Annual report pursuant to Section 13 and 15(d)

Composition of Certain Financial Statement Captions (Details)

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Composition of Certain Financial Statement Captions (Details) - USD ($)
$ in Thousands
Dec. 31, 2018
Dec. 31, 2017
Accounts receivable, net    
Accounts receivable $ 145,665 $ 166,962
Less: allowance for doubtful accounts (1,758) (1,446)
Accounts receivable, net 143,907 165,516
Inventories, net    
Consumable supplies 23,264 21,546
Finished products 15,259 21,012
Work in-process 2,473 5,873
Raw materials 4,259 7,467
Less: inventory reserve (2,956) (6,565)
Inventory, net 42,299 49,333
Other current assets and prepaid expenses    
Other receivables 2,368 3,398
Taxes recoverable 15,708 18,138
Prepaid supplies 9,693 8,207
Prepaid insurance 3,436 3,532
Other 3,847 9,238
Prepaid expenses and other current assets 35,052 42,513
Property, plant and equipment, net:    
Machinery, medical and other equipment 147,757 112,961
Leasehold improvements 34,607 34,121
Furniture and fixtures 12,737 11,540
Automobiles and aircraft 10,133 11,137
Software 13,425 12,469
Building 18,554 8,227
Land 2,453 2,552
Construction in process 16,670 39,397
Less: accumulated depreciation (111,662) (85,847)
Property, plant and equipment, net 144,674 146,557
Intangible assets, net:    
Less: accumulated amortization (258,539) (198,935)
Intangible assets, net 614,452 683,835
Accrued expenses:    
Contract liabilities 63,503 56,883
Employee benefits 45,621 50,377
Taxes payable 3,233 4,609
Contingent consideration 2,375 11,750
Clinical trials 10,401 12,191
Capital leases short-term 3,280 3,399
Milestone payment 4,871 4,868
Professional fees 7,935 2,355
Other 62,294 79,364
Accrued expenses 203,513 225,796
Other long-term liabilities:    
Contract liabilities 27,566 95,450
Line of credit 105,198 104,152
Contingent consideration 22,162 29,603
Capital leases long-term 5,620 7,786
Mortgages and other debts payable 4,654 1,567
Other 33,768 17,857
Other long-term liabilities 198,968 256,415
Customer relationships    
Intangible assets, net:    
Intangible assets 446,296 448,345
Technologies    
Intangible assets, net:    
Intangible assets 340,729 340,921
Trade names    
Intangible assets, net:    
Intangible assets 50,404 50,553
Covenants not to compete    
Intangible assets, net:    
Intangible assets 16,322 16,372
Licenses    
Intangible assets, net:    
Intangible assets 5,766 10,305
Product registrations    
Intangible assets, net:    
Intangible assets 7,861 10,475
Other    
Intangible assets, net:    
Intangible assets $ 5,613 $ 5,799