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Income Taxes (Tables)
12 Months Ended
Dec. 31, 2020
Income Tax Disclosure [Abstract]  
Schedule Of Components Of Loss Before Income Tax
The components of (loss) income before income taxes for the years ended twelve months ended December 31, are as follows: 
(Loss) Income Before Income Taxes:202020192018
Ireland$(27,205)$(50,134)$(42,604)
U.S.22,335 10,401 (70,340)
France(212)1,151 (253)
Total loss before income taxes$(5,082)$(38,582)$(113,197)
Schedule Of Income Tax (Benefit) Provision
The income tax (benefit) provision consists of the following for the years ended December 31:  
 Income Tax (Benefit) Provision:202020192018
Current:   
U.S. - Federal$(12,810)$— $— 
U.S. - State20 97 330 
Total current(12,790)97 330 
Deferred:   
Ireland— (1,256)— 
U.S. - Federal680 (4,093)(19,503)
U.S. - State— (104)1,280 
Total deferred680 (5,453)(18,223)
Income tax benefit$(12,110)$(5,356)$(17,893)
Schedule of Effective Income Tax Rate Reconciliation
The reconciliation between income taxes at the statutory rate and the Company’s benefit for income taxes is as follows for the years ended December 31: 
 Reconciliation to Effective Income Tax Rate:202020192018
Statutory tax rate 12.5 %12.5 %12.5 %
Differences in international tax rates(34.5)%3.2 %8.0 %
Nondeductible changes in fair value of contingent consideration(19.4)%(0.3)%4.0 %
Intercompany asset transfer— %21.2 %— %
Change in valuation allowances(83.3)%(19.1)%(5.3)%
Nondeductible stock-based compensation(20.9)%(2.7)%(1.3)%
Hospital Products sale183.5 %— %— %
Unrealized tax benefits5.4 %0.7 %(1.3)%
State and local taxes (net of federal)(0.4)%— %(0.3)%
Change in U.S. tax law179.5 %— %(0.2)%
Nondeductible interest expense(34.0)%(2.5)%(1.1)%
Orphan drug and R&D tax credit55.0 %— %— %
Other(5.1)%0.9 %0.7 %
Effective income tax rate238.3 %13.9 %15.7 %
Income tax benefit - at statutory tax rate$(636)$(4,823)$(14,149)
Differences in international tax rates1,755 (1,218)(9,039)
Nondeductible changes in fair value of contingent consideration988 121 (4,559)
Intercompany asset transfer— (8,190)— 
Change in valuation allowances4,231 7,379 5,998 
Nondeductible stock-based compensation1,060 1,039 1,499 
Hospital Products sale(9,328)— — 
Unrecognized tax benefits(274)(261)1,440 
State and local taxes (net of federal)20 (7)299 
Change in U.S. tax law(9,124)— 274 
Nondeductible interest expense1,728 982 1,269 
Orphan drug and R&D tax credit(2,793)— — 
Other263 (378)(925)
Income tax benefit - at effective income tax rate$(12,110)$(5,356)$(17,893)
Summary of Unrecognized Tax Benefits
The following table summarizes the activity related to the Company’s unrecognized tax benefits for the twelve months ended
December 31:
 Unrecognized Tax Benefit Activity202020192018
Balance at January 1: $6,465 $5,315 $3,954 
Additions based on tax positions related to the current year— — 1,087 
Increases for tax positions of prior years— 2,416 274 
Statute of limitations expiration— (1,266)— 
Settlements(3,322)— — 
Balance at December 31: $3,143 $6,465 $5,315 
Schedule of Deferred Tax Assets and Liabilities The net deferred tax assets (liabilities) at December 31, 2020 and 2019 resulted from the following temporary differences: 
 Net Deferred Tax Assets and Liabilities: 20202019
Deferred tax assets:  
Net operating loss carryforwards$31,302 $30,275 
Amortization3,701 11,602 
Stock based compensation2,626 3,577 
Accounts receivable— 53 
Fair value contingent consideration— 264 
Orphan drug and R&D tax credit2,793 — 
Other423 901 
Gross deferred tax assets40,845 46,672 
Deferred tax liabilities:  
Amortization— (172)
Prepaid expenses(75)(35)
Other(890)— 
Gross deferred tax liabilities(965)(207)
Less: valuation allowances(21,624)(17,038)
Net deferred tax assets $18,256 $29,427