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Restructuring, Strategic Transaction and Integration (Notes)
 12 Months Ended
Dec. 31, 2019
Restructuring and Related Activities [Abstract]  
Restructuring and Related Activities Disclosure [Text Block] RESTRUCTURING, STRATEGIC TRANSACTION AND INTEGRATION

Restructuring and strategic transaction and integration expenses were $80.6 million, $105.4 million and $78.0 million for the years ended December 31, 2019, 2018 and 2017, respectively.

Restructuring

Restructuring charges were $8.4 million, $4.5 million and $18.8 million for the years ended December 31, 2019, 2018 and 2017, respectively, and are included in the above restructuring, strategic transaction and integration amounts on a separate line item in our consolidated statement of operations.

During the year ended December 31, 2019, restructuring charges were primarily related to severance and facility closure costs. These charges were primarily related to a one-time charge to move our U.S. pump service depot to our existing Salt Lake City facility and other plant restructuring. The cumulative amount incurred to date in connection with the HIS acquisition is $25.1 million.
In 2018 and 2017, we incurred restructuring charges related to the acquisition of the HIS business (see Note 2, Acquisitions). The restructuring charges were incurred as a result of integrating the acquired operations into our business and include severance costs related to involuntary employee terminations and facility exit costs related to the closure of the Dominican Republic manufacturing facilities acquired from Pfizer.

In 2015, we incurred restructuring charges related to an agreement with Dr. Lopez, a member of our Board of Directors and a former employee in our research and development department, pursuant to which we bought out Dr. Lopez's right to employment under his then-existing employment agreement, the buy-out, including payroll taxes, will be paid in equal monthly installments until December 2020. The remaining payments owed are included in accrued liabilities in our consolidated balance sheet.
    
The following table summarizes the activity for the restructuring-related charges discussed above and related accrual (in thousands):
 
Accrued Balance January 1, 2018
 
Charges incurred
 
Payments
 
Other Adjustments
 
Accrued Balance December 31, 2018
 
Charges incurred
 
Payments
 
Other Adjustments
 
Accrued Balance December 31, 2019
Severance pay and benefits
$
915

 
$
4,311

 
$
(4,549
)
 
$
—

 
$
677

 
$
5,634

 
$
(2,433
)
 
$
—

 
$
3,878

Employment agreement buyout
1,114

 
—

 
(368
)
 
(7
)
 
739

 
—

 
(279
)
 
—

 
460

Retention and facility closure expenses
—

 
160

 
(160
)
 
—

 
—

 
2,741

 
(1,530
)
 
—

 
1,211

 
$
2,029

 
$
4,471

 
$
(5,077
)
 
$
(7
)
 
$
1,416

 
$
8,375

 
$
(4,242
)
 
$
—

 
$
5,549



Strategic Transaction and Integration Expenses

During the years ended December 31, 2019, 2018 and 2017, we incurred $72.2 million, $100.9 million and $59.2 million, respectively, in transaction and integration costs. These costs were primarily related to the acquisition and integration of HIS business, (see Note 2, Acquisitions). The integration expenses for the year ended December 31, 2019, included a one-time strategic supply chain restructuring charge of $22.1 million, which reduces our contracted commitments to our third party manufacturer and charges related to our Pfizer separation costs, which included a $12.7 million non-cash write-off of related assets.