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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2022
Sep. 30, 2021
Cash flows from operating activities:    
Net loss $ (110,014) $ (55,028)
Adjustments to reconcile net loss to net cash used in operating activities:    
Depreciation and amortization 907 614
Amortization of debt discount and debt issuance costs 4,147 937
Change in deferred taxes 25,916 (11,322)
Share-based compensation expense 5,086 6,088
Gain from release of certain liabilities (33) (166)
Other adjustments 1,539 1,056
Net changes in assets and liabilities    
Prepaid expenses and other current assets 27,948 (54)
Research and development tax credit receivable 27 3,079
Accounts payable & other current liabilities (11,629) (201)
Accrued expenses 4,277 2,421
Other assets and liabilities (3,109) (2,228)
Net cash used in operating activities (54,938) (54,804)
Cash flows from investing activities:    
Purchases of property and equipment (716) (26)
Proceeds from the disposition of the hospital products 0 16,500
Proceeds from sales of marketable securities 59,873 83,726
Purchases of marketable securities (2,334) (58,591)
Net cash provided by investing activities 56,823 41,609
Cash flows from financing activities:    
Payments for debt issuance costs (4,803) 0
Proceeds from issuance of shares off the at-the-market offering program 10,532 0
Proceeds from stock option exercises and employee share purchase plan 2,192 263
Net cash provided by financing activities 7,921 263
Effect of foreign currency exchange rate changes on cash and cash equivalents 201 (621)
Net change in cash and cash equivalents 10,007 (13,553)
Cash and cash equivalents at January 1, 50,708 71,722
Cash and cash equivalents at September 30, 60,715 58,169
Supplemental disclosures of cash flow information:    
Interest paid 9,660 6,469
Income taxes (refund) paid $ (32,323) $ 68