Property and Equipment (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 674,334	$ 608,823
Accumulated depreciation	(249,437)	(210,139)
Net property and equipment	424,897	398,684	[1]
Machinery and Equipment, Gross	195,278	220,999
Furniture and Fixtures, Gross	8,284	7,361
Construction in Progress, Gross	98,967	57,144
Land, Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	213,764	206,846
Molds [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	56,304	56,253
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	43,490	44,408
Instruments Placed with Customers [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 58,247	$ 15,812

[1] December 31, 2017 balances were derived from audited consolidated financial statements.