Document and Entity Information - USD ($)	12 Months Ended
Document and Entity Information - USD ($)	Dec. 31, 2017	Feb. 23, 2018	Jun. 30, 2017
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, 2017
Document Fiscal Year Focus	2017
Document Fiscal Period Focus	FY
Amendment Flag	false
Entity Common Stock, Shares Outstanding		50,266,889
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Public Float			$ 1,843,214,217

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
CURRENT ASSETS:
Cash and cash equivalents	$ 32,336	$ 19,171
Trade receivables — net of allowance for uncollectible accounts — 2017 — $1,769 and 2016 — $1,587	105,536	80,521
Other receivables	9,429	5,643
Inventories	155,288	120,695
Prepaid expenses and other assets	9,096	6,226
Prepaid income taxes	3,225	2,525
Deferred income tax assets	0	8,219
Income tax refund receivables	1,211	423
Total current assets	316,121	243,423
PROPERTY AND EQUIPMENT:
Land and land improvements	19,877	19,379
Buildings	147,356	139,119
Manufacturing equipment	197,651	178,110
Furniture and fixtures	49,528	43,433
Leasehold improvements	31,161	30,413
Construction-in-progress	32,896	28,180
Total property and equipment	478,469	438,634
Less accumulated depreciation	(185,649)	(162,061)
Property and equipment — net	292,820	276,573
OTHER ASSETS:
Goodwill	238,147	211,927
Deferred income tax assets	2,359	171
Other assets	35,040	28,012
Total other assets	502,870	422,807
TOTAL	1,111,811	942,803
CURRENT LIABILITIES:
Trade payables	34,931	30,619
Accrued expenses	58,932	45,519
Current portion of long-term debt	19,459	10,000
Income taxes payable	2,298	2,193
Total current liabilities	115,620	88,331
LONG-TERM DEBT	259,013	314,373
DEFERRED INCOME TAX LIABILITIES	23,289	25,981
LONG-TERM INCOME TAXES PAYABLE	4,846	0
LIABILITIES RELATED TO UNRECOGNIZED TAX BENEFITS	2,746	438
DEFERRED COMPENSATION PAYABLE	11,181	9,211
DEFERRED CREDITS	2,403	2,550
OTHER LONG-TERM OBLIGATIONS	16,379	3,730
Total liabilities	435,477	444,614
COMMITMENTS AND CONTINGENCIES (Notes 2, 7, 8, and 9)
STOCKHOLDERS’ EQUITY:
Preferred stock — 5,000 shares authorized as of December 31, 2017 and 2016; no shares issued	0	0
Common stock, no par value; shares authorized — 2017 and 2016 - 100,000; issued and outstanding as of December 31, 2017 - 50,248 and December 31, 2016 - 44,645	353,392	206,186
Retained earnings	321,408	293,885
Accumulated other comprehensive income (loss)	1,534	(1,882)
Total stockholders’ equity	676,334	498,189
TOTAL	1,111,811	942,803
Developed technology — net of accumulated amortization — 2017 — $72,420 and 2016 — $52,843
OTHER ASSETS:
Intangible assets	167,771	135,358
Other — net of accumulated amortization — 2017 — $38,127 and 2016 — $30,048
OTHER ASSETS:
Intangible assets	$ 59,553	$ 47,339

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
CURRENT ASSETS:
Trade receivables, allowances	$ 1,769	$ 1,587
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)	50,248,000	44,645,000
Common stock shares outstanding (in shares)	50,248,000	44,645,000
Other
OTHER ASSETS:
Intangibles, accumulated amortization	$ 38,127	$ 30,048
Developed technology
OTHER ASSETS:
Intangibles, accumulated amortization	$ 72,420	$ 52,843

CONSOLIDATED STATEMENTS OF INCOME - USD ($) shares in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Statement [Abstract]
NET SALES	$ 727,852,000	$ 603,838,000	$ 542,149,000
COST OF SALES	401,599,000	338,813,000	306,368,000
GROSS PROFIT	326,253,000	265,025,000	235,781,000
OPERATING EXPENSES:
Selling, general and administrative	229,134,000	184,398,000	156,348,000
Research and development	51,403,000	45,229,000	40,810,000
Intangible asset impairment charges	809,000	0	0
Contingent consideration expense (benefit)	(298,000)	61,000	80,000
Acquired in-process research and development	12,136,000	461,000	1,000,000
Total operating expenses	293,184,000	230,149,000	198,238,000
INCOME FROM OPERATIONS	33,069,000	34,876,000	37,543,000
OTHER INCOME (EXPENSE):
Interest income	381,000	81,000	272,000
Interest expense	(7,736,000)	(8,798,000)	(6,229,000)
Gain on bargain purchase	11,039,000	0	0
Other income (expense) - net	(872,000)	(773,000)	(386,000)
Other income (expense) — net	2,812,000	(9,490,000)	(6,343,000)
INCOME BEFORE INCOME TAXES	35,881,000	25,386,000	31,200,000
INCOME TAX EXPENSE	8,358,000	5,265,000	7,398,000
NET INCOME	$ 27,523,000	$ 20,121,000	$ 23,802,000
EARNINGS PER COMMON SHARE:
Basic (in dollars per share)	$ 0.56	$ 0.45	$ 0.54
Diluted (in dollars per share)	$ 0.55	$ 0.45	$ 0.53
AVERAGE COMMON SHARES:
Basic (in shares)	48,805	44,408	44,036
Diluted (in shares)	50,101	44,862	44,511

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Statement of Comprehensive Income [Abstract]
Net income	$ 27,523	$ 20,121	$ 23,802
Other comprehensive income (loss):
Cash flow hedges	901	4,784	(571)
Less income tax benefit (expense)	(350)	(1,861)	222
Foreign currency translation adjustment	3,117	878	(3,037)
Less income tax benefit (expense)	(252)	(196)	311
Total other comprehensive income (loss)	3,416	3,605	(3,075)
Total comprehensive income	$ 30,939	$ 23,726	$ 20,727

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, 2014	$ 435,259	$ 187,709	$ 249,962	$ (2,412)
Beginning balance (in shares) at Dec. 31, 2014		43,614
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	23,802		23,802
Other comprehensive income (loss)	(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
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 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
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	20,121		20,121
Other comprehensive income (loss)	3,605			3,605
Excess tax benefits from stock-based compensation	669	$ 669
Stock-based compensation expense	2,506	2,506
Options exercised	4,923	$ 4,923
Options exercised (in shares)		362
Issuance of common stock under Employee Stock Purchase Plans	694	$ 694
Issuance of common stock under Employee Stock Purchase Plans (in shares)		34
Shares surrendered in exchange for payment of payroll tax liabilities	(86)	$ (86)
Shares surrendered in exchange for payment of payroll tax liabilities (in shares)		(4)
Shares surrendered in exchange for exercise of stock options	(346)	$ (346)
Shares surrendered in exchange for the exercise of stock options (in shares)		(14)
Ending balance at Dec. 31, 2016	$ 498,189	$ 206,186	293,885	(1,882)
Ending balance (in shares) at Dec. 31, 2016	44,645	44,645
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	$ 27,523		27,523
Other comprehensive income (loss)	3,416			3,416
Stock-based compensation expense	4,075	$ 4,075
Options exercised	$ 5,689	$ 5,689
Options exercised (in shares)	404	404
Issuance of common stock under Employee Stock Purchase Plans	$ 836	$ 836
Issuance of common stock under Employee Stock Purchase Plans (in shares)		24
Shares surrendered in exchange for payment of payroll tax liabilities	136,606	$ 136,606
Shares surrendered in exchange for payment of payroll tax liabilities (in shares)		5,175
Shares surrendered in exchange for exercise of stock options	0
Shares surrendered in exchange for the exercise of stock options (in shares)		0
Ending balance at Dec. 31, 2017	$ 676,334	$ 353,392	$ 321,408	$ 1,534
Ending balance (in shares) at Dec. 31, 2017	50,248	50,248

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
CASH FLOWS FROM OPERATING ACTIVITIES:
Net income	$ 27,523	$ 20,121	$ 23,802
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	53,582	43,755	37,425
Gain on bargain purchase	(11,039)	0	0
Losses (gains) on sales and/or abandonment of property and equipment	427	530	(23)
Write-off of patents and intangible assets	988	101	141
Acquired in-process research and development	12,136	461	1,000
Amortization of deferred credits	(147)	(170)	(171)
Amortization of long-term debt issuance costs	685	952	987
Deferred income taxes	(1,304)	(962)	3,450
Excess tax benefits from stock-based compensation	0	(669)	(2,124)
Stock-based compensation expense	4,075	2,506	2,243
Changes in operating assets and liabilities, net of effects from acquisitions:
Trade receivables	(12,844)	(6,816)	(5,872)
Other receivables	(3,557)	1,161	335
Inventories	(17,834)	(3,656)	(13,113)
Prepaid expenses and other current assets	(1,236)	271	(696)
Prepaid income taxes	(611)	404	(1,788)
Income tax refund receivables	(588)	406	(784)
Other assets	(3,735)	(3,763)	(362)
Trade payables	417	(6,835)	14,766
Accrued expenses	6,461	3,242	5,873
Income taxes payable	21	1,451	2,199
Long-term income taxes payable	4,846	0	0
Liabilities related to unrecognized tax benefits	(19)	597	536
Deferred compensation payable	1,970	712	(135)
Other long-term obligations	2,510	(200)	1,769
Total adjustments	35,204	33,478	45,656
Net cash provided by operating activities	62,727	53,599	69,458
Capital expenditures for:
Property and equipment	(38,623)	(32,837)	(50,959)
Intangible assets	(2,577)	(2,217)	(1,956)
Proceeds from sale-leaseback transactions	0	0	2,017
Proceeds from sale of cost method investment	0	1,089	0
Proceeds from the sale of property and equipment	21	19	1,247
Cash paid in acquisitions, net of cash acquired	(105,582)	(125,161)	(12,368)
Net cash used in investing activities	(146,761)	(159,107)	(62,019)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of common stock	143,810	5,271	6,668
Offering costs	(816)	0	0
Proceeds from issuance of long-term debt	197,214	219,505	152,375
Payments on long-term debt	(243,214)	(102,098)	(169,272)
Excess tax benefits from stock-based compensation	0	669	2,124
Long-term debt issuance costs	(416)	(1,948)	0
Contingent payments related to acquisitions	(61)	(218)	(1,212)
Payment of taxes related to an exchange of common stock	0	(86)	(918)
Net cash provided by (used in) financing activities	96,517	121,095	(10,235)
EFFECT OF EXCHANGE RATES ON CASH	682	(593)	(382)
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS	13,165	14,994	(3,178)
CASH AND CASH EQUIVALENTS:
Beginning of year	19,171	4,177	7,355
End of year	32,336	19,171	4,177
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION
Interest (net of capitalized interest of $513, $460 and $325, respectively)	7,707	8,872	6,273
Income taxes	6,049	2,318	3,409
SUPPLEMENTAL DISCLOSURES OF NON-CASH INVESTING AND FINANCING ACTIVITIES
Property and equipment purchases in accounts payable	1,992	2,398	3,199
Cost method investment converted to intangible asset in acquisition in lieu of additional cash payment	0	0	1,010
Contingent receivable in exchange for sale of cost method investment	0	711	0
Receivable for issuance of common stock associated with option exercises	137	0	0
Acquisition purchases in accrued expenses and other long-term obligations	10,488	0	1,300
Merit common stock surrendered (0, 14 and 185 shares, respectively) in exchange for exercise of stock options	$ 0	$ 346	$ 3,802

Organization and Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2017

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 medical device products which assist in diagnosing and treating coronary artery disease, peripheral vascular disease and other non-vascular diseases and includes embolotherapeutic, cardiac rhythm management, electrophysiology, critical care, and interventional oncology and spine devices. Our endoscopy segment consists of gastroenterology and pulmonology devices which assist in the palliative treatment of expanding esophageal, tracheobronchial and biliary strictures caused by malignant tumors. Within those two operating segments, we offer products focused in five core product groups: peripheral intervention, cardiac intervention, interventional oncology and spine, cardiovascular and critical care, and endoscopy.

We manufacture our products in plants located in the United States, Mexico, The Netherlands, Ireland, France, Brazil, Australia, and Singapore. We export sales to dealers and have direct or modified direct sales forces in the United States, Canada, Western Europe, Australia, Brazil, Russia, Japan, China, Malaysia, South Korea, UAE and India (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 ("U.S. GAAP") 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.

Reclassifications. Certain prior period amounts were reclassified to conform to the current period presentation. The consolidated balance sheet previously presented employee receivables and advances from employees which are now presented as components of other receivables and accrued expenses, respectively. The reclassifications provide a more concise financial statement presentation and additional information is disclosed in the notes if material.

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. Trade accounts receivable are recorded at the net invoice value and are not interest bearing. An allowance for uncollectible accounts receivable is recorded based on our historical bad debt experience and on management’s evaluation of our ability to collect individual outstanding balances. Once collection efforts have been exhausted and a receivable is deemed to be uncollectible, such balance is charged against the allowance for uncollectible accounts.

Inventories. We value our inventories at the lower of cost, determined on a first-in, first-out method, 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 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 for impairment on an annual basis as of July 1 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 guideline public company market-based approach and a discounted cash flow income-based approach. 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.

Finite-lived intangible assets including developed technology, customer lists, distribution agreements, license agreements, trademarks, covenants not to compete and patents are subject to amortization. Intangible assets are amortized over their estimated useful life on a straight-line basis, except for customer lists, which are generally amortized on an accelerated basis. Estimated useful lives are determined considering the period the assets are expected to contribute to future cash flows. We evaluate the recoverability of our finite-lived intangible assets periodically and take into account events or circumstances that warrant revised estimates of useful lives or that indicate impairment exists.

In-process technology intangible assets, which are not subject to amortization until projects reach commercialization, are assessed for impairment at least annually and more frequently if events occur that would indicate a potential reduction in the fair value of the assets below their carrying value. An impairment charge would be recognized to the extent the carrying amount of the in-process technology exceeded its fair value.

Long-Lived Assets. We periodically review the carrying amount of our depreciable 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.

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, 2017, 2016 and 2015 was approximately $26.8 million, $24.5 million, and $22.6 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 $11.7 million and $9.9 million at December 31, 2017 and 2016, respectively, which is included in other assets in our consolidated balance sheets. We have recorded a deferred compensation payable of approximately $11.2 million and $9.2 million at December 31, 2017 and 2016, 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 issuance costs on revolving debt, investments in privately-held companies accounted for at cost, a long-term income tax refund receivable, deposits related to various leases, and the long-term assets related to derivatives.

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, 2017, 2016 and 2015. 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.

As noted further below, we do not expect our reported revenue to be affected materially in any period due to the adoption of Accounting Standards Codification ("ASC") Topic 606 because: (1) we expect to identify similar performance obligations under ASC Topic 606 as compared with deliverables and separate units of account previously identified; (2) we have determined the transaction price to be consistent; and (3) we record revenue at the same point in time, upon shipment or delivery under both ASC Topic 605 and ASC Topic 606, as applicable under the terms of the contract with the customer. Additionally, we do not expect the accounting for fulfillment costs or costs incurred to obtain a contract to be affected materially in any period due to the adoption of Topic 606.

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, 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. Under our accounting policies, we initially recognize a tax position in our financial statements when it becomes more likely than not that the position will be sustained upon examination by the tax authorities. Such tax positions are initially and subsequently measured as the largest amount of tax positions that has a greater than 50% likelihood of being realized upon ultimate settlement with the tax authorities assuming full knowledge of the position and all relevant facts. Although we believe our provisions for unrecognized tax positions are reasonable, we can make no assurance that the final tax outcome of these matters will not be different from that which we have reflected in our income tax provisions and accruals. The tax law is subject to varied interpretations, and we have taken positions related to certain matters where the law is subject to interpretation. Such differences could have a material impact on our income tax provisions and operating results in the period(s) in which we make such determination.

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 in 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 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, 2017, 2016 and 2015 was approximately $4.1 million, $2.5 million and $2.2 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 accounted for approximately 2%, 3%, and 3% of net sales for the years ended December 31, 2017, 2016 and 2015, respectively.

Foreign Currency. The financial statements of our foreign subsidiaries are measured using local currencies as the functional currency, with the exception of our subsidiaries in 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.

Derivatives. We use forward contracts to mitigate our exposure to volatility in foreign exchange rates, and we use interest rate swaps to hedge changes in the benchmark interest rate related to our Second Amended 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, 2017, accumulated other comprehensive income included approximately $3.5 million (net of tax of $(2.2) million) related to cash flow hedges and $(1.9) million (net of tax of $0) related to foreign currency translation. As of December 31, 2016, accumulated other comprehensive loss included approximately $2.9 million (net of tax of $(1.9) million) related to cash flow hedges and $(4.8) million (net of tax of $318,000) related to foreign currency translation.

New Financial Accounting Standards.

Recently Adopted

In January 2017, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standards Update (“ASU”) No. 2017-04, Intangibles - Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment, which eliminates the requirement to determine the fair value of individual assets and liabilities of a reporting unit to measure goodwill impairment. Under these amendments, goodwill impairment testing will be performed by comparing the fair value of the reporting unit with its carrying amount and recognizing an impairment charge for the amount by which the carrying amount exceeds the reporting unit’s fair value. We adopted ASU 2017-04 effective January 1, 2017 on a prospective basis, and it did not have a material impact on our consolidated financial statements for the year ended December 31, 2017.

In January 2017, the FASB issued ASU No. 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business, which provides guidance to assist entities with evaluating when a set of transferred assets and activities is a business and provides a screen to determine when a set is not a business. Under the new guidance, when substantially all the fair value of gross assets acquired (or disposed of) is concentrated in a single identifiable asset, or group of similar assets, the assets acquired would not represent a business. Also, to be considered a business, an acquisition would have to include an input and a substantive process that together significantly contribute to the ability to produce outputs. We adopted ASU 2017-01 effective January 1, 2017 on a prospective basis. The implementation of ASU 2017-01 did not have a material impact on our consolidated financial statements for the year ended December 31, 2017.

In March 2016, the FASB issued ASU No. 2016-09, Compensation - Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting, which requires companies to record excess tax benefits and deficiencies in income rather than the current requirement to record them through equity. ASU 2016-09 also allows companies the option to recognize forfeitures of share-based awards when they occur rather than the previous requirement to make an estimate upon the grant of the awards. We adopted ASU 2016-09 effective January 1, 2017 on a prospective basis and, as such, no prior periods were adjusted. In accordance with the new standard and prospectively since the date we adopted ASU 2016-09, excess tax benefits from stock-based compensation are reported as an income tax benefit in our consolidated statements of income (see Note 5).

In November 2015, the FASB issued ASU No. 2015-17, Income Taxes (Topic 740): Balance Sheet Classification of Deferred Taxes, which requires all deferred tax assets and deferred tax liabilities to be presented as noncurrent within a classified balance sheet. We adopted ASU 2015-17 effective January 1, 2017 on a prospective basis and did not reclassify presentation of prior year balances. The adoption of this standard did not have a material impact on our consolidated financial statements for the year ended December 31, 2017.

In July 2015, the FASB issued ASU No. 2015-11, Simplifying the Measurement of Inventory, which 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 ASU 2015-11, which is effective for fiscal years beginning after December 15, 2016, and interim periods within those fiscal years. The implementation of ASU 2015-11 did not have a material impact on our consolidated financial statements for the year ended December 31, 2017.

Not Yet Adopted

In February 2018, the FASB issued ASU 2018-02, Income Statement-Reporting Comprehensive Income (Topic 220): Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income, which allows a reclassification from accumulated other comprehensive income to retained earnings for stranded tax effects resulting from the Tax Cuts and Jobs Act enacted in December 2017. ASU 2018-02 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. Early adoption is permitted. We do not believe that the adoption of ASU 2018-02 will have a material impact on our consolidated financial statements.

In August 2017, the FASB issued ASU 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities, which expands and refines hedge accounting for both financial and non-financial risk components, aligns the recognition and presentation of the effects of hedging instruments and hedge items in the financial statements, and includes certain targeted improvements to ease the application of current guidance related to the assessment of hedge effectiveness. ASU 2017-12 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. Early adoption is permitted. We are currently evaluating the anticipated impact of adopting ASU 2017-12 on our consolidated financial statements.

In October 2016, the FASB issued ASU No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other than Inventory, which requires the recognition of the income tax consequences of an intra-entity transfer of an asset, other than inventory, when the transfer occurs. ASU 2016-16 became effective for us as of January 1, 2018. We do not believe that the adoption of ASU 2016-16 will have a material impact on our consolidated financial statements.

In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments, which addresses eight specific cash flow issues with the objective of reducing the existing diversity in practice in how certain cash receipts and cash payments are presented and classified in the statement of cash flows. ASU 2016-15 became effective for us on January 1, 2018. We do not believe that the adoption of ASU 2016-15 will have a material impact on our consolidated financial statements.

In February 2016, the FASB issued ASU No. 2016-02, Leases, which eliminates the current tests for lease classification under U.S. GAAP and requires lessees to recognize the right-of-use assets and related lease liabilities on the balance sheet for all leases greater than one year in duration. ASU 2016-02 is effective for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years. Early adoption of ASU 2016-02 is permitted. ASU 2016-02 provides that lessees (for capital and operating leases) and lessors (for sales-type, direct financing, and operating leases) must apply a modified retrospective transition approach for leases existing at, or entered into after, the beginning of the earliest comparative period presented in the financial statements. The modified retrospective approach would not require any transition accounting for leases that expired before the earliest comparative period presented. Lessees and lessors may not apply a full retrospective transition approach. We are assessing the impact that ASU 2016-02 is anticipated to have on our consolidated financial statements. We currently expect that most of our operating lease commitments will be subject to the new standard and recognized as lease liabilities and right-of-use assets upon our adoption of ASU 2016-02.

In January 2016, the FASB issued ASU No. 2016-01, Financial Instruments - Overall: Recognition and Measurement of Financial Assets and Financial Liabilities, which amends the guidance regarding the classification and measurement of financial instruments. Changes to the current guidance primarily affect the accounting for equity investments, financial liabilities under the fair value option, and the presentation and disclosure requirements for financial instruments. In addition, ASU 2016-01 clarifies guidance related to the valuation allowance assessment when recognizing deferred tax assets resulting from unrealized losses on available-for-sale debt securities. ASU 2016-01 became effective for us on January 1, 2018. Upon adoption of ASU 2016-01, an entity should apply the amendments by means of a cumulative-effect adjustment to the balance sheet at the beginning of the first reporting period in which the guidance is effective. We do not presently believe the application of ASU 2016-01 will have a material impact on our financial statements.

In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), to update the financial reporting requirements for revenue recognition. Topic 606 outlines a single comprehensive model for entities to use in accounting for revenue arising from contracts with customers and supersedes most current revenue recognition guidance, including industry-specific guidance. The guidance is based on the principle that an entity should recognize revenue to depict the transfer of 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 guidance also requires additional disclosure about the nature, amount, timing and uncertainty of revenue and cash flows arising from customer contracts, including significant judgments and changes in judgments and assets recognized from costs incurred to fulfill a contract. This guidance became effective for us beginning on January 1, 2018, and entities have the option of using either a full retrospective or a modified retrospective approach for the adoption of the new standard. We adopted this standard using the modified retrospective approach on January 1, 2018.

In preparation for adoption of the standard, we have implemented internal controls and completed our impact assessment of implementing this guidance. We have evaluated each of the five steps in Topic 606, which are as follows: 1) Identify the contract with the customer; 2) Identify the performance obligations in the contract; 3) Determine the transaction price; 4) Allocate the transaction price to the performance obligations; and 5) Recognize revenue when (or as) performance obligations are satisfied.

We do not expect reported revenue to be affected materially in any period due to the adoption of ASC Topic 606 because: (1) we expect to identify similar performance obligations under ASC Topic 606 as compared with deliverables and separate units of account previously identified; (2) we have determined the transaction price to be consistent; and (3) we record revenue at the same point in time, upon shipment or delivery under both ASC Topic 605 and ASC Topic 606, as applicable under the terms of the contract with the customer. Additionally, we do not expect the accounting for fulfillment costs or costs incurred to obtain a contract to be affected materially in any period due to the adoption of Topic 606.

There are also certain considerations related to accounting policies, business processes and internal control over financial reporting that are associated with implementing Topic 606. We have evaluated our policies, processes, and control framework for revenue recognition, and identified and implemented the changes needed in response to the new guidance.

Lastly, disclosure requirements under the new guidance in Topic 606 have been significantly expanded in comparison to the disclosure requirements under the current guidance, including disclosures related to disaggregation of revenue into appropriate categories, performance obligations, the judgments made in revenue recognition determinations, adjustments to revenue which relate to activities from previous quarters or years, any significant reversals of revenue, and costs to obtain or fulfill contracts. We have designed and implemented the appropriate controls over gathering and reporting the information as required under Topic 606, in order to support the expanded disclosure requirements.

All other issued and not yet effective accounting standards are not relevant to our financial statements.

Acquisitions

12 Months Ended

Dec. 31, 2017

Business Combinations [Abstract]

Acquisitions

ACQUISITIONS

On October 2, 2017 we acquired a custom procedure pack business located in Melbourne, Australia from ITL Healthcare Pty Ltd. ("ITL"), for an aggregate purchase price of $11.3 million. We accounted for this acquisition as a business combination. The following table summarizes the aggregate purchase price allocated to the assets acquired from ITL (in thousands):



Assets Acquired
Trade receivables	$	1,287
Other receivables	56
Inventories	1,808
Prepaid expenses and other assets	65
Property and equipment	1,053
Intangibles
Customer lists	5,940
Goodwill	3,740
Total assets acquired	13,949

Liabilities Assumed
Trade payables	(216		)
Accrued expenses	(542		)
Deferred tax liabilities	(1,901		)
Total liabilities assumed	(2,659		)

Total net assets acquired	$	11,290

We are amortizing the customer list on an accelerated basis over seven years. Acquisition-related costs associated with the ITL acquisition, which are 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, 2017, our net sales of ITL products were approximately $3.3 million. It is not practical to separately report the earnings related to the ITL acquisition, as we cannot split out sales costs related solely to the products we acquired from ITL, principally because our sales representatives sell multiple products (including the products we acquired from ITL) in our cardiovascular business segment.

On September 1, 2017, we acquired intellectual property rights associated with a steerable guidewire system from IntelliMedical Technologies Pty. Ltd. ("IntelliMedical"). We made an initial payment of approximately $11.9 million in September 2017, and we are obligated to pay up to an additional A$15.0 million (Australian dollars) if certain milestones set forth in the share purchase agreement with IntelliMedical are achieved. We are also required to pay royalties equal to 6% of net sales, commencing upon the first commercial sale of the product and throughout the term of the applicable patents. We accounted for this transaction as an asset purchase. The initial payment has been included in the accompanying consolidated statements of income as acquired in-process research and development expense for the year ended December 31, 2017, because both technological feasibility of the underlying research and development project had not yet been reached and such technology had no identified future alternative use as of the date of acquisition.

On August 4, 2017 we acquired from Laurane Medical S.A.S. ("Laurane") and its shareholders inventories and the intellectual property rights associated with certain manual bone biopsy devices, manual bone marrow needles and muscle biopsy kits for an aggregate purchase price of $16.5 million. We also recorded a contingent consideration liability of $5.5 million related to royalties potentially payable to Laurane's shareholders pursuant to the terms of an intellectual property purchase agreement. We accounted for this acquisition as a business combination. The following table summarizes the aggregate purchase price (including contingent royalty payment liabilities) allocated to the assets acquired from Laurane (in thousands):



Net Assets Acquired
Inventories	$	594
Intangibles
Developed technology	14,920
Customer list	120
Goodwill	6,366

Total net assets acquired	$	22,000

We are amortizing the developed technology intangible asset over 12 years and the customer list on an accelerated basis over one year. The total weighted-average amortization period for these acquired intangible assets is 11.9 years. The sales and results of operations related to the acquisition have been included in our cardiovascular segment since the acquisition date and were not material. Acquisition-related costs associated with the Laurane acquisition, which are included in selling, general and administrative expenses in the accompanying consolidated statements of income, were not material.

On July 3, 2017, we acquired from Osseon LLC (“Osseon”) substantially all the assets related to Osseon’s vertebral augmentation products. We accounted for this acquisition as a business combination. The purchase price for the assets was approximately $6.8 million. Acquisition-related costs associated with the Osseon acquisition, which are 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, 2017, our net sales of Osseon products were approximately $942,000. It is not practical to separately report the earnings related to the Osseon acquisition, as we cannot split out sales costs related solely to the products we acquired from Osseon, principally because our sales representatives sell multiple products (including the products we acquired from Osseon) in our cardiovascular business segment. The following table summarizes the preliminary purchase price allocated to the net assets acquired (in thousands):



Net Assets Acquired
Inventories	$	979
Property and equipment	58
Intangibles
Developed technology	5,400
Customer list	200
Goodwill	203

Total net assets acquired	$	6,840

We are amortizing the developed technology intangible asset over nine years and customer lists on an accelerated basis over eight years. The total weighted-average amortization period for these acquired intangible assets is approximately 9.0 years.

On July 1, 2017, we entered into an exclusive license agreement with Pleuratech ApS ("Pleuratech") to acquire the rights to manufacture and sell the KatGuide^TM chest tube insertion tool. As of December 31, 2017, we had paid $2.0 million in connection with this agreement. We are obligated to pay an additional $5.0 million if certain milestones set forth in the license agreement are met. We are also required to pay royalties equal to 6% of net sales throughout the term of the license agreement. We accounted for this transaction as an asset purchase. We recorded the amount paid upon closing as a license agreement intangible asset, which we intend to amortize over 15 years.

On June 16, 2017, we acquired from Lazarus Medical Technologies, LLC the patent rights and other intellectual property related to the Repositionable Chest Tube^TM and related devices. As of December 31, 2017, we had paid $570,000 in connection with this agreement. We are also obligated to pay an additional $750,000 if certain milestones set forth in the purchase agreement are met. We are also required to pay royalties equal to 6% of net sales throughout the term of the purchase agreement. We accounted for this transaction as an asset purchase. We recorded the amount paid upon closing as a license agreement intangible asset, which we intend to amortize over 15 years.

On May 23, 2017, we paid $2.5 million to acquire 182,000 shares of preferred stock of Fusion Medical, Inc. ("Fusion"), a developer of medical devices designed primarily for clot removal. The shares of preferred stock we acquired, which represent an ownership interest of approximately 19.5%, have been accounted for as an equity method investment of $2.5 million reflected within other assets in the accompanying consolidated balance sheets because we may be deemed to exercise significant influence over the operations of Fusion.

On May 19, 2017, we terminated our distribution agreement with Sheen Man Co., Ltd. and Sugan Co, Ltd., ("Sugan"), a Japanese medical device distributor and entered into a business purchase agreement, distribution agreement and a supply agreement with Sugan. Pursuant to these agreements, we acquired the customer list Sugan used in the distribution of our products in Japan. The purchase price is recorded as a customer list intangible asset of approximately $1.2 million. We intend to amortize the customer list intangible asset on an accelerated basis over five years. In addition, we granted to Sugan the right to continue to distribute a limited number of our products, related to fluid administration, through December 31, 2021 and to manufacture and sell to Sugan certain contrast injector products during a term of four years, subject to extensions.

On May 1, 2017, we entered into an agreement and plan of merger with Vascular Access Technologies, Inc. ("VAT"), pursuant to which we acquired the SAFECVAD™ device. We accounted for this acquisition as a business combination. The purchase price for the business was $5.0 million. We also recorded $4.9 million of contingent consideration related to royalties potentially payable to VAT pursuant to the merger agreement. The following table summarizes the preliminary purchase price allocated to the net assets acquired and liabilities assumed (in thousands):



		Preliminary Allocation			Adjustments ⁽¹⁾			Revised Allocation
	Net Assets Acquired
	Intangibles
	Developed technology	$	7,800		$	—		$	7,800
	In-process technology	850			70			920
	Goodwill	4,323			(42		)	4,281
	Deferred tax liabilities	(3,073		)	(28		)	(3,101		)

	Total net assets acquired	$	9,900		$	—		$	9,900

(1)	Under U.S. GAAP, measurement period adjustments are recognized on a prospective basis in the period of change, instead of restating prior periods. There was no impact to reported earnings in connection with these measurement period adjustments for the periods presented. Amounts represent adjustments to the preliminary purchase price allocation first presented in our Quarterly Report on Form 10-Q for the quarter ended June 30, 2017 resulting from our ongoing activities, including reassessment of the assets acquired and liabilities assumed, with respect to finalizing our purchase price allocation for this acquisition.

We are amortizing the developed technology intangible asset over 15 years. The sales and results of operations related to the acquisition have been included in our cardiovascular segment since the acquisition date and were not material. Acquisition-related costs associated with the VAT acquisition, which are included in selling, general and administrative expenses in the accompanying consolidated statements of income, were not material.

On January 31, 2017, we acquired Argon’s critical care division, including a manufacturing facility in Singapore, the related commercial operations in Europe and Japan, and certain inventories and intellectual property rights within the United States. We made an initial payment of approximately $10.9 million and received a subsequent reduction to the purchase price of approximately $797,000 related to a working capital adjustment according to the terms of the purchase agreement. We accounted for the acquisition as a business combination.

Acquisition-related costs associated with the acquisition of the Argon critical care division during the year ended December 31, 2017, which are included in selling, general and administrative expenses in the accompanying consolidated statements of income, were approximately $2.6 million. 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, 2017, our net sales of the Argon critical care products were approximately $41.2 million. It is not practical to separately report the earnings related to the Argon critical care acquisition, as we cannot split out sales costs related solely to the products we acquired from Argon, principally because our sales representatives sell multiple products (including the products we acquired from Argon) in our cardiovascular business segment.

The assets and liabilities in the purchase price allocation for the Argon critical care acquisition are stated at fair value based on estimates of fair value using available information and making assumptions our management believes are reasonable. The following table summarizes the preliminary purchase price allocated to the net tangible and intangible assets acquired and liabilities assumed (in thousands), adjusted as of December 31, 2017:



		Preliminary Allocation			Adjustments ⁽²⁾			Revised Allocation
	Assets Acquired
	Cash and cash equivalents	$	1,436		$	—		$	1,436
	Trade receivables	8,351			—			8,351
	Inventories	12,217			(995		)	11,222
	Prepaid expenses and other assets	1,275			—			1,275
	Income tax refund receivable	—			165			165
	Property and equipment	2,667			(348		)	2,319
	Deferred tax assets	184			18			202
	Intangibles
	Developed technology	2,600			(400		)	2,200
	Customer lists	1,300			200			1,500
	Trademarks	1,500			(600		)	900
	Total assets acquired	31,530			(1,960		)	29,570

	Liabilities Assumed
	Trade payables	(2,306		)	(108		)	(2,414		)
	Accrued expenses	(5,083		)	—			(5,083		)
	Income taxes payable	(2		)	2			—
	Deferred income tax liabilities	(999		)	65			(934		)
	Total liabilities assumed	(8,390		)	(41		)	(8,431		)

	Total net assets acquired	23,140			(2,001		)	21,139
	Gain on bargain purchase ⁽¹⁾	(12,243		)	1,204			(11,039		)
	Total purchase price	$	10,897		$	(797	)	$	10,100

(1)	The total fair value of the net assets acquired from Argon exceeded the purchase price, resulting in a gain on bargain purchase which was recorded within other income (expense) in our consolidated statements of income, and includes a negative adjustment of $1.2 million since the bargain purchase gain was first presented in our Quarterly Report on Form 10-Q for the quarter ended March 31, 2017. We believe the reason for the gain on bargain purchase was a result of the divestiture of a non-strategic, slow-growth critical care business for Argon. It is our understanding that the divestiture allows Argon to focus on its higher growth interventional portfolio.
(2)	Under U.S. GAAP, measurement period adjustments are recognized on a prospective basis in the period of change, instead of restating prior periods. There was no impact to reported earnings in connection with these measurement period adjustments for the periods presented. Amounts represent adjustments to the preliminary purchase price allocation first presented in our March 31, 2017 Form 10-Q resulting from our ongoing activities, including reassessment of the assets acquired and liabilities assumed, with respect to finalizing our purchase price allocation for this acquisition.

With respect to the Argon critical care assets, we are amortizing developed technology over seven years and customer lists on an accelerated basis over five 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 five years from the acquisition date. The total weighted-average amortization period for these acquired intangible assets is 6.0 years.

On January 31, 2017, we acquired substantially all the assets, including intellectual property covered by approximately 40 patents and pending applications, and assumed certain liabilities, of Catheter Connections, Inc. (“Catheter Connections”), in exchange for payment of $38.0 million. Catheter Connections, based in Salt Lake City, Utah, developed and marketed the DualCap® System, an innovative family of disinfecting products designed to protect patients from intravenous infections resulting from infusion therapy. We accounted for this acquisition as a business combination.

Acquisition-related costs associated with the Catheter Connections acquisition during the year ended December 31, 2017, which are included in selling, general and administrative expenses in the accompanying consolidated statements of income, were approximately $482,000. 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, 2017, our net sales of the products acquired from Catheter Connections were approximately $10.0 million. It is not practical to separately report the earnings related to the products acquired from Catheter Connections, as we cannot split out sales costs related solely to those products, principally because our sales representatives sell multiple products (including the DualCap System) in the cardiovascular business segment. The purchase price was preliminarily allocated as follows (in thousands):



		Preliminary Allocation			Adjustments ⁽¹⁾			Revised Allocation
	Assets Acquired
	Trade receivables	$	952		$	6		$	958
	Inventories	2,244			(87		)	2,157
	Prepaid expenses and other assets	181			(96		)	85
	Property and equipment	1,472			—			1,472
	Intangibles
	Developed technology	22,900			(1,800		)	21,100
	Customer lists	100			600			700
	Trademarks	2,900			—			2,900
	Goodwill	7,612			1,377			8,989
	Total assets acquired	38,361			—			38,361

	Liabilities Assumed
	Trade payables	(338		)	—			(338		)
	Accrued expenses	(23		)	—			(23		)
	Total liabilities assumed	(361		)	—			(361		)

	Net assets acquired	$	38,000		$	—		$	38,000

(1)	Under U.S. GAAP, measurement period adjustments are recognized on a prospective basis in the period of change, instead of restating prior periods. There was no impact to reported earnings in connection with these measurement period adjustments for the periods presented. Amounts represent adjustments to the preliminary purchase price first presented in our Quarterly Report on Form 10-Q for the Quarter Ended March 31, 2017, resulting from activities with respect to finalizing our purchase price allocation for this acquisition. The larger adjustments primarily relate to the valuation of the acquired intangible assets.

We are amortizing the Catheter Connections developed technology asset over 12 years, the related trademarks over 10 years, and the associated customer list over eight years. We have estimated the weighted average life of the intangible Catheter Connections assets acquired to be approximately 11.7 years.

On December 19, 2016, we paid $5.0 million for 1,251,878 shares of common stock and a distribution agreement with Bluegrass Vascular Technologies, Inc. ("Bluegrass"). The common stock, which represents an ownership interest of approximately 19.5%, has been accounted for as a cost method investment of $4.0 million reflected within other assets in the accompanying consolidated balance sheets because we are not able to exercise significant influence over the operations of Bluegrass. The distribution agreement intangible asset was valued at $1.0 million and will be amortized over a period of three years.

On July 6, 2016, we acquired all of the issued and outstanding shares of DFINE Inc. ("DFINE"). The DFINE acquisition added a line of vertebral augmentation products for the treatment of vertebral compression fractures ("VCF") as well as medical devices used to treat metastatic spine tumors. We made an initial payment of $97.5 million to certain DFINE stockholders on July 6, 2016 and paid approximately $578,000 related to a net working capital adjustment subject to review by Merit and the preferred stockholders of DFINE. We accounted for the acquisition as a business combination. In the three-month period ended December 31, 2016, we negotiated the final net working capital adjustment resulting in a reduction to the purchase price of approximately $1.1 million. As a result, we recorded measurement period adjustments to reduce inventories by approximately $89,000, reduce property and equipment by approximately $109,000, reduce goodwill by approximately $1.2 million, reduce accrued expenses by approximately $407,000 and increase the associated deferred tax liabilities by approximately $113,000. Under U.S. GAAP, measurement period adjustments are recognized on a prospective basis in the period of change, instead of restating prior periods. There was no impact to reported earnings in connection with these measurement period adjustments.

Acquisition-related costs during the year ended December 31, 2016, which are included in selling, general, and administrative expenses in the accompanying consolidated statements of income, were approximately $1.6 million. The results of operations related to this acquisition have been included in our cardiovascular segment since the acquisition date. During the years ended December 31, 2017 and 2016, our net sales of DFINE products were approximately $27.0 million and $13.5 million, respectively. It is not practical to separately report the earnings related to the DFINE acquisition, as we cannot split out sales costs related to DFINE products, principally because our sales representatives are selling multiple products (including DFINE products) in the cardiovascular business segment.

The purchase price was allocated to the net tangible and intangible assets acquired and liabilities assumed, based on estimated fair values, as follows (in thousands):



Assets Acquired
Trade receivables	$	4,054
Other receivables	6
Inventories	8,585
Prepaid expenses	630
Property and equipment	1,630
Other long-term assets	145
Intangibles
Developed technology	67,600
Customer lists	2,400
Trademarks	4,400
Goodwill	24,818
Total assets acquired	114,268

Liabilities Assumed
Trade payables	(1,790		)
Accrued expenses	(5,298		)
Deferred income tax liabilities - current	(701		)
Deferred income tax liabilities - noncurrent	(10,844		)
Total liabilities assumed	(18,633		)

Net assets acquired, net of cash received of $1,327	$	95,635

The gross amount of trade receivables we acquired in the acquisition was approximately $4.3 million, of which approximately $224,000 was expected to be uncollectible or returned. With respect to the DFINE assets, we are amortizing developed technology over 15 years and customer lists on an accelerated basis over nine 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 14.8 years.

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, Georgia ("CryoLife"). The HeRO Graft is a fully subcutaneous vascular access system intended for use in maintaining long-term vascular access for chronic hemodialysis patients who have failing fistulas, grafts or are catheter dependent due to a central venous blockage. The purchase price was $18.5 million, which was paid in full during 2016. We accounted for this acquisition as a business combination. The purchase price was allocated as follows (in thousands):



Assets Acquired
Inventories	$	2,455
Property and equipment	290
Intangibles
Developed technology	12,100
Trademarks	700
Customers Lists	400
Goodwill	2,555

Total assets acquired	$	18,500

We are amortizing the developed HeRO Graft technology asset over 10 years, the related trademarks over 5.5 years, and the associated customer lists over 12 years. We have estimated the weighted average life of the intangible HeRO Graft assets acquired to be approximately 9.8 years. Acquisition-related costs related to the HeRO Graft device and other related assets during the year ended December 31, 2016, which are 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 years ended December 31, 2017 and 2016, our net sales of the products acquired from CryoLife were approximately $8.6 million and $7.1 million, respectively. It is not practical to separately report the earnings related to the products acquired from CryoLife, as we cannot split out sales costs related to those products, principally because our sales representatives are selling multiple products (including the HeRO Graft device) in the cardiovascular business segment.

During 2016, we paid approximately $3.0 million for 3,000,000 preferred limited liability company units of Cagent Vascular, LLC, a medical device company ("Cagent"), which represents a current ownership interest of approximately 18.1% and has been accounted for as a cost method investment reflected within other assets in the accompanying consolidated balance sheets because we are not able to exercise significant influence over the operations of Cagent.

On December 4, 2015, we entered into a license agreement with ArraVasc Limited, an Irish medical device company, for the right to manufacture and sell certain percutaneous transluminal angioplasty balloon catheter products. As of December 31, 2016, we had paid $2 million in connection with the agreement. During the year ended December 31, 2017, we paid an additional $500,000. There are no additional payments due under this agreement. We accounted for the transaction as an asset purchase and are amortizing the license agreement intangible 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. We recorded $2.7 million to a license agreement intangible asset, which we intend to amortize over 10 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. During the three months ended December 31, 2017, we paid $247,500 for 656,848 shares of Series B Preferred Stock of Xablecath. Our ownership interest in Xablecath is approximately 15.9% and is accounted for as a cost-method investment reflected within other assets in the accompanying consolidated balance sheets. Xablecath is developing an over-the-wire crossing catheter.

On July 17, 2015, we entered into an asset purchase agreement with LeMaitre 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 are amortizing 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 and paid in the first quarter of 2016. We also recorded $270,000 of contingent consideration related to royalties payable to Quellent pursuant to the asset purchase 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. We are amortizing the developed technology intangible asset over 13 years.

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. As of December 31, 2017, we have paid cash of $600,000, have a current liability recorded in accrued expenses of $200,000 for the payment that will be due in less than a year and have a long-term obligation of $200,000 recorded for the payments 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 are amortizing 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 paid an additional $400,000 in the year-ended December 31, 2016, which was recorded to the customer list intangible asset, because Teleflex met certain obligations under the agreement. There are no additional payments due under this agreement. We are amortizing the asset over a period of five years.

The following table summarizes our consolidated results of operations for the years ended December 31, 2017, 2016 and 2015, as well as unaudited pro forma consolidated results of operations as though the DFINE acquisition had occurred on January 1, 2015 and the acquisition of the Argon critical care division had occurred on January 1, 2016 (in thousands, except per common share amounts):



	2017				2016				2015
	As Reported		Pro Forma		As Reported		Pro Forma		As Reported		Pro Forma
Net sales	$	727,852	$	730,612	$	603,838	$	664,366	$	542,149	$	575,541
Net income	27,523		17,419		20,121		23,068		23,802		3,135
Earnings per common share:
Basic	$	0.56	$	0.36	$	0.45	$	0.52	$	0.54	$	0.07
Diluted	$	0.55	$	0.35	$	0.45	$	0.51	$	0.53	$	0.07

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 of acquired intangible assets, interest expense on long-term debt and changes in the timing of the recognition of the gain on bargain purchase. The pro forma information should not be considered indicative of actual results that would have been achieved if the DFINE acquisition had occurred on January 1, 2015 and the acquisition of the Argon critical care division had occurred on January 1, 2016, or results that may be obtained in any future period. The proforma consolidated results of operations do not include the ITL, Laurane, Osseon, VAT, Catheter Connections, HeRO Graft or Quellent acquisitions as we do not deem the pro forma effect of these transactions 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 certain 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
-Topic 805
-SubTopic 10
-Section 50
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-URI http://asc.fasb.org/extlink&oid=65885119&loc=d3e1497-128463

Reference 2: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 805
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-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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Reference 5: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
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Reference 6: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
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Reference 7: http://www.xbrl.org/2003/role/presentationRef
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-URI http://asc.fasb.org/extlink&oid=73530397&loc=d3e4845-128472

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-Publisher FASB
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Reference 10: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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-Publisher FASB
-Name Accounting Standards Codification
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Reference 13: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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-URI http://asc.fasb.org/extlink&oid=73530397&loc=SL65897772-128472

Reference 14: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 15: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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+ Details

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2017

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, 2017 and 2016, are as follows (in thousands):



	2017		2016
Goodwill balance at January 1	$	211,927	$	184,472
Effect of foreign exchange	2,641		82
Additions as the result of acquisitions	23,579		27,373
Goodwill balance at December 31	$	238,147	$	211,927

As of December 31, 2017, we had recorded $8.3 million of accumulated goodwill impairment charges. All of the goodwill balance as of December 31, 2017 and 2016, is related to our cardiovascular segment.

Other intangible assets at December 31, 2017 and 2016, consisted of the following (in thousands):



	2017
	Gross Carrying Amount		Accumulated Amortization			Net Carrying Amount
Patents	$	16,528	$	(3,737	)	$	12,791
Distribution agreements	7,262		(4,686		)	2,576
License agreements	23,783		(5,568		)	18,215
Trademarks	16,224		(4,686		)	11,538
Covenants not to compete	1,028		(968		)	60
Customer lists	31,935		(18,482		)	13,453
In-process technology	920		—			920

Total	$	97,680	$	(38,127	)	$	59,553



	2016
	Gross Carrying Amount		Accumulated Amortization			Net Carrying Amount
Patents	$	14,130	$	(3,165	)	$	10,965
Distribution agreements	6,626		(3,527		)	3,099
License agreements	20,695		(3,422		)	17,273
Trademarks	12,380		(3,330		)	9,050
Covenants not to compete	1,028		(936		)	92
Customer lists	22,261		(15,401		)	6,860
Royalty agreements	267		(267		)	—

Total	$	77,387	$	(30,048	)	$	47,339

Aggregate amortization expense for the years ended December 31, 2017, 2016 and 2015 was approximately $26.8 million, $19.3 million and $14.8 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. During the fourth quarter of 2017, we compared the carrying value of the amortizing intangible assets acquired in our July 2015 acquisition of certain assets from Distal Access, LLC, all of which pertained to our cardiovascular segment, 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 Distal Access 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 Distal Access 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 recorded an impairment charge for Distal Access of approximately $809,000. We did not record any impairment charges during the years ended December 31, 2016 and 2015.

Estimated amortization expense for the developed technology and other intangible assets for the next five years consists of the following as of December 31, 2017 (in thousands):



Year Ending December 31
2018	$	30,413
2019	29,787
2020	28,373
2021	21,001
2022	19,396

- 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, 2017

Income Tax Disclosure [Abstract]

Income Taxes

INCOME TAXES

On December 22, 2017, U.S. federal tax legislation, commonly referred to as the Tax Cuts and Jobs Act (“TCJA”) was signed into law. Significant provisions that have impacted (and will in the future impact) our effective tax rate include the reduction in the corporate tax rate from 35% to 21%, effective in 2018; a one-time deemed repatriation (“transition tax”) on earnings of certain foreign subsidiaries that were previously tax deferred; and new taxes on certain foreign sourced earnings. At December 31, 2017, we had not completed our accounting for the tax effects of the TCJA; however, in certain cases, as described below, we have made reasonable estimates of the effects on our existing deferred tax balances and impact of the one-time transition tax. In accordance with SEC Staff Accounting Bulletin 118 (“SAB 118”), income tax effects of the TCJA may be refined upon obtaining, preparing, and/or analyzing additional information during the measurement period and such changes could be material. During the measurement period, provisional amounts may also be adjusted for the effects, if any, of interpretative guidance issued after December 31, 2017, by U.S. regulatory and standard-setting bodies. For the items for which we were able to determine a reasonable estimate, we recognized the following provisional impacts.


•	The reduction in the U.S. corporate tax rate resulted in a net tax benefit of approximately $8.4 million related to the revaluation of our U.S. net deferred tax liability. We are still analyzing certain aspects of the TCJA and refining our calculations, which could potentially affect the measurement of these balances or potentially give rise to new deferred tax amounts.


•	The transition tax resulted in a one-time tax expense of approximately $10.6 million. We have not yet completed our calculation of the total post-1986 foreign earnings and profits (“E&P”) for our foreign subsidiaries as E&P will not be finalized until the federal income tax return is filed.

The tax expense recognized represents our best estimate of the impact of the TCJA. During 2018, we will continue to refine the calculations related to both provisional amounts as we gain a more thorough understanding of the tax law and certain aspects of the TCJA are clarified by U.S. tax, regulatory, and standard-setting authorities.

For tax years beginning after December 31, 2017, the TCJA introduces new provisions of U.S. taxation of certain Global Intangible Low-Tax Income (“GILTI”). Due to its complexity and a current lack of guidance as to how to calculate the tax, we are not yet able to determine a reasonable estimate for the impact of the incremental tax liability. The FASB provided guidance that companies should make an accounting policy election to either treat taxes on GILTI as period costs or use the deferred method. When additional analysis is complete and further guidance is available, we will make a policy election for how GILTI will be recorded.

Our non-U.S. earnings are currently considered as indefinitely reinvested overseas. Previously, any repatriation by way of a dividend may have been subject to both U.S. federal and state income taxes, as adjusted for any non-U.S. tax credits. Such dividends should not be subject to U.S. federal tax under the TCJA. We are still analyzing how the TCJA impacts our existing accounting position to indefinitely reinvest foreign earnings, and we have yet to determine whether we plan to change our position. We will record the tax effects of any change to our existing assertion in the period that we complete our analysis and make such a change. If such earnings were to be distributed, any foreign withholding taxes could be material.

For the years ended December 31, 2017, 2016 and 2015, income before income taxes is broken out between U.S. and foreign-sourced operations and consisted of the following (in thousands):



	2017		2016		2015
Domestic	$	14,531	$	6,174	$	9,470
Foreign	21,350		19,212		21,730
Total	$	35,881	$	25,386	$	31,200

The components of the provision for income taxes for the years ended December 31, 2017, 2016 and 2015, consisted of the following (in thousands):



	2017			2016			2015
Current expense (benefit):
Federal	$	3,849		$	1,933		$	(17	)
State	645			492			747
Foreign	5,168			3,802			3,218
Total current expense	9,662			6,227			3,948

Deferred expense (benefit):
Federal	(314		)	(144		)	3,250
State	(216		)	(195		)	294
Foreign	(774		)	(623		)	(94		)
Total deferred (benefit) expense	(1,304		)	(962		)	3,450

Total income tax expense	$	8,358		$	5,265		$	7,398

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, 2017, 2016 and 2015, consisted of the following (in thousands):



	2017			2016			2015
Computed federal income tax expense at statutory rate of 35%	$	12,559		$	8,885		$	10,920
State income taxes	279			193			698
Tax credits	(1,377		)	(1,164		)	(1,019		)
Production activity deduction	—			(53		)	—
Foreign tax rate differential	(3,329		)	(3,717		)	(3,564		)
Uncertain tax positions	(19		)	597			536
Deferred compensation insurance assets	(479		)	(307		)	182
Transaction-related expenses	90			274			—
U.S. transition tax	10,612			—			—
TCJA remeasurement of deferred taxes	(8,383		)	—			—
Share-based payments	(2,264		)	—			—
Bargain purchase gain	(1,570		)	—			—
In-process research and development	1,486			—			—
Other — including the effect of graduated rates	753			557			(355		)
Total income tax expense	$	8,358		$	5,265		$	7,398

Deferred income tax assets and liabilities at December 31, 2017 and 2016, consisted of the following temporary differences and carry-forward items (in thousands):



	2017			2016
Deferred income tax assets:
Allowance for uncollectible accounts receivable	$	467		$	645
Accrued compensation expense	5,154			6,203
Inventory differences	2,505			1,065
Net operating loss carryforwards	15,741			27,742
Deferred revenue	58			73
Stock-based compensation expense	2,281			2,738
Federal research and development credit carryforward	—			3,524
Foreign tax credits	—			364
Other	8,986			6,984
Total deferred income tax assets	35,192			49,338

Deferred income tax liabilities:
Prepaid expenses	(930		)	(782		)
Property and equipment	(20,352		)	(25,108		)
Intangible assets	(28,588		)	(35,773		)
Other	(1,830		)	(1,480		)
Total deferred income tax liabilities	(51,700		)	(63,143		)
Valuation allowance	(4,422		)	(3,786		)
Net deferred income tax assets (liabilities)	$	(20,930	)	$	(17,591	)

Reported as:
Deferred income tax assets - Current	$	—		$	8,219
Deferred income tax assets - Long-term	2,359			171
Deferred income tax liabilities - Long-term	(23,289		)	(25,981		)
Net deferred income tax liabilities	$	(20,930	)	$	(17,591	)

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 basis 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, non-US net operating loss carryforwards, and capital loss carryforwards 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 $636,000, $1.8 million, and $378,000 during the years ended December 31, 2017, 2016 and 2015, respectively.

As of December 31, 2017 and 2016, we had U.S federal net operating loss carryforwards of approximately $67.9 million and $76.4 million, respectively, which were generated by Vascular Access Technologies, Inc., DFINE, Inc., and Biosphere Medical, Inc. prior to our acquisition of these companies. Vascular Access Technologies, Inc. was acquired on May 1, 2017. These net operating loss carryforwards, which expire at various dates through 2035, 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 18 years. We utilized a total of approximately $9.1 million and $6.2 million in U.S. federal net operating loss carryforwards during the years ended December 31, 2017 and 2016, respectively.

As of December 31, 2017, we had approximately $5.4 million of non-U.S. net operating loss carryforwards, of which approximately $4.9 million have no expiration date and approximately $526,000 expire at various dates through 2027. As of December 31, 2016, we had $3.0 million of non-U.S. net operating loss carryforwards, which have no expiration date. Non-U.S. net operating loss carryforwards utilized during the years ended December 31, 2017 and 2016 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 2014. In foreign jurisdictions, we are no longer subject to income tax examinations for years before 2011.

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, 2017, including interest and penalties, was approximately $3.1 million, of which approximately $2.7 million would favorably impact our effective tax rate if recognized. The total liability for uncertain tax benefits, as presented on our consolidated balance sheets, has been reduced by approximately $307,000 related to certain liabilities for unrecognized tax benefits, which, if realized, would reduce the transition tax under the TCJA by approximately $307,000. The total liability for unrecognized tax benefits at December 31, 2016, including interest and penalties, was approximately $2.8 million, of which approximately $2.8 million would favorably impact our effective tax rate if recognized. Approximately $2.3 million of the total liability at December 31, 2016 was presented as a reduction to non-current deferred income tax assets on our consolidated balance sheet. As of December 31, 2017 and 2016, we had accrued approximately $304,000 and $216,000 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, 2017, 2016 and 2015 we added interest and penalties of approximately $88,000, $30,000 and $6,000, respectively, to our liability for unrecognized tax benefits. It is reasonably possible that within the next 12 months the total liability for unrecognized tax benefits may change, net of potential decreases due to the expiration of statutes of limitation, up to $500,000.

A reconciliation of the beginning and ending amount of liabilities associated with uncertain tax benefits for the years ended December 31, 2017, 2016 and 2015, consisted of the following (in thousands):



Tabular Roll-forward	2017			2016			2015

Unrecognized tax benefits, opening balance	$	2,549		$	1,982		$	1,736
Gross increases in tax positions taken in a prior year	80			77			187
Gross increases in tax positions taken in the current year	403			856			763
Lapse of applicable statute of limitations	(283		)	(366		)	(704		)
Unrecognized tax benefits, ending balance	$	2,749		$	2,549		$	1,982

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, 2017

Debt Disclosure [Abstract]

Revolving Credit Facility and Long-Term Debt

REVOLVING CREDIT FACILITY AND LONG-TERM DEBT

Principal balances outstanding under our long-term debt obligations as of December 31, 2017 and 2016, consisted of the following (in thousands):



	2017			2016
2016 Term loan	$	85,000		$	145,000
2016 Revolving credit loans	187,000			180,000
2017 Debt facility	6,959			—
Less unamortized debt issuance costs	(487		)	(627		)
Total long-term debt	278,472			324,373
Less current portion	19,459			10,000
Long-term portion	$	259,013		$	314,373

2017 Debt Facility

On February 23, 2017, we entered into a loan agreement with HSBC Bank USA, National Association ("HSBC Bank") whereby HSBC Bank agreed to provide us with a loan in the amount of approximately $7.0 million. The loan matures on February 1, 2018, with an extension available at our option, subject to certain conditions. The loan agreement bears interest at the three-month London Inter-Bank Offered Rate (“LIBOR”) plus 1.0%, which resets quarterly. The loan is secured by assets equal to the currently outstanding loan balance. The loan contains covenants, representations and warranties and other terms customary for loans of this nature. As of December 31, 2017, our interest rate on the loan was a variable rate of 2.38%.

2016 Term Loan and Revolving Credit Loans

On July 6, 2016, we entered into a Second Amended and Restated Credit Agreement (as amended to date, the “Second Amended Credit Agreement”), with Wells Fargo Bank, National Association, as administrative agent, swingline lender and a lender, and Wells Fargo Securities, LLC, as sole lead arranger and sole bookrunner. In addition to Wells Fargo Bank, National Association, Bank of America, N.A., U.S. Bank, National Association, and HSBC Bank USA, National Association, are parties to the Second Amended Credit Agreement as lenders. The Second Amended Credit Agreement amends and restates in its entirety our previously outstanding Amended and Restated Credit Agreement and all amendments thereto. The Second Amended Credit Agreement was amended on September 28, 2016 to allow for a new revolving credit loan to our wholly-owned subsidiary, on March 20, 2017 to allow flexibility in how we apply net proceeds received from equity issuances to prepay outstanding indebtedness, and on December 13, 2017 to increase the revolving credit commitment by $100 million up to $375 million.

The Second Amended Credit Agreement provides for a term loan of $150 million and a revolving credit commitment up to an aggregate amount of $375 million, which includes a reserve of $25 million to make swingline loans from time to time. The term loan is payable in quarterly installments in the amounts provided in the Second Amended Credit Agreement until the maturity date of July 6, 2021, at which time the term and revolving credit loans, together with accrued interest thereon, will be due and payable. 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.

Revolving credit loans denominated in dollars and term loans made under the Second Amended Credit Agreement bear interest, at our election, at either a Base Rate or Eurocurrency Base Rate (as such terms are defined in the Second Amended Credit Agreement) plus the applicable margin, which increases as our Consolidated Total Leverage Ratio (as defined in the Second Amended Credit Agreement) increases. Revolving credit loans denominated in an Alternative Currency (as defined in the Second Amended Credit Agreement) bear interest at the Eurocurrency rate plus the applicable margin. Swingline loans bear interest at the base rate plus the applicable margin. Upon an event of default, the interest rate may be increased by 2.0%. The revolving credit commitment will also carry a commitment fee of 0.15% to 0.40% per annum on the unused portion.

The Second Amended Credit Agreement is collateralized by substantially all our assets. The Second Amended Credit Agreement contains covenants, representations and warranties and other terms customary for loans of this nature. The Second Amended Credit Agreement requires that we maintain certain financial covenants, as follows:



		Covenant Requirement
Consolidated Total Leverage Ratio (1)
	July 1, 2017 through December 31, 2017	3.75 to 1.0
	January 1, 2018 through March 31, 2018	3.5 to 1.0
	April 1, 2018 and thereafter	3.25 to 1.0
Consolidated EBITDA (2)		1.25 to 1.0
Consolidated Net Income (3)		$—
Facility Capital Expenditures (4)		$30 million

(1)	Maximum Consolidated Total Leverage Ratio (as defined in the Second Amended Credit Agreement) as of any fiscal quarter end.
(2)	Minimum ratio of Consolidated EBITDA (as defined in the Second Amended Credit Agreement and adjusted for certain expenditures) to Consolidated Fixed Charges (as defined in the Second Amended Credit Agreement) for any period of four consecutive fiscal quarters.
(3)	Minimum level of Consolidated Net Income (as defined in the Second Amended Credit Agreement) for certain periods, and subject to certain adjustments.
(4)	Maximum level of the aggregate amount of all Facility Capital Expenditures (as defined in the Second Amended Credit Agreement) in any fiscal year.

Additionally, the Second Amended Credit Agreement contains customary events of default and affirmative and negative covenants for transactions of this type. As of December 31, 2017, we believe we were in compliance with all covenants set forth in the Second Amended Credit Agreement.

Future Payments

Future minimum principal payments on our long-term debt as of December 31, 2017, are as follows (in thousands):



Years Ending	Future Minimum
December 31	Principal Payments
2018	$	19,459
2019	15,000
2020	17,500
2021	227,000
Total future minimum principal payments	$	278,959

As of December 31, 2017, we had outstanding borrowings of approximately $272.0 million under the Second Amended Credit Agreement, with available borrowings of approximately $188.0 million, based on the leverage ratio required pursuant to the Second Amended Credit Agreement. Our interest rate as of December 31, 2017 was a fixed rate of 2.68% on $175.0 million as a result an interest rate swap (see Note 8) and a variable floating rate of 2.82% on $97.0 million. Our interest rate as of December 31, 2016 was a fixed rate of 2.98% on $130.0 million and 3.12% on $45.0 million as a result of an interest rate swaps, and a variable floating rate of 2.77% on approximately $150.0 million.

Derivatives

12 Months Ended

Dec. 31, 2017

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 interest rate swaps 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 hedging instruments are recorded in earnings throughout the term of the derivative.

Interest Rate Risk. 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 Second Amended Credit Agreement that is solely due to changes in the benchmark interest rate.

Derivatives Designated as Cash Flow Hedges

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 interest rate swap expired on December 19, 2017. The variable portion of the interest rate swap was 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 was settled with the counterparty, and interest was paid, on a monthly basis. The notional amount of the interest rate swap was reduced quarterly by 50% of the minimum principal payment due under the terms of our Second Amended Credit Agreement.

On August 5, 2016, we entered into a pay-fixed, receive-variable interest rate swap having an initial notional amount of $42.5 million with Wells Fargo to fix the one-month LIBOR rate at 1.12%. The variable portion of the interest rate swap is tied to the one-month LIBOR rate (the benchmark interest rate). On a monthly basis, 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. The notional amount of the interest rate swap increased quarterly by an amount equal to the decrease of the hedge entered into on December 19, 2012, up to the amount of $175.0 million, which was reached upon expiration of the other swap on December 19, 2017. The interest rate swap is scheduled to expire on July 6, 2021.

At December 31, 2017 and 2016, our interest rate swaps qualified as cash flow hedges. The fair value of our interest rate swap at December 31, 2017 was an asset of approximately $5.7 million, which was partially offset by approximately $1.5 million in deferred taxes. The fair value of our interest rate swaps at December 31, 2016 was an asset of approximately $5.0 million, which was offset by approximately $1.9 million in deferred taxes.

Foreign Currency Risk. We operate on a global basis and are exposed to the risk that our financial condition, results of operations, and cash flows could be adversely affected by changes in foreign currency exchange rates. To reduce the potential effects of foreign currency exchange rate movements on net earnings, we enter into derivative financial instruments in the form of foreign currency exchange forward contracts with major financial institutions. Our policy is to enter into foreign currency derivative contracts with maturities of up to two years. We are primarily exposed to foreign currency exchange rate risk with respect to transactions and balances denominated in Euros, British Pounds, Chinese Renminbi, Mexican Pesos, Brazilian Reals, Australian Dollars, Hong Kong Dollars, Swiss Francs, Swedish Krona, Canadian Dollars, Danish Krone, Japanese Yen, Korea Won, and Singapore Dollars. We do not use derivative financial instruments for trading or speculative purposes. We are not subject to any credit risk contingent features related to our derivative contracts, and counterparty risk is managed by allocating derivative contracts among several major financial institutions.

Derivatives Designated as Cash Flow Hedges

For derivative instruments that are designated and qualify as cash flow hedges, the effective portion of the gain or loss on the derivative instrument is reported as a component of other comprehensive income (loss) and reclassified into earnings in the same line item associated with the forecasted transaction and in the same period or periods during which the hedged transaction affects earnings. The remaining gain or loss on the derivative instrument in excess of the cumulative change in the present value of future cash flows of the hedged item, if any (i.e., the ineffective portion) or hedge components excluded from the assessment of effectiveness, are recognized in earnings during the current period. We entered into forward contracts on various foreign currencies to manage the risk associated with forecasted exchange rates which impact revenues, cost of sales, and operating expenses in various international markets. The objective of the hedges is to reduce the variability of cash flows associated with the forecasted purchase or sale of the associated foreign currencies.

We enter into approximately 100 cash flow foreign currency hedges every month. As of December 31, 2017, we had entered into foreign currency forward contracts, which qualified as cash flow hedges, with the following notional amounts (in thousands and in local currencies):



Currency	Symbol	Forward Notional Amount
Canadian Dollar	CAD	2,310
Swiss Franc	CHF	1,375
Chinese Renminbi	CNY	45,000
Danish Krone	DKK	14,470
Euro	EUR	9,165
British Pound	GBP	3,625
Mexican Peso	MXN	95,075
Swedish Krona	SEK	16,330

Derivatives Not Designated as Cash Flow Hedges

We forecast our net exposure in various receivables and payables to fluctuations in the value of various currencies, and we enter into foreign currency forward contracts to mitigate that exposure. We enter into approximately 20 foreign currency fair value hedges every month. As of December 31, 2017, we had entered into foreign currency forward contracts related to those balance sheet accounts with the following notional amounts (in thousands and in local currencies):



Currency	Symbol	Forward Notional Amount
Australian Dollar	AUD	5,600
Brazilian Real	BRL	8,500
Canadian Dollar	CAD	2,076
Swiss Franc	CHF	242
Chinese Renminbi	CNY	22,990
Danish Krone	DKK	1,881
Euro	EUR	23,333
British Pound	GBP	1,868
Hong Kong Dollar	HKD	11,000
Japanese Yen	JPY	178,500
Korean Won	KRW	1,800,000
Mexican Peso	MXN	17,540
Swedish Krona	SEK	4,775
Singapore Dollar	SGD	5,023

Balance Sheet Presentation of Derivatives. As of December 31, 2017 and 2016, all derivatives, both those designated as hedging instruments and those that were not designated as hedging instruments, were recorded gross at fair value on our consolidated balance sheets. We are not subject to any master netting agreements.

The fair value of derivative instruments on a gross basis is as follows (in thousands):



		Fair Value
	Balance Sheet Location	December 31, 2017			December 31, 2016
Derivatives designated as hedging instruments
Assets
Interest rates swaps	Other assets (long-term)	$	5,749		$	4,991
Foreign currency forward contracts	Prepaid expenses and other assets	363			116
Foreign currency forward contracts	Other assets (long-term)	35			18

Liabilities
Foreign currency forward contracts	Accrued expenses	(468		)	(275		)
Foreign currency forward contracts	Other long-term obligations	(82		)	(18		)

Derivatives not designated as hedging instruments
Assets
Foreign currency forward contracts	Prepaid expenses and other assets	$	223		$	220
Liabilities
Foreign currency forward contracts	Accrued expenses	(841		)	(171		)

Income Statement Presentation of Derivatives

Derivatives Designated as Cash Flow Hedges

Derivative instruments designated as cash flow hedges had the following effects, before income taxes, on other comprehensive income and net earnings in our consolidated statements of earnings, consolidated statements of comprehensive income and consolidated balance sheets (in thousands):



	Amount of Gain/(Loss) recognized in OCI								Amount of Gain/(Loss) reclassified from AOCI
	Year ended December 31,								Year ended December 31,
	2017	2016			2015				2017		2016		2015
Derivative instrument								Location in statements of income
Interest rate swaps	$853	$	4,989		$	(571	)	Interest Expense	$95		(718	)	(1,103	)
Foreign currency forward contracts	491	(205		)	—			Revenue	(277	)	21		—
								Cost of goods sold	625		(26	)	—

The net amount recognized in earnings during the years ended December 31, 2017, 2016 and 2015 due to ineffectiveness and amounts excluded from the assessment of hedge effectiveness were not significant.

As of December 31, 2017, approximately $44,000, or $33,000 after taxes, was expected to be reclassified from accumulated other comprehensive income to earnings in revenue and cost of sales over the succeeding twelve months. As of December 31, 2017, approximately $1.1 million, or $840,000 after taxes, was expected to be reclassified from accumulated other comprehensive income to earnings in interest expense over the succeeding twelve months.

Derivatives Not Designated as Hedging Instruments

The following gains/(losses) from these derivative instruments were recognized in our consolidated statements of income for the years presented (in thousands):



		Year ended December 31,
		2017			2016		2015
Derivative Instrument	Location in statements of income
Foreign currency forward contracts	Other expense	$	(4,746	)	$	69	$	(302	)

See Note 15 for more information about our derivatives.

- 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, 2017

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, 2017, 2016 and 2015, approximated $13.6 million, $11.4 million and $10.7 million, respectively.

The future minimum lease payments for operating leases as of December 31, 2017, consisted of the following (in thousands):



Years Ending	Operating
December 31	Leases

2018	$	12,293
2019	11,237
2020	9,307
2021	7,527
2022	6,468
Thereafter	57,211

Total minimum lease payments	$	104,043

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. We did not enter into any new sale and leaseback transactions during the years ended December 31, 2017 and 2016. The lease agreements from the sale and leaseback transactions are accounted for as operating leases. Under the terms of the lease agreements, we have agreed to operate and maintain the equipment. The lease term of the agreements is seven years.

Irish Government Development Agency Grants. As of December 31, 2017, we had entered into several grant agreements with the Irish Government Development Agency. 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, 2017 and 2016, was approximately $2.4 million and $2.5 million, respectively. During the years ended December 31, 2017, 2016 and 2015, approximately $147,000, $170,000 and $171,000, 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, 2017, the total amount of grants that could be subject to refund was approximately $3.0 million, and the remaining grant liability period was one year. 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.

Royalties. As of December 31, 2017, we had entered into several agreements to license or acquire rights to certain intellectual property which require us to make royalty payments during the term of the agreements generally based on a percentage of sales. Total royalty expense during the years ended December 31, 2017, 2016 and 2015, approximated $4.4 million, $3.2 million and $2.7 million, respectively. See Note 2 for discussion of future royalty commitments related to acquisitions.

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, contract disputes, and employment or other matters that are significant to our business. Based upon our review of currently available information, we do not believe that any such actions are likely to be, individually or in the aggregate, materially adverse to our business, financial condition, results of operations or liquidity.

In October 2016, we received a subpoena from the U.S. Department of Justice seeking information on certain of our marketing and promotional practices. We are in the process of responding to the subpoena, which we anticipate will continue during 2018. We have incurred, and anticipate that we will continue to incur, substantial costs in connection with the matter. The investigation is ongoing and at this stage we are unable to predict its scope, duration or outcome. Investigations such as this may result in the imposition of, among other things, significant damages, injunctions, fines or civil or criminal claims or penalties against our company or individuals.

In the event of unexpected further developments, it is possible that the ultimate resolution of any of the foregoing matters, or other similar matters, if resolved in a manner unfavorable to us, 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, 2017

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, 2017:
Basic EPS	$	27,523	48,805	$	0.56
Effect of dilutive stock options and warrants			1,296

Diluted EPS	$	27,523	50,101	$	0.55

Year ended December 31, 2016:
Basic EPS	$	20,121	44,408	$	0.45
Effect of dilutive stock options and warrants			454

Diluted EPS	$	20,121	44,862	$	0.45

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

For the years ended December 31, 2017, 2016 and 2015, approximately 381,000, 727,000 and 423,000, 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, 2017

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, 2017, a total of 492,292 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, 2017, the total number of shares of Common Stock that remained available to be issued under our non-qualified plan was 126,863 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, 2017, 2016 and 2015, consisted of the following (in thousands):



	2017		2016		2015
Cost of goods sold	$	632	$	472	$	398
Research and development	376		184		122
Selling, general, and administrative	3,067		1,850		1,723
Stock-based compensation expense before taxes	$	4,075	$	2,506	$	2,243

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, 2017, the total remaining unrecognized compensation cost related to non-vested stock options, net of expected forfeitures, was approximately $15.1 million and is expected to be recognized over a weighted average period of 3.46 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:



	2017			2016			2015
Risk-free interest rate	1.77%	-	1.83%	1.15%	-	1.40%	1.53%	-	1.66%
Expected option life	5.0 years			5.0 years			5.0 years
Expected dividend yield	—%			—%			—%
Expected price volatility	33.81%	-	34.07%	34.28%	-	37.06%	33.72%	-	35.11%

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, 2017, 2016 and 2015, approximately 1.3 million, 880,000 and 618,000 stock-based compensation grants were made, respectively, for a total fair value of approximately $12.4 million, $5.2 million and $3.7 million, net of estimated forfeitures, respectively.

The table below presents information related to stock option activity for the years ended December 31, 2017, 2016 and 2015 (in thousands):



	2017		2016		2015
Total intrinsic value of stock options exercised	$	9,264	$	3,648	$	7,548
Cash received from stock option exercises	5,552		4,577		6,227
Excess tax benefit from the exercise of stock options	2,264		669		2,124

Changes in stock options for the year ended December 31, 2017, consisted of the following (shares and intrinsic value in thousands):



	Number of Shares		Weighted Average Exercise Price		Remaining Contractual Term (in years)	Intrinsic Value
Beginning balance	2,817		$	15.32
Granted	1,297		29.31
Exercised	(404	)	14.02
Forfeited/expired	(87	)	18.79
Outstanding at December 31	3,623		20.40		4.57 years	$	82,615
Exercisable	1,110		14.35		2.55 years	32,019
Ending vested and expected to vest	3,484		20.23		4.52 years	80,052

The weighted average grant-date fair value of options granted during the years ended December 31, 2017, 2016 and 2015 was $9.57, $5.94 and $5.98, respectively.

The following table summarizes information about stock options outstanding at December 31, 2017 (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	-	$13.75	925	2.17 years	$	12.65	713	$	12.84
$13.77	-	$17.27	991	4.38 years	$	16.18	294	$	15.96
$18.80	-	$22.00	425	5.00 years	$	20.14	103	$	20.18
$28.20	-	$38.35	1,282	6.30 years	$	29.33	0	$	—
$9.95	-	$38.35	3,623				1,110

- Definition

The entire disclosure for compensation-related costs for equity-based compensation, which may include disclosure of policies, compensation plan details, allocation of equity compensation, incentive distributions, equity-based arrangements to obtain goods and services, deferred compensation arrangements, employee stock ownership plan details and employee stock purchase plan details.

+ References + Details

Segment Reporting and Foreign Operations

12 Months Ended

Dec. 31, 2017

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 embolotherapeutic, cardiac rhythm management ("CRM"), electrophysiology ("EP"), critical care and interventional oncology and spine 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, 2017, 2016 and 2015 (in thousands):



	% Change	2017		% Change	2016*		% Change	2015

Cardiovascular
Stand-alone devices	44%	$	275,431	23%	$	191,148	8%	$	155,414
Custom kits and procedure trays	6%	126,114		2%	119,226		5%	116,368
Inflation devices	8%	79,875		1%	73,916		1%	73,373
Catheters	13%	127,747		17%	113,367		11%	96,833
Embolization devices	8%	49,532		2%	46,035		3%	45,025
CRM/EP	15%	41,914		8%	36,459		3%	33,902
Total	21%	700,613		11%	580,151		6%	520,915

Endoscopy
Endoscopy devices	15%	27,239		12%	23,687		18%	21,234

Total	21%	$	727,852	11%	$	603,838	6%	$	542,149

* Certain product categories for 2016 have been adjusted from prior disclosure to reflect changes in product classifications to be consistent with updates in the management of our product portfolios in 2017.

During the years ended December 31, 2017, 2016 and 2015, we had international sales of approximately $307.1 million, $233.5 million and $214.0 million, respectively, or approximately 42%, 39% and 39%, respectively, of net sales, primarily in China, Japan, Germany, France, the United Kingdom and Russia. China represents our most significant international sales market with sales of approximately $73.4 million, $59.9 million, and $50.7 million for the years ended December 31, 2017, 2016 and 2015, respectively. International sales are attributed based on location of the customer receiving the product.

Our long-lived assets by geographic area at December 31, 2017, 2016 and 2015, consisted of the following (in thousands):



	2017		2016		2015
United States	$	202,504	$	194,715	$	186,389
Ireland	45,671		47,337		48,896
Other foreign countries	44,645		34,521		32,493
Total	$	292,820	$	276,573	$	267,778

Financial information relating to our reportable operating segments and reconciliations to the consolidated totals for the years ended December 31, 2017, 2016 and 2015, are as follows (in thousands):



	2017		2016			2015
Net Sales ⁽¹⁾
Cardiovascular	$	700,613	$	580,151		$	520,915
Endoscopy	27,239		23,687			21,234
Total net sales	727,852		603,838			542,149

Operating expenses
Cardiovascular	281,095		218,659			187,492
Endoscopy	12,089		11,490			10,746
Total operating expenses	293,184		230,149			198,238

Operating income (loss) ⁽¹⁾
Cardiovascular	24,819		30,053			34,052
Endoscopy	8,250		4,823			3,491
Total operating income	33,069		34,876			37,543

Total other expense - net	2,812		(9,490		)	(6,343		)
Income tax expense	8,358		5,265			7,398

Net income	$	27,523	$	20,121		$	23,802

(1) Sales and operating income have been adjusted from prior disclosure to reflect changes in product classifications between our operating segments, which were made to be consistent with updates in the management of our product portfolios in 2017.

Total assets by business segment at December 31, 2017, 2016 and 2015, consisted of the following (in thousands):



	2017		2016		2015
Cardiovascular	$	1,103,806	$	932,927	$	767,952
Endoscopy	8,005		9,876		10,776
Total	$	1,111,811	$	942,803	$	778,728

Total depreciation and amortization by business segment for the years ended December 31, 2017, 2016, and 2015 consisted of the following (in thousands):



	2017		2016		2015

Cardiovascular	$	52,700	$	42,806	$	36,474
Endoscopy	882		949		951
Total	$	53,582	$	43,755	$	37,425

Total capital expenditures for property and equipment by business segment for the years ended December 31, 2017, 2016 and 2015 consisted of the following (in thousands):



	2017		2016		2015

Cardiovascular	$	38,437	$	32,613	$	50,927
Endoscopy	186		224		32
Total	$	38,623	$	32,837	$	50,959

- 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
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
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Reference 2: http://www.xbrl.org/2003/role/presentationRef
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-Name Accounting Standards Codification
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Reference 3: http://www.xbrl.org/2003/role/presentationRef
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+ Details

Employee Benefit Plans	12 Months Ended
Employee Benefit Plans	Dec. 31, 2017
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, 2017, 2016 and 2015, totaled approximately $2.4 million, $2.3 million and $2.0 million, respectively. We also 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, 2017, 2016 and 2015, totaled approximately $2.3 million, $1.1 million and $893,000, respectively.

Quarterly Results of Operations (Unaudited)

12 Months Ended

Dec. 31, 2017

Quarterly Financial Information Disclosure [Abstract]

Quarterly Results of Operations (Unaudited)

QUARTERLY RESULTS OF OPERATIONS (UNAUDITED)

Quarterly data for the years ended December 31, 2017 and 2016 consisted of the following (in thousands, except per share amounts):



	Quarter Ended
	March 31		June 30		September 30			December 31
2017
Net sales	$	171,069	$	186,549	$	179,337		$	190,897
Gross profit	75,942		84,141		80,514			85,656
Income from operations	5,609		13,362		879			13,219
Income tax expense	690		1,830		1,364			4,474
Net income (loss)	14,803		9,483		(3,569		)	6,806
Basic earnings per common share	0.33		0.19		(0.07		)	0.14
Diluted earnings per common share	0.32		0.19		(0.07		)	0.13

2016
Net sales	$	138,077	$	151,071	$	156,975		$	157,715
Gross profit	60,100		66,854		67,815			70,256
Income from operations	7,706		11,581		2,987			12,602
Income tax expense (benefit)	1,555		2,572		(978		)	2,116
Net income	4,351		7,290		973			7,507
Basic earnings per common share	0.10		0.16		0.02			0.17
Diluted earnings per common share	0.10		0.16		0.02			0.17

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, 2017

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, 2017 and 2016, 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, 2017			(Level 1)		(Level 2)			(Level 3)

Interest rate contracts (1)	$	5,749		$	—	$	5,749		$	—
Foreign currency contract assets, current and long-term (2)	$	621		$	—	$	621		$	—
Foreign currency contract liabilities, current and long-term (3)	$	(1,391	)	$	—	$	(1,391	)	$	—

				Fair Value Measurements Using
	Total Fair			Quoted prices in		Significant other			Significant
	Value at			active markets		observable inputs			unobservable inputs
Description	December 31, 2016			(Level 1)		(Level 2)			(Level 3)

Interest rate contracts (1)	$	4,991		$	—	$	4,991		$	—
Foreign currency contract assets, current and long-term (2)	$	354		$	—	$	354		$	—
Foreign currency contract liabilities, current and long-term (3)	$	(464	)	$	—	$	(464	)	$	—

(1) The fair value of the interest rate contracts is determined using Level 2 fair value inputs and is recorded as other assets or other long-term obligations in the consolidated balance sheets.

(2) The fair value of the foreign currency contract assets (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as prepaid and other assets or other long-term assets in the consolidated balance sheets.

(3) The fair value of the foreign currency contract liabilities (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as accrued expenses or other long-term obligations 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, 2017 and 2016, consisted of the following (in thousands):



	2017			2016
Beginning balance	$	683		$	1,024
Contingent consideration liability recorded as the result of acquisitions (see Note 2)	10,400			—
Fair value adjustments recorded to income during the period	(66		)	(123		)
Contingent payments made	(61		)	(218		)
Ending balance	$	10,956		$	683

As of December 31, 2017, approximately $10.7 million was included in other long-term obligations and approximately $289,000 was included in accrued expenses in our consolidated balance sheet. As of December 31, 2016, approximately $595,000 was included in other long-term obligations and $88,000 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 year ended December 31, 2016, we sold a cost method investment for cash and for the right to receive additional payments based on various contingent milestones. We determined the fair value of the contingent payments using Level 3 inputs defined under authoritative guidance for fair value measurements, and we recorded a contingent receivable asset, which as of December 31, 2017 and 2016 had a value of approximately $760,000 and $528,000, respectively. We record any changes in fair value to operating expenses as part of our cardiovascular segment in our consolidated statements of income. During the year ended December 31, 2017, we recorded a gain on the contingent receivable of approximately $232,000. During the year ended December 31, 2016, we recorded a loss on the contingent receivable of approximately $184,000. As of December 31, 2017, approximately $319,000 was included in other long-term assets and approximately $441,000 was included in other receivables as a current asset in our consolidated balance sheet. During the year ended December 31, 2016, approximately $367,000 was included in other long-term assets and approximately $161,000 was included in other receivables as a current asset in our consolidated balance sheet.

The recurring Level 3 measurement of our contingent consideration liability and contingent receivable includes the following significant unobservable inputs at December 31, 2017 and 2016 (amounts in thousands):



Contingent consideration asset or liability	Fair value at December 31, 2017		Valuation technique	Unobservable inputs	Range
Revenue-based payments	$	10,956	Discounted cash flow	Discount rate	9.9% - 15%
contingent liability			Discounted cash flow	Probability of milestone payment	100%
				Projected year of payments	2018-2037

Contingent receivable	$	760	Discounted cash flow	Discount rate	10%
asset			Discounted cash flow	Probability of milestone payment	75%
				Projected year of payments	2018-2019

Contingent consideration asset or liability	Fair value at December 31, 2016		Valuation technique	Unobservable inputs	Range
Revenue-based payments	$	683	Discounted cash flow	Discount rate	9.9% - 15%
contingent liability			Discounted cash flow	Probability of milestone payment	100%
				Projected year of payments	2017-2028

Contingent receivable	$	528	Discounted cash flow	Discount rate	10%
asset			Discounted cash flow	Probability of milestone payment	57%
				Projected year of payments	2017-2019

The contingent consideration liability and contingent receivable are 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. 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. A decrease in the probability of any milestone payment may result in lower fair value measurements. Our determination of the fair value of the contingent consideration liability and contingent receivable 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.

During the years ended December 31, 2017, 2016 and 2015, we had losses of approximately $988,000, $101,000, and $141,000, respectively, related to the measurement of non-financial assets at fair value on a nonrecurring basis subsequent to their initial recognition (see Note 4).

The carrying amount of cash and cash equivalents, receivables, and trade payables approximate 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

Issuance of Common Stock	12 Months Ended
Issuance of Common Stock	Dec. 31, 2017
Equity [Abstract]
Issuance of Common Stock	ISSUANCE OF COMMON STOCK On March 28, 2017, we closed a public offering of 5,175,000 shares of common stock and received proceeds of approximately $136.6 million, which is net of approximately $8.8 million in underwriting discounts and commissions and approximately $816,000 in other direct cost incurred and paid by us in connection with this equity offering. The net proceeds from the offering were used primarily to repay outstanding indebtedness under our Second Amended Credit Agreement (including our term loan and revolving credit loans).

- Definition

The entire disclosure for shareholders' equity comprised of portions attributable to the parent entity and noncontrolling interest, including other comprehensive income. Includes, but is not limited to, balances of common stock, preferred stock, additional paid-in capital, other capital and retained earnings, accumulated balance for each classification of other comprehensive income and amount of comprehensive income.

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Reference 14: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Glossary Preferred Stock
-URI http://asc.fasb.org/extlink&oid=6521494

Reference 15: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=6928386&loc=d3e21463-112644

Reference 16: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 11
-URI http://asc.fasb.org/extlink&oid=6928386&loc=d3e21564-112644

+ Details

Subsequent Events	12 Months Ended
Subsequent Events	Dec. 31, 2017
Subsequent Events [Abstract]
Subsequent Events	SUBSEQUENT EVENTS We evaluate events occurring after the date of our accompanying consolidated balance sheets for potential recognition or disclosure in our financial statements. We did not identify any material subsequent events requiring adjustment to our accompanying consolidated financial statements (recognized subsequent events). We have also evaluated whether any subsequent events have occurred after the date of our accompanying consolidated balance sheets to the time of filing of this report that would require disclosure in the consolidated financial statements. We note the following event below. On February 14, 2018, we completed the acquisition of two product lines from BD. Pursuant to the terms of the BD Agreement, we paid BD the purchase consideration of approximately $100.1 million in cash. The purchased assets constitute the soft tissue core needle biopsy products under the trade names of Achieve™ Programmable Automatic Biopsy System, Temno™ Biopsy System, and Tru-Cut™ Biopsy Needles previously sold by BD as well as the Aspira® Pleural Effusion Drainage Kits and the Aspira® Peritoneal Drainage System previously sold by C.R. Bard, Inc. We are currently evaluating the accounting treatment of this purchase, as well as performing the valuation of assets acquired and the related purchase price allocation.

Schedule II - Valuation and qualifying accounts

12 Months Ended

Dec. 31, 2017

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, 2017, 2016 and 2015

(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:

2015	(893	)	(607	)	203	(1,297	)
2016	(1,297	)	(612	)	322	(1,587	)
2017	(1,587	)	(1,012	)	830	(1,769	)

(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, 2017, 2016 and 2015

(In thousands)



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

TAX VALUATION ALLOWANCE:

2015	(1,603	)	(378	)	—	(1,981	)
2016	(1,981	)	(1,805	)	—	(3,786	)
2017	(3,786	)	(636	)	—	(4,422	)

(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, 2017

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Use of Estimates in Preparing Financial Statements

Reclassifications

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

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 of Sales

Research and Development

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

Income Taxes

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

DERIVATIVES

Derivatives Designated as Cash Flow Hedges

New Financial Accounting Standards

New Financial Accounting Standards.

Recently Adopted

Not Yet Adopted

All other issued and not yet effective accounting standards are not relevant to our financial statements.

Organization and Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2017

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Intangible Assets

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, 2017

Business Combinations [Abstract]

Schedule of Recognized Identified Assets Acquired and Liabilities Assumed

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



		Preliminary Allocation			Adjustments ⁽¹⁾			Revised Allocation
	Assets Acquired
	Trade receivables	$	952		$	6		$	958
	Inventories	2,244			(87		)	2,157
	Prepaid expenses and other assets	181			(96		)	85
	Property and equipment	1,472			—			1,472
	Intangibles
	Developed technology	22,900			(1,800		)	21,100
	Customer lists	100			600			700
	Trademarks	2,900			—			2,900
	Goodwill	7,612			1,377			8,989
	Total assets acquired	38,361			—			38,361

	Liabilities Assumed
	Trade payables	(338		)	—			(338		)
	Accrued expenses	(23		)	—			(23		)
	Total liabilities assumed	(361		)	—			(361		)

	Net assets acquired	$	38,000		$	—		$	38,000

(1)	Under U.S. GAAP, measurement period adjustments are recognized on a prospective basis in the period of change, instead of restating prior periods. There was no impact to reported earnings in connection with these measurement period adjustments for the periods presented. Amounts represent adjustments to the preliminary purchase price first presented in our Quarterly Report on Form 10-Q for the Quarter Ended March 31, 2017, resulting from activities with respect to finalizing our purchase price allocation for this acquisition. The larger adjustments primarily relate to the valuation of the acquired intangible assets.

The purchase price was allocated to the net tangible and intangible assets acquired and liabilities assumed, based on estimated fair values, as follows (in thousands):



Assets Acquired
Trade receivables	$	4,054
Other receivables	6
Inventories	8,585
Prepaid expenses	630
Property and equipment	1,630
Other long-term assets	145
Intangibles
Developed technology	67,600
Customer lists	2,400
Trademarks	4,400
Goodwill	24,818
Total assets acquired	114,268

Liabilities Assumed
Trade payables	(1,790		)
Accrued expenses	(5,298		)
Deferred income tax liabilities - current	(701		)
Deferred income tax liabilities - noncurrent	(10,844		)
Total liabilities assumed	(18,633		)

Net assets acquired, net of cash received of $1,327	$	95,635

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



Assets Acquired
Inventories	$	2,455
Property and equipment	290
Intangibles
Developed technology	12,100
Trademarks	700
Customers Lists	400
Goodwill	2,555

Total assets acquired	$	18,500

The following table summarizes the aggregate purchase price (including contingent royalty payment liabilities) allocated to the assets acquired from Laurane (in thousands):



Net Assets Acquired
Inventories	$	594
Intangibles
Developed technology	14,920
Customer list	120
Goodwill	6,366

Total net assets acquired	$	22,000

The following table summarizes the aggregate purchase price allocated to the assets acquired from ITL (in thousands):



Assets Acquired
Trade receivables	$	1,287
Other receivables	56
Inventories	1,808
Prepaid expenses and other assets	65
Property and equipment	1,053
Intangibles
Customer lists	5,940
Goodwill	3,740
Total assets acquired	13,949

Liabilities Assumed
Trade payables	(216		)
Accrued expenses	(542		)
Deferred tax liabilities	(1,901		)
Total liabilities assumed	(2,659		)

Total net assets acquired	$	11,290

The following table summarizes the preliminary purchase price allocated to the net tangible and intangible assets acquired and liabilities assumed (in thousands), adjusted as of December 31, 2017:



		Preliminary Allocation			Adjustments ⁽²⁾			Revised Allocation
	Assets Acquired
	Cash and cash equivalents	$	1,436		$	—		$	1,436
	Trade receivables	8,351			—			8,351
	Inventories	12,217			(995		)	11,222
	Prepaid expenses and other assets	1,275			—			1,275
	Income tax refund receivable	—			165			165
	Property and equipment	2,667			(348		)	2,319
	Deferred tax assets	184			18			202
	Intangibles
	Developed technology	2,600			(400		)	2,200
	Customer lists	1,300			200			1,500
	Trademarks	1,500			(600		)	900
	Total assets acquired	31,530			(1,960		)	29,570

	Liabilities Assumed
	Trade payables	(2,306		)	(108		)	(2,414		)
	Accrued expenses	(5,083		)	—			(5,083		)
	Income taxes payable	(2		)	2			—
	Deferred income tax liabilities	(999		)	65			(934		)
	Total liabilities assumed	(8,390		)	(41		)	(8,431		)

	Total net assets acquired	23,140			(2,001		)	21,139
	Gain on bargain purchase ⁽¹⁾	(12,243		)	1,204			(11,039		)
	Total purchase price	$	10,897		$	(797	)	$	10,100

(1)	The total fair value of the net assets acquired from Argon exceeded the purchase price, resulting in a gain on bargain purchase which was recorded within other income (expense) in our consolidated statements of income, and includes a negative adjustment of $1.2 million since the bargain purchase gain was first presented in our Quarterly Report on Form 10-Q for the quarter ended March 31, 2017. We believe the reason for the gain on bargain purchase was a result of the divestiture of a non-strategic, slow-growth critical care business for Argon. It is our understanding that the divestiture allows Argon to focus on its higher growth interventional portfolio.
(2)	Under U.S. GAAP, measurement period adjustments are recognized on a prospective basis in the period of change, instead of restating prior periods. There was no impact to reported earnings in connection with these measurement period adjustments for the periods presented. Amounts represent adjustments to the preliminary purchase price allocation first presented in our March 31, 2017 Form 10-Q resulting from our ongoing activities, including reassessment of the assets acquired and liabilities assumed, with respect to finalizing our purchase price allocation for this acquisition.

The following table summarizes the preliminary purchase price allocated to the net assets acquired (in thousands):



Net Assets Acquired
Inventories	$	979
Property and equipment	58
Intangibles
Developed technology	5,400
Customer list	200
Goodwill	203

Total net assets acquired	$	6,840

The following table summarizes the preliminary purchase price allocated to the net assets acquired and liabilities assumed (in thousands):



		Preliminary Allocation			Adjustments ⁽¹⁾			Revised Allocation
	Net Assets Acquired
	Intangibles
	Developed technology	$	7,800		$	—		$	7,800
	In-process technology	850			70			920
	Goodwill	4,323			(42		)	4,281
	Deferred tax liabilities	(3,073		)	(28		)	(3,101		)

	Total net assets acquired	$	9,900		$	—		$	9,900

(1)	Under U.S. GAAP, measurement period adjustments are recognized on a prospective basis in the period of change, instead of restating prior periods. There was no impact to reported earnings in connection with these measurement period adjustments for the periods presented. Amounts represent adjustments to the preliminary purchase price allocation first presented in our Quarterly Report on Form 10-Q for the quarter ended June 30, 2017 resulting from our ongoing activities, including reassessment of the assets acquired and liabilities assumed, with respect to finalizing our purchase price allocation for this acquisition.

Business Acquisition, Pro Forma Information



	2017				2016				2015
	As Reported		Pro Forma		As Reported		Pro Forma		As Reported		Pro Forma
Net sales	$	727,852	$	730,612	$	603,838	$	664,366	$	542,149	$	575,541
Net income	27,523		17,419		20,121		23,068		23,802		3,135
Earnings per common share:
Basic	$	0.56	$	0.36	$	0.45	$	0.52	$	0.54	$	0.07
Diluted	$	0.55	$	0.35	$	0.45	$	0.51	$	0.53	$	0.07

Inventories (Tables)

12 Months Ended

Dec. 31, 2017

Inventory Disclosure [Abstract]

Schedule of Inventory

Inventories at December 31, 2017 and 2016, consisted of the following (in thousands):



	2017		2016
Finished goods	$	86,555	$	63,852
Work-in-process	12,799		11,008
Raw materials	55,934		45,835

Total	$	155,288	$	120,695

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2017

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, 2017 and 2016, are as follows (in thousands):



	2017		2016
Goodwill balance at January 1	$	211,927	$	184,472
Effect of foreign exchange	2,641		82
Additions as the result of acquisitions	23,579		27,373
Goodwill balance at December 31	$	238,147	$	211,927

Other intangible assets

Other intangible assets at December 31, 2017 and 2016, consisted of the following (in thousands):



	2017
	Gross Carrying Amount		Accumulated Amortization			Net Carrying Amount
Patents	$	16,528	$	(3,737	)	$	12,791
Distribution agreements	7,262		(4,686		)	2,576
License agreements	23,783		(5,568		)	18,215
Trademarks	16,224		(4,686		)	11,538
Covenants not to compete	1,028		(968		)	60
Customer lists	31,935		(18,482		)	13,453
In-process technology	920		—			920

Total	$	97,680	$	(38,127	)	$	59,553



	2016
	Gross Carrying Amount		Accumulated Amortization			Net Carrying Amount
Patents	$	14,130	$	(3,165	)	$	10,965
Distribution agreements	6,626		(3,527		)	3,099
License agreements	20,695		(3,422		)	17,273
Trademarks	12,380		(3,330		)	9,050
Covenants not to compete	1,028		(936		)	92
Customer lists	22,261		(15,401		)	6,860
Royalty agreements	267		(267		)	—

Total	$	77,387	$	(30,048	)	$	47,339

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, 2017 (in thousands):



Year Ending December 31
2018	$	30,413
2019	29,787
2020	28,373
2021	21,001
2022	19,396

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2017

Income Tax Disclosure [Abstract]

Schedule of Income before Income Tax, Domestic and Foreign

For the years ended December 31, 2017, 2016 and 2015, income before income taxes is broken out between U.S. and foreign-sourced operations and consisted of the following (in thousands):



	2017		2016		2015
Domestic	$	14,531	$	6,174	$	9,470
Foreign	21,350		19,212		21,730
Total	$	35,881	$	25,386	$	31,200

Schedule of Components of Income Tax Expense (Benefit)

The components of the provision for income taxes for the years ended December 31, 2017, 2016 and 2015, consisted of the following (in thousands):



	2017			2016			2015
Current expense (benefit):
Federal	$	3,849		$	1,933		$	(17	)
State	645			492			747
Foreign	5,168			3,802			3,218
Total current expense	9,662			6,227			3,948

Deferred expense (benefit):
Federal	(314		)	(144		)	3,250
State	(216		)	(195		)	294
Foreign	(774		)	(623		)	(94		)
Total deferred (benefit) expense	(1,304		)	(962		)	3,450

Total income tax expense	$	8,358		$	5,265		$	7,398

Schedule of Effective Income Tax Rate Reconciliation



	2017			2016			2015
Computed federal income tax expense at statutory rate of 35%	$	12,559		$	8,885		$	10,920
State income taxes	279			193			698
Tax credits	(1,377		)	(1,164		)	(1,019		)
Production activity deduction	—			(53		)	—
Foreign tax rate differential	(3,329		)	(3,717		)	(3,564		)
Uncertain tax positions	(19		)	597			536
Deferred compensation insurance assets	(479		)	(307		)	182
Transaction-related expenses	90			274			—
U.S. transition tax	10,612			—			—
TCJA remeasurement of deferred taxes	(8,383		)	—			—
Share-based payments	(2,264		)	—			—
Bargain purchase gain	(1,570		)	—			—
In-process research and development	1,486			—			—
Other — including the effect of graduated rates	753			557			(355		)
Total income tax expense	$	8,358		$	5,265		$	7,398

Schedule of Deferred Tax Assets and Liabilities

Deferred income tax assets and liabilities at December 31, 2017 and 2016, consisted of the following temporary differences and carry-forward items (in thousands):



	2017			2016
Deferred income tax assets:
Allowance for uncollectible accounts receivable	$	467		$	645
Accrued compensation expense	5,154			6,203
Inventory differences	2,505			1,065
Net operating loss carryforwards	15,741			27,742
Deferred revenue	58			73
Stock-based compensation expense	2,281			2,738
Federal research and development credit carryforward	—			3,524
Foreign tax credits	—			364
Other	8,986			6,984
Total deferred income tax assets	35,192			49,338

Deferred income tax liabilities:
Prepaid expenses	(930		)	(782		)
Property and equipment	(20,352		)	(25,108		)
Intangible assets	(28,588		)	(35,773		)
Other	(1,830		)	(1,480		)
Total deferred income tax liabilities	(51,700		)	(63,143		)
Valuation allowance	(4,422		)	(3,786		)
Net deferred income tax assets (liabilities)	$	(20,930	)	$	(17,591	)

Reported as:
Deferred income tax assets - Current	$	—		$	8,219
Deferred income tax assets - Long-term	2,359			171
Deferred income tax liabilities - Long-term	(23,289		)	(25,981		)
Net deferred income tax liabilities	$	(20,930	)	$	(17,591	)

Summary of Income Tax Contingencies



Tabular Roll-forward	2017			2016			2015

Unrecognized tax benefits, opening balance	$	2,549		$	1,982		$	1,736
Gross increases in tax positions taken in a prior year	80			77			187
Gross increases in tax positions taken in the current year	403			856			763
Lapse of applicable statute of limitations	(283		)	(366		)	(704		)
Unrecognized tax benefits, ending balance	$	2,749		$	2,549		$	1,982

Revolving Credit Facility and Long-Term Debt (Tables)

12 Months Ended

Dec. 31, 2017

Debt Disclosure [Abstract]

Schedule of Long-term Debt Instruments

rincipal balances outstanding under our long-term debt obligations as of December 31, 2017 and 2016, consisted of the following (in thousands):



	2017			2016
2016 Term loan	$	85,000		$	145,000
2016 Revolving credit loans	187,000			180,000
2017 Debt facility	6,959			—
Less unamortized debt issuance costs	(487		)	(627		)
Total long-term debt	278,472			324,373
Less current portion	19,459			10,000
Long-term portion	$	259,013		$	314,373

Schedule of Long-term Debt Covenants

The Second Amended Credit Agreement requires that we maintain certain financial covenants, as follows:



		Covenant Requirement
Consolidated Total Leverage Ratio (1)
	July 1, 2017 through December 31, 2017	3.75 to 1.0
	January 1, 2018 through March 31, 2018	3.5 to 1.0
	April 1, 2018 and thereafter	3.25 to 1.0
Consolidated EBITDA (2)		1.25 to 1.0
Consolidated Net Income (3)		$—
Facility Capital Expenditures (4)		$30 million

(1)	Maximum Consolidated Total Leverage Ratio (as defined in the Second Amended Credit Agreement) as of any fiscal quarter end.
(2)	Minimum ratio of Consolidated EBITDA (as defined in the Second Amended Credit Agreement and adjusted for certain expenditures) to Consolidated Fixed Charges (as defined in the Second Amended Credit Agreement) for any period of four consecutive fiscal quarters.
(3)	Minimum level of Consolidated Net Income (as defined in the Second Amended Credit Agreement) for certain periods, and subject to certain adjustments.
(4)	Maximum level of the aggregate amount of all Facility Capital Expenditures (as defined in the Second Amended Credit Agreement) in any fiscal year.

Schedule of Maturities of Long-term Debt

Future minimum principal payments on our long-term debt as of December 31, 2017, are as follows (in thousands):



Years Ending	Future Minimum
December 31	Principal Payments
2018	$	19,459
2019	15,000
2020	17,500
2021	227,000
Total future minimum principal payments	$	278,959

- 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)
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-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
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-Section 50
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Reference 3: http://www.xbrl.org/2003/role/presentationRef
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-Name Accounting Standards Codification
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-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=6479336&loc=d3e64711-112823

Reference 4: http://www.xbrl.org/2003/role/presentationRef
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-Name Accounting Standards Codification
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-Paragraph 1
-Subparagraph (SX 210.4-08.(e),(f))
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-Paragraph 8
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Reference 9: http://www.xbrl.org/2003/role/presentationRef
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-Name Accounting Standards Codification
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-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
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-Paragraph 7
-URI http://asc.fasb.org/extlink&oid=6928386&loc=d3e21521-112644

+ Details

Derivatives (Tables)

12 Months Ended

Dec. 31, 2017

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Schedule of Notional Amounts of Outstanding Derivative Positions



Currency	Symbol	Forward Notional Amount
Canadian Dollar	CAD	2,310
Swiss Franc	CHF	1,375
Chinese Renminbi	CNY	45,000
Danish Krone	DKK	14,470
Euro	EUR	9,165
British Pound	GBP	3,625
Mexican Peso	MXN	95,075
Swedish Krona	SEK	16,330



Currency	Symbol	Forward Notional Amount
Australian Dollar	AUD	5,600
Brazilian Real	BRL	8,500
Canadian Dollar	CAD	2,076
Swiss Franc	CHF	242
Chinese Renminbi	CNY	22,990
Danish Krone	DKK	1,881
Euro	EUR	23,333
British Pound	GBP	1,868
Hong Kong Dollar	HKD	11,000
Japanese Yen	JPY	178,500
Korean Won	KRW	1,800,000
Mexican Peso	MXN	17,540
Swedish Krona	SEK	4,775
Singapore Dollar	SGD	5,023

Schedule of Derivative Instruments in Statement of Financial Position, Fair Value

The fair value of derivative instruments on a gross basis is as follows (in thousands):



		Fair Value
	Balance Sheet Location	December 31, 2017			December 31, 2016
Derivatives designated as hedging instruments
Assets
Interest rates swaps	Other assets (long-term)	$	5,749		$	4,991
Foreign currency forward contracts	Prepaid expenses and other assets	363			116
Foreign currency forward contracts	Other assets (long-term)	35			18

Liabilities
Foreign currency forward contracts	Accrued expenses	(468		)	(275		)
Foreign currency forward contracts	Other long-term obligations	(82		)	(18		)

Derivatives not designated as hedging instruments
Assets
Foreign currency forward contracts	Prepaid expenses and other assets	$	223		$	220
Liabilities
Foreign currency forward contracts	Accrued expenses	(841		)	(171		)

Schedule of Cash Flow Hedges Included in Accumulated Other Comprehensive Income (Loss)



	Amount of Gain/(Loss) recognized in OCI								Amount of Gain/(Loss) reclassified from AOCI
	Year ended December 31,								Year ended December 31,
	2017	2016			2015				2017		2016		2015
Derivative instrument								Location in statements of income
Interest rate swaps	$853	$	4,989		$	(571	)	Interest Expense	$95		(718	)	(1,103	)
Foreign currency forward contracts	491	(205		)	—			Revenue	(277	)	21		—
								Cost of goods sold	625		(26	)	—

Derivative Instruments, Gain (Loss)

The following gains/(losses) from these derivative instruments were recognized in our consolidated statements of income for the years presented (in thousands):



		Year ended December 31,
		2017			2016		2015
Derivative Instrument	Location in statements of income
Foreign currency forward contracts	Other expense	$	(4,746	)	$	69	$	(302	)

Earnings Per Common Share (EPS) (Tables)

12 Months Ended

Dec. 31, 2017

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, 2017:
Basic EPS	$	27,523	48,805	$	0.56
Effect of dilutive stock options and warrants			1,296

Diluted EPS	$	27,523	50,101	$	0.55

Year ended December 31, 2016:
Basic EPS	$	20,121	44,408	$	0.45
Effect of dilutive stock options and warrants			454

Diluted EPS	$	20,121	44,862	$	0.45

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

Employee Stock Purchase Plan, Stock Options and Warrants (Tables)

12 Months Ended

Dec. 31, 2017

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, 2017, 2016 and 2015, consisted of the following (in thousands):



	2017		2016		2015
Cost of goods sold	$	632	$	472	$	398
Research and development	376		184		122
Selling, general, and administrative	3,067		1,850		1,723
Stock-based compensation expense before taxes	$	4,075	$	2,506	$	2,243

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:



	2017			2016			2015
Risk-free interest rate	1.77%	-	1.83%	1.15%	-	1.40%	1.53%	-	1.66%
Expected option life	5.0 years			5.0 years			5.0 years
Expected dividend yield	—%			—%			—%
Expected price volatility	33.81%	-	34.07%	34.28%	-	37.06%	33.72%	-	35.11%

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, 2017, 2016 and 2015 (in thousands):



	2017		2016		2015
Total intrinsic value of stock options exercised	$	9,264	$	3,648	$	7,548
Cash received from stock option exercises	5,552		4,577		6,227
Excess tax benefit from the exercise of stock options	2,264		669		2,124

Schedule of Share-based Compensation, Stock Options, Activity

Changes in stock options for the year ended December 31, 2017, consisted of the following (shares and intrinsic value in thousands):



	Number of Shares		Weighted Average Exercise Price		Remaining Contractual Term (in years)	Intrinsic Value
Beginning balance	2,817		$	15.32
Granted	1,297		29.31
Exercised	(404	)	14.02
Forfeited/expired	(87	)	18.79
Outstanding at December 31	3,623		20.40		4.57 years	$	82,615
Exercisable	1,110		14.35		2.55 years	32,019
Ending vested and expected to vest	3,484		20.23		4.52 years	80,052

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, 2017 (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	-	$13.75	925	2.17 years	$	12.65	713	$	12.84
$13.77	-	$17.27	991	4.38 years	$	16.18	294	$	15.96
$18.80	-	$22.00	425	5.00 years	$	20.14	103	$	20.18
$28.20	-	$38.35	1,282	6.30 years	$	29.33	0	$	—
$9.95	-	$38.35	3,623				1,110

Segment Reporting and Foreign Operations (Tables)

12 Months Ended

Dec. 31, 2017

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, 2017, 2016 and 2015 (in thousands):



	% Change	2017		% Change	2016*		% Change	2015

Cardiovascular
Stand-alone devices	44%	$	275,431	23%	$	191,148	8%	$	155,414
Custom kits and procedure trays	6%	126,114		2%	119,226		5%	116,368
Inflation devices	8%	79,875		1%	73,916		1%	73,373
Catheters	13%	127,747		17%	113,367		11%	96,833
Embolization devices	8%	49,532		2%	46,035		3%	45,025
CRM/EP	15%	41,914		8%	36,459		3%	33,902
Total	21%	700,613		11%	580,151		6%	520,915

Endoscopy
Endoscopy devices	15%	27,239		12%	23,687		18%	21,234

Total	21%	$	727,852	11%	$	603,838	6%	$	542,149

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

Our long-lived assets by geographic area at December 31, 2017, 2016 and 2015, consisted of the following (in thousands):



	2017		2016		2015
United States	$	202,504	$	194,715	$	186,389
Ireland	45,671		47,337		48,896
Other foreign countries	44,645		34,521		32,493
Total	$	292,820	$	276,573	$	267,778

Schedule of Segment Reporting Information, by Segment

Total depreciation and amortization by business segment for the years ended December 31, 2017, 2016, and 2015 consisted of the following (in thousands):



	2017		2016		2015

Cardiovascular	$	52,700	$	42,806	$	36,474
Endoscopy	882		949		951
Total	$	53,582	$	43,755	$	37,425

Total capital expenditures for property and equipment by business segment for the years ended December 31, 2017, 2016 and 2015 consisted of the following (in thousands):



	2017		2016		2015

Cardiovascular	$	38,437	$	32,613	$	50,927
Endoscopy	186		224		32
Total	$	38,623	$	32,837	$	50,959

Financial information relating to our reportable operating segments and reconciliations to the consolidated totals for the years ended December 31, 2017, 2016 and 2015, are as follows (in thousands):



	2017		2016			2015
Net Sales ⁽¹⁾
Cardiovascular	$	700,613	$	580,151		$	520,915
Endoscopy	27,239		23,687			21,234
Total net sales	727,852		603,838			542,149

Operating expenses
Cardiovascular	281,095		218,659			187,492
Endoscopy	12,089		11,490			10,746
Total operating expenses	293,184		230,149			198,238

Operating income (loss) ⁽¹⁾
Cardiovascular	24,819		30,053			34,052
Endoscopy	8,250		4,823			3,491
Total operating income	33,069		34,876			37,543

Total other expense - net	2,812		(9,490		)	(6,343		)
Income tax expense	8,358		5,265			7,398

Net income	$	27,523	$	20,121		$	23,802

Reconciliation of Assets from Segment to Consolidated

Total assets by business segment at December 31, 2017, 2016 and 2015, consisted of the following (in thousands):



	2017		2016		2015
Cardiovascular	$	1,103,806	$	932,927	$	767,952
Endoscopy	8,005		9,876		10,776
Total	$	1,111,811	$	942,803	$	778,728

Quarterly Results of Operations (Unaudited) (Tables)

12 Months Ended

Dec. 31, 2017

Quarterly Financial Information Disclosure [Abstract]

Schedule of Quarterly Financial Information

Quarterly data for the years ended December 31, 2017 and 2016 consisted of the following (in thousands, except per share amounts):



	Quarter Ended
	March 31		June 30		September 30			December 31
2017
Net sales	$	171,069	$	186,549	$	179,337		$	190,897
Gross profit	75,942		84,141		80,514			85,656
Income from operations	5,609		13,362		879			13,219
Income tax expense	690		1,830		1,364			4,474
Net income (loss)	14,803		9,483		(3,569		)	6,806
Basic earnings per common share	0.33		0.19		(0.07		)	0.14
Diluted earnings per common share	0.32		0.19		(0.07		)	0.13

2016
Net sales	$	138,077	$	151,071	$	156,975		$	157,715
Gross profit	60,100		66,854		67,815			70,256
Income from operations	7,706		11,581		2,987			12,602
Income tax expense (benefit)	1,555		2,572		(978		)	2,116
Net income	4,351		7,290		973			7,507
Basic earnings per common share	0.10		0.16		0.02			0.17
Diluted earnings per common share	0.10		0.16		0.02			0.17

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2017

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, 2017 and 2016, 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, 2017			(Level 1)		(Level 2)			(Level 3)

Interest rate contracts (1)	$	5,749		$	—	$	5,749		$	—
Foreign currency contract assets, current and long-term (2)	$	621		$	—	$	621		$	—
Foreign currency contract liabilities, current and long-term (3)	$	(1,391	)	$	—	$	(1,391	)	$	—

				Fair Value Measurements Using
	Total Fair			Quoted prices in		Significant other			Significant
	Value at			active markets		observable inputs			unobservable inputs
Description	December 31, 2016			(Level 1)		(Level 2)			(Level 3)

Interest rate contracts (1)	$	4,991		$	—	$	4,991		$	—
Foreign currency contract assets, current and long-term (2)	$	354		$	—	$	354		$	—
Foreign currency contract liabilities, current and long-term (3)	$	(464	)	$	—	$	(464	)	$	—

(1) The fair value of the interest rate contracts is determined using Level 2 fair value inputs and is recorded as other assets or other long-term obligations 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, 2017 and 2016, consisted of the following (in thousands):



	2017			2016
Beginning balance	$	683		$	1,024
Contingent consideration liability recorded as the result of acquisitions (see Note 2)	10,400			—
Fair value adjustments recorded to income during the period	(66		)	(123		)
Contingent payments made	(61		)	(218		)
Ending balance	$	10,956		$	683

Fair Value Inputs, Liabilities, Quantitative Information



Contingent consideration asset or liability	Fair value at December 31, 2017		Valuation technique	Unobservable inputs	Range
Revenue-based payments	$	10,956	Discounted cash flow	Discount rate	9.9% - 15%
contingent liability			Discounted cash flow	Probability of milestone payment	100%
				Projected year of payments	2018-2037

Contingent receivable	$	760	Discounted cash flow	Discount rate	10%
asset			Discounted cash flow	Probability of milestone payment	75%
				Projected year of payments	2018-2019

Contingent consideration asset or liability	Fair value at December 31, 2016		Valuation technique	Unobservable inputs	Range
Revenue-based payments	$	683	Discounted cash flow	Discount rate	9.9% - 15%
contingent liability			Discounted cash flow	Probability of milestone payment	100%
				Projected year of payments	2017-2028

Contingent receivable	$	528	Discounted cash flow	Discount rate	10%
asset			Discounted cash flow	Probability of milestone payment	57%
				Projected year of payments	2017-2019

Organization and Summary of Significant Accounting Policies - Organization (Details)	12 Months Ended
	Dec. 31, 2017 product_group segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of operating segments \| segment	2
Number of core product groups \| product_group	5

Organization and Summary of Significant Accounting Policies - Property and Equipment (Details) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Impairment of long-lived assets	$ 809,000	$ 0	$ 0
Property, Plant and Equipment [Line Items]
Depreciation	$ 26,800,000	$ 24,500,000	$ 22,600,000
Buildings
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, 2017	Dec. 31, 2016
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Cash surrender value of life insurance	$ 11,700	$ 9,900
Deferred compensation cost	$ 11,181	$ 9,211

Organization and Summary of Significant Accounting Policies - Stock Based Compensation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Allocated share-based compensation	$ 4,075	$ 2,506	$ 2,243

Organization and Summary of Significant Accounting Policies - Concentration of Credit Risk (Details)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Customer concentration risk \| Sales \| One Customer
Product Information [Line Items]
Concentration for largest customer	2.00%	3.00%	3.00%

Organization and Summary of Significant Accounting Policies - Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Accumulated other comprehensive income (loss), interest rate swaps, net of tax	$ 3,500	$ 2,900
Accumulated other comprehensive income (loss), interest rate swap, tax benefit	(2,200)	(1,900)
Accumulated other comprehensive income (loss) related to foreign currency translation, net of tax	(1,900)	(4,800)
Accumulated other comprehensive income (loss), foreign currency translation, tax benefit	$ 0	$ 318

Acquisitions - Narrative (Details) AUD in Millions																				1 Months Ended	3 Months Ended		8 Months Ended	11 Months Ended	12 Months Ended			13 Months Ended
Acquisitions - Narrative (Details) AUD in Millions	Oct. 02, 2017 USD ($)	Sep. 01, 2017	Aug. 04, 2017 USD ($)	Jul. 03, 2017 USD ($)	Jul. 01, 2017 USD ($)	Jun. 16, 2017 USD ($)	May 23, 2017 USD ($) shares	May 19, 2017	May 01, 2017 USD ($)	Jan. 31, 2017 USD ($) patents	Dec. 19, 2016 USD ($) shares	Jul. 06, 2016 USD ($)	Feb. 04, 2016 USD ($)	Dec. 04, 2015	Sep. 29, 2015 USD ($)	Jul. 17, 2015	Jul. 14, 2015 USD ($)	Jul. 01, 2015 USD ($)	Mar. 26, 2015	Sep. 30, 2017 USD ($)	Dec. 31, 2016 USD ($) shares	Mar. 31, 2016 USD ($)	Dec. 31, 2017 USD ($) shares	Dec. 31, 2017 USD ($) shares	Dec. 31, 2017 USD ($) shares	Dec. 31, 2016 USD ($) shares	Dec. 31, 2015 USD ($)	Dec. 31, 2016 USD ($) shares	Sep. 30, 2017 AUD	Aug. 19, 2015 USD ($) shares
Business Acquisition [Line Items]
Payments to acquire intangible assets																									$ 2,577,000	$ 2,217,000	$ 1,956,000
Goodwill acquired																									23,579,000	27,373,000
Acquired in-process research and development																									$ 12,136,000	461,000	1,000,000
Fusion Medical, Inc.
Business Acquisition [Line Items]
Total purchase price							$ 2,500,000
Ownership interest (percent)							19.50%
Equity method investment							$ 2,500,000
Fusion Medical, Inc. \| Preferred Stock
Business Acquisition [Line Items]
Shares acquired (in shares) \| shares							182,000
Sugan Co, Ltd.
Business Acquisition [Line Items]
Right to Manufacture and Sell Certain Products, Term																									4 years
Bluegrass Vascular Technologies, Inc. \| Investee
Business Acquisition [Line Items]
Payments to acquire investment											$ 5,000,000
Number of units acquired \| shares											1,251,878
Percent owned											19.50%
Cost method investment											$ 4,000,000
Cagent Vascular, LLC \| Limited Liability Company
Business Acquisition [Line Items]
Payments to acquire investment																										$ 3,000,000
Number of units acquired \| shares																					3,000,000					3,000,000		3,000,000
Percent owned																					18.10%					18.10%		18.10%
Blockade Medical LLC
Business Acquisition [Line Items]
License agreements															$ 2,700,000
Blockade Medical LLC \| Cost-method Investments
Business Acquisition [Line Items]
Consideration paid related to net working capital adjustment															1,000,000
Blockade Medical LLC \| Loans Receivable
Business Acquisition [Line Items]
Consideration paid related to net working capital adjustment															$ 1,700,000
Xablecath Inc.
Business Acquisition [Line Items]
Number of units acquired \| shares																														116,279
Percent owned																														15.90%
Cost method investment																														$ 300,000
Xablecath Inc. \| Series B Preferred Stock
Business Acquisition [Line Items]
Number of units acquired \| shares																							656,848	656,848	656,848
Cost method investment																							$ 248,000	$ 248,000	$ 248,000
Quellent, LLC
Business Acquisition [Line Items]
Total purchase price																	$ 1,000,000
Payments to acquire intangible assets																											500,000
Accrued purchase obligation																						$ 500,000
Noncurrent contingent consideration																	270,000
Goodwill acquired																	$ 60,000
Catch Medical, LLC
Business Acquisition [Line Items]
Payments to acquire intangible assets																									600,000
Accrued purchase obligation																									200,000
Acquired in-process research and development																		$ 1,000,000
Long term purchase obligations																									200,000
Teleflex Incorporated
Business Acquisition [Line Items]
Future payments under agreement																					$ 400,000					$ 400,000		$ 400,000
Developed technology
Business Acquisition [Line Items]
Intangible assets																					135,358,000		167,771,000	167,771,000	167,771,000	135,358,000		135,358,000
Developed technology \| LeMaitre Vascular, Inc.
Business Acquisition [Line Items]
Useful life																10 years
Payments to acquire intangible assets																											400,000
Developed technology \| Quellent, LLC
Business Acquisition [Line Items]
Useful life																	13 years
Intangible assets																	$ 1,210,000
Customer Lists
Business Acquisition [Line Items]
Intangible assets																					6,860,000		13,453,000	13,453,000	13,453,000	6,860,000		6,860,000
Customer Lists \| Sugan Co, Ltd.
Business Acquisition [Line Items]
Useful life								5 years
Consideration payable																							1,200,000	1,200,000	1,200,000
Customer Lists \| Teleflex Incorporated
Business Acquisition [Line Items]
Useful life																			5 years
Payments to acquire intangible assets																											400,000
License agreements
Business Acquisition [Line Items]
Intangible assets																					17,273,000		18,215,000	18,215,000	18,215,000	17,273,000		17,273,000
License agreements \| Pleuratech ApS
Business Acquisition [Line Items]
Useful life					15 years
Asset purchase agreement, liability for certain milestones					$ 5,000,000
Current royalty rate					6.00%
Payments to acquire intangible assets																									2,000,000
License agreements \| Medical Company 1
Business Acquisition [Line Items]
Useful life														12 years
Payments to acquire intangible assets																												2,000,000
License agreements \| Medical Company 1 \| Additional Payments for License Agreement Milestone
Business Acquisition [Line Items]
Payments to acquire intangible assets																									500,000
License agreements \| Blockade Medical LLC
Business Acquisition [Line Items]
Useful life															10 years
License agreements \| Distal Access, LLC
Business Acquisition [Line Items]
Useful life																		6 years
Payments to acquire intangible assets																											$ 3,500,000
Intangible assets																		$ 3,500,000
Intellectual Property \| IntelliMedical Technologies Pty Ltd
Business Acquisition [Line Items]
Total purchase price																				$ 11,900,000
Asset purchase agreement, liability for certain milestones \| AUD																													AUD 15.0
Current royalty rate		6.00%
Intellectual Property \| Lazarus Medical Technologies, LLC
Business Acquisition [Line Items]
Useful life						15 years
Asset purchase agreement, liability for certain milestones						$ 750,000
Current royalty rate						6.00%
Payments to acquire intangible assets																									570,000
Trademarks
Business Acquisition [Line Items]
Intangible assets																					9,050,000		11,538,000	11,538,000	11,538,000	9,050,000		9,050,000
Distribution agreements
Business Acquisition [Line Items]
Intangible assets																					3,099,000		2,576,000	2,576,000	2,576,000	3,099,000		$ 3,099,000
Distribution agreements \| Bluegrass Vascular Technologies, Inc. \| Investee
Business Acquisition [Line Items]
Useful life											3 years
Intangible assets											$ 1,000,000
ITL Healthcare Pty Ltd
Business Acquisition [Line Items]
Total purchase price	$ 11,300,000
Net sales related to acquisition																									3,300,000
ITL Healthcare Pty Ltd \| Customer Lists
Business Acquisition [Line Items]
Useful life	7 years
Laurane Medical S.A.S.
Business Acquisition [Line Items]
Total purchase price			$ 16,500,000
Contingent liability			$ 5,500,000
Weighted average useful life			11 years 11 months
Laurane Medical S.A.S. \| Developed technology
Business Acquisition [Line Items]
Useful life			12 years
Laurane Medical S.A.S. \| Customer Lists
Business Acquisition [Line Items]
Useful life			1 year
Osseon LLC
Business Acquisition [Line Items]
Total purchase price				$ 6,800,000
Net sales related to acquisition																									942,000
Weighted average useful life				8 years 11 months 15 days
Osseon LLC \| Developed technology
Business Acquisition [Line Items]
Useful life				9 years
Osseon LLC \| Customer Lists
Business Acquisition [Line Items]
Useful life				8 years
Vascular Access Technologies, Inc.
Business Acquisition [Line Items]
Total purchase price									$ 5,000,000
Contingent liability									$ 4,900,000
Goodwill																							(42,000)
Measurement period adjustment, increase in deferred tax liabilities																							$ 28,000
Vascular Access Technologies, Inc. \| Developed technology
Business Acquisition [Line Items]
Useful life									15 years
Argon Medical Devices, Inc.
Business Acquisition [Line Items]
Total purchase price										$ 10,897,000															10,100,000
Net sales related to acquisition																									41,200,000
Weighted average useful life										5 years 11 months 15 days
Total purchase price										$ (797,000)														(797,000)
Inventories																								(995,000)
Property and equipment																								(348,000)
Argon Medical Devices, Inc. \| Cardiovascular Segment
Business Acquisition [Line Items]
Acquisition-related costs																									2,600,000
Argon Medical Devices, Inc. \| Scenario, Previously Reported
Business Acquisition [Line Items]
Total purchase price										$ 10,900,000
Argon Medical Devices, Inc. \| Developed technology
Business Acquisition [Line Items]
Useful life										7 years
Argon Medical Devices, Inc. \| Customer Lists
Business Acquisition [Line Items]
Useful life										5 years
Argon Medical Devices, Inc. \| Trademarks
Business Acquisition [Line Items]
Useful life										5 years
Catheter Connections, Inc.
Business Acquisition [Line Items]
Total purchase price										$ 38,000,000
Net sales related to acquisition																									10,000,000
Weighted average useful life										11 years 8 months
Number of patents acquired \| patents										40
Inventories																								(87,000)
Property and equipment																								0
Goodwill																								$ 1,377,000
Catheter Connections, Inc. \| Cardiovascular Segment
Business Acquisition [Line Items]
Acquisition-related costs																									482,000
Catheter Connections, Inc. \| Developed technology
Business Acquisition [Line Items]
Useful life										12 years
Catheter Connections, Inc. \| Customer Lists
Business Acquisition [Line Items]
Useful life										8 years
Catheter Connections, Inc. \| Trademarks
Business Acquisition [Line Items]
Useful life										10 years
DFINE, Inc.
Business Acquisition [Line Items]
Total purchase price												$ 97,500,000
Net sales related to acquisition																									27,000,000	13,500,000
Weighted average useful life												14 years 10 months
Total purchase price																					1,100,000
Consideration paid related to net working capital adjustment												$ 578,000
Inventories																					89,000
Property and equipment																					109,000
Goodwill																					1,200,000
Measurement period adjustment, reduction in accrued expenses																					407,000
Measurement period adjustment, increase in deferred tax liabilities																					$ (113,000)
Trade receivables acquired, gross												4,300,000
Trade receivables, expected to be uncollectible												$ 224,000
DFINE, Inc. \| Cardiovascular Segment
Business Acquisition [Line Items]
Acquisition-related costs																										1,600,000
DFINE, Inc. \| Developed technology
Business Acquisition [Line Items]
Useful life												15 years
DFINE, Inc. \| Customer Lists
Business Acquisition [Line Items]
Useful life												9 years
DFINE, Inc. \| Trademarks
Business Acquisition [Line Items]
Useful life												15 years
HeRO®Graft
Business Acquisition [Line Items]
Total purchase price													$ 18,500,000
Weighted average useful life													9 years 9 months 25 days
Income since acquisition date																									$ 8,600,000	$ 7,100,000
HeRO®Graft \| Developed technology
Business Acquisition [Line Items]
Useful life													10 years
HeRO®Graft \| Customer Lists
Business Acquisition [Line Items]
Useful life													12 years
HeRO®Graft \| Trademarks
Business Acquisition [Line Items]
Useful life													5 years 6 months

Acquisitions - Purchase Price Allocation (Details) - USD ($) $ in Thousands								3 Months Ended	8 Months Ended	11 Months Ended	12 Months Ended
	Oct. 02, 2017	Aug. 04, 2017	Jul. 03, 2017	May 01, 2017	Jan. 31, 2017	Jul. 06, 2016	Feb. 04, 2016	Dec. 31, 2016	Dec. 31, 2017	Dec. 31, 2017	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Assets Acquired
Goodwill								$ 211,927	$ 238,147	$ 238,147	$ 238,147	$ 211,927	$ 184,472
Liabilities Assumed
Gain on bargain purchase											11,039	$ 0	$ 0
ITL Healthcare Pty Ltd
Assets Acquired
Trade receivables	$ 1,287
Other receivables	56
Inventories	1,808
Prepaid expenses and other assets	65
Property and equipment	1,053
Goodwill	3,740
Total assets acquired	13,949
Liabilities Assumed
Trade payables	(216)
Accrued expenses	(542)
Deferred income tax liabilities - current	(1,901)
Total liabilities assumed	(2,659)
Total net assets acquired	11,290
Total purchase price	11,300
ITL Healthcare Pty Ltd \| Customer lists
Assets Acquired
Intangibles	$ 5,940
Laurane Medical S.A.S.
Assets Acquired
Inventories		$ 594
Goodwill		6,366
Total assets acquired		22,000
Liabilities Assumed
Total purchase price		16,500
Laurane Medical S.A.S. \| Developed technology
Assets Acquired
Intangibles		14,920
Laurane Medical S.A.S. \| Customer lists
Assets Acquired
Intangibles		$ 120
Osseon LLC
Assets Acquired
Inventories			$ 979
Property and equipment			58
Goodwill			203
Total assets acquired			6,840
Liabilities Assumed
Total purchase price			6,800
Osseon LLC \| Developed technology
Assets Acquired
Intangibles			5,400
Osseon LLC \| Customer lists
Assets Acquired
Intangibles			$ 200
Vascular Access Technologies, Inc.
Assets Acquired
Goodwill				$ 4,323					4,281	4,281	4,281
Total assets acquired				9,900					9,900	9,900	9,900
Liabilities Assumed
Deferred income tax liabilities - current				(3,073)					(3,101)	(3,101)	(3,101)
Total purchase price				5,000
Adjustments
Goodwill									(42)
Deferred tax liabilities									(28)
Total net assets acquired									0
Vascular Access Technologies, Inc. \| Developed technology
Assets Acquired
Intangibles				7,800					7,800	7,800	7,800
Adjustments
Intangibles									0
Vascular Access Technologies, Inc. \| In Process Research and Development
Assets Acquired
Intangibles				$ 850					920	920	920
Adjustments
Intangibles									70
Argon Medical Devices, Inc.
Assets Acquired
Cash and cash equivalents					$ 1,436				1,436	1,436	1,436
Trade receivables					8,351				8,351	8,351	8,351
Inventories					12,217				11,222	11,222	11,222
Prepaid expenses and other assets					1,275				1,275	1,275	1,275
Income tax refund receivable					0				165	165	165
Property and equipment					2,667				2,319	2,319	2,319
Deferred tax assets					184				202	202	202
Total assets acquired					31,530				29,570	29,570	29,570
Liabilities Assumed
Trade payables					(2,306)				(2,414)	(2,414)	(2,414)
Accrued expenses					(5,083)				(5,083)	(5,083)	(5,083)
Income taxes payable					2				0	0	0
Deferred income tax liabilities					(999)				(934)	(934)	(934)
Total liabilities assumed					(8,390)				(8,431)	(8,431)	(8,431)
Total net assets acquired					23,140				21,139	21,139	21,139
Gain on bargain purchase					12,243						11,039
Total purchase price					10,897						10,100
Adjustments
Cash and cash equivalents										0
Trade receivables										0
Inventories										(995)
Prepaid expenses and other assets										0
Income tax refund receivable										165
Property and equipment										(348)
Deferred tax assets										18
Total assets acquired										(1,960)
Trade payables										(108)
Accrued expenses										0
Income taxes payable										2
Deferred income tax liabilities										65
Total liabilities assumed										(41)
Total net assets acquired										(2,001)
Gain on bargain purchase										1,204
Total purchase price					(797)					(797)
Business Combination, Bargain Purchase, Gain Recognized, Negative Adjustment, Amount											1,200
Argon Medical Devices, Inc. \| Developed technology
Assets Acquired
Intangibles					2,600				2,200	2,200	2,200
Adjustments
Intangibles										(400)
Argon Medical Devices, Inc. \| Customer lists
Assets Acquired
Intangibles					1,300				1,500	1,500	1,500
Adjustments
Intangibles										200
Argon Medical Devices, Inc. \| Trademarks
Assets Acquired
Intangibles					1,500				900	900	900
Adjustments
Intangibles										(600)
Catheter Connections, Inc.
Assets Acquired
Trade receivables					952				958	958	958
Inventories					2,244				2,157	2,157	2,157
Prepaid expenses and other assets					181				85	85	85
Property and equipment					1,472				1,472	1,472	1,472
Goodwill					7,612				8,989	8,989	8,989
Total assets acquired					38,361				38,361	38,361	38,361
Liabilities Assumed
Trade payables					(338)				(338)	(338)	(338)
Accrued expenses					(23)				(23)	(23)	(23)
Total liabilities assumed					(361)				(361)	(361)	(361)
Total net assets acquired					38,000				38,000	38,000	38,000
Total purchase price					38,000
Adjustments
Trade receivables										6
Inventories										(87)
Prepaid expenses and other assets										(96)
Property and equipment										0
Goodwill										1,377
Total assets acquired										0
Trade payables										0
Accrued expenses										0
Total liabilities assumed										0
Total net assets acquired										0
Catheter Connections, Inc. \| Developed technology
Assets Acquired
Intangibles					22,900				21,100	21,100	21,100
Adjustments
Intangibles										(1,800)
Catheter Connections, Inc. \| Customer lists
Assets Acquired
Intangibles					100				700	700	700
Adjustments
Intangibles										600
Catheter Connections, Inc. \| Trademarks
Assets Acquired
Intangibles					$ 2,900				$ 2,900	2,900	2,900
Adjustments
Intangibles										$ 0
DFINE, Inc.
Assets Acquired
Trade receivables						$ 4,054
Other receivables						6
Inventories						8,585
Prepaid expenses and other assets						630
Property and equipment						1,630
Other long-term assets						145
Goodwill						24,818
Total assets acquired						114,268
Liabilities Assumed
Trade payables						(1,790)
Accrued expenses						(5,298)
Deferred income tax liabilities - current						(701)
Deferred income tax liabilities						(10,844)
Total liabilities assumed						(18,633)
Total net assets acquired						95,635
Total purchase price						97,500
Cash received											$ 1,327
Adjustments
Inventories								89
Property and equipment								109
Goodwill								1,200
Deferred tax liabilities								113
Total purchase price								$ 1,100
DFINE, Inc. \| Developed technology
Assets Acquired
Intangibles						67,600
DFINE, Inc. \| Customer lists
Assets Acquired
Intangibles						2,400
DFINE, Inc. \| Trademarks
Assets Acquired
Intangibles						$ 4,400
HeRO®Graft
Assets Acquired
Inventories							$ 2,455
Property and equipment							290
Goodwill							2,555
Total assets acquired							18,500
Liabilities Assumed
Total purchase price							18,500
HeRO®Graft \| Developed technology
Assets Acquired
Intangibles							12,100
HeRO®Graft \| Customer lists
Assets Acquired
Intangibles							400
HeRO®Graft \| Trademarks
Assets Acquired
Intangibles							$ 700

Acquisitions - Summary of Unaudited Consolidated Results of Operations, Including Proforma Results (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
As Reported
Net Sales	$ 190,897	$ 179,337	$ 186,549	$ 171,069	$ 157,715	$ 156,975	$ 151,071	$ 138,077	$ 727,852	$ 603,838	$ 542,149
Net income	$ 6,806	$ (3,569)	$ 9,483	$ 14,803	$ 7,507	$ 973	$ 7,290	$ 4,351	$ 27,523	$ 20,121	$ 23,802
Basic (in dollars per share)	$ 0.14	$ (0.07)	$ 0.19	$ 0.33	$ 0.17	$ 0.02	$ 0.16	$ 0.10	$ 0.56	$ 0.45	$ 0.54
Diluted (in dollars per share)	$ 0.13	$ (0.07)	$ 0.19	$ 0.32	$ 0.17	$ 0.02	$ 0.16	$ 0.10	$ 0.55	$ 0.45	$ 0.53
Pro Forma
Net Sales, Pro Forma									$ 730,612	$ 664,366	$ 575,541
Net Income, Pro Forma									$ 17,419	$ 23,068	$ 3,135
Basic, Pro Forma (in dollars per share)									$ 0.36	$ 0.52	$ 0.07
Diluted, Pro Forma (in dollars per share)									$ 0.35	$ 0.51	$ 0.07

Inventories (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Inventory Disclosure [Abstract]
Finished goods	$ 86,555	$ 63,852
Work-in-process	12,799	11,008
Raw materials	55,934	45,835
Total	$ 155,288	$ 120,695

Goodwill and Intangible Assets - Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Goodwill [Roll Forward]
Goodwill balance at January 1	$ 211,927	$ 184,472
Effect of foreign exchange	2,641	82
Additions as the result of acquisitions	23,579	27,373
Goodwill balance at December 31	$ 238,147	$ 211,927

Goodwill and Intangible Assets - Other Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Other
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 97,680	$ 77,387
Accumulated Amortization	(38,127)	(30,048)
Net Carrying Amount	59,553	47,339
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	16,528	14,130
Accumulated Amortization	(3,737)	(3,165)
Net Carrying Amount	12,791	10,965
Distribution agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	7,262	6,626
Accumulated Amortization	(4,686)	(3,527)
Net Carrying Amount	2,576	3,099
License agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	23,783	20,695
Accumulated Amortization	(5,568)	(3,422)
Net Carrying Amount	18,215	17,273
Trademarks
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	16,224	12,380
Accumulated Amortization	(4,686)	(3,330)
Net Carrying Amount	11,538	9,050
Covenants not to compete
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,028	1,028
Accumulated Amortization	(968)	(936)
Net Carrying Amount	60	92
Customer lists
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	31,935	22,261
Accumulated Amortization	(18,482)	(15,401)
Net Carrying Amount	13,453	6,860
In-process technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	920
Accumulated Amortization	0
Net Carrying Amount	$ 920
Royalty agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount		267
Accumulated Amortization		(267)
Net Carrying Amount		$ 0

Goodwill and Intangible Assets - Narrative (Details) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Finite-Lived Intangible Assets [Line Items]
Accumulated impairment loss	$ 8,300,000
Aggregate amortization expense	26,800,000	$ 19,300,000	$ 14,800,000
Intangible asset impairment charges	809,000	$ 0	$ 0
Distal Access, LLC
Finite-Lived Intangible Assets [Line Items]
Intangible asset impairment charges	$ 809,000

Goodwill and Intangible Assets - Future Amortization Expense (Details) $ in Thousands	Dec. 31, 2017 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2018	$ 30,413
2019	29,787
2020	28,373
2021	21,001
2022	$ 19,396

Income Taxes - Domestic and Foreign (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Domestic	$ 14,531	$ 6,174	$ 9,470
Foreign	21,350	19,212	21,730
INCOME BEFORE INCOME TAXES	$ 35,881	$ 25,386	$ 31,200

Income Taxes - Components of Income Tax Expense (Benefit) (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current expense (benefit):
Federal									$ 3,849	$ 1,933	$ (17)
State									645	492	747
Foreign									5,168	3,802	3,218
Total current expense									9,662	6,227	3,948
Deferred expense (benefit):
Federal									(314)	(144)	3,250
State									(216)	(195)	294
Foreign									(774)	(623)	(94)
Total deferred (benefit) expense									(1,304)	(962)	3,450
Total income tax expense	$ 4,474	$ 1,364	$ 1,830	$ 690	$ 2,116	$ (978)	$ 2,572	$ 1,555	$ 8,358	$ 5,265	$ 7,398

Income Taxes - Effective Income Tax Rate Reconciliation (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Computed federal income tax expense at statutory rate of 35%									$ 12,559	$ 8,885	$ 10,920
State income taxes									279	193	698
Tax credits									(1,377)	(1,164)	(1,019)
Production activity deduction									0	(53)	0
Foreign tax rate differential									(3,329)	(3,717)	(3,564)
Uncertain tax positions									(19)	597	536
Deferred compensation insurance assets									(479)	(307)	182
Transaction-related expenses									90	274	0
U.S. transition tax									10,612	0	0
TCJA remeasurement of deferred taxes									(8,383)	0	0
Share-based payments									(2,264)	0	0
Bargain purchase gain									(1,570)	0	0
In-process research and development									1,486	0	0
Other — including the effect of graduated rates									753	557	(355)
Total income tax expense	$ 4,474	$ 1,364	$ 1,830	$ 690	$ 2,116	$ (978)	$ 2,572	$ 1,555	$ 8,358	$ 5,265	$ 7,398

Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Deferred income tax assets:
Allowance for uncollectible accounts receivable	$ 467	$ 645
Accrued compensation expense	5,154	6,203
Inventory differences	2,505	1,065
Net operating loss carryforwards	15,741	27,742
Deferred revenue	58	73
Stock-based compensation expense	2,281	2,738
Federal research and development credit carryforward	0	3,524
Foreign tax credits	0	364
Other	8,986	6,984
Total deferred income tax assets	35,192	49,338
Deferred income tax liabilities:
Prepaid expenses	(930)	(782)
Property and equipment	(20,352)	(25,108)
Intangible assets	(28,588)	(35,773)
Other	(1,830)	(1,480)
Total deferred income tax liabilities	(51,700)	(63,143)
Valuation allowance	(4,422)	(3,786)
Net deferred income tax liabilities	(20,930)	(17,591)
Reported as:
Deferred income tax assets - Current	0	8,219
Deferred income tax assets - Long-term	2,359	171
Deferred income tax liabilities - Long-term	(23,289)	(25,981)
Net deferred income tax liabilities	$ (20,930)	$ (17,591)

Income Taxes - Narrative (Details) - USD ($)	12 Months Ended
Income Taxes - Narrative (Details) - USD ($)	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Net tax benefit related to reduction in U.S. corporate tax rate	$ 8,400,000
One-time tax expense resulting from transition tax	$ 10,600,000
Statutory federal rate	35.00%	35.00%	35.00%
Increase in valuation allowance	$ 636,000	$ 1,800,000	$ 378,000
U.S federal net operating loss carryforwards	$ 67,900,000	76,400,000
Period to utilize the net operating loss carryforwards	18 years
NOL carryforward used in period	$ 9,100,000	6,200,000
Foreign operating loss carryforwards	5,400,000	3,000,000
Foreign operating loss carryforward, no expiration	4,900,000
Foreign operating loss carryforward, expiring	526,000
Unrecognized tax benefits including interest and penalties	3,100,000	2,800,000
Unrecognized tax benefits that would impact effective rate	2,700,000	2,800,000
Reduction of uncertain tax benefits related to certain liabilities for unrecognized tax benefits	307,000
Reduction in transition tax under TCJA, if realized	307,000
Reduction in valuation allowance		2,300,000
Accrued interest and penalties	304,000	216,000
Income tax penalties and interest expense	88,000	$ 30,000	$ 6,000
Maximum
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Estimated change in unrecognized tax benefit in next twelve months, lower bound	$ (500,000)

Income Taxes - Summary of Income Tax Contingencies (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Unrecognized tax benefits, opening balance	$ 2,549	$ 1,982	$ 1,736
Gross increases in tax positions taken in a prior year	80	77	187
Gross increases in tax positions taken in the current year	403	856	763
Lapse of applicable statute of limitations	(283)	(366)	(704)
Unrecognized tax benefits, ending balance	$ 2,749	$ 2,549	$ 1,982

Accrued Expenses (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Payables and Accruals [Abstract]
Payroll and related liabilities	$ 30,225	$ 24,429
Advances from employees	796	572
Other accrued expenses	27,911	20,518
Total	$ 58,932	$ 45,519

Revolving Credit Facility and Long-Term Debt - Principal Balances under Long-term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Feb. 23, 2017	Dec. 31, 2016
Line of Credit Facility [Line Items]
Total long-term debt	$ 278,472		$ 324,373
2017 Debt facility	6,959	$ 7,000	0
Less unamortized debt issuance costs	(487)		(627)
Less current portion	19,459		10,000
Long-term portion	259,013		314,373
Term Loan
Line of Credit Facility [Line Items]
Total long-term debt	85,000		145,000
Revolving Credit Facility
Line of Credit Facility [Line Items]
Total long-term debt	$ 187,000		$ 180,000

Revolving Credit Facility and Long-Term Debt - Narrative (Details) - USD ($)		12 Months Ended
	Feb. 23, 2017	Dec. 31, 2017	Dec. 31, 2016	Jul. 06, 2016
Line of Credit Facility [Line Items]
2017 Debt facility	$ 7,000,000	$ 6,959,000	$ 0
Variable rate on loan		2.38%
Outstanding borrowings		$ 278,959,000
LIBOR
Line of Credit Facility [Line Items]
Debt instrument, basis spread on variable rate	1.00%
Credit Agreement
Line of Credit Facility [Line Items]
Outstanding borrowings		272,000,000
Remaining borrowing capacity on line of credit		188,000,000
Fixed interest rate percent			2.98%
Debt subject to fixed interest rate		$ 175,000,000	$ 130,000,000
Credit Agreement \| Variable Rate 1
Line of Credit Facility [Line Items]
Variable interest rate percent		2.82%	3.12%
Debt subject to variable interest rate		$ 97,000,000	$ 45,000,000
Credit Agreement \| Variable Rate 2
Line of Credit Facility [Line Items]
Variable interest rate percent			2.77%
Debt subject to variable interest rate			$ 150,000,000
Credit Agreement \| Interest Rate Swap 2
Line of Credit Facility [Line Items]
Fixed interest rate percent		2.68%
Revolving Credit Facility \| Credit Agreement
Line of Credit Facility [Line Items]
Increase to revolving credit commitment		$ 100,000,000
Maximum borrowing capacity		$ 375,000,000
Interest rate increase if in event of default		2.00%
Revolving Credit Facility \| Credit Agreement \| Minimum
Line of Credit Facility [Line Items]
Commitment fee percentage		0.15%
Revolving Credit Facility \| Credit Agreement \| Maximum
Line of Credit Facility [Line Items]
Commitment fee percentage		0.40%
Term Loan \| Credit Agreement
Line of Credit Facility [Line Items]
Debt instrument, face amount				$ 150,000,000
Bridge Loan \| Credit Agreement
Line of Credit Facility [Line Items]
Maximum borrowing capacity				$ 25,000,000

Revolving Credit Facility and Long-Term Debt - Financial Covenants (Details)	12 Months Ended
	Dec. 31, 2017 USD ($) quarter
Debt Instrument [Line Items]
Number of consecutive quarters for EBITDA to fixed charges ratio covenants \| quarter	4
Credit Agreement
Debt Instrument [Line Items]
Consolidated EBITDA	$ 1.25
Consolidated Net Income	0
Facility Capital Expenditures	$ 30,000,000
July 1, 2017 through December 31, 2017 \| Credit Agreement
Debt Instrument [Line Items]
Consolidated Total Leverage Ratio	3.75
January 1, 2018 through March 31, 2018 \| Credit Agreement
Debt Instrument [Line Items]
Consolidated Total Leverage Ratio	3.5
April 1, 2018 and thereafter \| Credit Agreement
Debt Instrument [Line Items]
Consolidated Total Leverage Ratio	3.25

Revolving Credit Facility and Long-Term Debt - Future Minimum Payments on Long-term Debt (Details) $ in Thousands	Dec. 31, 2017 USD ($)
Debt Disclosure [Abstract]
2018	$ 19,459
2019	15,000
2020	17,500
2021	227,000
Total future minimum principal payments	$ 278,959

Derivatives - Narrative (Details) € in Thousands, ₩ in Thousands, ¥ in Thousands, ¥ in Thousands, £ in Thousands, SGD in Thousands, SFr in Thousands, SEK in Thousands, MXN in Thousands, HKD in Thousands, DKK in Thousands, CAD in Thousands, BRL in Thousands, AUD in Thousands		12 Months Ended
	Dec. 19, 2012 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2017 AUD	Dec. 31, 2017 CNY (¥)	Dec. 31, 2017 DKK	Dec. 31, 2017 MXN	Dec. 31, 2017 CHF (SFr)	Dec. 31, 2017 KRW (₩)	Dec. 31, 2017 GBP (£)	Dec. 31, 2017 CAD	Dec. 31, 2017 JPY (¥)	Dec. 31, 2017 SGD	Dec. 31, 2017 SEK	Dec. 31, 2017 EUR (€)	Dec. 31, 2017 HKD	Dec. 31, 2017 BRL	Dec. 31, 2016 USD ($)	Aug. 05, 2016 USD ($)
Derivative [Line Items]
Deferred taxes used to offset fair value of interest rate swap		$ (2,200,000)															$ (1,900,000)
Maturity of derivative contract (up to)		2 years
Revenue and cost of sales
Derivative [Line Items]
Amount expected to be reclassified from accumulated other comprehensive income to earnings in next twelve months, gross		$ 44,000
Amount expected to be reclassified from accumulated other comprehensive income to earnings in next twelve months, net of tax		33,000
Interest expense
Derivative [Line Items]
Amount expected to be reclassified from accumulated other comprehensive income to earnings in next twelve months, gross		1,100,000
Amount expected to be reclassified from accumulated other comprehensive income to earnings in next twelve months, net of tax		840,000
Interest rate swap
Derivative [Line Items]
Notional amount of derivative	$ 150,000,000																	$ 42,500,000
Fixed rate	0.9825%																	1.12%
Quarterly reduction of notional amount	50.00%
Deferred taxes used to offset fair value of interest rate swap		$ (1,500,000)
Interest rate swap \| Maximum
Derivative [Line Items]
Notional amount of derivative																		$ 175,000,000
Foreign currency forward contracts \| Designated as hedging instrument
Derivative [Line Items]
Average number of contracts entered into per month		100	100	100	100	100	100	100	100	100	100	100	100	100	100	100
Foreign currency forward contracts \| Not designated as hedging instrument
Derivative [Line Items]
Notional amount of derivative			AUD 5,600	¥ 22,990	DKK 1,881	MXN 17,540	SFr 242	₩ 1,800,000	£ 1,868	CAD 2,076	¥ 178,500	SGD 5,023	SEK 4,775	€ 23,333	HKD 11,000	BRL 8,500
Average number of contracts entered into per month		20	20	20	20	20	20	20	20	20	20	20	20	20	20	20

Derivatives - Forward Notional Contracts (Details) - Dec. 31, 2017 - Foreign currency forward contracts € in Thousands, ₩ in Thousands, ¥ in Thousands, ¥ in Thousands, £ in Thousands, SGD in Thousands, SFr in Thousands, SEK in Thousands, MXN in Thousands, HKD in Thousands, DKK in Thousands, CAD in Thousands, BRL in Thousands, AUD in Thousands	AUD	CNY (¥)	DKK	MXN	CHF (SFr)	KRW (₩)	GBP (£)	CAD	JPY (¥)	SGD	SEK	EUR (€)	HKD	BRL
Not designated as hedging instrument
Derivative [Line Items]
Notional amount of derivative	AUD 5,600	¥ 22,990	DKK 1,881	MXN 17,540	SFr 242	₩ 1,800,000	£ 1,868	CAD 2,076	¥ 178,500	SGD 5,023	SEK 4,775	€ 23,333	HKD 11,000	BRL 8,500
Derivatives designated as cash flow hedges \| Designated as hedging instrument
Derivative [Line Items]
Notional amount of derivative		¥ 45,000	DKK 14,470	MXN 95,075	SFr 1,375		£ 3,625	CAD 2,310			SEK 16,330	€ 9,165

Derivatives - Fair Value of Derivative Instruments (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Designated as hedging instrument \| Interest rate swap \| Other assets (long-term)
Derivatives, Fair Value [Line Items]
Total Asset Derivatives	$ 5,749	$ 4,991
Designated as hedging instrument \| Foreign currency forward contracts \| Other assets (long-term)
Derivatives, Fair Value [Line Items]
Total Asset Derivatives	35	18
Designated as hedging instrument \| Foreign currency forward contracts \| Prepaid expenses and other assets
Derivatives, Fair Value [Line Items]
Total Asset Derivatives	363	116
Designated as hedging instrument \| Foreign currency forward contracts \| Accrued expenses
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	(468)	(275)
Designated as hedging instrument \| Foreign currency forward contracts \| Other long-term obligations
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	(82)	(18)
Not designated as hedging instrument \| Foreign currency forward contracts \| Prepaid expenses and other assets
Derivatives, Fair Value [Line Items]
Total Asset Derivatives	223	220
Not designated as hedging instrument \| Foreign currency forward contracts \| Accrued expenses
Derivatives, Fair Value [Line Items]
Total Liability Derivatives	$ (841)	$ (171)

Derivatives - Amount of Gain (Loss) Recognized in OCI and Income Statement (Details) - Derivatives designated as cash flow hedges - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Interest rate swap
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	$ 853	$ 4,989	$ (571)
Interest rate swap \| Interest Expense
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	95	(718)	(1,103)
Foreign currency forward contracts
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI		(205)	0
Foreign currency forward contracts \| Revenue
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) recognized in OCI	491
Amount of Gain/(Loss) reclassified from AOCI	(277)	21	0
Foreign currency forward contracts \| Cost of goods sold
Derivative Instruments, Gain (Loss) [Line Items]
Amount of Gain/(Loss) reclassified from AOCI	$ 625	$ (26)	$ 0

Derivatives - Gain (Loss) in the Consolidated Statements of Income (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Not designated as hedging instrument \| Foreign currency forward contracts \| Other expense
Derivative [Line Items]
Gain (loss) on derivative	$ (4,746)	$ 69	$ (302)

Commitments and Contingencies - Schedule of Future Minimum Rental Payments for Operating Leases (Details) $ in Thousands	Dec. 31, 2017 USD ($)
Commitments and Contingencies Disclosure [Abstract]
2018	$ 12,293
2019	11,237
2020	9,307
2021	7,527
2022	6,468
Thereafter	57,211
Total minimum lease payments	$ 104,043

Commitments and Contingencies - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Other Commitments [Line Items]
Rent expense	$ 13,600	$ 11,400	$ 10,700
Proceeds from sale-leaseback transactions	0	0	$ 2,017
Term of lease			7 years
Deferred credits	2,400	2,500
Property, plant, and equipment grants from Ireland	147	170	$ 171
Irish grants refundable if operations discontinued	$ 3,000
Remaining grant liability period	1 year
Royalty expense	$ 4,400	$ 3,200	$ 2,700
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, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Earnings Per Share, Basic and Diluted [Abstract]
Net income, basic									$ 27,523	$ 20,121	$ 23,802
Basic (in shares)									48,805	44,408	44,036
Basic (in dollars per share)	$ 0.14	$ (0.07)	$ 0.19	$ 0.33	$ 0.17	$ 0.02	$ 0.16	$ 0.10	$ 0.56	$ 0.45	$ 0.54
Effect of dilutive stock options and warrants (in shares)									1,296	454	475
Net income, diluted									$ 27,523	$ 20,121	$ 23,802
Diluted (in shares)									50,101	44,862	44,511
Diluted (in dollars per share)	$ 0.13	$ (0.07)	$ 0.19	$ 0.32	$ 0.17	$ 0.02	$ 0.16	$ 0.10	$ 0.55	$ 0.45	$ 0.53
Antidilutive securities excluded from EPS (in shares)									381	727	423

Employee Stock Purchase Plan, Stock Options and Warrants - Narrative (Details) - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Compensation cost not yet recognized	$ 15.1
Compensation cost not yet recognized, period of recognition	3 years 5 months 16 days
Options granted in period (in shares)	1,300,000	880,000	618,000
Fair value of options, net of forfeitures	$ 12.4	$ 5.2	$ 3.7
Options granted in period, weighted average grant date fair value (in dollars per share)	$ 9.57	$ 5.94	$ 5.98
2006 Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for grant (in shares)	500,000
2006 Incentive Plan \| Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Option contractual life	7 years
2006 Incentive Plan \| Stock Options \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	3 years
2006 Incentive Plan \| Stock Options \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	5 years
2006 Incentive Plan \| Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	1 year
Employee Stock Purchase Plan Qualified
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for grant (in shares)	126,863.000
Purchase price for ESPP, percent of market price	95.00%

Employee Stock Purchase Plan, Stock Options and Warrants - Allocation of Recognized Period Costs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	$ 4,075	$ 2,506	$ 2,243
Cost of goods sold
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	632	472	398
Research and development
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	376	184	122
Selling, general, and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation	$ 3,067	$ 1,850	$ 1,723

Employee Stock Purchase Plan, Stock Options and Warrants - Fair Value Calculation Assumptions (Details)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate, minimum	1.77%	1.15%	1.53%
Risk-free interest rate, maximum	1.83%	1.40%	1.66%
Expected option life	5 years	5 years
Expected dividend yield	0.00%	0.00%	0.00%
Expected price volatility, minimum	33.81%	34.28%	33.72%
Expected price volatility, maximum	34.07%	37.06%	35.11%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected option life			5 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, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2017
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Total intrinsic value of stock options exercised	$ 9,264	$ 3,648	$ 7,548
Cash received from stock option exercises	5,552	4,577	6,227
Excess tax benefit from the exercise of stock options	$ 2,264	$ 669	$ 2,124
Number of Shares
Beginning balance (in shares)	2,817
Granted (in shares)	1,297
Exercised (in shares)	(404)
Forfeited/expired (in shares)	(87)
Outstanding at December 31 (in shares)	3,623	2,817
Exercisable (in shares)				1,110
Ending vested and expected to vest (in shares)				3,484
Weighted Average Exercise Price
Beginning balance (in dollars per share)	$ 20.40	$ 15.32		$ 20.40
Granted (in dollars per share)	29.31
Exercised (in dollars per share)	14.02
Forfeited/expired (in dollars per share)	18.79
Outstanding at December 31 (in dollars per share)	$ 20.40	$ 15.32
Exercisable (in dollars per share)				14.35
Ending vested and expected to vest (in dollars per share)				$ 20.23
Outstanding, remaining contractual term	4 years 6 months 26 days
Exercisable, remaining contractual term	2 years 6 months 18 days
Ending vested and expected to vest, remaining contractual term	4 years 6 months 7 days
Outstanding, intrinsic value				$ 82,615
Exercisable, intrinsic value				32,019
Ending vested and expected to vest, intrinsic value				$ 80,052

Employee Stock Purchase Plan, Stock Options and Warrants - Options Outstanding (Details) shares in Thousands	12 Months Ended
	Dec. 31, 2017 $ / 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)	$ 38.35
Number outstanding (in shares) \| shares	3,623
Number exercisable (in shares) \| shares	1,110
$9.95 - $13.99
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)	$ 13.75
Number outstanding (in shares) \| shares	925
Weighted Average Remaining Contractual Life (in years)	2 years 2 months
Weighted average exercise price (in dollars per share)	$ 12.65
Number exercisable (in shares) \| shares	713
Weighted average exercise price (in dollars per share)	$ 12.84
$16.05 - $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)	$ 17.27
Number outstanding (in shares) \| shares	991
Weighted Average Remaining Contractual Life (in years)	4 years 4 months 16 days
Weighted average exercise price (in dollars per share)	$ 16.18
Number exercisable (in shares) \| shares	294
Weighted average exercise price (in dollars per share)	$ 15.96
$22.00 - $34.4
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of exercise, lower (in dollars per share)	18.80
Range of exercise, upper (in dollars per share)	$ 22.00
Number outstanding (in shares) \| shares	425
Weighted Average Remaining Contractual Life (in years)	5 years
Weighted average exercise price (in dollars per share)	$ 20.14
Number exercisable (in shares) \| shares	103
Weighted average exercise price (in dollars per share)	$ 20.18
$38.35 - $38.00
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Range of exercise, lower (in dollars per share)	28.20
Range of exercise, upper (in dollars per share)	$ 38.35
Number outstanding (in shares) \| shares	1,282
Weighted Average Remaining Contractual Life (in years)	6 years 3 months 17 days
Weighted average exercise price (in dollars per share)	$ 29.33
Number exercisable (in shares) \| shares	0
Weighted average exercise price (in dollars per share)	$ 0.00

Segment Reporting and Foreign Operations - Narrative (Details) $ in Millions	12 Months Ended
	Dec. 31, 2017 USD ($) segment	Dec. 31, 2016 USD ($)	Dec. 31, 2015 USD ($)
Segment Reporting [Abstract]
Number of operating segments \| segment	2
Segment Reporting Information [Line Items]
Foreign sales as a percent of total sales	42.00%	39.00%	39.00%
Foreign Sales
Segment Reporting Information [Line Items]
Revenue	$ 307.1	$ 233.5	$ 214.0
Foreign sales	$ 73.4	$ 59.9	$ 50.7

Segment Reporting and Foreign Operations - Sales by Business Segment (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Revenue from External Customer [Line Items]
% Change	21.00%				11.00%				21.00%	11.00%	6.00%
Net Sales	$ 190,897	$ 179,337	$ 186,549	$ 171,069	$ 157,715	$ 156,975	$ 151,071	$ 138,077	$ 727,852	$ 603,838	$ 542,149
Cardiovascular Segment
Revenue from External Customer [Line Items]
% Change	21.00%				11.00%				21.00%	11.00%	6.00%
Net Sales									$ 700,613	$ 580,151	$ 520,915
Cardiovascular Segment \| Stand-alone devices
Revenue from External Customer [Line Items]
% Change	44.00%				23.00%				44.00%	23.00%	8.00%
Net Sales									$ 275,431	$ 191,148	$ 155,414
Cardiovascular Segment \| Custom kits and procedure trays
Revenue from External Customer [Line Items]
% Change	6.00%				2.00%				6.00%	2.00%	5.00%
Net Sales									$ 126,114	$ 119,226	$ 116,368
Cardiovascular Segment \| Inflation devices
Revenue from External Customer [Line Items]
% Change	8.00%				1.00%				8.00%	1.00%	1.00%
Net Sales									$ 79,875	$ 73,916	$ 73,373
Cardiovascular Segment \| Catheters
Revenue from External Customer [Line Items]
% Change	13.00%				17.00%				13.00%	17.00%	11.00%
Net Sales									$ 127,747	$ 113,367	$ 96,833
Cardiovascular Segment \| Embolization devices
Revenue from External Customer [Line Items]
% Change	8.00%				2.00%				8.00%	2.00%	3.00%
Net Sales									$ 49,532	$ 46,035	$ 45,025
Cardiovascular Segment \| CRM/EP
Revenue from External Customer [Line Items]
% Change	15.00%				8.00%				15.00%	8.00%	3.00%
Net Sales									$ 41,914	$ 36,459	$ 33,902
Endoscopy Segment
Revenue from External Customer [Line Items]
Net Sales									$ 27,239	$ 23,687	$ 21,234
Endoscopy Segment \| Endoscopy devices
Revenue from External Customer [Line Items]
% Change	15.00%				12.00%				15.00%	12.00%	18.00%
Net Sales									$ 27,239	$ 23,687	$ 21,234

Segment Reporting and Foreign Operations - Long-lived Assets by Geographic Area (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	$ 292,820	$ 276,573	$ 267,778
United States
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	202,504	194,715	186,389
Ireland
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	45,671	47,337	48,896
Other foreign countries
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	$ 44,645	$ 34,521	$ 32,493

Segment Reporting and Foreign Operations - Operating Income (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Segment Reporting Information [Line Items]
Net Sales	$ 190,897	$ 179,337	$ 186,549	$ 171,069	$ 157,715	$ 156,975	$ 151,071	$ 138,077	$ 727,852	$ 603,838	$ 542,149
Operating expenses									293,184	230,149	198,238
Operating income (loss)	13,219	879	13,362	5,609	12,602	2,987	11,581	7,706	33,069	34,876	37,543
Total other expense - net									2,812	(9,490)	(6,343)
Income tax expense	4,474	1,364	1,830	690	2,116	(978)	2,572	1,555	8,358	5,265	7,398
NET INCOME	$ 6,806	$ (3,569)	$ 9,483	$ 14,803	$ 7,507	$ 973	$ 7,290	$ 4,351	27,523	20,121	23,802
Cardiovascular
Segment Reporting Information [Line Items]
Net Sales									700,613	580,151	520,915
Operating expenses									281,095	218,659	187,492
Operating income (loss)									24,819	30,053	34,052
Endoscopy
Segment Reporting Information [Line Items]
Net Sales									27,239	23,687	21,234
Operating expenses									12,089	11,490	10,746
Operating income (loss)									$ 8,250	$ 4,823	$ 3,491

Segment Reporting and Foreign Operations - Assets, Depreciation, Amortization and Capital Expenditures (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Segment Reporting, Asset Reconciling Item [Line Items]
Assets	$ 1,111,811	$ 942,803	$ 778,728
Depreciation and amortization	53,582	43,755	37,425
Capital expenditures	38,623	32,837	50,959
Cardiovascular
Segment Reporting, Asset Reconciling Item [Line Items]
Assets	1,103,806	932,927	767,952
Depreciation and amortization	52,700	42,806	36,474
Capital expenditures	38,437	32,613	50,927
Endoscopy
Segment Reporting, Asset Reconciling Item [Line Items]
Assets	8,005	9,876	10,776
Depreciation and amortization	882	949	951
Capital expenditures	$ 186	$ 224	$ 32

Employee Benefit Plans (Details) - USD ($) $ in Thousands	12 Months Ended
Employee Benefit Plans (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Defined Contribution Plan Disclosure [Line Items]
Minimum age for participation (in years)	18 years
Minimum time at the company for participation (in days)	90 days
Total paid into 401(k)	$ 2,400	$ 2,300	$ 2,000
Non-US
Defined Contribution Plan Disclosure [Line Items]
Total paid into 401(k)	$ 2,300	$ 1,100	$ 893
Non-US \| Minimum
Defined Contribution Plan Disclosure [Line Items]
Employer matching, percent of gross pay	2.00%
Non-US \| Maximum
Defined Contribution Plan Disclosure [Line Items]
Employer matching, percent of gross pay	32.00%
Non-US \| Management \| Minimum
Defined Contribution Plan Disclosure [Line Items]
Employer matching, percent of gross pay	2.00%
Non-US \| Management \| Maximum
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, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Quarterly Financial Information Disclosure [Abstract]
Net sales	$ 190,897	$ 179,337	$ 186,549	$ 171,069	$ 157,715	$ 156,975	$ 151,071	$ 138,077	$ 727,852	$ 603,838	$ 542,149
Gross profit	85,656	80,514	84,141	75,942	70,256	67,815	66,854	60,100	326,253	265,025	235,781
Income from operations	13,219	879	13,362	5,609	12,602	2,987	11,581	7,706	33,069	34,876	37,543
Income tax expense	4,474	1,364	1,830	690	2,116	(978)	2,572	1,555	8,358	5,265	7,398
Net income	$ 6,806	$ (3,569)	$ 9,483	$ 14,803	$ 7,507	$ 973	$ 7,290	$ 4,351	$ 27,523	$ 20,121	$ 23,802
Basic (in dollars per share)	$ 0.14	$ (0.07)	$ 0.19	$ 0.33	$ 0.17	$ 0.02	$ 0.16	$ 0.10	$ 0.56	$ 0.45	$ 0.54
Diluted (in dollars per share)	$ 0.13	$ (0.07)	$ 0.19	$ 0.32	$ 0.17	$ 0.02	$ 0.16	$ 0.10	$ 0.55	$ 0.45	$ 0.53

Fair Value Measurements - Financial Assets and (Liabilities) Carried at Fair Value (Details) - Fair Value, Measurements, Recurring - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Fair Value, Inputs, Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate contracts	$ 0	$ 0
Foreign currency contract liabilities, current and long-term	0	0
Foreign currency contract liabilities, current and long-term	0	0
Fair Value, Inputs, Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate contracts	5,749	4,991
Foreign currency contract liabilities, current and long-term	621	354
Foreign currency contract liabilities, current and long-term	(1,391)	(464)
Fair Value, Inputs, Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate contracts	0	0
Foreign currency contract liabilities, current and long-term	0	0
Foreign currency contract liabilities, current and long-term	0	0
Estimate of Fair Value, Fair Value Disclosure
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest rate contracts	5,749	4,991
Foreign currency contract liabilities, current and long-term	621	354
Foreign currency contract liabilities, current and long-term	$ (1,391)	$ (464)

Fair Value Measurements - Liability Measured on Recurring Basis, Unobservable Input Reconciliation (Details) - Contingent Consideration - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ 683	$ 1,024
Contingent consideration liability recorded as the result of acquisitions	10,400	0
Fair value adjustments recorded to income during the period	(66)	(123)
Contingent payments made	(61)	(218)
Ending balance	$ 10,956	$ 683

Fair Value Measurements - Fair Value Inputs, Liabilities, Quantitative Information (Details) - Contingent Consideration - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Contingent consideration liability	$ 10,956	$ 683	$ 1,024
Revenue-based Payments
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Contingent consideration liability	$ 10,956	$ 683
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%	100.00%
Revenue-based Payments \| Minimum \| Discounted Cash Flow \| Fair Value, Inputs, Level 3
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Discount rate	9.90%	10.00%
Revenue-based Payments \| Maximum \| Discounted Cash Flow \| Fair Value, Inputs, Level 3
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Discount rate	15.00%	15.00%
Other Payments
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Contingent consideration asset	$ 760	$ 528
Other Payments \| Discounted Cash Flow \| Fair Value, Inputs, Level 3
Fair Value Inputs, Liabilities, Quantitative Information [Line Items]
Probability of milestone payment	75.00%	57.00%
Discount rate	10.00%	10.00%

Fair Value Measurements - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Impairment of other assets	$ 988	$ 101	$ 141
Other Payments \| Contingent Consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining contingent receivable asset	760	528
Contingent Receivable \| Contingent Consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Gain (loss) on contingent receivable	232	(184)
Other Long-term Obligations
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability, noncurrent	10,700	595
Accrued expenses
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration liability, current	289	88
Other assets (long-term) \| Contingent Receivable \| Contingent Consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining contingent receivable asset	319	367
Other Current Assets \| Contingent Receivable \| Contingent Consideration
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining contingent receivable asset	$ 441	$ 161

Issuance of Common Stock (Details) - USD ($) $ in Thousands		12 Months Ended
Issuance of Common Stock (Details) - USD ($) $ in Thousands	Mar. 28, 2017	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Equity [Abstract]
Common stock shares issued (in shares)	5,175,000	50,248,000	44,645,000
Proceeds from issuance of common stock	$ 136,600	$ 143,810	$ 5,271	$ 6,668
Underwriting discounts and commissions	8,800
Other direct costs incurred	$ 816	$ 816	$ 0	$ 0

Subsequent Events (Details) - USD ($) $ in Thousands		12 Months Ended
Subsequent Events (Details) - USD ($) $ in Thousands	Feb. 14, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Subsequent Event [Line Items]
Payments to acquire intangible assets		$ 2,577	$ 2,217	$ 1,956
Subsequent Event \| Becton, Dickinson and Company
Subsequent Event [Line Items]
Payments to acquire intangible assets	$ 100,100

Schedule II - Valuation and qualifying accounts (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Allowance for Doubtful Accounts
Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Year	$ (1,587)	$ (1,297)	$ (893)
Additions Charged to Costs and Expenses	(1,012)	(612)	(607)
Deduction	830	322	203
Balance at End of Year	(1,769)	(1,587)	(1,297)
Tax Valuation Allowance
Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Year	(3,786)	(1,981)	(1,603)
Additions Charged to Costs and Expenses	(636)	(1,805)	(378)
Deduction	0	0	0
Balance at End of Year	$ (4,422)	$ (3,786)	$ (1,981)