.34
Outstanding, remaining contractual term	4 years 3 months 35 days
Exercisable, remaining contractual term	4 years 3 months 20 days
Ending vested and expected to vest, remaining contractual term	2 years 10 months 10 days
Outstanding, intrinsic value				$ 10,752
Exercisable, intrinsic value				10,461
Ending vested and expected to vest, intrinsic value				$ 5,206

Employee Stock Purchase Plan Stock Options and Warrants - Options Outstanding (Details) shares in Thousands	12 Months Ended
	Dec. 31, 2015 $ / shares shares
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of exercise, lower (in dollars per share)	$ 9.95
Range of exercise, upper (in dollars per share)	$ 21.98
Number outstanding (in shares) \| shares	2,408
Number exercisable (in shares) \| shares	992
$9.95 - $12.91
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of exercise, lower (in dollars per share)	$ 9.95
Range of exercise, upper (in dollars per share)	$ 12.91
Number outstanding (in shares) \| shares	671
Weighted Average Remaining Contractual Life (in years)	5 years 2 months 11 days
Weighted average exercise price (in dollars per share)	$ 11.82
Number exercisable (in shares) \| shares	187
Weighted average exercise price (in dollars per share)	$ 11.85
$13.14 - $13.16
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of exercise, lower (in dollars per share)	13.14
Range of exercise, upper (in dollars per share)	$ 13.16
Number outstanding (in shares) \| shares	216
Weighted Average Remaining Contractual Life (in years)	3 years 3 months 39 days
Weighted average exercise price (in dollars per share)	$ 13.15
Number exercisable (in shares) \| shares	129
Weighted average exercise price (in dollars per share)	$ 13.15
$13.75 - $13.75
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of exercise, lower (in dollars per share)	13.75
Range of exercise, upper (in dollars per share)	$ 13.75
Number outstanding (in shares) \| shares	638
Weighted Average Remaining Contractual Life (in years)	2 years 7 months 10 days
Weighted average exercise price (in dollars per share)	$ 13.75
Number exercisable (in shares) \| shares	511
Weighted average exercise price (in dollars per share)	$ 13.75
$13.77 - 21.98
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of exercise, lower (in dollars per share)	13.77
Range of exercise, upper (in dollars per share)	$ 21.98
Number outstanding (in shares) \| shares	883
Weighted Average Remaining Contractual Life (in years)	5 years 2 months 9 days
Weighted average exercise price (in dollars per share)	$ 16.76
Number exercisable (in shares) \| shares	165
Weighted average exercise price (in dollars per share)	$ 13.92

Segment Reporting and Foreign Operations - Narrative (Details) $ in Millions	12 Months Ended
	Dec. 31, 2015 USD ($) segment	Dec. 31, 2014 USD ($)	Dec. 31, 2013 USD ($)
Segment Reporting [Abstract]
Number of operating segments \| segment	2
Segment Reporting Information [Line Items]
Foreign sales as a percent of total sales	39.00%	39.00%	37.00%
Foreign Sales
Segment Reporting Information [Line Items]
Revenue \| $	$ 214.0	$ 198.3	$ 165.8

Segment Reporting and Foreign Operations - Sales by Business Segment (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Revenue from External Customer [Line Items]
% Change	6.00%				14.00%				6.00%	14.00%	14.00%
Revenues	$ 138,404	$ 136,086	$ 138,082	$ 129,577	$ 132,780	$ 128,808	$ 128,865	$ 119,236	$ 542,149	$ 509,689	$ 449,049
Cardiovascular Segment
Revenue from External Customer [Line Items]
% Change	6.00%				14.00%				6.00%	14.00%	14.00%
Revenues									$ 520,915	$ 491,706	$ 432,124
Cardiovascular Segment \| Stand Alone Devices
Revenue from External Customer [Line Items]
% Change	8.00%				15.00%				8.00%	15.00%	10.00%
Revenues									$ 155,414	$ 143,712	$ 125,445
Cardiovascular Segment \| Custom Kit And Procedures Trays
Revenue from External Customer [Line Items]
% Change	5.00%				7.00%				5.00%	7.00%	10.00%
Revenues									$ 116,368	$ 111,076	$ 103,700
Cardiovascular Segment \| Inflation Devices
Revenue from External Customer [Line Items]
% Change	1.00%				10.00%				1.00%	10.00%	(4.00%)
Revenues									$ 73,373	$ 72,538	$ 66,182
Cardiovascular Segment \| Catheters
Revenue from External Customer [Line Items]
% Change	11.00%				17.00%				11.00%	17.00%	16.00%
Revenues									$ 96,833	$ 87,550	$ 75,131
Cardiovascular Segment \| Embolization Devices
Revenue from External Customer [Line Items]
% Change	3.00%				31.00%				3.00%	31.00%	(1.00%)
Revenues									$ 45,025	$ 43,855	$ 33,395
Cardiovascular Segment \| Electrophysiology
Revenue from External Customer [Line Items]
% Change	3.00%				17.00%				3.00%	17.00%	1359.00%
Revenues									$ 33,902	$ 32,975	$ 28,271
Endoscopy Segment
Revenue from External Customer [Line Items]
Revenues									$ 21,234	$ 17,983	$ 16,925
Endoscopy Segment \| Endoscopy Devices
Revenue from External Customer [Line Items]
% Change	18.00%				6.00%				18.00%	6.00%	7.00%
Revenues									$ 21,234	$ 17,983	$ 16,925

Segment Reporting and Foreign Operations - Long-lived Assets by Geographic Area (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	$ 267,778	$ 244,171	$ 243,270
United States
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	186,389	177,627	178,130
Ireland
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	48,896	49,708	50,274
Other Foreign Countries
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	$ 32,493	$ 16,836	$ 14,866

Segment Reporting and Foreign Operations - Operating Income (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Segment Reporting Information [Line Items]
Revenues	$ 138,404	$ 136,086	$ 138,082	$ 129,577	$ 132,780	$ 128,808	$ 128,865	$ 119,236	$ 542,149	$ 509,689	$ 449,049
Operating expenses									198,238	185,056	166,523
Operating income (loss)									37,543	40,166	27,844
Total other expense - net									(6,343)	(8,594)	(8,005)
Income tax expense	145	1,842	3,122	2,289	3,680	2,489	1,366	1,063	7,398	8,598	3,269
NET INCOME	$ 6,409	$ 4,818	$ 7,401	$ 5,174	$ 8,671	$ 7,764	$ 3,716	$ 2,823	23,802	22,974	16,570
Cardiovascular Segment
Segment Reporting Information [Line Items]
Revenues									520,915	491,706	432,124
Operating expenses									187,492	175,152	157,479
Operating income (loss)									34,052	38,601	26,597
Endoscopy Segment
Segment Reporting Information [Line Items]
Revenues									21,234	17,983	16,925
Operating expenses									10,746	9,904	9,044
Operating income (loss)									$ 3,491	$ 1,565	$ 1,247

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References + Details

Segment Reporting and Foreign Operations - Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Segment Reporting, Asset Reconciling Item [Line Items]
Assets	$ 778,728	$ 747,165	$ 728,283
Depreciation and amortization	37,425	35,929	32,542
Capital expenditures	50,959	34,181	59,505
Cardiovascular Segment
Segment Reporting, Asset Reconciling Item [Line Items]
Assets	767,952	734,940	716,659
Depreciation and amortization	36,474	34,975	31,594
Capital expenditures	50,927	33,660	59,421
Endoscopy Segment
Segment Reporting, Asset Reconciling Item [Line Items]
Assets	10,776	12,225	11,624
Depreciation and amortization	951	954	948
Capital expenditures	$ 32	$ 521	$ 84

Royalty Agreements - Narrative (Details) - BioSphere APHP Royalty - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Royalty Agreements [Line Items]
Current royalty rate	5.00%
Future royalty rate	2.50%
Royalty expense	$ 1.5	$ 1.5	$ 1.3

Employee Benefit Plans (Details) - USD ($) $ in Thousands	12 Months Ended
Employee Benefit Plans (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Defined Contribution Plan Disclosure [Line Items]
Minimum age for participation	18 years
Minimum time at the company for participation	90 days
Total paid into 401(k)	$ 2,000	$ 1,800	$ 400
Non-US
Defined Contribution Plan Disclosure [Line Items]
Total paid into 401(k)	$ 893	$ 912	$ 748
Minimum \| Non-US
Defined Contribution Plan Disclosure [Line Items]
Employer matching, percent of gross pay	2.00%
Maximum \| Non-US
Defined Contribution Plan Disclosure [Line Items]
Employer matching, percent of gross pay	31.50%
Management \| Minimum \| Non-US
Defined Contribution Plan Disclosure [Line Items]
Employer matching, percent of gross pay	2.00%
Management \| Maximum \| Non-US
Defined Contribution Plan Disclosure [Line Items]
Employer matching, percent of gross pay	32.00%

Quarterly Results of Operations (Unaudited) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Quarterly Financial Information Disclosure [Abstract]
Net sales	$ 138,404	$ 136,086	$ 138,082	$ 129,577	$ 132,780	$ 128,808	$ 128,865	$ 119,236	$ 542,149	$ 509,689	$ 449,049
Gross profit	60,307	59,205	60,886	55,383	60,134	57,421	55,624	52,043	235,781	225,222	194,367
Income from operations	8,050	8,547	12,242	8,704	14,217	12,076	7,384	6,489	31,200	31,572	19,839
Income tax expense	145	1,842	3,122	2,289	3,680	2,489	1,366	1,063	7,398	8,598	3,269
Net income	$ 6,409	$ 4,818	$ 7,401	$ 5,174	$ 8,671	$ 7,764	$ 3,716	$ 2,823	$ 23,802	$ 22,974	$ 16,570
Basic (in dollars per share)	$ 0.14	$ 0.11	$ 0.17	$ 0.12	$ 0.20	$ 0.18	$ 0.09	$ 0.07	$ 0.54	$ 0.53	$ 0.39
Diluted (in dollars per share)	$ 0.14	$ 0.11	$ 0.17	$ 0.12	$ 0.20	$ 0.18	$ 0.09	$ 0.07	$ 0.53	$ 0.53	$ 0.39

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

+ References + Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References + Details

Fair Value Measurements - Financial Assets and (Liabilities) Carried at Fair Value (Details) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate swap	$ 2	$ 573
Foreign Currency Derivative Instruments Not Designated as Hedging Instruments, Liability at Fair Value	(278)
Fair Value, Measurements, Recurring \| Fair Value, Inputs, Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate swap	0	0
Foreign Currency Derivative Instruments Not Designated as Hedging Instruments, Liability at Fair Value	0
Fair Value, Measurements, Recurring \| Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate swap	2	573
Foreign Currency Derivative Instruments Not Designated as Hedging Instruments, Liability at Fair Value	(278)
Fair Value, Measurements, Recurring \| Fair Value, Inputs, Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate swap	0	0
Foreign Currency Derivative Instruments Not Designated as Hedging Instruments, Liability at Fair Value	0
Estimate of Fair Value, Fair Value Disclosure \| Fair Value, Measurements, Recurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate swap	$ 2	$ 573

Fair Value Measurements - Liability Measured on Recurring Basis, Unobservable Input Reconciliation (Details) - Contingent Consideration - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ 1,886	$ 2,526
Contingent consideration liability recorded as the result of acquisitions	270	0
Fair value adjustments recorded to income during the period	80	(572)
Contingent payments made	(1,212)	(68)
Ending balance	$ 1,024	$ 1,886

Fair Value Measurements - Fair Value Inputs, Liabilities, Quantitative Information (Details) - Contingent Consideration - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Contingent consideration liability	$ 1,024	$ 1,886	$ 2,526
Revenue-based Payments
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Contingent consideration liability	$ 874	$ 1,610
Revenue-based Payments \| Discounted Cash Flow \| Fair Value, Inputs, Level 3
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Probability of milestone payment	100.00%	90.00%
Revenue-based Payments \| Minimum \| Discounted Cash Flow \| Fair Value, Inputs, Level 3
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Discount rate	5.00%	1.00%
Revenue-based Payments \| Maximum \| Discounted Cash Flow \| Fair Value, Inputs, Level 3
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Discount rate	15.00%	14.00%
Other Payments
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Contingent consideration liability	$ 150	$ 276
Other Payments \| Discounted Cash Flow \| Fair Value, Inputs, Level 3
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Probability of milestone payment	100.00%	100.00%
Discount rate	0.00%	5.00%

Fair Value Measurements - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment of other assets	$ 141	$ 1,400	$ 8,200
Other Long-term Obligations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability	775	803
Accrued Liabilities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability	$ 249	$ 1,100

Subsequent Events (Details) - USD ($)		12 Months Ended
Subsequent Events (Details) - USD ($)	Feb. 04, 2016	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013	Feb. 03, 2016	Oct. 04, 2013	Dec. 19, 2012
Subsequent Event [Line Items]
Cash paid in acquisitions, net of cash acquired		$ 12,368,000	$ 5,927,000	$ 31,600,000
Revolving Credit Facility \| Third Amendment to Amended and Restated Credit Agreement \| Subsequent Event
Subsequent Event [Line Items]
Increase to maximum borrowing capacity					$ 50,000,000
Maximum borrowing capacity					$ 225,000,000
Revolving Credit Facility \| Credit Agreement
Subsequent Event [Line Items]
Maximum borrowing capacity						$ 215,000,000
Term Loan \| Credit Agreement
Subsequent Event [Line Items]
Maximum borrowing capacity							$ 100,000,000
CryoLife Inc. \| Subsequent Event
Subsequent Event [Line Items]
Cash paid in acquisitions, net of cash acquired	$ 18,500,000

Schedule II - Valuation and qualifying accounts (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Allowance for Doubtful Accounts
Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Year	$ (893)	$ (840)	$ (892)
Additions Charged to Costs and Expenses	(607)	(83)	(376)
Deduction	203	30	428
Balance at End of Year	(1,297)	(893)	(840)
Tax Valuation Allowance
Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Year	(1,603)	(1,363)	(1,225)
Additions Charged to Costs and Expenses	(378)	(240)	(138)
Deduction	0	0	0
Balance at End of Year	$ (1,981)	$ (1,603)	$ (1,363)

Organization and Summary of Significant Accounting Policies - Other Assets (Details)	Dec. 31, 2015 investment
Accounting Policies [Abstract]
Number of investments held	2

Organization and Summary of Significant Accounting Policies - Organization (Details)	12 Months Ended
	Dec. 31, 2015 segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of operating segments	2