RMTI Rockwell Medical Inc

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Rockwell Medical, Inc. (the "Company", "Rockwell", "we", or "us") is a healthcare company that develops, manufactures, commercializes, and distributes a portfolio of hemodialysis products for dialysis providers worldwide.

Rockwell is a revenue-generating business and the second largest supplier of liquid and powder acid and bicarbonate concentrates for dialysis patients in the United States. Hemodialysis is the most common form of end-stage kidney disease treatment and is typically performed at freestanding outpatient dialysis centers, hospital-based outpatient centers, skilled nursing facilities, or in a patient’s home.

Rockwell provides the hemodialysis community with products controlled by a Quality Management System regulated by the U.S. Food and Drug Administration ("FDA"). Rockwell is ISO 13485 Certified and adheres to current Good Manufacturing Practices ("cGMP") and Association for Advancement of Medical Instrumentation ("AAMI") standards. Rockwell manufactures hemodialysis concentrates at its facilities in Michigan, South Carolina, and Texas totaling approximately 175,000 square feet, and manufactures its dry acid concentrate mixers at its facility in Iowa. Rockwell delivers the majority of its hemodialysis concentrates products and mixers to dialysis clinics throughout the United States and internationally utilizing its own delivery trucks and third-party carriers.

On July 10, 2023, Rockwell acquired the hemodialysis concentrates business from Evoqua Water Technologies LLC ("Evoqua"). This acquisition expands the Company's geographic footprint, customer base, and product offerings. In addition, this acquisition provides fully automated processing that potentially results in a lower cost to manufacture. As part of this acquisition, the Company now manufactures hemodialysis concentrates in Minnesota under a contract manufacturing agreement with a contract manufacturing organization. (See Note 16 for further detail).

In addition to its primary focus on hemodialysis concentrates, Rockwell also has a proprietary parenteral iron product, Triferic® (ferric pyrophosphate citrate ("FPC")), which is indicated to maintain hemoglobin in adult patients with hemodialysis-dependent chronic kidney disease. While Rockwell has discontinued commercialization of Triferic in the United States, the Company has established several international partnerships with companies seeking to develop and commercialize Triferic outside the United States and is working closely with these international partners to develop and commercialize Triferic in their respective regions. Additionally, Rockwell continues to evaluate the viability of its FPC platform and FPC's potential to treat iron deficiency, iron deficiency anemia, and acute heart failure.

Rockwell was incorporated in the state of Michigan in 1996 and re-domiciled to the state of Delaware in 2019. Rockwell's headquarters is located at 30142 Wixom Road, Wixom, Michigan 48393.

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As of June 30, 2023, Rockwell had approximately $14.9 million of cash, cash equivalents and investments available-for-sale, and working capital of $10.1 million. Net cash used in operating activities for the six months ended June 30, 2023 was approximately $5.6 million. Based on the currently available working capital, management believes the Company currently has sufficient funds to meet its operating requirements for at least the next twelve months from the date of the filing of this report.

On July 10, 2023, Armistice Capital Master Fund Ltd. (“Armistice”), which held a warrant to purchase 9,900,990 shares of common stock of the Company with an exercise price of $1.39 per share, exercised the warrant and the Company received gross proceeds of approximately $13.8 million (See Note 16 for further detail).

Also on July 10, 2023, Rockwell acquired the hemodialysis concentrates business from Evoqua Water Technologies LLC ("Evoqua") for an aggregate purchase price, subject to certain adjustments pursuant to the terms of the Purchase Agreement, of $11.0 million in cash paid at closing and equal annual installments of $2.5 million payable on each of the first and second anniversaries of the closing. In addition, the Company purchased approximately $1.2 million of inventory. This acquisition expands the Company's geographic footprint, customer base, and product offerings. In addition, this acquisition provides fully automated processing that potentially results in a lower cost to manufacture. As part of this acquisition, the Company manufactures hemodialysis concentrates under a contract manufacturing agreement with a contract manufacturing organization. (See Note 16 for further detail).

The Company continues to review its operational plans and execute on the acquisition of new customers, and has implemented cost containment activities. The Company may require additional capital to sustain its operations and make the investments it needs to execute its strategic plan. Additionally, the Company's operational plans include raising capital, if needed, by using its at-the-market ("ATM") facility or other methods or forms of financings, subject to existing limitations.

If the Company attempts to obtain additional debt or equity financing, the Company cannot assume such financing will be available on favorable terms, if at all.

As of June 30, 2023, the Company is no longer subject to the baby shelf limitations under Form S-3, which limit the amount the Company may offer pursuant to its registration statement on Form S-3.

The Company is subject to certain covenants and cure provisions under its Loan Agreement with Innovatus. As of the date of this report, the Company is in compliance with all covenants (See Note 14 for further detail).

In addition, the global macroeconomic environment is uncertain, and could be negatively affected by, among other things, increased U.S. trade tariffs and trade disputes with other countries, instability in the global capital and credit markets, recent bank failures in the United States, supply chain weaknesses, and instability in the geopolitical environment, including as a result of the Russian invasion of Ukraine and other political tensions, and lingering effects of the COVID-19 pandemic. Such challenges have caused, and may continue to cause, recession fears, rising interest rates, foreign exchange volatility and inflationary pressures. At this time, the Company is unable to quantify the potential effects of this economic instability on our future operations.

Rockwell has utilized a range of financing methods to fund its operations in the past; however, current conditions in the financial and credit markets may limit the availability of funding, refinancing or increase the cost of funding. Due to the rapidly evolving nature of the global situation, it is not possible to predict the extent to which these conditions could adversely affect the Company's liquidity and capital resources in the future.

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The accompanying condensed consolidated financial statements have been prepared in accordance with the accounting principles generally accepted in the United States of America (“U.S. GAAP”) for interim financial information and pursuant to the instructions to Form 10-Q and Rule 10-01 of Regulation S-X of the U. S. Securities and Exchange Commission (“SEC”) and on the same basis as the Company prepares its annual audited consolidated financial statements.

The condensed consolidated balance sheet at June 30, 2023, and the condensed consolidated statements of operations, comprehensive loss, and changes in stockholders' equity for the three and six months ended June 30, 2023 and 2022 and cash flows for the six months ended June 30, 2023 and 2022 are unaudited, but include all adjustments, consisting of normal recurring adjustments the Company considers necessary for a fair presentation of the financial position, operating results and cash flows for the periods presented. The results for the three and six months ended June 30, 2023 are not necessarily indicative of results to be expected for the year ending December 31, 2023 or for any future interim period. The condensed consolidated balance sheet at December 31, 2022 has been derived from audited financial statements, however, it does not include all of the information and notes required by U.S. GAAP for complete financial statements. The accompanying condensed consolidated financial statements should be read in conjunction with the audited financial statements for the year ended December 31, 2022 and notes thereto included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022 as filed with the SEC on March 30, 2023. The Company’s consolidated subsidiaries consist of its wholly-owned subsidiaries, Rockwell Transportation, Inc. and Rockwell Medical India Private Limited.

The accompanying condensed consolidated interim financial statements include the accounts of the Company and its subsidiaries. All material intercompany balances and transactions have been eliminated in consolidation.

Use of Estimates

The preparation of the condensed consolidated financial statements in conformity with U.S. generally accepted accounting principles ("GAAP") requires management to make estimates and assumptions that may affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of expenses during the reporting period. Actual results could differ from those estimates.

Restatement of Loss Per Share

Earnings per share for the three and six months ended June 30, 2022 have been recalculated and restated and is presented on a comparable basis with the three and six months ended June 30, 2023. In the first quarter of 2023, the Company determined it should have included pre-funded warrants issued in Q2 2022 in the earnings per share calculation accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC’) 260-10-45-13, which treats shares of common stock exercisable for little to no consideration as included in the denominator of both the basic and diluted earnings per share calculations. While the Company has determined the impact of including the pre-funded warrants in the earnings per share calculations does not have a material impact on previously issued financial statements and is correct to recalculate and restate amounts presented on a comparative and consistent basis with current period results. The table below summarizes previously reported and restated amounts on a comparative basis. See the table presentation of loss per share calculations as of June 30, 2023 and 2022 in the "Loss Per Share Including Restated Amounts" section below.

						Three Months Ended June 30,												Six Months Ended June 30,
									2022												2022
As Previously Reported:
Net loss per share attributable to common stockholders - basic and diluted									$	(0.56)											$	(1.40)
Weighted average number of shares of common stock outstanding - basic and diluted									8,805,190												8,675,428
As Restated:
Net loss per share attributable to common stockholders - basic and diluted									$	(0.43)											$	(1.20)
Weighted average number of shares of common stock outstanding - basic and diluted									11,591,768												10,076,415

Loss Per Share

Basic and diluted net loss per share for the three and six months ended June 30, 2023 and 2022, after giving effect to the restatement discussed above, was calculated as follows:

			Three Months Ended June 30,												Six Months Ended June 30,
(In Thousands, Except Shares and Per Share Amounts)			2023						2022						2023						2022
Numerator:
Net loss			$	(3,305)					$	(4,967)					$	(5,055)					$	(12,128)
Net loss attributable to common stockholders for basic and diluted loss per share			$	(3,305)					$	(4,967)					$	(5,055)					$	(12,128)
Denominator:
Weighted average number of shares of common stock outstanding - basic and diluted			18,496,640						11,591,768						18,480,248						10,076,415
Net loss per share attributable to common stockholders - basic and diluted			$	(0.18)					$	(0.43)					$	(0.27)					$	(1.20)

Included within the weighted average shares of common stock outstanding for the three and six months ended June 30, 2023 and 2022, are 1,793,000 and 9,056,377 shares of common stock issuable upon the exercise of the pre-funded warrants (See Note 10), as the warrants are exercisable at any time for nominal consideration, and as such, the shares are considered outstanding for the purpose of calculating basic and diluted net loss per share attributable to common stockholders.

The Company’s potentially dilutive securities include stock options, restricted stock awards and units, convertible preferred stock and warrants. These securities were excluded from the computations of diluted net loss per share for the three and six months ended June 30, 2023 and 2022, as the effect would be to reduce the net loss per share. The following table includes the potential shares of common stock, presented based on amounts outstanding at each period end, that were excluded from the computation of diluted net loss per share attributable to common stockholders for the periods indicated because including them would have had an anti-dilutive effect:

			As of June 30,
			2023						2022
Options to purchase common stock			1,570,599						423,317
Unvested restricted stock awards			891						891
Unvested restricted stock units			313,065						125,000
Convertible Preferred Stock			1,363,636						1,363,636
Warrants to purchase common stock			10,196,268						12,303,432
Total			13,444,459						14,216,276

Adoption of Recent Accounting Pronouncements

The Company continually assesses new accounting pronouncements to determine their applicability. When it is determined a new accounting pronouncement affects the Company’s financial reporting, the Company undertakes a review to determine the consequences of the change to its consolidated financial statements and assures there are sufficient controls in place to ascertain the Company’s consolidated financial statements properly reflect the change.

In June 2016, the FASB issued Accounting Standards Update ("ASU") 2016-13, "Financial Instruments - Credit Losses (Topic 326)," which introduced an impairment model that is based on expected credit losses, rather than incurred losses, to estimate credit losses on certain types of financial instruments (e.g., loan commitments). The expected credit losses should consider historical information, current information, and reasonable and supportable forecasts, including estimates of prepayments, over the contractual term. Financial instruments with similar risk characteristics may be grouped together when estimating expected credit losses. In addition, ASC 326 requires expected credit relates losses for available-for-sale debt securities to be recorded through an allowance for credit losses, while non-credit related losses will continue to be recognized through other comprehensive income. The Company adopted the new guidance, as of January 1, 2023, and it did not have a material impact on the Condensed Consolidated Financial Statements.

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The Company recognizes revenue under ASC 606, Revenue from Contracts with Customers. The core principle of the new revenue standard is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The following five steps are applied to achieve that core principle:

•Step 1: Identify the contract with the customer

•Step 2: Identify the performance obligations in the contract

•Step 3: Determine the transaction price

•Step 4: Allocate the transaction price to the performance obligations in the contract

•Step 5: Recognize revenue when the company satisfies a performance obligation

Taxes assessed by a governmental authority that are both imposed on and concurrent with a specific revenue-producing transaction, that are collected by us from a customer, are excluded from revenue.

Shipping and handling costs associated with outbound freight related to contracts with customers are accounted for as a fulfillment cost and are included in cost of sales when control of the goods transfers to the customer.

Nature of goods and services

The following is a description of principal activities from which the Company generates its revenue.

We currently operate in one market segment, the hemodialysis market, which involves the manufacture, sale and distribution of hemodialysis products to hemodialysis clinics, including pharmaceutical, dialysis concentrates, dialysis kits and other ancillary products used in the dialysis process. Our customer mix is diverse with most customer sales concentrations under 10% and one customer, DaVita, Inc., at approximately 50% for the six months ended June 30, 2023. Our accounts receivable from this customer were approximately 33% of the total consolidated accounts receivable balance at June 30, 2023.

Product sales – The Company accounts for individual products and services separately if they are distinct (i.e., if a product or service is separately identifiable from other items and if a customer can benefit from it on its own or with other resources that are readily available to the customer). The consideration, including any discounts, is allocated between separate products and services based on their stand-alone selling prices. The stand-alone selling prices are determined based on the cost plus margin approach.

Drug and dialysis concentrates products are sold directly to dialysis clinics and to wholesale distributors in both domestic and international markets. Distribution and license agreements for which upfront fees are received are evaluated upon execution or modification of the agreement to determine if the agreement creates a separate performance obligation from the underlying product sales.  For all existing distribution and license agreements, the distribution and license agreement is not a distinct performance obligation from the product sales.  In instances where regulatory approval of the product has not been established and the Company does not have sufficient experience with the foreign regulatory body to conclude regulatory approval is probable, the revenue for the performance obligation is recognized over the term of the license agreement (over time recognition). Conversely, when regulatory approval already exists or is probable, revenue is recognized at the point in time control of the product transfers to the customer.

The Company received upfront fees under five distribution and license agreements that have been deferred as a contract liability.  The amounts received from Wanbang Biopharmaceuticals Co., Ltd. (“Wanbang”), Sun Pharmaceutical Industries Ltd. ("Sun Pharma"), Jeil Pharmaceutical Co., Ltd. ("Jeil Pharma") and Drogsan Pharmaceuticals ("Drogsan Pharma") are recognized as revenue over the estimated term of the applicable distribution and license agreement as regulatory approval was not received and the Company did not have sufficient experience in China, India, South Korea and Turkey, respectively, to determine regulatory approval was probable as of the execution of the agreement.  The amounts received from Baxter Healthcare Corporation (“Baxter”) were deferred and recognized as revenue at the point in time the estimated product sales under the agreement occurred. 

In November 2022, Rockwell reacquired its distribution rights to its hemodialysis concentrates products from Baxter and terminated the exclusive distribution agreement. Under the exclusive distribution agreement, Baxter distributed and

commercialized Rockwell’s hemodialysis concentrates products and provided customer service and order delivery to nearly all United States customers. Following the reacquisition of these rights, Rockwell is now unrestricted in its ability to sell its hemodialysis concentrates products to dialysis clinics throughout the United States and around the world.

Rockwell agreed to pay Baxter a fee for the reacquisition of its distribution rights which was reflected as an expense at that time. This fee was payable in two equal installments on January 1, 2023 and April 1, 2023. As of June 30, 2023, all payments were completed.

For the majority of the Company’s U.S. and international customers, the Company recognizes revenue at the shipping point, which is generally the Company’s plant or warehouse. For other business, the Company recognizes revenue based on when the customer takes control of the product. The amount of revenue recognized is based on the purchase order less returns and adjusted for any rebates, discounts, chargebacks or other amounts paid to customers. There were no such adjustments for the periods reported. Customers typically pay for the product based on customary business practices with payment terms averaging 30 days, while a small subset of customers have payment terms averaging 60 days.

Disaggregation of revenue

Revenue is disaggregated by primary geographical market, major product line, and timing of revenue recognition.

In thousands of U.S. dollars ($)			Three Months Ended June 30, 2023																		Six Months Ended June 30, 2023
Products By Geographic Area			Total						U.S.						Rest of World						Total						U.S.						Rest of World
Drug Revenues
Product Sales – Point-in-time			$	—					$	—					$	—					$	—					$	—					$	—
License Fee – Over time			65						—						65						130						—						130
Total Drug Products			65						—						65						130						—						130
Concentrates Products
Product Sales – Point-in-time			18,015						16,125						1,890						36,146						32,585						3,561
License Fee – Over time			—						—						—						1,472						1,472						—
Total Concentrate Products			18,015						16,125						1,890						37,618						34,057						3,561
Net Revenue			$	18,080					$	16,125					$	1,955					$	37,748					$	34,057					$	3,691

In thousands of U.S. dollars ($)			Three Months Ended June 30, 2022																		Six Months Ended June 30, 2022
Products By Geographic Area			Total						U.S.						Rest of World						Total						U.S.						Rest of World
Drug Revenues
Product Sales – Point-in-time			$	482					$	209					$	273					$	641					$	368					$	273
License Fee – Over time			65						—						65						127						—						127
Total Drug Products			547						209						338						768						368						400
Concentrates Products
Product Sales – Point-in-time			17,655						15,906						1,749						33,082						29,715						3,367
License Fee – Over time			480						480						—						956						956						—
Total Concentrate Products			18,135						16,386						1,749						34,038						30,671						3,367
Net Revenue			$	18,682					$	16,595					$	2,087					$	34,806					$	31,039					$	3,767

Contract balances

The following table provides information about receivables, contract assets, and contract liabilities from contracts with customers.

In thousands of U.S. dollars ($)			June 30, 2023						December 31, 2022
Accounts Receivable, net			$	5,411					$	6,259
Contract liabilities, which are included in deferred revenue			$	2,729					$	4,331

There were no bad debt expenses recognized related to any receivables arising from the Company’s contracts with customers for the three and six months ended June 30, 2023 and 2022.

There were no other material contract assets recorded on the condensed consolidated balance sheet as of June 30, 2023 and December 31, 2022.  The Company does not generally accept returns of its concentrates products and no material reserve for returns of concentrates products was established as of June 30, 2023 or December 31, 2022. 

The contract liabilities primarily relate to upfront payments and consideration received from customers in advance of the customer assuming control of the related products.

Transaction price allocated to remaining performance obligations

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Investments available-for-sale consisted of the following as of June 30, 2023 and December 31, 2022 (table in thousands):

			June 30, 2023
			Amortized Cost						Unrealized Gain						Unrealized Loss						Accrued Interest						Fair Value
Available-for-Sale Securities
Debt securities			$	5,852					$	54					$	—					$	—					$	5,906

			December 31, 2022
			Amortized Cost						Unrealized Gain						Unrealized Loss						Accrued Interest						Fair Value
Available-for-Sale Securities
Debt securities			$	11,315					$	75					$	—					$	—					$	11,390

The fair value of investments available-for-sale are determined using quoted market prices from daily exchange-traded markets based on the closing price as of the balance sheet date and are classified as a Level 1 measurement under ASC 820 Fair Value Measurements.

As of June 30, 2023 and December 31, 2022, the amortized cost and estimated fair value of our available-for-sale securities were all due within one year.

Components of inventory, net of reserves, as of June 30, 2023 and December 31, 2022 are as follows (table in thousands):

			June 30, 2023						December 31, 2022
Inventory - Current Portion
Raw Materials			$	2,805					$	3,351
Work in Process			411						351
Finished Goods			2,598						2,112
Total Current Inventory			5,814						5,814
Inventory - Long Term			1,276						1,276
Total Inventory			$	7,090					$	7,090

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As of June 30, 2023 and December 31, 2022, the Company’s property and equipment consisted of the following (table in thousands):

			June 30, 2023						December 31, 2022
Leasehold Improvements			$	1,398					$	1,256
Machinery and Equipment			6,006						5,922
Information Technology & Office Equipment			1,845						1,845
Laboratory Equipment			807						807
Total Property and Equipment			10,056						9,830
Accumulated Depreciation			(7,963)						(7,636)
Property and Equipment, net			$	2,093					$	2,194

Depreciation expense for the three months ended June 30, 2023 and 2022 was $0.2 million and $0.1 million, respectively. Depreciation expense for both the six months ended June 30, 2023 and 2022 was $0.3 million.

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Accrued liabilities as of June 30, 2023 and December 31, 2022 consisted of the following (table in thousands):

			June 30, 2023						December 31, 2022
Accrued Research & Development Expense			$	—					$	43
Accrued Compensation and Benefits			1,574						2,568
Accrued Unvouchered Receipts			552						585
Accrued Workers Compensation			173						306
Other Accrued Liabilities			1,464						4,200
Total Accrued Liabilities			$	3,763					$	7,702

In October 2014, the Company entered into an exclusive distribution agreement with Baxter, which had a term of 10 years and received an upfront fee of $20 million. The upfront fee was recorded as deferred revenue and was being recognized based on the proportion of product shipments to Baxter in each period, compared with total expected sales volume over the term of the distribution agreement. On November 9, 2022, Rockwell reacquired its distribution rights to its hemodialysis concentrates products from Baxter and terminated the distribution agreement. Exclusivity and other provisions associated with the distribution agreement terminated November 9, 2022 and the remaining operational elements of the agreement terminated December 31, 2022. Rockwell agreed to provide certain services to a group of Baxter's customers until March 31, 2023. Under the distribution agreement, Baxter distributed and commercialized Rockwell’s hemodialysis concentrates products and provided customer service and order delivery to nearly all United States customers. Following the reacquisition of these rights, Rockwell is now unrestricted in its ability to sell its hemodialysis concentrates products to dialysis clinics throughout the United States and around the world. The Company recognized the remaining revenue of $1.5 million during the three months ended March 31, 2023.

In 2016, the Company entered into a distribution agreement with Wanbang (the "Wanbang Agreement") and received an upfront fee of $4.0 million. The upfront fee was recorded as deferred revenue and is being recognized as revenue based on the agreement term. The Company recognized revenue of approximately $53,000 and $0.1 million for each of the three and six months ended June 30, 2023 and 2022, respectively. Deferred revenue related to the Wanbang Agreement totaled $2.2 million as of June 30, 2023 and $2.3 million as of December 31, 2022. On August 7, 2023, Rockwell was informed by Wanbang, the Company’s commercialization partner in China for Triferic, that the main efficacy results of Wanbang’s clinical trial for Triferic (dialysate) compared with placebo were not obtained. The Company is working with Wanbang to determine next steps.

In January 2020, the Company entered into license and supply agreements with Sun Pharma (the "Sun Pharma Agreements"), for the rights to commercialize Triferic (dialysate) in India. In consideration for the license, the Company received an upfront fee of $0.1 million. The upfront fee was recorded as deferred revenue and is being recognized as revenue based on the agreement term. The Company recognized revenue of approximately $2,500 and $5,000 for the three and six months ended June 30, 2023 and 2022, respectively. Deferred revenue related to the Sun Pharma Agreement totaled $65,000 and $70,000 as of June 30, 2023 and December 31, 2022, respectively.

In September 2020, the Company entered into a license and supply agreements with Jeil Pharmaceutical (the "Jeil Agreements"), for the rights to commercialize Triferic (dialysate) in South Korea. In consideration for the license, the Company received an upfront fee of $0.2 million. In May 2022, Jeil Pharmaceutical obtained regulatory approval in South Korea and paid the Company $0.2 million in consideration of reaching the milestone. The upfront fee and milestone payments were recorded as deferred revenue and are being recognized as revenue based on the agreement term. The Company recognized revenue of $5,200 and $10,400 for the three and six months ended June 30, 2023 and 2022, respectively. Deferred revenue related to the Jeil Agreement totaled approximately $0.4 million as of both June 30, 2023 and December 31, 2022.

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The Company held its annual meeting of stockholders on May 23, 2023 (the “Annual Meeting”). At the Annual Meeting, the Company’s stockholders approved the amendment and restatement of the Rockwell Medical, Inc. 2018 Long Term Incentive Plan to increase the number of shares of common stock issuable thereunder by 1,600,000 shares (the “Amended 2018 Plan”).

Preferred Stock

On April 6, 2022, the Company and DaVita entered into the Securities Purchase Agreement (the "SPA"), which provided for the issuance by the Company of up to $15 million of preferred stock to DaVita. On April 6, 2022, the Company issued 7,500 shares of Series X Preferred Stock for gross proceeds of $7.5 million. On June 16, 2022 the Company issued an additional 7,500 shares of the Series X Preferred Stock to DaVita for gross proceeds of $7.5 million.

The Series X Preferred Stock was issued for a price of $1,000 per share (the "Face Amount"), subject to accretion at a rate of 1% per annum, compounded annually. If the Company’s common stock trades above $22.00 for a period of 30 calendar days, the accretion will thereafter cease. As of June 30, 2023, the Series X Preferred Stock accreted a total $150,000.

The Series X Convertible Preferred Stock is convertible to common stock at a rate equal to the Face Amount, divided by a conversion price of $11.00 per share (subject to adjustment for future stock splits, reverse stock splits and similar recapitalization events). As a result, each share of Series X Preferred Stock will initially convert into approximately 91 shares of common stock. DaVita’s right to convert to common stock is subject to a beneficial ownership limitation, which is initially set at 9.9% of the outstanding common stock, which limitation may be reset (not to exceed 19.9%) at DaVita’s option and upon providing prior written notice to the Company. In addition, any debt financing is limited by the terms of our Securities Purchase Agreement with DaVita. Specifically, until DaVita owns less than 50% of its investment, the Company may only incur additional debt in the form of a purchase money loan, a working capital line of up to $5 million or to refinance existing debt, unless DaVita consents.

Additionally, the Series X Preferred Stock has a deemed liquidation event and redemption clause which could be triggered if the sale of all or substantially all of the Company's assets relating to the Company's dialysis concentrates business line. Since the Series X Preferred Stock may be redeemed if certain assets are sold at the option of the holder, but is not mandatorily redeemable, the preferred stock has been classified as permanent equity and initially recognized at fair value of $15 million (the proceeds on the date of issuance) less issuance costs of $0.1 million, resulting in an initial value of $14.9 million. The Company will assess at each reporting period whether conditions have changed to now meet the mandatory redemption definition which could trigger liability classification.

As of both June 30, 2023 and December 31, 2022, there were 2,000,000 shares of preferred stock, $0.0001 par value per share, authorized and 15,000 shares of preferred stock issued and outstanding.

Common Stock

As of June 30, 2023 and December 31, 2022, there were 170,000,000 shares of common stock, $0.0001 par value per share, authorized and 16,795,673 and 12,163,673 shares issued and outstanding, respectively.

As of June 30, 2023 and 2022, the Company has reserved for issuance the following shares of common stock related to the potential exercise of employee stock options, unvested restricted stock, convertible preferred stock, pre-funded warrants and all other warrants (collectively, "common stock equivalents"):

			As of June 30,
Common stock and common stock equivalents:			2023						2022
Common stock			16,795,673						9,407,296
Common stock issuable upon exercise of pre-funded warrants			1,793,000						9,056,377
Common stock and pre-funded stock warrants			18,588,673						18,463,673
Options to purchase common stock			1,570,599						423,317
Unvested restricted stock awards			891						891
Unvested restricted stock units			313,065						125,000
Convertible Preferred Stock			1,363,636						1,363,636
Warrants to purchase common stock			10,196,268						10,196,268
Total			32,033,132						30,572,785

During the three months ended June 30, 2023 and 2022, 4,118,000 and nil pre-funded warrants were exercised, respectively. During the six months ended June 30, 2023 and 2022, 4,507,000 and nil pre-funded warrants were exercised, respectively.

During the three and six months ended June 30, 2023 and 2022, no vested employee stock options were exercised.

Controlled Equity Offering

On April 8, 2022, the Company entered into the Sales Agreement with Cantor Fitzgerald & Co. as Agent, pursuant to which the Company may offer and sell from time to time up to $12,200,000 of shares of Company’s common stock through the Agent. The offering and sale of such shares has been registered under the Securities Act of 1933, as amended, pursuant to the Company’s Registration Statement on Form S-3 (File No. 333-259923) (the “Registration Statement”), which was originally filed with the SEC on September 30, 2021 and declared effective by the SEC on October 8, 2021, the base prospectus contained within the Registration Statement, and a prospectus supplement that was filed with the SEC on April 8, 2022.

During the quarter ended June 30, 2023, no sales were made pursuant to the Sales Agreement. Approximately $12.2 million remains available for sale under the ATM facility.

Registered Direct Offering

On May 30, 2022, the Company entered into the RD Purchase Agreement with the Purchaser named therein, pursuant to which the Company agreed to issue and sell, in a registered direct offering (the “Offering”), 844,613 shares of its common stock at price of $1.39 per share, and pre-funded warrants to purchase up to an aggregate of 7,788,480 shares of common stock (the “Pre-Funded Warrants” and the shares of common stock underlying the Pre-Funded Warrants, the “Warrant Shares”). The purchase price of each Pre-Funded Warrant is equal to the price at which a share of common stock was sold to the public in the Offering, minus $0.0001, and the exercise price of each Pre-Funded Warrant is $0.0001 per share.

A holder (together with its affiliates) may not exercise any portion of the Pre-Funded Warrants to the extent the holder would own more than 9.99% of the Company’s outstanding common stock immediately after exercise, as such percentage ownership is determined in accordance with the terms of the Pre-Funded Warrant. The RD Purchase Agreement contains customary representations and warranties and agreements of the Company and the Purchaser and customary indemnification rights and obligations of the parties.

A total of 1,793,000 Pre-Funded Warrants remained outstanding as of June 30, 2023. On July 5, 2023, the remaining 1,793,000 Pre-Funded Warrants to purchase common stock were exercised.

Private Placement

Also on May 30, 2022, concurrently with the Offering, the Company entered into the PIPE Purchase Agreement relating to the offering and sale (the “Private Placement”) of warrants to purchase up to a total of 9,900,990 shares of common stock (the "PIPE Warrants") and pre-funded warrants to purchase up to a total of 1,267,897 shares of common stock (the “Pre-

Funded PIPE Warrants”). Each warrant was sold at a price of $0.125 per underlying warrant share and is exercisable at an exercise price of $1.39 per share. The purchase price of each Pre-Funded Warrant was equal to the price at which a share of common stock was sold to the public in the Offering, minus $0.0001, and the exercise price of each Pre-Funded Warrant is $0.0001 per share. As of December 2022, all Pre-Funded PIPE Warrants have been exercised.

As of June 30, 2023, 9,900,990 PIPE Warrants remained outstanding. On July 10, 2023, 9,900,990 PIPE Warrants were exercised for 9,900,990 shares of common stock (See Note 16 for further details).

---

The Company recognized total stock-based compensation expense during the three and six months ended June 30, 2023 and 2022 as follows (table in thousands):

			Three Months Ended June 30,												Six Months Ended June 30,
			2023						2022						2023						2022
Service-based awards:
Restricted stock units			$	119					$	26					$	164					$	37
Stock option awards			190						72						338						272
Total Service Based Awards			309						98						502						309
Performance-based awards:
Restricted stock awards			—						—						—						(391)
Total			$	309					$	98					$	502					$	(82)

Performance Based Restricted Stock

A summary of the Company’s restricted stock awards during the six months ended June 30, 2023 is as follows:

			Number of Shares						Weighted Average Grant-Date Fair Value
Unvested at January 1, 2023			891						$	62.70
Unvested at June 30, 2023			891						$	62.70

A summary of the Company’s restricted stock awards during the six months ended June 30, 2022 is as follows:

			Number of Shares						Weighted Average Grant-Date Fair Value
Unvested at January 1, 2022			7,118						$	62.70
Forfeited			(6,227)						$	62.70
Unvested at June 30, 2022			891						$	62.70

Restricted stock awards are measured based on their fair value on the date of grant and amortized over the vesting period of 20 months. As of both June 30, 2023 and 2022, unvested restricted stock awards of 891 were related to performance-based awards. The forfeited performance-based restricted stock awards of 6,227 was due to the resignation of the Company's Chief Development Officer on March 25, 2022. These forfeited awards reduced stock-based compensation expense by $0.4 million in 2022.

---

Service-Based Restricted Stock Units

A summary of the Company’s service-based restricted stock units during the six months ended June 30, 2023 is as follows:

			Number of Shares						Weighted Average Grant-Date Fair Value
Unvested at January 1, 2023			125,000						$	1.47
Granted			313,065						1.87
Vested			(125,000)						1.47
Unvested at June 30, 2023			313,065						$	1.87

A summary of the Company’s service-based restricted stock units during the six months ended June 30, 2022 is as follows:

			Number of Shares						Weighted Average Grant-Date Fair Value
Unvested at January 1, 2022			29,289						$	12.87
Granted			125,000						1.47
Vested			(23,515)						11.33
Forfeited			(5,774)						19.00
Unvested at June 30, 2022			125,000						$	1.47

Service based restricted stock units are measured based on their fair value on the date of grant and amortized over the vesting period. The vesting periods range from 1 to 3 years. Stock-based compensation expense of $0.1 million and $25,554 was recognized for the three months ended June 30, 2023 and 2022, respectively. Stock-based compensation expense of $0.2 million and $37 thousand was recognized for the six months ended June 30, 2023 and 2022, respectively. As of June 30, 2023, the unrecognized stock-based compensation expense was $0.5 million, which is expected to be recognized over an estimated weighted average remaining term of less than 1.7 years.

Service-Based Stock Options

The fair value of the service-based stock options granted for the six months ended June 30, 2022 were based on the following assumptions:

			Six Months Ended June 30, 2023
Exercise price			$1.37 - $2.83
Expected stock price volatility			81.64% - 81.9%
Risk-free interest rate			3.41% - 3.55%
Term (years)			4 - 6

---

A summary of the Company’s service-based stock option activity for the six months ended June 30, 2023 is as follows:

			Shares Underlying Options						Weighted Average Exercise Price						Weighted Average Remaining Contractual Term
Outstanding at January 1, 2023			1,206,905						$	8.32					8.9
Granted			382,745						1.48						5.5
Forfeited			(13,447)						4.02						—
Expired			(5,604)						19.01						—
Outstanding at June 30, 2023			1,570,599						$	6.65					8.7
Exercisable at June 30, 2023			301,986						$	26.15					6.5

A summary of the Company’s service-based stock option activity for the six months ended June 30, 2022 is as follows:

			Shares Underlying Options						Weighted Average Exercise Price						Weighted Average Remaining Contractual Term
Outstanding at January 1, 2022			528,591						$	32.01					7.5
Granted			909						4.07						9.5
Forfeited			(24,488)						15.00						—
Expired			(81,695)						83.32						—
Outstanding at June 30, 2022			423,317						$	23.03					7.8
Exercisable at June 30, 2022			227,412						$	31.19					5.8

The aggregate intrinsic value is calculated as the difference between the closing price of the Company's common stock and the exercise price of the stock options that had strike prices below the closing price. The intrinsic value of the outstanding options were not significant for all periods presented.

During the six months ended June 30, 2023, the Company granted 382,745 stock options to purchase shares of common stock. During the six months ended June 30, 2023, 13,447 shares were forfeited and 5,604 shares expired. Forfeitures are recorded in the period of occurrence and compensation expense is adjusted accordingly.

Stock-based compensation expense recognized for service-based stock options was $0.2 million and $0.1 million for the three months ended June 30, 2023, and 2022 respectively. Stock-based compensation expense recognized for service-based stock options was $0.3 million and $0.3 million for the six months ended June 30, 2023, and 2022, respectively. As of June 30, 2023, total stock-based compensation expense related to unvested options not yet recognized totaled approximately $0.9 million, which is expected to be recognized over an estimated weighted average remaining term of 8.7 years.

---

Product License Agreements

The Company is a party to a Licensing Agreement between the Company and Charak, LLC ("Charak") dated January 7, 2002 (the "2002 Agreement") that grants the Company exclusive worldwide rights to certain patents and information related to our Triferic product. On October 7, 2018, the Company entered into a Master Services and IP Agreement (the “Charak MSA”) with Charak and Dr. Ajay Gupta, a former Officer of the Company. Pursuant to the MSA, the parties entered into three additional agreements described below related to the license of certain soluble ferric pyrophosphate (“SFP”) intellectual property owned by Charak. As of June 30, 2023 and December 31, 2022, the Company has accrued $85,400 relating to certain IP reimbursement expenses and certain sublicense royalty fees, which is included within accrued liabilities on the condensed consolidated balance sheet.

Pursuant to the Charak MSA, the aforementioned parties entered into an Amendment, dated as of October 7, 2018 (the “Charak Amendment”), to the 2002 Agreement, under which Charak granted the Company an exclusive, worldwide, non-transferable license to commercialize SFP for the treatment of patients with renal failure. The Charak Amendment amends the royalty payments due to Charak under the 2002 Agreement such that the Company is liable to pay Charak royalties on net sales by the Company of products developed under the license, which includes the Company’s Triferic product, at a specified rate until December 31, 2021 and thereafter at a reduced rate from January 1, 2022 until February 1, 2034. Additionally, the Company shall pay Charak a percentage of any sublicense income during the term of the agreement, which amount shall not be less than a minimum specified percentage of net sales of the licensed products by the sublicensee in jurisdictions where there exists a valid claim, on a country-by-country basis, and be no less than a lower rate of the net sales of the licensed products by the sublicensee in jurisdictions where there exists no valid claim, on a country-by-country basis.

Also pursuant to the Charak MSA, the Company and Charak entered into a Commercialization and Technology License Agreement I.V. Triferic dated as of October 7, 2018 (the “IV Agreement”), under which Charak granted the Company an exclusive, sub-licensable, royalty-bearing license to SFP for the purpose of commercializing certain intravenous-delivered products incorporating SFP for the treatment of iron disorders worldwide for a term that expires on the later of February 1, 2034 or upon the expiration or termination of a valid claim of a licensed patent. The Company was liable to pay Charak royalties on net sales by the Company of products developed under the license at a specified rate until December 31, 2021. From January 1, 2022 until February 1, 2034, the Company is liable to pay Charak a base royalty at a reduced rate on net sales and an additional royalty on net sales while there exists a valid claim of a licensed patent, on a country-by-country basis. The Company shall also pay to Charak a percentage of any sublicense income received during the term of the IV Agreement, which amount shall not be less than a minimum specified percentage of net sales of the licensed products by the sublicensee in jurisdictions where there exists a valid claim, on a country-by-country basis, and not be less than a lower rate of the net sales of the licensed products by the sublicensee in jurisdictions where there exists no valid claim, on a country-by-country basis.

Also pursuant to the Charak MSA, the Company and Charak entered into a Technology License Agreement TPN Triferic dated as of October 7, 2018 (the “TPN Agreement”), pursuant to which Charak granted the Company an exclusive, sub-licensable, royalty-bearing license to SFP for the purpose of commercializing worldwide certain TPN products incorporating SFP. The license grant under the TPN Agreement continues for a term that expires on the later of February 1, 2034 or upon the expiration or termination of a valid claim of a licensed patent. During the term of the TPN Agreement, the Company is liable to pay Charak a base royalty on net sales and an additional royalty on net sales while there exists a valid claim of a licensed patent, on a country-by-country basis. The Company shall also pay to Charak a percentage of any sublicense income received during the term of the TPN Agreement, which amount shall not be less than a minimum royalty on net sales of the licensed products by the sublicensee in jurisdictions where there exists a valid claim, on a country-by-country basis, and not be less than a lower rate of the net sales of the licensed products by the sublicensee in jurisdictions where there exists no valid claim, on a country-by-country basis.

The potential sub-license milestone payments are not yet considered probable, and no milestone payments have been accrued as of June 30, 2023 and December 31, 2022.

---

Rockwell leases its production facilities and administrative offices as well as certain equipment used in its operations including leases on transportation equipment used in the delivery of its products. The lease terms range from monthly to six years. Rockwell occupies a 51,000 square foot facility and a 17,500 square foot facility in Wixom, Michigan under a lease expiring in August 2024. Rockwell also occupies two other manufacturing facilities, a 51,000 square foot facility in Grapevine, Texas under a lease expiring in December 2025, and a 57,000 square foot facility in Greer, South Carolina under a lease expiring February 2026. In addition, Rockwell occupied 4,100 square feet of office space in Hackensack, New Jersey under a lease expiring on October 31, 2024. This lease was subleased on December 15, 2021 with an expiration date of October 31, 2024.

At June 30, 2023, the Company had operating and finance lease liabilities of $5.9 million and right-of-use assets of $5.7 million, which are included in the condensed consolidated balance sheet.

At December 31, 2022, the Company had operating and finance lease liabilities of $6.7 million and right-of-use assets of $6.4 million, which are included in the condensed consolidated balance sheet.

The following summarizes quantitative information about the Company’s operating and finance leases (table in thousands):

			Three Months Ended June 30, 2023						Three Months Ended June 30, 2022						Six Months Ended June 30, 2023						Six Months Ended June 30, 2022
Operating leases
Operating lease cost			$	391					$	366					$	735					$	745
Interest on lease obligations			64						65						124						135
Variable lease cost			109						92						224						187
Operating lease expense			564						523						1,083						1,067
Finance leases
Non-cash lease expense from right-of-use assets			141						141						282						282
Interest on lease obligations			38						45						77						92
Finance lease expense			179						186						359						374
Short-term lease rent expense			4						4						8						8
Total lease expense			$	747					$	713					$	1,450					$	1,449
Other information
Payments for principal from operating leases			$	478					$	447					$	902					$	911
Payments for interest from finance leases			$	38					$	45					$	77					$	92
Payments for principal from finance leases			$	129					$	119					$	258					$	237
Weighted-average remaining lease term – operating leases			2.7						3.2						2.7						3.2
Weighted-average remaining lease term – finance leases			3.9						4.9						3.9						4.9
Weighted-average discount rate – operating leases			6.5		%				6.3		%				6.5		%				6.3		%
Weighted-average discount rate – finance leases			6.4		%				6.4		%				6.4		%				6.4		%

Future minimum rental payments under operating and finance lease agreements are as follows (in thousands):

			Operating						Finance
Year ending December 31, 2023 (remaining)			$	875					$	335
Year ending December 31, 2024			1,511						672
Year ending December 31, 2025			1,021						676
Year ending December 31, 2026			362						666
Year ending December 31, 2027			131						311
Total			3,900						2,660
Less present value discount			(318)						(308)
Operating and finance lease liabilities			$	3,582					$	2,352

---

On March 16, 2020, the Company and Rockwell Transportation, Inc., as Borrowers, entered into a Loan and Security Agreement (the "Loan Agreement") with Innovatus Life Sciences Lending Fund I, LP ("Innovatus"), as collateral agent and the lenders party thereto, pursuant to which Innovatus, as a lender, agreed to make certain term loans to the Company in the aggregate principal amount of up to $35.0 million (the "Term Loans"). Funding of the first $22.5 million tranche was completed on March 16, 2020. The Company is no longer eligible to draw on a second tranche of $5.0 million or a third tranche of $7.5 million, which were tied to the achievement of certain milestones by a specific date. Net draw down proceeds were $21.2 million with closing costs of $1.3 million.

In connection with each funding of the Term Loans, the Company was required to issue to Innovatus a warrant (the “Warrants”) to purchase a number of shares of the Company’s common stock equal to 3.5% of the principal amount of the relevant Term Loan funded divided by the exercise price, which was based on the lower of (i) the volume weighted average closing price of the Company’s stock for the 5-trading day period ending on the last trading day immediately preceding the execution of the Loan Agreement or (ii) the closing price on the last trading day immediately preceding the execution of the Loan Agreement (or for the second and third tranches only at the lower of (i) $18.15 per share or (ii) the volume weighted average closing price of the Company’s stock for the 5-trading day period ending on the last trading day immediately preceding the relevant Term Loan funding). The Warrants may be exercised on a cashless basis and are immediately exercisable through the seventh anniversary of the applicable funding date. The number of shares of common stock for which each Warrant is exercisable and the associated exercise price are subject to certain proportional adjustments as set forth in such Warrant. In connection with the first tranche of the Term Loans, the Company issued a Warrant to Innovatus, exercisable for an aggregate of 43,388 shares of the Company’s common stock at an exercise price of $18.15 per share. The Company evaluated the warrant under ASC 470, Debt, and recognized an additional debt discount of approximately $0.5 million based on the relative fair value of the base instruments and warrants. The Company calculated the fair value of the warrant using the Black-Scholes model.

The Company is entitled to make interest-only payments for thirty months, or up to thirty-six months if certain conditions are met. The Term Loans will mature on March 16, 2025, and will bear interest at the greater of (i) Prime Rate (as defined in the Loan Agreement) and (ii) 4.75%, plus 4.00% with an initial interest rate of 8.75% per annum and an effective interest rate of 10.9%. The Company has the option, under certain circumstances, to add 1.00% of such interest rate amount to the then outstanding principal balance in lieu of paying such amount in cash. For the three months ended June 30, 2023 and 2022, interest expense amounted to $0.3 million and $0.4 million, respectively. For the six months ended June 30, 2023 and 2022, interest expense amounted to $0.6 million and $0.8 million, respectively.

The Loan Agreement is secured by all assets of the Company and Rockwell Transportation, Inc. Proceeds are used for working capital purposes. The Loan Agreement contained customary representations and warranties and covenants, subject to customary carve outs, and included financial covenants related to liquidity and trailing twelve months sales of Triferic, with the latter beginning with the period ending December 31, 2020.

In September 2021, the Company entered into an amendment to the Loan Agreement in which the Company, in exchange for Innovatus lowering the sales covenants, agreed to (i) prepay an aggregate principal amount of $7.5 million in ten installments commencing on December 1, 2021; (ii) pay an additional prepayment premium of 5% on prepaid amounts if the Company elects to prepay all outstanding Term Loans on or before September 24, 2023 and (iii) maintain minimum liquidity of no less than $5.0 million if the aggregate principal amount of Term Loans is greater than $15 million pursuant to the liquidity covenant in the Loan Agreement.

On November 10, 2022, the Company entered into a Second Amendment to the Loan and Security Agreement (the “Second Amendment”) dated as of November 14, 2022 with Innovatus, which amended the Loan Agreement. Pursuant to the Second Amendment, the Company (i) prepaid an aggregate principal amount of $5.0 million in Term Loans in one installment on November 14, 2022; (ii) shall pay interest only payments until September 2023 at which time will resume scheduled debt payments. Additionally, the financial covenants related to the trailing twelve months sales of Triferic was replaced with a trailing 6 months revenue of our concentrates products beginning with the period ending September 30, 2022. The Company cannot assure that it can maintain compliance with the covenants under our Loan Agreement, which may result in an event of default. The Company's ability to comply with these covenants may be adversely affected by events beyond its control. If the Company is unable to comply with the covenants under the Loan Agreement, it would pursue all available cure options in order to regain compliance. However, the Company may not be able to mutually agree with Innovatus on appropriate remedies to

cure a future breach of a covenant, which could give rise to an event of default. If the Company is unable to avoid an event of default, any required repayments could have an adverse effect on its liquidity.

As of June 30, 2023, the Company was in compliance with all covenants under the Loan Agreement.

As of June 30, 2023, the outstanding balance of the Term Loan was $9.4 million, net of unamortized issuance costs and discount of $0.6 million.

The following table reflects the schedule of principal payments on the Term Loan as of June 30, 2023 (in thousands):

			Principal Payments
2023 (remaining)			$	2,000
2024			6,000
2025			2,000
			$	10,000

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On July 5, 2023, all of the remaining Pre-Funded Warrants to purchase 1,793,000 shares of common stock issued on May 30, 2022 were exercised. The exercise price of each Pre-Funded Warrant was $0.0001 per share and resulted in gross proceeds to the Company of $179 (See Note 10 for more detail on the Pre-Funded Warrants).

Asset Purchase Agreement

On July 10, 2023, the Company executed and consummated the transactions contemplated by an Asset Purchase Agreement (the “Purchase Agreement”) with Evoqua.

Subject to the terms and conditions of the Purchase Agreement, at the closing of the transaction (the “Closing”), the Company purchased from Evoqua substantially all of the assets of Evoqua that are related to its business of manufacturing, marketing, distributing, and selling hemodialysis concentrates products in powder and liquid form (the “Concentrates Business”) for an aggregate purchase price, subject to certain adjustments pursuant to the terms of the Purchase Agreement, of $11.0 million in cash paid at Closing and equal annual installments of $2.5 million payable on each of the first and second anniversaries of the Closing.

The foregoing summary of the Purchase Agreement is subject to, and qualified in its entirety by reference to, the Purchase Agreement, which is filed as Exhibit 10.2 to this Quarterly Report on Form 10-Q.

Warrant Exercise and Reload Warrants

On July 10, 2023, the Company entered into a letter agreement (the “Letter Agreement”) with Armistice Capital Master Fund Ltd. (“Armistice”), which held a warrant (the “Prior Warrant”) to purchase 9,900,990 shares of common stock of the Company (the “Common Stock”) with an exercise price of $1.39 per share, offering Armistice the opportunity to exercise the Prior Warrant for cash, provided the Prior Warrant was exercised for cash on or prior to 5:00 P.M. Eastern Time on July 10, 2028 (the “End Date”). In addition, Armistice would receive a “reload” warrant (the “Reload Warrant”) to purchase 3,750,000 shares of Common Stock with an exercise price of $5.13 per share, the closing price as reported by the Nasdaq Capital Market on July 7, 2023. The terms of the Reload Warrant and Letter Agreement provide for customary resale registration rights. The Letter Agreement also provides that for a period of 45 days after the issuance of the Reload Warrant, the Company’s may not sell shares of Common Stock pursuant to its sales agreement with Cantor Fitzgerald & Co., dated as of April 8, 2022, at price per share less than $6.25. The Reload Warrant may be exercised at all times prior to the 54 months month anniversary of its issuance date. The Prior Warrant and the Reload Warrant both provide that a holder (together with its affiliates) may not exercise any portion of the Prior Warrant or the Reload Warrant to the extent that the holder would own more than 9.99% of the Company’s outstanding Common Stock immediately after exercise, as such percentage ownership is determined in accordance with the terms of such warrant. To the extent the exercise of the Prior Warrant would result in Armistice holding more than 9.99% of the Company’s outstanding Common Stock, such shares of Common Stock in excess of 9.99% will be held in abeyance. The Letter Agreement amended the Prior Warrant to extend the expiration date thereof to one year following the original expiration date set forth therein.

Armistice exercised the Prior Warrant on July 10, 2023, and the Company received gross proceeds of approximately $13.8 million from the exercise of the Prior Warrant as a result of such exercise pursuant to the terms of the Letter Agreement. As of July 10, 2023, following the exercise of the Prior Warrant, the Company had 28,489,663 shares of common stock outstanding. The Letter Agreement and Reload Warrant were entered into pursuant to Section 4(a)(2) of the Securities Act of 1933, as amended, and Regulation D as promulgated thereunder.

The foregoing summaries of the Reload Warrant and the Letter Agreement are subject to, and qualified in their entirety by reference to, the Reload Warrant and the Letter Agreement, which are filed as Exhibits 4.1 and 10.1 to this Quarterly Report on Form 10-Q, respectively.

International Distribution Agreement

On August 7, 2023, Rockwell was informed by Wanbang, the Company’s commercialization partner in China for Triferic, that the main efficacy results of Wanbang’s clinical trial for Triferic (dialysate) compared with placebo were not obtained. The Company is working with Wanbang to determine next steps.

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v3.23.2

Cover - shares	6 Months Ended
	Jun. 30, 2023	Aug. 11, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2023
Document Transition Report	false
Entity File Number	000-23661
Entity Registrant Name	ROCKWELL MEDICAL, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	38-3317208
Entity Address, Address Line One	30142 S. Wixom Road
Entity Address, City or Town	Wixom
Entity Address, State or Province	MI
Entity Address, Postal Zip Code	48393
City Area Code	248
Local Phone Number	960-9009
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Title of 12(b) Security	Common Stock, par value $0.0001
Trading Symbol	RMTI
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding (in shares)		28,489,663
Entity Central Index Key	0001041024
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q2

v3.23.2

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
ASSETS
Cash and Cash Equivalents	$ 8,959	$ 10,102
Investments Available-for-Sale	5,906	11,390
Accounts Receivable, net	5,411	6,259
Inventory	5,814	5,814
Prepaid and Other Current Assets	1,475	1,745
Total Current Assets	27,565	35,310
Property and Equipment, net	2,093	2,194
Inventory, Non-Current	1,276	1,276
Right of Use Assets-Operating, net	3,470	3,943
Right of Use Assets-Financing, net	2,185	2,468
Goodwill	921	921
Other Non-Current Assets	527	523
Total Assets	38,037	46,635
LIABILITIES AND STOCKHOLDERS’ EQUITY
Accounts Payable	5,927	4,053
Accrued Liabilities	3,763	7,702
Lease Liability-Operating - Current	1,560	1,483
Lease Liability-Financing - Current	541	522
Deferred License Revenue - Current	259	1,731
Term Loan - Net of Issuance Costs	4,631	1,631
Insurance Financing Note Payable	733	503
Customer Deposits	38	66
Total Current Liabilities	17,452	17,691
Lease Liability-Operating - Long-Term	2,022	2,581
Lease Liability-Financing - Long-Term	1,811	2,088
Term Loan, Net of Issuance Costs	4,740	7,555
Deferred License Revenue - Long-Term	2,470	2,600
Long Term Liability - Other	14	14
Total Liabilities	28,509	32,529
Stockholders’ Equity:
Preferred Stock, $0.0001 par value, 2,000,000 shares authorized; 15,000 shares issued and outstanding at June 30, 2023 and December 31, 2022	0	0
Common Stock, $0.0001 par value; 170,000,000 shares authorized; 16,795,673 and 12,163,673 shares issued and outstanding at June 30, 2023 and December 31, 2022, respectively	2	1
Additional Paid-in Capital	403,203	402,701
Accumulated Deficit	(393,814)	(388,759)
Accumulated Other Comprehensive Income	137	163
Total Stockholders’ Equity	9,528	14,106
Total Liabilities and Stockholders’ Equity	$ 38,037	$ 46,635

v3.23.2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Jun. 30, 2023	Dec. 31, 2022	Jun. 30, 2022
Statement of Financial Position [Abstract]
Preferred shares, par value (in dollars per share)	$ 0.0001	$ 0.0001
Preferred shares, shares authorized (in shares)	2,000,000	2,000,000
Preferred shares, shares issued (in shares)	15,000	15,000
Preferred shares, shares outstanding (in shares)	15,000	15,000
Common shares, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common shares, shares authorized (in shares)	170,000,000	170,000,000
Common shares, shares issued (in shares)	16,795,673	12,163,673
Common shares, shares outstanding (in shares)	16,795,673	12,163,673	9,407,296

v3.23.2

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands		3 Months Ended		6 Months Ended
		Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Income Statement [Abstract]
Net Sales		$ 18,080	$ 18,682	$ 37,748	$ 34,806
Cost of Sales		17,047	16,937	34,116	33,846
Gross Profit		1,033	1,745	3,632	960
Research and Product Development		167	926	445	2,494
Selling and Marketing		530	526	1,028	981
General and Administrative		3,295	4,775	6,545	8,592
Operating Loss		(2,959)	(4,482)	(4,386)	(11,107)
Other (Expense) Income
Realized Gain on Investments		0	0	0	4
Interest Expense		(395)	(485)	(782)	(1,025)
Interest Income		49	0	113	0
Total Other Expense		(346)	(485)	(669)	(1,021)
Net Loss		$ (3,305)	$ (4,967)	$ (5,055)	$ (12,128)
Basic Net Loss per Share (in dollars per share)		$ (0.18)	$ (0.43)	$ (0.27)	$ (1.20)
Diluted Net Loss per Share (in dollars per share)		$ (0.18)	$ (0.43)	$ (0.27)	$ (1.20)
Basic Weighted Average Shares Outstanding (in shares)	[1]	18,496,640	11,591,768	18,480,248	10,076,415
Diluted Weighted Average Shares Outstanding (in shares)	[1]	18,496,640	11,591,768	18,480,248	10,076,415
[1] See Note 3 for more detail related to Basic and Diluted Weighted Average Shares Outstanding

v3.23.2

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Statement of Comprehensive Income [Abstract]
Net Loss	$ (3,305)	$ (4,967)	$ (5,055)	$ (12,128)
Unrealized Loss on Available-for-Sale Investments	(18)	0	(21)	0
Foreign Currency Translation Adjustments	(1)	(2)	(4)	(3)
Comprehensive Loss	$ (3,324)	$ (4,969)	$ (5,080)	$ (12,131)

v3.23.2

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Public Offering	At-the-Market Offering	PREFERRED STOCK	COMMON STOCK	COMMON STOCK Public Offering	COMMON STOCK At-the-Market Offering	ADDITIONAL PAID-IN CAPITAL	ADDITIONAL PAID-IN CAPITAL Public Offering	ADDITIONAL PAID-IN CAPITAL At-the-Market Offering	ACCUMULATED DEFICIT	ACCUMULATED OTHER COMPREHENSIVE INCOME
Beginning balance (in shares) at Dec. 31, 2021					8,544,225
Beginning balance at Dec. 31, 2021	$ 2,535				$ 1			$ 372,562			$ (370,080)	$ 52
Increase (Decrease) in Shareholders' Equity
Net Loss	(7,162)										(7,162)
Foreign Currency Translation Adjustments	(1)											(1)
Stock-based Compensation expense	(179)							(179)
Ending balance (in shares) at Mar. 31, 2022				0
Ending balance (in shares) at Mar. 31, 2022					8,544,225
Ending balance at Mar. 31, 2022	(4,807)				$ 1			372,383			(377,242)	51
Beginning balance (in shares) at Dec. 31, 2021					8,544,225
Beginning balance at Dec. 31, 2021	2,535				$ 1			372,562			(370,080)	52
Increase (Decrease) in Shareholders' Equity
Net Loss	(12,128)
Unrealized Loss on Available-for-Sale Investments	0
Foreign Currency Translation Adjustments	$ (3)
Ending balance (in shares) at Jun. 30, 2022				15,000
Ending balance (in shares) at Jun. 30, 2022	9,407,296				9,407,296
Ending balance at Jun. 30, 2022	$ 20,145				$ 1			402,304			(382,209)	49
Beginning balance (in shares) at Mar. 31, 2022				0
Beginning balance (in shares) at Mar. 31, 2022					8,544,225
Beginning balance at Mar. 31, 2022	(4,807)				$ 1			372,383			(377,242)	51
Increase (Decrease) in Shareholders' Equity
Net Loss	(4,967)										(4,967)
Unrealized Loss on Available-for-Sale Investments	0
Foreign Currency Translation Adjustments	(2)											(2)
Issuance of stock, net of offering costs (in shares)				15,000		844,613	7,500
Issuance of stock, net of offering costs (in dollars)	14,916	$ 14,893	$ 15					14,916	$ 14,893	$ 15
Vesting of Restricted Stock Units Issued, net of taxes withheld (in shares)					10,958
Stock-based Compensation expense	$ 97							97
Ending balance (in shares) at Jun. 30, 2022				15,000
Ending balance (in shares) at Jun. 30, 2022	9,407,296				9,407,296
Ending balance at Jun. 30, 2022	$ 20,145				$ 1			402,304			(382,209)	49
Beginning balance (in shares) at Dec. 31, 2022	15,000			15,000
Beginning balance (in shares) at Dec. 31, 2022	12,163,673				12,163,673
Beginning balance at Dec. 31, 2022	$ 14,106				$ 1			402,701			(388,759)	163
Increase (Decrease) in Shareholders' Equity
Net Loss	(1,750)										(1,750)	0
Unrealized Loss on Available-for-Sale Investments	(3)											(3)
Foreign Currency Translation Adjustments	(4)											(4)
Issuance of common stock upon exercise of prefunded warrants (in shares)					389,000
Vesting of Restricted Stock Units Issued, net of taxes withheld (in shares)					125,000
Stock-based Compensation expense	193							193
Ending balance (in shares) at Mar. 31, 2023				15,000
Ending balance (in shares) at Mar. 31, 2023					12,552,673
Ending balance at Mar. 31, 2023	$ 12,542				$ 1			402,894			(390,509)	156
Beginning balance (in shares) at Dec. 31, 2022	15,000			15,000
Beginning balance (in shares) at Dec. 31, 2022	12,163,673				12,163,673
Beginning balance at Dec. 31, 2022	$ 14,106				$ 1			402,701			(388,759)	163
Increase (Decrease) in Shareholders' Equity
Net Loss	(5,055)
Unrealized Loss on Available-for-Sale Investments	(21)
Foreign Currency Translation Adjustments	$ (4)
Ending balance (in shares) at Jun. 30, 2023	15,000			15,000
Ending balance (in shares) at Jun. 30, 2023	16,795,673				16,795,673
Ending balance at Jun. 30, 2023	$ 9,528				$ 2			403,203			(393,814)	137
Beginning balance (in shares) at Mar. 31, 2023				15,000
Beginning balance (in shares) at Mar. 31, 2023					12,552,673
Beginning balance at Mar. 31, 2023	12,542				$ 1			402,894			(390,509)	156
Increase (Decrease) in Shareholders' Equity
Net Loss	(3,305)										(3,305)
Unrealized Loss on Available-for-Sale Investments	(18)											(18)
Foreign Currency Translation Adjustments	(1)											(1)
Issuance of common stock upon exercise of prefunded warrants (in shares)					4,118,000
Issuance of Common Stock upon exercise of Pre-Funded Warrants	1				$ 1
Stock-based Compensation expense	$ 309							309
Ending balance (in shares) at Jun. 30, 2023	15,000			15,000
Ending balance (in shares) at Jun. 30, 2023	16,795,673				16,795,673
Ending balance at Jun. 30, 2023	$ 9,528				$ 2			$ 403,203			$ (393,814)	$ 137

v3.23.2

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Cash Flows From Operating Activities:
Net Loss	$ (5,055)	$ (12,128)
Adjustments To Reconcile Net Loss To Net Cash Used In Operating Activities:
Depreciation and Amortization	330	279
Stock-based Compensation	502	(82)
Increase in Inventory Reserves	0	10
Non-cash lease expense from Right of Use Assets	1,017	1,027
Amortization of Debt Financing Costs and Accretion of Debt Discount	184	184
Loss on Disposal of Assets	0	(2)
Realized Gain on Sale of Investments Available-for-Sale	0	(4)
Changes in operating Assets and Liabilities:
Accounts Receivable, net	848	(2,177)
Inventory	0	(1,063)
Prepaid and Other Assets	998	1,275
Accounts Payable	1,874	(797)
Lease Liability	(744)	(969)
Other Liabilities	(3,968)	(385)
Deferred License Revenue	(1,602)	(883)
Changes in operating Assets and Liabilities	(2,594)	(4,999)
Cash Used In Operating Activities	(5,616)	(15,715)
Cash Flows From Investing Activities:
Purchase of Investments Available-for-Sale	(3,835)	(2,810)
Sale of Investments Available-for-Sale	9,298	11,972
Purchase of Equipment	(225)	(80)
Cash Provided by Investing Activities	5,238	9,082
Cash Flows From Financing Activities:
Payments on Debt	0	(5,250)
Payments on Insurance Financing Note Payable	(503)	(439)
Payment on Financing Lease Liabilities	(258)	0
Proceeds from the Issuance of Common Stock	0	15,016
Offering Costs from the Issuance of Common Stock	0	(106)
Proceeds from the Issuance of Preferred Stock	0	15,000
Offering Costs from the Issuance of Preferred Stock	0	(85)
Cash (Used In) Provided by Financing Activities	(761)	24,136
Effect of exchange rate changes on cash	(4)	(3)
(Decrease) Increase in Cash and Cash Equivalents	(1,143)	17,500
Cash and Cash Equivalents at Beginning of Period	10,102	13,280
Cash and Cash Equivalents at End of Period	8,959	30,780
Supplemental Disclosure of Cash Flow Information:
Cash Paid for Interest	295	998
Supplemental Disclosure of Noncash Investing and Financing Activities:
Change in Unrealized Loss on Available-for-Sale Investments	(21)	0
Insurance Financing Note Payable	$ 733	$ 0

v3.23.2

Description of Business	6 Months Ended
	Jun. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Description of Business	Description of Business Rockwell Medical, Inc. (the "Company", "Rockwell", "we", or "us") is a healthcare company that develops, manufactures, commercializes, and distributes a portfolio of hemodialysis products for dialysis providers worldwide. Rockwell is a revenue-generating business and the second largest supplier of liquid and powder acid and bicarbonate concentrates for dialysis patients in the United States. Hemodialysis is the most common form of end-stage kidney disease treatment and is typically performed at freestanding outpatient dialysis centers, hospital-based outpatient centers, skilled nursing facilities, or in a patient’s home. Rockwell provides the hemodialysis community with products controlled by a Quality Management System regulated by the U.S. Food and Drug Administration ("FDA"). Rockwell is ISO 13485 Certified and adheres to current Good Manufacturing Practices ("cGMP") and Association for Advancement of Medical Instrumentation ("AAMI") standards. Rockwell manufactures hemodialysis concentrates at its facilities in Michigan, South Carolina, and Texas totaling approximately 175,000 square feet, and manufactures its dry acid concentrate mixers at its facility in Iowa. Rockwell delivers the majority of its hemodialysis concentrates products and mixers to dialysis clinics throughout the United States and internationally utilizing its own delivery trucks and third-party carriers. On July 10, 2023, Rockwell acquired the hemodialysis concentrates business from Evoqua Water Technologies LLC ("Evoqua"). This acquisition expands the Company's geographic footprint, customer base, and product offerings. In addition, this acquisition provides fully automated processing that potentially results in a lower cost to manufacture. As part of this acquisition, the Company now manufactures hemodialysis concentrates in Minnesota under a contract manufacturing agreement with a contract manufacturing organization. (See Note 16 for further detail). In addition to its primary focus on hemodialysis concentrates, Rockwell also has a proprietary parenteral iron product, Triferic® (ferric pyrophosphate citrate ("FPC")), which is indicated to maintain hemoglobin in adult patients with hemodialysis-dependent chronic kidney disease. While Rockwell has discontinued commercialization of Triferic in the United States, the Company has established several international partnerships with companies seeking to develop and commercialize Triferic outside the United States and is working closely with these international partners to develop and commercialize Triferic in their respective regions. Additionally, Rockwell continues to evaluate the viability of its FPC platform and FPC's potential to treat iron deficiency, iron deficiency anemia, and acute heart failure. Rockwell was incorporated in the state of Michigan in 1996 and re-domiciled to the state of Delaware in 2019. Rockwell's headquarters is located at 30142 Wixom Road, Wixom, Michigan 48393.

v3.23.2

Liquidity and Capital Resources	6 Months Ended
	Jun. 30, 2023
Liquidity and Capital Resources [Abstract]
Liquidity and Capital Resources	Liquidity and Capital Resources As of June 30, 2023, Rockwell had approximately $14.9 million of cash, cash equivalents and investments available-for-sale, and working capital of $10.1 million. Net cash used in operating activities for the six months ended June 30, 2023 was approximately $5.6 million. Based on the currently available working capital, management believes the Company currently has sufficient funds to meet its operating requirements for at least the next twelve months from the date of the filing of this report. On July 10, 2023, Armistice Capital Master Fund Ltd. (“Armistice”), which held a warrant to purchase 9,900,990 shares of common stock of the Company with an exercise price of $1.39 per share, exercised the warrant and the Company received gross proceeds of approximately $13.8 million (See Note 16 for further detail). Also on July 10, 2023, Rockwell acquired the hemodialysis concentrates business from Evoqua Water Technologies LLC ("Evoqua") for an aggregate purchase price, subject to certain adjustments pursuant to the terms of the Purchase Agreement, of $11.0 million in cash paid at closing and equal annual installments of $2.5 million payable on each of the first and second anniversaries of the closing. In addition, the Company purchased approximately $1.2 million of inventory. This acquisition expands the Company's geographic footprint, customer base, and product offerings. In addition, this acquisition provides fully automated processing that potentially results in a lower cost to manufacture. As part of this acquisition, the Company manufactures hemodialysis concentrates under a contract manufacturing agreement with a contract manufacturing organization. (See Note 16 for further detail). The Company continues to review its operational plans and execute on the acquisition of new customers, and has implemented cost containment activities. The Company may require additional capital to sustain its operations and make the investments it needs to execute its strategic plan. Additionally, the Company's operational plans include raising capital, if needed, by using its at-the-market ("ATM") facility or other methods or forms of financings, subject to existing limitations. If the Company attempts to obtain additional debt or equity financing, the Company cannot assume such financing will be available on favorable terms, if at all. As of June 30, 2023, the Company is no longer subject to the baby shelf limitations under Form S-3, which limit the amount the Company may offer pursuant to its registration statement on Form S-3. The Company is subject to certain covenants and cure provisions under its Loan Agreement with Innovatus. As of the date of this report, the Company is in compliance with all covenants (See Note 14 for further detail). In addition, the global macroeconomic environment is uncertain, and could be negatively affected by, among other things, increased U.S. trade tariffs and trade disputes with other countries, instability in the global capital and credit markets, recent bank failures in the United States, supply chain weaknesses, and instability in the geopolitical environment, including as a result of the Russian invasion of Ukraine and other political tensions, and lingering effects of the COVID-19 pandemic. Such challenges have caused, and may continue to cause, recession fears, rising interest rates, foreign exchange volatility and inflationary pressures. At this time, the Company is unable to quantify the potential effects of this economic instability on our future operations. Rockwell has utilized a range of financing methods to fund its operations in the past; however, current conditions in the financial and credit markets may limit the availability of funding, refinancing or increase the cost of funding. Due to the rapidly evolving nature of the global situation, it is not possible to predict the extent to which these conditions could adversely affect the Company's liquidity and capital resources in the future.

v3.23.2

Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements	6 Months Ended
	Jun. 30, 2023
Accounting Policies [Abstract]
Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements	Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements The accompanying condensed consolidated financial statements have been prepared in accordance with the accounting principles generally accepted in the United States of America (“U.S. GAAP”) for interim financial information and pursuant to the instructions to Form 10-Q and Rule 10-01 of Regulation S-X of the U. S. Securities and Exchange Commission (“SEC”) and on the same basis as the Company prepares its annual audited consolidated financial statements. The condensed consolidated balance sheet at June 30, 2023, and the condensed consolidated statements of operations, comprehensive loss, and changes in stockholders' equity for the three and six months ended June 30, 2023 and 2022 and cash flows for the six months ended June 30, 2023 and 2022 are unaudited, but include all adjustments, consisting of normal recurring adjustments the Company considers necessary for a fair presentation of the financial position, operating results and cash flows for the periods presented. The results for the three and six months ended June 30, 2023 are not necessarily indicative of results to be expected for the year ending December 31, 2023 or for any future interim period. The condensed consolidated balance sheet at December 31, 2022 has been derived from audited financial statements, however, it does not include all of the information and notes required by U.S. GAAP for complete financial statements. The accompanying condensed consolidated financial statements should be read in conjunction with the audited financial statements for the year ended December 31, 2022 and notes thereto included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022 as filed with the SEC on March 30, 2023. The Company’s consolidated subsidiaries consist of its wholly-owned subsidiaries, Rockwell Transportation, Inc. and Rockwell Medical India Private Limited. The accompanying condensed consolidated interim financial statements include the accounts of the Company and its subsidiaries. All material intercompany balances and transactions have been eliminated in consolidation. Use of Estimates The preparation of the condensed consolidated financial statements in conformity with U.S. generally accepted accounting principles ("GAAP") requires management to make estimates and assumptions that may affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of expenses during the reporting period. Actual results could differ from those estimates. Restatement of Loss Per Share Earnings per share for the three and six months ended June 30, 2022 have been recalculated and restated and is presented on a comparable basis with the three and six months ended June 30, 2023. In the first quarter of 2023, the Company determined it should have included pre-funded warrants issued in Q2 2022 in the earnings per share calculation accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC’) 260-10-45-13, which treats shares of common stock exercisable for little to no consideration as included in the denominator of both the basic and diluted earnings per share calculations. While the Company has determined the impact of including the pre-funded warrants in the earnings per share calculations does not have a material impact on previously issued financial statements and is correct to recalculate and restate amounts presented on a comparative and consistent basis with current period results. The table below summarizes previously reported and restated amounts on a comparative basis. See the table presentation of loss per share calculations as of June 30, 2023 and 2022 in the "Loss Per Share Including Restated Amounts" section below. Three Months Ended June 30, Six Months Ended June 30, 2022 2022 As Previously Reported: Net loss per share attributable to common stockholders - basic and diluted $ (0.56) $ (1.40) Weighted average number of shares of common stock outstanding - basic and diluted 8,805,190  8,675,428  As Restated: Net loss per share attributable to common stockholders - basic and diluted $ (0.43) $ (1.20) Weighted average number of shares of common stock outstanding - basic and diluted 11,591,768  10,076,415  Loss Per Share Basic and diluted net loss per share for the three and six months ended June 30, 2023 and 2022, after giving effect to the restatement discussed above, was calculated as follows: Three Months Ended June 30, Six Months Ended June 30, (In Thousands, Except Shares and Per Share Amounts) 2023 2022 2023 2022 Numerator: Net loss $ (3,305) $ (4,967) $ (5,055) $ (12,128) Net loss attributable to common stockholders for basic and diluted loss per share $ (3,305) $ (4,967) $ (5,055) $ (12,128) Denominator: Weighted average number of shares of common stock outstanding - basic and diluted 18,496,640  11,591,768  18,480,248  10,076,415  Net loss per share attributable to common stockholders - basic and diluted $ (0.18) $ (0.43) $ (0.27) $ (1.20) Included within the weighted average shares of common stock outstanding for the three and six months ended June 30, 2023 and 2022, are 1,793,000 and 9,056,377 shares of common stock issuable upon the exercise of the pre-funded warrants (See Note 10), as the warrants are exercisable at any time for nominal consideration, and as such, the shares are considered outstanding for the purpose of calculating basic and diluted net loss per share attributable to common stockholders. The Company’s potentially dilutive securities include stock options, restricted stock awards and units, convertible preferred stock and warrants. These securities were excluded from the computations of diluted net loss per share for the three and six months ended June 30, 2023 and 2022, as the effect would be to reduce the net loss per share. The following table includes the potential shares of common stock, presented based on amounts outstanding at each period end, that were excluded from the computation of diluted net loss per share attributable to common stockholders for the periods indicated because including them would have had an anti-dilutive effect: As of June 30, 2023 2022 Options to purchase common stock 1,570,599  423,317  Unvested restricted stock awards 891  891  Unvested restricted stock units 313,065  125,000  Convertible Preferred Stock 1,363,636  1,363,636  Warrants to purchase common stock 10,196,268 12,303,432  Total 13,444,459 14,216,276  Adoption of Recent Accounting Pronouncements The Company continually assesses new accounting pronouncements to determine their applicability. When it is determined a new accounting pronouncement affects the Company’s financial reporting, the Company undertakes a review to determine the consequences of the change to its consolidated financial statements and assures there are sufficient controls in place to ascertain the Company’s consolidated financial statements properly reflect the change. In June 2016, the FASB issued Accounting Standards Update ("ASU") 2016-13, "Financial Instruments - Credit Losses (Topic 326)," which introduced an impairment model that is based on expected credit losses, rather than incurred losses, to estimate credit losses on certain types of financial instruments (e.g., loan commitments). The expected credit losses should consider historical information, current information, and reasonable and supportable forecasts, including estimates of prepayments, over the contractual term. Financial instruments with similar risk characteristics may be grouped together when estimating expected credit losses. In addition, ASC 326 requires expected credit relates losses for available-for-sale debt securities to be recorded through an allowance for credit losses, while non-credit related losses will continue to be recognized through other comprehensive income. The Company adopted the new guidance, as of January 1, 2023, and it did not have a material impact on the Condensed Consolidated Financial Statements.

v3.23.2

Revenue Recognition	6 Months Ended
	Jun. 30, 2023
Revenue from Contract with Customer [Abstract]
Revenue Recognition	Revenue Recognition The Company recognizes revenue under ASC 606, Revenue from Contracts with Customers. The core principle of the new revenue standard is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The following five steps are applied to achieve that core principle: •Step 1: Identify the contract with the customer •Step 2: Identify the performance obligations in the contract •Step 3: Determine the transaction price •Step 4: Allocate the transaction price to the performance obligations in the contract •Step 5: Recognize revenue when the company satisfies a performance obligation Taxes assessed by a governmental authority that are both imposed on and concurrent with a specific revenue-producing transaction, that are collected by us from a customer, are excluded from revenue. Shipping and handling costs associated with outbound freight related to contracts with customers are accounted for as a fulfillment cost and are included in cost of sales when control of the goods transfers to the customer. Nature of goods and services The following is a description of principal activities from which the Company generates its revenue. We currently operate in one market segment, the hemodialysis market, which involves the manufacture, sale and distribution of hemodialysis products to hemodialysis clinics, including pharmaceutical, dialysis concentrates, dialysis kits and other ancillary products used in the dialysis process. Our customer mix is diverse with most customer sales concentrations under 10% and one customer, DaVita, Inc., at approximately 50% for the six months ended June 30, 2023. Our accounts receivable from this customer were approximately 33% of the total consolidated accounts receivable balance at June 30, 2023. Product sales – The Company accounts for individual products and services separately if they are distinct (i.e., if a product or service is separately identifiable from other items and if a customer can benefit from it on its own or with other resources that are readily available to the customer). The consideration, including any discounts, is allocated between separate products and services based on their stand-alone selling prices. The stand-alone selling prices are determined based on the cost plus margin approach. Drug and dialysis concentrates products are sold directly to dialysis clinics and to wholesale distributors in both domestic and international markets. Distribution and license agreements for which upfront fees are received are evaluated upon execution or modification of the agreement to determine if the agreement creates a separate performance obligation from the underlying product sales.  For all existing distribution and license agreements, the distribution and license agreement is not a distinct performance obligation from the product sales.  In instances where regulatory approval of the product has not been established and the Company does not have sufficient experience with the foreign regulatory body to conclude regulatory approval is probable, the revenue for the performance obligation is recognized over the term of the license agreement (over time recognition). Conversely, when regulatory approval already exists or is probable, revenue is recognized at the point in time control of the product transfers to the customer. The Company received upfront fees under five distribution and license agreements that have been deferred as a contract liability.  The amounts received from Wanbang Biopharmaceuticals Co., Ltd. (“Wanbang”), Sun Pharmaceutical Industries Ltd. ("Sun Pharma"), Jeil Pharmaceutical Co., Ltd. ("Jeil Pharma") and Drogsan Pharmaceuticals ("Drogsan Pharma") are recognized as revenue over the estimated term of the applicable distribution and license agreement as regulatory approval was not received and the Company did not have sufficient experience in China, India, South Korea and Turkey, respectively, to determine regulatory approval was probable as of the execution of the agreement.  The amounts received from Baxter Healthcare Corporation (“Baxter”) were deferred and recognized as revenue at the point in time the estimated product sales under the agreement occurred.  In November 2022, Rockwell reacquired its distribution rights to its hemodialysis concentrates products from Baxter and terminated the exclusive distribution agreement. Under the exclusive distribution agreement, Baxter distributed and commercialized Rockwell’s hemodialysis concentrates products and provided customer service and order delivery to nearly all United States customers. Following the reacquisition of these rights, Rockwell is now unrestricted in its ability to sell its hemodialysis concentrates products to dialysis clinics throughout the United States and around the world. Rockwell agreed to pay Baxter a fee for the reacquisition of its distribution rights which was reflected as an expense at that time. This fee was payable in two equal installments on January 1, 2023 and April 1, 2023. As of June 30, 2023, all payments were completed. For the majority of the Company’s U.S. and international customers, the Company recognizes revenue at the shipping point, which is generally the Company’s plant or warehouse. For other business, the Company recognizes revenue based on when the customer takes control of the product. The amount of revenue recognized is based on the purchase order less returns and adjusted for any rebates, discounts, chargebacks or other amounts paid to customers. There were no such adjustments for the periods reported. Customers typically pay for the product based on customary business practices with payment terms averaging 30 days, while a small subset of customers have payment terms averaging 60 days. Disaggregation of revenue Revenue is disaggregated by primary geographical market, major product line, and timing of revenue recognition. In thousands of U.S. dollars ($)  Three Months Ended June 30, 2023 Six Months Ended June 30, 2023 Products By Geographic Area Total U.S. Rest of World Total U.S. Rest of World Drug Revenues Product Sales – Point-in-time $ —  $ —  $ —  $ —  $ —  $ —  License Fee – Over time 65  —  65  130  —  130  Total Drug Products 65  —  65  130  —  130  Concentrates Products Product Sales – Point-in-time 18,015  16,125  1,890  36,146  32,585  3,561  License Fee – Over time —  —  —  1,472  1,472  —  Total Concentrate Products 18,015  16,125  1,890  37,618  34,057  3,561  Net Revenue $ 18,080  $ 16,125  $ 1,955  $ 37,748  $ 34,057  $ 3,691  In thousands of U.S. dollars ($) Three Months Ended June 30, 2022 Six Months Ended June 30, 2022 Products By Geographic Area Total U.S. Rest of World Total U.S. Rest of World Drug Revenues Product Sales – Point-in-time $ 482  $ 209  $ 273  $ 641  $ 368  $ 273  License Fee – Over time 65  —  65  127  —  127  Total Drug Products 547  209  338  768  368  400  Concentrates Products Product Sales – Point-in-time 17,655  15,906  1,749  33,082  29,715  3,367  License Fee – Over time 480  480  —  956  956  —  Total Concentrate Products 18,135  16,386  1,749  34,038  30,671  3,367  Net Revenue $ 18,682  $ 16,595  $ 2,087  $ 34,806  $ 31,039  $ 3,767  Contract balances The following table provides information about receivables, contract assets, and contract liabilities from contracts with customers. In thousands of U.S. dollars ($) June 30, 2023 December 31, 2022 Accounts Receivable, net $ 5,411  $ 6,259  Contract liabilities, which are included in deferred revenue $ 2,729  $ 4,331  There were no bad debt expenses recognized related to any receivables arising from the Company’s contracts with customers for the three and six months ended June 30, 2023 and 2022. There were no other material contract assets recorded on the condensed consolidated balance sheet as of June 30, 2023 and December 31, 2022.  The Company does not generally accept returns of its concentrates products and no material reserve for returns of concentrates products was established as of June 30, 2023 or December 31, 2022.  The contract liabilities primarily relate to upfront payments and consideration received from customers in advance of the customer assuming control of the related products. Transaction price allocated to remaining performance obligations Revenue expected to be recognized in any future year related to remaining performance obligations, excluding revenue pertaining to contracts that have an original expected duration of one year or less, contracts where revenue is recognized as invoiced, and contracts with variable consideration related to undelivered performance obligations, totaled $2.7 million as of June 30, 2023. The amount relates primarily to upfront payments and consideration received from customers in advance of the customer assuming control of the related products. The Company applies the practical expedient in paragraph 606-10-50-14 and does not disclose information about remaining performance obligations that have original expected durations of one year or less.

v3.23.2

Investments - Available-for-Sale	6 Months Ended
	Jun. 30, 2023
Investments, Debt and Equity Securities [Abstract]
Investments - Available-for-Sale	Investments - Available-for-Sale Investments available-for-sale consisted of the following as of June 30, 2023 and December 31, 2022 (table in thousands): June 30, 2023 Amortized Cost Unrealized Gain Unrealized Loss Accrued Interest Fair Value Available-for-Sale Securities Debt securities $ 5,852  $ 54  $ —  $ —  $ 5,906  December 31, 2022 Amortized Cost Unrealized Gain Unrealized Loss Accrued Interest Fair Value Available-for-Sale Securities Debt securities $ 11,315  $ 75  $ —  $ —  $ 11,390  The fair value of investments available-for-sale are determined using quoted market prices from daily exchange-traded markets based on the closing price as of the balance sheet date and are classified as a Level 1 measurement under ASC 820 Fair Value Measurements. As of June 30, 2023 and December 31, 2022, the amortized cost and estimated fair value of our available-for-sale securities were all due within one year.

v3.23.2

Inventory	6 Months Ended
	Jun. 30, 2023
Inventory Disclosure [Abstract]
Inventory	Inventory Components of inventory, net of reserves, as of June 30, 2023 and December 31, 2022 are as follows (table in thousands): June 30, 2023 December 31, 2022 Inventory - Current Portion Raw Materials $ 2,805  $ 3,351  Work in Process 411  351  Finished Goods 2,598  2,112  Total Current Inventory 5,814  5,814  Inventory - Long Term 1,276  1,276  Total Inventory $ 7,090  $ 7,090  As of both June 30, 2023 and December 31, 2022, Rockwell had total concentrate inventory aggregating $5.8 million against which Rockwell had reserved $25,000 for both periods. As of both June 30, 2023 and December 31, 2022, the Company classified $1.3 million of inventory as non-current, all of which was related to Triferic raw materials. This Triferic inventory will be utilized for the Company's international partnerships. In September 2022, the Company discontinued its New Drug Applications ("NDAs") for Triferic (dialysate) and Triferic AVNU in the United States.

v3.23.2

Property and Equipment, net	6 Months Ended
	Jun. 30, 2023
Property, Plant and Equipment [Abstract]
Property and Equipment, net	Property and Equipment, net As of June 30, 2023 and December 31, 2022, the Company’s property and equipment consisted of the following (table in thousands): June 30, 2023 December 31, 2022 Leasehold Improvements $ 1,398  $ 1,256  Machinery and Equipment 6,006  5,922  Information Technology & Office Equipment 1,845  1,845  Laboratory Equipment 807  807     Total Property and Equipment 10,056  9,830  Accumulated Depreciation (7,963) (7,636) Property and Equipment, net $ 2,093  $ 2,194  Depreciation expense for the three months ended June 30, 2023 and 2022 was $0.2 million and $0.1 million, respectively. Depreciation expense for both the six months ended June 30, 2023 and 2022 was $0.3 million.

v3.23.2

Accrued Liabilities	6 Months Ended
	Jun. 30, 2023
Payables and Accruals [Abstract]
Accrued Liabilities	Accrued Liabilities Accrued liabilities as of June 30, 2023 and December 31, 2022 consisted of the following (table in thousands): June 30, 2023 December 31, 2022 Accrued Research & Development Expense $ —  $ 43  Accrued Compensation and Benefits 1,574  2,568  Accrued Unvouchered Receipts 552  585  Accrued Workers Compensation 173  306  Other Accrued Liabilities 1,464  4,200  Total Accrued Liabilities $ 3,763  $ 7,702

v3.23.2

Deferred Revenue	6 Months Ended
	Jun. 30, 2023
Revenue from Contract with Customer [Abstract]
Deferred Revenue	Deferred Revenue In October 2014, the Company entered into an exclusive distribution agreement with Baxter, which had a term of 10 years and received an upfront fee of $20 million. The upfront fee was recorded as deferred revenue and was being recognized based on the proportion of product shipments to Baxter in each period, compared with total expected sales volume over the term of the distribution agreement. On November 9, 2022, Rockwell reacquired its distribution rights to its hemodialysis concentrates products from Baxter and terminated the distribution agreement. Exclusivity and other provisions associated with the distribution agreement terminated November 9, 2022 and the remaining operational elements of the agreement terminated December 31, 2022. Rockwell agreed to provide certain services to a group of Baxter's customers until March 31, 2023. Under the distribution agreement, Baxter distributed and commercialized Rockwell’s hemodialysis concentrates products and provided customer service and order delivery to nearly all United States customers. Following the reacquisition of these rights, Rockwell is now unrestricted in its ability to sell its hemodialysis concentrates products to dialysis clinics throughout the United States and around the world. The Company recognized the remaining revenue of $1.5 million during the three months ended March 31, 2023. In 2016, the Company entered into a distribution agreement with Wanbang (the "Wanbang Agreement") and received an upfront fee of $4.0 million. The upfront fee was recorded as deferred revenue and is being recognized as revenue based on the agreement term. The Company recognized revenue of approximately $53,000 and $0.1 million for each of the three and six months ended June 30, 2023 and 2022, respectively. Deferred revenue related to the Wanbang Agreement totaled $2.2 million as of June 30, 2023 and $2.3 million as of December 31, 2022. On August 7, 2023, Rockwell was informed by Wanbang, the Company’s commercialization partner in China for Triferic, that the main efficacy results of Wanbang’s clinical trial for Triferic (dialysate) compared with placebo were not obtained. The Company is working with Wanbang to determine next steps. In January 2020, the Company entered into license and supply agreements with Sun Pharma (the "Sun Pharma Agreements"), for the rights to commercialize Triferic (dialysate) in India. In consideration for the license, the Company received an upfront fee of $0.1 million. The upfront fee was recorded as deferred revenue and is being recognized as revenue based on the agreement term. The Company recognized revenue of approximately $2,500 and $5,000 for the three and six months ended June 30, 2023 and 2022, respectively. Deferred revenue related to the Sun Pharma Agreement totaled $65,000 and $70,000 as of June 30, 2023 and December 31, 2022, respectively. In September 2020, the Company entered into a license and supply agreements with Jeil Pharmaceutical (the "Jeil Agreements"), for the rights to commercialize Triferic (dialysate) in South Korea. In consideration for the license, the Company received an upfront fee of $0.2 million. In May 2022, Jeil Pharmaceutical obtained regulatory approval in South Korea and paid the Company $0.2 million in consideration of reaching the milestone. The upfront fee and milestone payments were recorded as deferred revenue and are being recognized as revenue based on the agreement term. The Company recognized revenue of $5,200 and $10,400 for the three and six months ended June 30, 2023 and 2022, respectively. Deferred revenue related to the Jeil Agreement totaled approximately $0.4 million as of both June 30, 2023 and December 31, 2022. In June 2021, the Company entered into license and supply agreements with Drogsan Pharmaceuticals (the "Drogsan Agreements"), for the rights to commercialize Triferic (dialysate) and Triferic AVNU in Turkey. In consideration for the license, the Company received an upfront fee of $0.15 million. The upfront fee was recorded as deferred revenue and will be recognized as revenue based on the agreement term. The Company recognized revenue of $3,750 and $7,500 for the three and six months ended June 30, 2023 and 2022, respectively. Deferred revenue related to the Drogsan Agreements totaled approximately $120,000 and $127,500 as of June 30, 2023 and December 31, 2022, respectively. In April 2023, Drogsan submitted a Marketing Authorization application and GMP application for Triferic AVNU to the Turkish Medicines and Medical Devices Agency, for which Drogsan received priority status and high priority status, respectively. Taking into consideration that Drogsan was granted an accelerated review for Triferic AVNU with the Turkish regulatory authority, Rockwell anticipates approval for Triferic AVNU in Turkey in 2024. Drogsan is responsible for all regulatory approval and commercialization activities.

v3.23.2

Stockholders’ Equity	6 Months Ended
	Jun. 30, 2023
Equity [Abstract]
Stockholders' Equity	Stockholders’ Equity The Company held its annual meeting of stockholders on May 23, 2023 (the “Annual Meeting”). At the Annual Meeting, the Company’s stockholders approved the amendment and restatement of the Rockwell Medical, Inc. 2018 Long Term Incentive Plan to increase the number of shares of common stock issuable thereunder by 1,600,000 shares (the “Amended 2018 Plan”). Preferred Stock On April 6, 2022, the Company and DaVita entered into the Securities Purchase Agreement (the "SPA"), which provided for the issuance by the Company of up to $15 million of preferred stock to DaVita. On April 6, 2022, the Company issued 7,500 shares of Series X Preferred Stock for gross proceeds of $7.5 million. On June 16, 2022 the Company issued an additional 7,500 shares of the Series X Preferred Stock to DaVita for gross proceeds of $7.5 million. The Series X Preferred Stock was issued for a price of $1,000 per share (the "Face Amount"), subject to accretion at a rate of 1% per annum, compounded annually. If the Company’s common stock trades above $22.00 for a period of 30 calendar days, the accretion will thereafter cease. As of June 30, 2023, the Series X Preferred Stock accreted a total $150,000. The Series X Convertible Preferred Stock is convertible to common stock at a rate equal to the Face Amount, divided by a conversion price of $11.00 per share (subject to adjustment for future stock splits, reverse stock splits and similar recapitalization events). As a result, each share of Series X Preferred Stock will initially convert into approximately 91 shares of common stock. DaVita’s right to convert to common stock is subject to a beneficial ownership limitation, which is initially set at 9.9% of the outstanding common stock, which limitation may be reset (not to exceed 19.9%) at DaVita’s option and upon providing prior written notice to the Company. In addition, any debt financing is limited by the terms of our Securities Purchase Agreement with DaVita. Specifically, until DaVita owns less than 50% of its investment, the Company may only incur additional debt in the form of a purchase money loan, a working capital line of up to $5 million or to refinance existing debt, unless DaVita consents. Additionally, the Series X Preferred Stock has a deemed liquidation event and redemption clause which could be triggered if the sale of all or substantially all of the Company's assets relating to the Company's dialysis concentrates business line. Since the Series X Preferred Stock may be redeemed if certain assets are sold at the option of the holder, but is not mandatorily redeemable, the preferred stock has been classified as permanent equity and initially recognized at fair value of $15 million (the proceeds on the date of issuance) less issuance costs of $0.1 million, resulting in an initial value of $14.9 million. The Company will assess at each reporting period whether conditions have changed to now meet the mandatory redemption definition which could trigger liability classification. As of both June 30, 2023 and December 31, 2022, there were 2,000,000 shares of preferred stock, $0.0001 par value per share, authorized and 15,000 shares of preferred stock issued and outstanding. Common Stock As of June 30, 2023 and December 31, 2022, there were 170,000,000 shares of common stock, $0.0001 par value per share, authorized and 16,795,673 and 12,163,673 shares issued and outstanding, respectively. As of June 30, 2023 and 2022, the Company has reserved for issuance the following shares of common stock related to the potential exercise of employee stock options, unvested restricted stock, convertible preferred stock, pre-funded warrants and all other warrants (collectively, "common stock equivalents"): As of June 30, Common stock and common stock equivalents: 2023 2022 Common stock 16,795,673  9,407,296  Common stock issuable upon exercise of pre-funded warrants 1,793,000  9,056,377  Common stock and pre-funded stock warrants 18,588,673  18,463,673  Options to purchase common stock 1,570,599  423,317 Unvested restricted stock awards 891  891  Unvested restricted stock units 313,065  125,000  Convertible Preferred Stock 1,363,636  1,363,636  Warrants to purchase common stock 10,196,268 10,196,268  Total 32,033,132 30,572,785  During the three months ended June 30, 2023 and 2022, 4,118,000 and nil pre-funded warrants were exercised, respectively. During the six months ended June 30, 2023 and 2022, 4,507,000 and nil pre-funded warrants were exercised, respectively. During the three and six months ended June 30, 2023 and 2022, no vested employee stock options were exercised. Controlled Equity Offering On April 8, 2022, the Company entered into the Sales Agreement with Cantor Fitzgerald & Co. as Agent, pursuant to which the Company may offer and sell from time to time up to $12,200,000 of shares of Company’s common stock through the Agent. The offering and sale of such shares has been registered under the Securities Act of 1933, as amended, pursuant to the Company’s Registration Statement on Form S-3 (File No. 333-259923) (the “Registration Statement”), which was originally filed with the SEC on September 30, 2021 and declared effective by the SEC on October 8, 2021, the base prospectus contained within the Registration Statement, and a prospectus supplement that was filed with the SEC on April 8, 2022. During the quarter ended June 30, 2023, no sales were made pursuant to the Sales Agreement. Approximately $12.2 million remains available for sale under the ATM facility. Registered Direct Offering On May 30, 2022, the Company entered into the RD Purchase Agreement with the Purchaser named therein, pursuant to which the Company agreed to issue and sell, in a registered direct offering (the “Offering”), 844,613 shares of its common stock at price of $1.39 per share, and pre-funded warrants to purchase up to an aggregate of 7,788,480 shares of common stock (the “Pre-Funded Warrants” and the shares of common stock underlying the Pre-Funded Warrants, the “Warrant Shares”). The purchase price of each Pre-Funded Warrant is equal to the price at which a share of common stock was sold to the public in the Offering, minus $0.0001, and the exercise price of each Pre-Funded Warrant is $0.0001 per share. A holder (together with its affiliates) may not exercise any portion of the Pre-Funded Warrants to the extent the holder would own more than 9.99% of the Company’s outstanding common stock immediately after exercise, as such percentage ownership is determined in accordance with the terms of the Pre-Funded Warrant. The RD Purchase Agreement contains customary representations and warranties and agreements of the Company and the Purchaser and customary indemnification rights and obligations of the parties. A total of 1,793,000 Pre-Funded Warrants remained outstanding as of June 30, 2023. On July 5, 2023, the remaining 1,793,000 Pre-Funded Warrants to purchase common stock were exercised. Private Placement Also on May 30, 2022, concurrently with the Offering, the Company entered into the PIPE Purchase Agreement relating to the offering and sale (the “Private Placement”) of warrants to purchase up to a total of 9,900,990 shares of common stock (the "PIPE Warrants") and pre-funded warrants to purchase up to a total of 1,267,897 shares of common stock (the “Pre- Funded PIPE Warrants”). Each warrant was sold at a price of $0.125 per underlying warrant share and is exercisable at an exercise price of $1.39 per share. The purchase price of each Pre-Funded Warrant was equal to the price at which a share of common stock was sold to the public in the Offering, minus $0.0001, and the exercise price of each Pre-Funded Warrant is $0.0001 per share. As of December 2022, all Pre-Funded PIPE Warrants have been exercised. As of June 30, 2023, 9,900,990 PIPE Warrants remained outstanding. On July 10, 2023, 9,900,990 PIPE Warrants were exercised for 9,900,990 shares of common stock (See Note 16 for further details).

v3.23.2

Stock-Based Compensation	6 Months Ended
	Jun. 30, 2023
Share-Based Payment Arrangement [Abstract]
Stock-Based Compensation	Stock-Based Compensation The Company recognized total stock-based compensation expense during the three and six months ended June 30, 2023 and 2022 as follows (table in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Service-based awards: Restricted stock units $ 119  $ 26  $ 164  $ 37  Stock option awards 190  72  338  272     Total Service Based Awards 309  98  502  309  Performance-based awards: Restricted stock awards —  —  —  (391) Total $ 309  $ 98  $ 502  $ (82) Performance Based Restricted Stock A summary of the Company’s restricted stock awards during the six months ended June 30, 2023 is as follows: Number of Shares Weighted Average Grant-Date Fair Value Unvested at January 1, 2023 891  $ 62.70  Unvested at June 30, 2023 891  $ 62.70  A summary of the Company’s restricted stock awards during the six months ended June 30, 2022 is as follows: Number of Shares Weighted Average Grant-Date Fair Value Unvested at January 1, 2022 7,118  $ 62.70  Forfeited (6,227) $ 62.70  Unvested at June 30, 2022 891  $ 62.70  Restricted stock awards are measured based on their fair value on the date of grant and amortized over the vesting period of 20 months. As of both June 30, 2023 and 2022, unvested restricted stock awards of 891 were related to performance-based awards. The forfeited performance-based restricted stock awards of 6,227 was due to the resignation of the Company's Chief Development Officer on March 25, 2022. These forfeited awards reduced stock-based compensation expense by $0.4 million in 2022. Service-Based Restricted Stock Units A summary of the Company’s service-based restricted stock units during the six months ended June 30, 2023 is as follows: Number of Shares Weighted Average Grant-Date Fair Value Unvested at January 1, 2023 125,000  $ 1.47  Granted 313,065  1.87  Vested (125,000) 1.47  Unvested at June 30, 2023 313,065  $ 1.87  A summary of the Company’s service-based restricted stock units during the six months ended June 30, 2022 is as follows: Number of Shares Weighted Average Grant-Date Fair Value Unvested at January 1, 2022 29,289  $ 12.87  Granted 125,000  1.47  Vested (23,515) 11.33  Forfeited (5,774) 19.00  Unvested at June 30, 2022 125,000  $ 1.47  Service based restricted stock units are measured based on their fair value on the date of grant and amortized over the vesting period. The vesting periods range from 1 to 3 years. Stock-based compensation expense of $0.1 million and $25,554 was recognized for the three months ended June 30, 2023 and 2022, respectively. Stock-based compensation expense of $0.2 million and $37 thousand was recognized for the six months ended June 30, 2023 and 2022, respectively. As of June 30, 2023, the unrecognized stock-based compensation expense was $0.5 million, which is expected to be recognized over an estimated weighted average remaining term of less than 1.7 years. Service-Based Stock Options The fair value of the service-based stock options granted for the six months ended June 30, 2022 were based on the following assumptions: Six Months Ended June 30, 2023 Exercise price $1.37 - $2.83 Expected stock price volatility 81.64% - 81.9% Risk-free interest rate 3.41% - 3.55% Term (years) 4 - 6 A summary of the Company’s service-based stock option activity for the six months ended June 30, 2023 is as follows: Shares Underlying Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Outstanding at January 1, 2023 1,206,905  $ 8.32  8.9 Granted 382,745  1.48  5.5 Forfeited (13,447) 4.02  —  Expired (5,604) 19.01  —  Outstanding at June 30, 2023 1,570,599  $ 6.65  8.7 Exercisable at June 30, 2023 301,986  $ 26.15  6.5 A summary of the Company’s service-based stock option activity for the six months ended June 30, 2022 is as follows: Shares Underlying Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Outstanding at January 1, 2022 528,591  $ 32.01  7.5 Granted 909  4.07  9.5 Forfeited (24,488) 15.00  —  Expired (81,695) 83.32  —  Outstanding at June 30, 2022 423,317  $ 23.03  7.8 Exercisable at June 30, 2022 227,412  $ 31.19  5.8 The aggregate intrinsic value is calculated as the difference between the closing price of the Company's common stock and the exercise price of the stock options that had strike prices below the closing price. The intrinsic value of the outstanding options were not significant for all periods presented. During the six months ended June 30, 2023, the Company granted 382,745 stock options to purchase shares of common stock. During the six months ended June 30, 2023, 13,447 shares were forfeited and 5,604 shares expired. Forfeitures are recorded in the period of occurrence and compensation expense is adjusted accordingly. Stock-based compensation expense recognized for service-based stock options was $0.2 million and $0.1 million for the three months ended June 30, 2023, and 2022 respectively. Stock-based compensation expense recognized for service-based stock options was $0.3 million and $0.3 million for the six months ended June 30, 2023, and 2022, respectively. As of June 30, 2023, total stock-based compensation expense related to unvested options not yet recognized totaled approximately $0.9 million, which is expected to be recognized over an estimated weighted average remaining term of 8.7 years.

v3.23.2

Licensing Agreements	6 Months Ended
	Jun. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Licensing Agreements	Licensing Agreements Product License Agreements The Company is a party to a Licensing Agreement between the Company and Charak, LLC ("Charak") dated January 7, 2002 (the "2002 Agreement") that grants the Company exclusive worldwide rights to certain patents and information related to our Triferic product. On October 7, 2018, the Company entered into a Master Services and IP Agreement (the “Charak MSA”) with Charak and Dr. Ajay Gupta, a former Officer of the Company. Pursuant to the MSA, the parties entered into three additional agreements described below related to the license of certain soluble ferric pyrophosphate (“SFP”) intellectual property owned by Charak. As of June 30, 2023 and December 31, 2022, the Company has accrued $85,400 relating to certain IP reimbursement expenses and certain sublicense royalty fees, which is included within accrued liabilities on the condensed consolidated balance sheet. Pursuant to the Charak MSA, the aforementioned parties entered into an Amendment, dated as of October 7, 2018 (the “Charak Amendment”), to the 2002 Agreement, under which Charak granted the Company an exclusive, worldwide, non-transferable license to commercialize SFP for the treatment of patients with renal failure. The Charak Amendment amends the royalty payments due to Charak under the 2002 Agreement such that the Company is liable to pay Charak royalties on net sales by the Company of products developed under the license, which includes the Company’s Triferic product, at a specified rate until December 31, 2021 and thereafter at a reduced rate from January 1, 2022 until February 1, 2034. Additionally, the Company shall pay Charak a percentage of any sublicense income during the term of the agreement, which amount shall not be less than a minimum specified percentage of net sales of the licensed products by the sublicensee in jurisdictions where there exists a valid claim, on a country-by-country basis, and be no less than a lower rate of the net sales of the licensed products by the sublicensee in jurisdictions where there exists no valid claim, on a country-by-country basis. Also pursuant to the Charak MSA, the Company and Charak entered into a Commercialization and Technology License Agreement I.V. Triferic dated as of October 7, 2018 (the “IV Agreement”), under which Charak granted the Company an exclusive, sub-licensable, royalty-bearing license to SFP for the purpose of commercializing certain intravenous-delivered products incorporating SFP for the treatment of iron disorders worldwide for a term that expires on the later of February 1, 2034 or upon the expiration or termination of a valid claim of a licensed patent. The Company was liable to pay Charak royalties on net sales by the Company of products developed under the license at a specified rate until December 31, 2021. From January 1, 2022 until February 1, 2034, the Company is liable to pay Charak a base royalty at a reduced rate on net sales and an additional royalty on net sales while there exists a valid claim of a licensed patent, on a country-by-country basis. The Company shall also pay to Charak a percentage of any sublicense income received during the term of the IV Agreement, which amount shall not be less than a minimum specified percentage of net sales of the licensed products by the sublicensee in jurisdictions where there exists a valid claim, on a country-by-country basis, and not be less than a lower rate of the net sales of the licensed products by the sublicensee in jurisdictions where there exists no valid claim, on a country-by-country basis. Also pursuant to the Charak MSA, the Company and Charak entered into a Technology License Agreement TPN Triferic dated as of October 7, 2018 (the “TPN Agreement”), pursuant to which Charak granted the Company an exclusive, sub-licensable, royalty-bearing license to SFP for the purpose of commercializing worldwide certain TPN products incorporating SFP. The license grant under the TPN Agreement continues for a term that expires on the later of February 1, 2034 or upon the expiration or termination of a valid claim of a licensed patent. During the term of the TPN Agreement, the Company is liable to pay Charak a base royalty on net sales and an additional royalty on net sales while there exists a valid claim of a licensed patent, on a country-by-country basis. The Company shall also pay to Charak a percentage of any sublicense income received during the term of the TPN Agreement, which amount shall not be less than a minimum royalty on net sales of the licensed products by the sublicensee in jurisdictions where there exists a valid claim, on a country-by-country basis, and not be less than a lower rate of the net sales of the licensed products by the sublicensee in jurisdictions where there exists no valid claim, on a country-by-country basis. The potential sub-license milestone payments are not yet considered probable, and no milestone payments have been accrued as of June 30, 2023 and December 31, 2022.

v3.23.2

Leases	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
Leases	Leases Rockwell leases its production facilities and administrative offices as well as certain equipment used in its operations including leases on transportation equipment used in the delivery of its products. The lease terms range from monthly to six years. Rockwell occupies a 51,000 square foot facility and a 17,500 square foot facility in Wixom, Michigan under a lease expiring in August 2024. Rockwell also occupies two other manufacturing facilities, a 51,000 square foot facility in Grapevine, Texas under a lease expiring in December 2025, and a 57,000 square foot facility in Greer, South Carolina under a lease expiring February 2026. In addition, Rockwell occupied 4,100 square feet of office space in Hackensack, New Jersey under a lease expiring on October 31, 2024. This lease was subleased on December 15, 2021 with an expiration date of October 31, 2024. At June 30, 2023, the Company had operating and finance lease liabilities of $5.9 million and right-of-use assets of $5.7 million, which are included in the condensed consolidated balance sheet. At December 31, 2022, the Company had operating and finance lease liabilities of $6.7 million and right-of-use assets of $6.4 million, which are included in the condensed consolidated balance sheet. The following summarizes quantitative information about the Company’s operating and finance leases (table in thousands): Three Months Ended June 30, 2023 Three Months Ended June 30, 2022 Six Months Ended June 30, 2023 Six Months Ended June 30, 2022 Operating leases Operating lease cost $ 391  $ 366  $ 735  $ 745  Interest on lease obligations 64  65  124  135  Variable lease cost 109  92  224  187  Operating lease expense 564  523  1,083  1,067  Finance leases Non-cash lease expense from right-of-use assets 141  141  282  282  Interest on lease obligations 38  45  77  92  Finance lease expense 179  186  359  374  Short-term lease rent expense 4  4  8  8  Total lease expense $ 747  $ 713  $ 1,450  $ 1,449  Other information Payments for principal from operating leases $ 478  $ 447  $ 902  $ 911  Payments for interest from finance leases $ 38  $ 45  $ 77  $ 92  Payments for principal from finance leases $ 129  $ 119  $ 258  $ 237  Weighted-average remaining lease term – operating leases 2.7 3.2 2.7 3.2 Weighted-average remaining lease term – finance leases 3.9 4.9 3.9 4.9 Weighted-average discount rate – operating leases 6.5  % 6.3  % 6.5  % 6.3  % Weighted-average discount rate – finance leases 6.4  % 6.4  % 6.4  % 6.4  % Future minimum rental payments under operating and finance lease agreements are as follows (in thousands): Operating Finance Year ending December 31, 2023 (remaining) $ 875  $ 335  Year ending December 31, 2024 1,511  672  Year ending December 31, 2025 1,021  676  Year ending December 31, 2026 362  666  Year ending December 31, 2027 131  311  Total 3,900  2,660  Less present value discount (318) (308) Operating and finance lease liabilities $ 3,582  $ 2,352
Leases	Leases Rockwell leases its production facilities and administrative offices as well as certain equipment used in its operations including leases on transportation equipment used in the delivery of its products. The lease terms range from monthly to six years. Rockwell occupies a 51,000 square foot facility and a 17,500 square foot facility in Wixom, Michigan under a lease expiring in August 2024. Rockwell also occupies two other manufacturing facilities, a 51,000 square foot facility in Grapevine, Texas under a lease expiring in December 2025, and a 57,000 square foot facility in Greer, South Carolina under a lease expiring February 2026. In addition, Rockwell occupied 4,100 square feet of office space in Hackensack, New Jersey under a lease expiring on October 31, 2024. This lease was subleased on December 15, 2021 with an expiration date of October 31, 2024. At June 30, 2023, the Company had operating and finance lease liabilities of $5.9 million and right-of-use assets of $5.7 million, which are included in the condensed consolidated balance sheet. At December 31, 2022, the Company had operating and finance lease liabilities of $6.7 million and right-of-use assets of $6.4 million, which are included in the condensed consolidated balance sheet. The following summarizes quantitative information about the Company’s operating and finance leases (table in thousands): Three Months Ended June 30, 2023 Three Months Ended June 30, 2022 Six Months Ended June 30, 2023 Six Months Ended June 30, 2022 Operating leases Operating lease cost $ 391  $ 366  $ 735  $ 745  Interest on lease obligations 64  65  124  135  Variable lease cost 109  92  224  187  Operating lease expense 564  523  1,083  1,067  Finance leases Non-cash lease expense from right-of-use assets 141  141  282  282  Interest on lease obligations 38  45  77  92  Finance lease expense 179  186  359  374  Short-term lease rent expense 4  4  8  8  Total lease expense $ 747  $ 713  $ 1,450  $ 1,449  Other information Payments for principal from operating leases $ 478  $ 447  $ 902  $ 911  Payments for interest from finance leases $ 38  $ 45  $ 77  $ 92  Payments for principal from finance leases $ 129  $ 119  $ 258  $ 237  Weighted-average remaining lease term – operating leases 2.7 3.2 2.7 3.2 Weighted-average remaining lease term – finance leases 3.9 4.9 3.9 4.9 Weighted-average discount rate – operating leases 6.5  % 6.3  % 6.5  % 6.3  % Weighted-average discount rate – finance leases 6.4  % 6.4  % 6.4  % 6.4  % Future minimum rental payments under operating and finance lease agreements are as follows (in thousands): Operating Finance Year ending December 31, 2023 (remaining) $ 875  $ 335  Year ending December 31, 2024 1,511  672  Year ending December 31, 2025 1,021  676  Year ending December 31, 2026 362  666  Year ending December 31, 2027 131  311  Total 3,900  2,660  Less present value discount (318) (308) Operating and finance lease liabilities $ 3,582  $ 2,352

v3.23.2

Loans and Security Agreement	6 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Loans and Security Agreement	Loan and Security Agreement On March 16, 2020, the Company and Rockwell Transportation, Inc., as Borrowers, entered into a Loan and Security Agreement (the "Loan Agreement") with Innovatus Life Sciences Lending Fund I, LP ("Innovatus"), as collateral agent and the lenders party thereto, pursuant to which Innovatus, as a lender, agreed to make certain term loans to the Company in the aggregate principal amount of up to $35.0 million (the "Term Loans"). Funding of the first $22.5 million tranche was completed on March 16, 2020. The Company is no longer eligible to draw on a second tranche of $5.0 million or a third tranche of $7.5 million, which were tied to the achievement of certain milestones by a specific date. Net draw down proceeds were $21.2 million with closing costs of $1.3 million. In connection with each funding of the Term Loans, the Company was required to issue to Innovatus a warrant (the “Warrants”) to purchase a number of shares of the Company’s common stock equal to 3.5% of the principal amount of the relevant Term Loan funded divided by the exercise price, which was based on the lower of (i) the volume weighted average closing price of the Company’s stock for the 5-trading day period ending on the last trading day immediately preceding the execution of the Loan Agreement or (ii) the closing price on the last trading day immediately preceding the execution of the Loan Agreement (or for the second and third tranches only at the lower of (i) $18.15 per share or (ii) the volume weighted average closing price of the Company’s stock for the 5-trading day period ending on the last trading day immediately preceding the relevant Term Loan funding). The Warrants may be exercised on a cashless basis and are immediately exercisable through the seventh anniversary of the applicable funding date. The number of shares of common stock for which each Warrant is exercisable and the associated exercise price are subject to certain proportional adjustments as set forth in such Warrant. In connection with the first tranche of the Term Loans, the Company issued a Warrant to Innovatus, exercisable for an aggregate of 43,388 shares of the Company’s common stock at an exercise price of $18.15 per share. The Company evaluated the warrant under ASC 470, Debt, and recognized an additional debt discount of approximately $0.5 million based on the relative fair value of the base instruments and warrants. The Company calculated the fair value of the warrant using the Black-Scholes model. The Company is entitled to make interest-only payments for thirty months, or up to thirty-six months if certain conditions are met. The Term Loans will mature on March 16, 2025, and will bear interest at the greater of (i) Prime Rate (as defined in the Loan Agreement) and (ii) 4.75%, plus 4.00% with an initial interest rate of 8.75% per annum and an effective interest rate of 10.9%. The Company has the option, under certain circumstances, to add 1.00% of such interest rate amount to the then outstanding principal balance in lieu of paying such amount in cash. For the three months ended June 30, 2023 and 2022, interest expense amounted to $0.3 million and $0.4 million, respectively. For the six months ended June 30, 2023 and 2022, interest expense amounted to $0.6 million and $0.8 million, respectively. The Loan Agreement is secured by all assets of the Company and Rockwell Transportation, Inc. Proceeds are used for working capital purposes. The Loan Agreement contained customary representations and warranties and covenants, subject to customary carve outs, and included financial covenants related to liquidity and trailing twelve months sales of Triferic, with the latter beginning with the period ending December 31, 2020. In September 2021, the Company entered into an amendment to the Loan Agreement in which the Company, in exchange for Innovatus lowering the sales covenants, agreed to (i) prepay an aggregate principal amount of $7.5 million in ten installments commencing on December 1, 2021; (ii) pay an additional prepayment premium of 5% on prepaid amounts if the Company elects to prepay all outstanding Term Loans on or before September 24, 2023 and (iii) maintain minimum liquidity of no less than $5.0 million if the aggregate principal amount of Term Loans is greater than $15 million pursuant to the liquidity covenant in the Loan Agreement. On November 10, 2022, the Company entered into a Second Amendment to the Loan and Security Agreement (the “Second Amendment”) dated as of November 14, 2022 with Innovatus, which amended the Loan Agreement. Pursuant to the Second Amendment, the Company (i) prepaid an aggregate principal amount of $5.0 million in Term Loans in one installment on November 14, 2022; (ii) shall pay interest only payments until September 2023 at which time will resume scheduled debt payments. Additionally, the financial covenants related to the trailing twelve months sales of Triferic was replaced with a trailing 6 months revenue of our concentrates products beginning with the period ending September 30, 2022. The Company cannot assure that it can maintain compliance with the covenants under our Loan Agreement, which may result in an event of default. The Company's ability to comply with these covenants may be adversely affected by events beyond its control. If the Company is unable to comply with the covenants under the Loan Agreement, it would pursue all available cure options in order to regain compliance. However, the Company may not be able to mutually agree with Innovatus on appropriate remedies to cure a future breach of a covenant, which could give rise to an event of default. If the Company is unable to avoid an event of default, any required repayments could have an adverse effect on its liquidity. As of June 30, 2023, the Company was in compliance with all covenants under the Loan Agreement. As of June 30, 2023, the outstanding balance of the Term Loan was $9.4 million, net of unamortized issuance costs and discount of $0.6 million. The following table reflects the schedule of principal payments on the Term Loan as of June 30, 2023 (in thousands): Principal Payments 2023 (remaining) $ 2,000  2024 6,000  2025 2,000  $ 10,000

v3.23.2

Insurance Financing Note Payable	6 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Insurance Financing Note Payable	Insurance Financing Note PayableOn June 3, 2023, the Company entered into a short-term note payable for $0.7 million, bearing interest at 9.59% per annum to finance various insurance policies. Principal and interest payments related to this note began on July 3, 2023 and will be paid on a straight-line amortization over nine months with the final payment due on March 3, 2024. As of June 30, 2023, the outstanding balance was $0.7 million.

v3.23.2

Subsequent Events	6 Months Ended
	Jun. 30, 2023
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events On July 5, 2023, all of the remaining Pre-Funded Warrants to purchase 1,793,000 shares of common stock issued on May 30, 2022 were exercised. The exercise price of each Pre-Funded Warrant was $0.0001 per share and resulted in gross proceeds to the Company of $179 (See Note 10 for more detail on the Pre-Funded Warrants). Asset Purchase Agreement On July 10, 2023, the Company executed and consummated the transactions contemplated by an Asset Purchase Agreement (the “Purchase Agreement”) with Evoqua. Subject to the terms and conditions of the Purchase Agreement, at the closing of the transaction (the “Closing”), the Company purchased from Evoqua substantially all of the assets of Evoqua that are related to its business of manufacturing, marketing, distributing, and selling hemodialysis concentrates products in powder and liquid form (the “Concentrates Business”) for an aggregate purchase price, subject to certain adjustments pursuant to the terms of the Purchase Agreement, of $11.0 million in cash paid at Closing and equal annual installments of $2.5 million payable on each of the first and second anniversaries of the Closing. The foregoing summary of the Purchase Agreement is subject to, and qualified in its entirety by reference to, the Purchase Agreement, which is filed as Exhibit 10.2 to this Quarterly Report on Form 10-Q. Warrant Exercise and Reload Warrants On July 10, 2023, the Company entered into a letter agreement (the “Letter Agreement”) with Armistice Capital Master Fund Ltd. (“Armistice”), which held a warrant (the “Prior Warrant”) to purchase 9,900,990 shares of common stock of the Company (the “Common Stock”) with an exercise price of $1.39 per share, offering Armistice the opportunity to exercise the Prior Warrant for cash, provided the Prior Warrant was exercised for cash on or prior to 5:00 P.M. Eastern Time on July 10, 2028 (the “End Date”). In addition, Armistice would receive a “reload” warrant (the “Reload Warrant”) to purchase 3,750,000 shares of Common Stock with an exercise price of $5.13 per share, the closing price as reported by the Nasdaq Capital Market on July 7, 2023. The terms of the Reload Warrant and Letter Agreement provide for customary resale registration rights. The Letter Agreement also provides that for a period of 45 days after the issuance of the Reload Warrant, the Company’s may not sell shares of Common Stock pursuant to its sales agreement with Cantor Fitzgerald & Co., dated as of April 8, 2022, at price per share less than $6.25. The Reload Warrant may be exercised at all times prior to the 54 months month anniversary of its issuance date. The Prior Warrant and the Reload Warrant both provide that a holder (together with its affiliates) may not exercise any portion of the Prior Warrant or the Reload Warrant to the extent that the holder would own more than 9.99% of the Company’s outstanding Common Stock immediately after exercise, as such percentage ownership is determined in accordance with the terms of such warrant. To the extent the exercise of the Prior Warrant would result in Armistice holding more than 9.99% of the Company’s outstanding Common Stock, such shares of Common Stock in excess of 9.99% will be held in abeyance. The Letter Agreement amended the Prior Warrant to extend the expiration date thereof to one year following the original expiration date set forth therein. Armistice exercised the Prior Warrant on July 10, 2023, and the Company received gross proceeds of approximately $13.8 million from the exercise of the Prior Warrant as a result of such exercise pursuant to the terms of the Letter Agreement. As of July 10, 2023, following the exercise of the Prior Warrant, the Company had 28,489,663 shares of common stock outstanding. The Letter Agreement and Reload Warrant were entered into pursuant to Section 4(a)(2) of the Securities Act of 1933, as amended, and Regulation D as promulgated thereunder. The foregoing summaries of the Reload Warrant and the Letter Agreement are subject to, and qualified in their entirety by reference to, the Reload Warrant and the Letter Agreement, which are filed as Exhibits 4.1 and 10.1 to this Quarterly Report on Form 10-Q, respectively. International Distribution Agreement On August 7, 2023, Rockwell was informed by Wanbang, the Company’s commercialization partner in China for Triferic, that the main efficacy results of Wanbang’s clinical trial for Triferic (dialysate) compared with placebo were not obtained. The Company is working with Wanbang to determine next steps.

v3.23.2

Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements (Policies)	6 Months Ended
	Jun. 30, 2023
Accounting Policies [Abstract]
Basis of Presentation	The accompanying condensed consolidated financial statements have been prepared in accordance with the accounting principles generally accepted in the United States of America (“U.S. GAAP”) for interim financial information and pursuant to the instructions to Form 10-Q and Rule 10-01 of Regulation S-X of the U. S. Securities and Exchange Commission (“SEC”) and on the same basis as the Company prepares its annual audited consolidated financial statements. The condensed consolidated balance sheet at June 30, 2023, and the condensed consolidated statements of operations, comprehensive loss, and changes in stockholders' equity for the three and six months ended June 30, 2023 and 2022 and cash flows for the six months ended June 30, 2023 and 2022 are unaudited, but include all adjustments, consisting of normal recurring adjustments the Company considers necessary for a fair presentation of the financial position, operating results and cash flows for the periods presented. The results for the three and six months ended June 30, 2023 are not necessarily indicative of results to be expected for the year ending December 31, 2023 or for any future interim period. The condensed consolidated balance sheet at December 31, 2022 has been derived from audited financial statements, however, it does not include all of the information and notes required by U.S. GAAP for complete financial statements. The accompanying condensed consolidated financial statements should be read in conjunction with the audited financial statements for the year ended December 31, 2022 and notes thereto included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022 as filed with the SEC on March 30, 2023. The Company’s consolidated subsidiaries consist of its wholly-owned subsidiaries, Rockwell Transportation, Inc. and Rockwell Medical India Private Limited. The accompanying condensed consolidated interim financial statements include the accounts of the Company and its subsidiaries. All material intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates	Use of Estimates The preparation of the condensed consolidated financial statements in conformity with U.S. generally accepted accounting principles ("GAAP") requires management to make estimates and assumptions that may affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of expenses during the reporting period. Actual results could differ from those estimates.
Loss Per Share	Included within the weighted average shares of common stock outstanding for the three and six months ended June 30, 2023 and 2022, are 1,793,000 and 9,056,377 shares of common stock issuable upon the exercise of the pre-funded warrants (See Note 10), as the warrants are exercisable at any time for nominal consideration, and as such, the shares are considered outstanding for the purpose of calculating basic and diluted net loss per share attributable to common stockholders.The Company’s potentially dilutive securities include stock options, restricted stock awards and units, convertible preferred stock and warrants. These securities were excluded from the computations of diluted net loss per share for the three and six months ended June 30, 2023 and 2022, as the effect would be to reduce the net loss per share.
Adoption of Recent Accounting Pronouncements	Adoption of Recent Accounting Pronouncements The Company continually assesses new accounting pronouncements to determine their applicability. When it is determined a new accounting pronouncement affects the Company’s financial reporting, the Company undertakes a review to determine the consequences of the change to its consolidated financial statements and assures there are sufficient controls in place to ascertain the Company’s consolidated financial statements properly reflect the change. In June 2016, the FASB issued Accounting Standards Update ("ASU") 2016-13, "Financial Instruments - Credit Losses (Topic 326)," which introduced an impairment model that is based on expected credit losses, rather than incurred losses, to estimate credit losses on certain types of financial instruments (e.g., loan commitments). The expected credit losses should consider historical information, current information, and reasonable and supportable forecasts, including estimates of prepayments, over the contractual term. Financial instruments with similar risk characteristics may be grouped together when estimating expected credit losses. In addition, ASC 326 requires expected credit relates losses for available-for-sale debt securities to be recorded through an allowance for credit losses, while non-credit related losses will continue to be recognized through other comprehensive income. The Company adopted the new guidance, as of January 1, 2023, and it did not have a material impact on the Condensed Consolidated Financial Statements.
Revenue recognition	The Company recognizes revenue under ASC 606, Revenue from Contracts with Customers. The core principle of the new revenue standard is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods or services. The following five steps are applied to achieve that core principle: •Step 1: Identify the contract with the customer •Step 2: Identify the performance obligations in the contract •Step 3: Determine the transaction price •Step 4: Allocate the transaction price to the performance obligations in the contract •Step 5: Recognize revenue when the company satisfies a performance obligation Taxes assessed by a governmental authority that are both imposed on and concurrent with a specific revenue-producing transaction, that are collected by us from a customer, are excluded from revenue. Shipping and handling costs associated with outbound freight related to contracts with customers are accounted for as a fulfillment cost and are included in cost of sales when control of the goods transfers to the customer.

v3.23.2

Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements (Tables)	6 Months Ended
	Jun. 30, 2023
Accounting Policies [Abstract]
Summary of Potentially Dilutive Securities	The following table includes the potential shares of common stock, presented based on amounts outstanding at each period end, that were excluded from the computation of diluted net loss per share attributable to common stockholders for the periods indicated because including them would have had an anti-dilutive effect: As of June 30, 2023 2022 Options to purchase common stock 1,570,599  423,317  Unvested restricted stock awards 891  891  Unvested restricted stock units 313,065  125,000  Convertible Preferred Stock 1,363,636  1,363,636  Warrants to purchase common stock 10,196,268 12,303,432  Total 13,444,459 14,216,276
Schedule of Basic and Diluted Net Loss Per Share	Basic and diluted net loss per share for the three and six months ended June 30, 2023 and 2022, after giving effect to the restatement discussed above, was calculated as follows: Three Months Ended June 30, Six Months Ended June 30, (In Thousands, Except Shares and Per Share Amounts) 2023 2022 2023 2022 Numerator: Net loss $ (3,305) $ (4,967) $ (5,055) $ (12,128) Net loss attributable to common stockholders for basic and diluted loss per share $ (3,305) $ (4,967) $ (5,055) $ (12,128) Denominator: Weighted average number of shares of common stock outstanding - basic and diluted 18,496,640  11,591,768  18,480,248  10,076,415  Net loss per share attributable to common stockholders - basic and diluted $ (0.18) $ (0.43) $ (0.27) $ (1.20)
Summary of Loss Per Share Restated Amounts	See the table presentation of loss per share calculations as of June 30, 2023 and 2022 in the "Loss Per Share Including Restated Amounts" section below. Three Months Ended June 30, Six Months Ended June 30, 2022 2022 As Previously Reported: Net loss per share attributable to common stockholders - basic and diluted $ (0.56) $ (1.40) Weighted average number of shares of common stock outstanding - basic and diluted 8,805,190  8,675,428  As Restated: Net loss per share attributable to common stockholders - basic and diluted $ (0.43) $ (1.20) Weighted average number of shares of common stock outstanding - basic and diluted 11,591,768  10,076,415

v3.23.2

Revenue Recognition (Tables)	6 Months Ended
	Jun. 30, 2023
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue	Revenue is disaggregated by primary geographical market, major product line, and timing of revenue recognition. In thousands of U.S. dollars ($)  Three Months Ended June 30, 2023 Six Months Ended June 30, 2023 Products By Geographic Area Total U.S. Rest of World Total U.S. Rest of World Drug Revenues Product Sales – Point-in-time $ —  $ —  $ —  $ —  $ —  $ —  License Fee – Over time 65  —  65  130  —  130  Total Drug Products 65  —  65  130  —  130  Concentrates Products Product Sales – Point-in-time 18,015  16,125  1,890  36,146  32,585  3,561  License Fee – Over time —  —  —  1,472  1,472  —  Total Concentrate Products 18,015  16,125  1,890  37,618  34,057  3,561  Net Revenue $ 18,080  $ 16,125  $ 1,955  $ 37,748  $ 34,057  $ 3,691  In thousands of U.S. dollars ($) Three Months Ended June 30, 2022 Six Months Ended June 30, 2022 Products By Geographic Area Total U.S. Rest of World Total U.S. Rest of World Drug Revenues Product Sales – Point-in-time $ 482  $ 209  $ 273  $ 641  $ 368  $ 273  License Fee – Over time 65  —  65  127  —  127  Total Drug Products 547  209  338  768  368  400  Concentrates Products Product Sales – Point-in-time 17,655  15,906  1,749  33,082  29,715  3,367  License Fee – Over time 480  480  —  956  956  —  Total Concentrate Products 18,135  16,386  1,749  34,038  30,671  3,367  Net Revenue $ 18,682  $ 16,595  $ 2,087  $ 34,806  $ 31,039  $ 3,767
Contract Balances	The following table provides information about receivables, contract assets, and contract liabilities from contracts with customers. In thousands of U.S. dollars ($) June 30, 2023 December 31, 2022 Accounts Receivable, net $ 5,411  $ 6,259  Contract liabilities, which are included in deferred revenue $ 2,729  $ 4,331

v3.23.2

Investments - Available-for-Sale (Tables)	6 Months Ended
	Jun. 30, 2023
Investments, Debt and Equity Securities [Abstract]
Investments Available-for-Sale	Investments available-for-sale consisted of the following as of June 30, 2023 and December 31, 2022 (table in thousands): June 30, 2023 Amortized Cost Unrealized Gain Unrealized Loss Accrued Interest Fair Value Available-for-Sale Securities Debt securities $ 5,852  $ 54  $ —  $ —  $ 5,906  December 31, 2022 Amortized Cost Unrealized Gain Unrealized Loss Accrued Interest Fair Value Available-for-Sale Securities Debt securities $ 11,315  $ 75  $ —  $ —  $ 11,390

v3.23.2

Inventory (Tables)	6 Months Ended
	Jun. 30, 2023
Inventory Disclosure [Abstract]
Schedule Components of Inventory	Components of inventory, net of reserves, as of June 30, 2023 and December 31, 2022 are as follows (table in thousands): June 30, 2023 December 31, 2022 Inventory - Current Portion Raw Materials $ 2,805  $ 3,351  Work in Process 411  351  Finished Goods 2,598  2,112  Total Current Inventory 5,814  5,814  Inventory - Long Term 1,276  1,276  Total Inventory $ 7,090  $ 7,090

v3.23.2

Property and Equipment, net (Tables)	6 Months Ended
	Jun. 30, 2023
Property, Plant and Equipment [Abstract]
Schedule of Major Classes of Property and Equipment	As of June 30, 2023 and December 31, 2022, the Company’s property and equipment consisted of the following (table in thousands): June 30, 2023 December 31, 2022 Leasehold Improvements $ 1,398  $ 1,256  Machinery and Equipment 6,006  5,922  Information Technology & Office Equipment 1,845  1,845  Laboratory Equipment 807  807     Total Property and Equipment 10,056  9,830  Accumulated Depreciation (7,963) (7,636) Property and Equipment, net $ 2,093  $ 2,194

v3.23.2

Accrued Liabilities (Tables)	6 Months Ended
	Jun. 30, 2023
Payables and Accruals [Abstract]
Schedule of Accrued Liabilities	Accrued liabilities as of June 30, 2023 and December 31, 2022 consisted of the following (table in thousands): June 30, 2023 December 31, 2022 Accrued Research & Development Expense $ —  $ 43  Accrued Compensation and Benefits 1,574  2,568  Accrued Unvouchered Receipts 552  585  Accrued Workers Compensation 173  306  Other Accrued Liabilities 1,464  4,200  Total Accrued Liabilities $ 3,763  $ 7,702

v3.23.2

Stockholder's Equity (Tables)	6 Months Ended
	Jun. 30, 2023
Equity [Abstract]
Summary of Common Stock Reserved for Issuance	As of June 30, 2023 and 2022, the Company has reserved for issuance the following shares of common stock related to the potential exercise of employee stock options, unvested restricted stock, convertible preferred stock, pre-funded warrants and all other warrants (collectively, "common stock equivalents"): As of June 30, Common stock and common stock equivalents: 2023 2022 Common stock 16,795,673  9,407,296  Common stock issuable upon exercise of pre-funded warrants 1,793,000  9,056,377  Common stock and pre-funded stock warrants 18,588,673  18,463,673  Options to purchase common stock 1,570,599  423,317 Unvested restricted stock awards 891  891  Unvested restricted stock units 313,065  125,000  Convertible Preferred Stock 1,363,636  1,363,636  Warrants to purchase common stock 10,196,268 10,196,268  Total 32,033,132 30,572,785

v3.23.2

Stock-Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2023
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Schedule of Total Stock-Based Compensation Expense	The Company recognized total stock-based compensation expense during the three and six months ended June 30, 2023 and 2022 as follows (table in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Service-based awards: Restricted stock units $ 119  $ 26  $ 164  $ 37  Stock option awards 190  72  338  272     Total Service Based Awards 309  98  502  309  Performance-based awards: Restricted stock awards —  —  —  (391) Total $ 309  $ 98  $ 502  $ (82)
Schedule of Stock Option Assumptions	The fair value of the service-based stock options granted for the six months ended June 30, 2022 were based on the following assumptions: Six Months Ended June 30, 2023 Exercise price $1.37 - $2.83 Expected stock price volatility 81.64% - 81.9% Risk-free interest rate 3.41% - 3.55% Term (years) 4 - 6
Restricted stock awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Schedule of Restricted Stock Awards	A summary of the Company’s restricted stock awards during the six months ended June 30, 2023 is as follows: Number of Shares Weighted Average Grant-Date Fair Value Unvested at January 1, 2023 891  $ 62.70  Unvested at June 30, 2023 891  $ 62.70  A summary of the Company’s restricted stock awards during the six months ended June 30, 2022 is as follows: Number of Shares Weighted Average Grant-Date Fair Value Unvested at January 1, 2022 7,118  $ 62.70  Forfeited (6,227) $ 62.70  Unvested at June 30, 2022 891  $ 62.70
Restricted stock units - service based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Schedule of Restricted Stock Awards	A summary of the Company’s service-based restricted stock units during the six months ended June 30, 2023 is as follows: Number of Shares Weighted Average Grant-Date Fair Value Unvested at January 1, 2023 125,000  $ 1.47  Granted 313,065  1.87  Vested (125,000) 1.47  Unvested at June 30, 2023 313,065  $ 1.87  A summary of the Company’s service-based restricted stock units during the six months ended June 30, 2022 is as follows: Number of Shares Weighted Average Grant-Date Fair Value Unvested at January 1, 2022 29,289  $ 12.87  Granted 125,000  1.47  Vested (23,515) 11.33  Forfeited (5,774) 19.00  Unvested at June 30, 2022 125,000  $ 1.47
Stock option awards - service based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Schedule of Stock Options Activity	A summary of the Company’s service-based stock option activity for the six months ended June 30, 2023 is as follows: Shares Underlying Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Outstanding at January 1, 2023 1,206,905  $ 8.32  8.9 Granted 382,745  1.48  5.5 Forfeited (13,447) 4.02  —  Expired (5,604) 19.01  —  Outstanding at June 30, 2023 1,570,599  $ 6.65  8.7 Exercisable at June 30, 2023 301,986  $ 26.15  6.5 A summary of the Company’s service-based stock option activity for the six months ended June 30, 2022 is as follows: Shares Underlying Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Outstanding at January 1, 2022 528,591  $ 32.01  7.5 Granted 909  4.07  9.5 Forfeited (24,488) 15.00  —  Expired (81,695) 83.32  —  Outstanding at June 30, 2022 423,317  $ 23.03  7.8 Exercisable at June 30, 2022 227,412  $ 31.19  5.8

v3.23.2

Leases (Tables)	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
Summary of Lease Costs	The following summarizes quantitative information about the Company’s operating and finance leases (table in thousands): Three Months Ended June 30, 2023 Three Months Ended June 30, 2022 Six Months Ended June 30, 2023 Six Months Ended June 30, 2022 Operating leases Operating lease cost $ 391  $ 366  $ 735  $ 745  Interest on lease obligations 64  65  124  135  Variable lease cost 109  92  224  187  Operating lease expense 564  523  1,083  1,067  Finance leases Non-cash lease expense from right-of-use assets 141  141  282  282  Interest on lease obligations 38  45  77  92  Finance lease expense 179  186  359  374  Short-term lease rent expense 4  4  8  8  Total lease expense $ 747  $ 713  $ 1,450  $ 1,449  Other information Payments for principal from operating leases $ 478  $ 447  $ 902  $ 911  Payments for interest from finance leases $ 38  $ 45  $ 77  $ 92  Payments for principal from finance leases $ 129  $ 119  $ 258  $ 237  Weighted-average remaining lease term – operating leases 2.7 3.2 2.7 3.2 Weighted-average remaining lease term – finance leases 3.9 4.9 3.9 4.9 Weighted-average discount rate – operating leases 6.5  % 6.3  % 6.5  % 6.3  % Weighted-average discount rate – finance leases 6.4  % 6.4  % 6.4  % 6.4  %
Operating Lease Maturities	Future minimum rental payments under operating and finance lease agreements are as follows (in thousands): Operating Finance Year ending December 31, 2023 (remaining) $ 875  $ 335  Year ending December 31, 2024 1,511  672  Year ending December 31, 2025 1,021  676  Year ending December 31, 2026 362  666  Year ending December 31, 2027 131  311  Total 3,900  2,660  Less present value discount (318) (308) Operating and finance lease liabilities $ 3,582  $ 2,352
Finance Lease Maturities	Future minimum rental payments under operating and finance lease agreements are as follows (in thousands): Operating Finance Year ending December 31, 2023 (remaining) $ 875  $ 335  Year ending December 31, 2024 1,511  672  Year ending December 31, 2025 1,021  676  Year ending December 31, 2026 362  666  Year ending December 31, 2027 131  311  Total 3,900  2,660  Less present value discount (318) (308) Operating and finance lease liabilities $ 3,582  $ 2,352

v3.23.2

Loans and Security Agreement (Tables)	6 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Schedule of Principal Payments on Term Loan	The following table reflects the schedule of principal payments on the Term Loan as of June 30, 2023 (in thousands): Principal Payments 2023 (remaining) $ 2,000  2024 6,000  2025 2,000  $ 10,000

v3.23.2

Description of Business (Details)	6 Months Ended
	Jun. 30, 2023 ft²
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Operating space	175,000

v3.23.2

Liquidity and Capital Resources (Details) - USD ($) $ / shares in Units, $ in Thousands		6 Months Ended
	Jul. 10, 2023	Jun. 30, 2023	Jun. 30, 2022
Liquidity and Capital Resources [Line Items]
Cash, cash equivalents and investments available-for-sale		$ 14,900
Working capital		10,100
Net cash used in operating activities		$ (5,616)	$ (15,715)
Evoqua Water Technologies LLC | Subsequent event
Liquidity and Capital Resources [Line Items]
Cash paid	$ 11,000
Milestone payments	2,500
Asset acquisition, inventory	$ 1,200
Armistice Warrant Agreement | Subsequent event
Liquidity and Capital Resources [Line Items]
Number of shares of common stock for which warrant is exercisable (in shares)	9,900,990
Exercise price of warrant (in dollars per share)	$ 1.39
Gross proceeds	$ 13,800

v3.23.2

Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements - Summary of Loss Per Share Restated Amounts (Details) - $ / shares		3 Months Ended		6 Months Ended
		Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Reclassification [Line Items]
Net loss per share attributable to common stockholders - basic (in dollars per share)		$ (0.18)	$ (0.43)	$ (0.27)	$ (1.20)
Net loss per share attributable to common stockholders - diluted (in dollars per share)		$ (0.18)	$ (0.43)	$ (0.27)	$ (1.20)
Weighted average number of common shares outstanding - basic (in shares)	[1]	18,496,640	11,591,768	18,480,248	10,076,415
Weighted average number of common shares outstanding - diluted (in shares)	[1]	18,496,640	11,591,768	18,480,248	10,076,415
Previously Reported
Reclassification [Line Items]
Net loss per share attributable to common stockholders - basic (in dollars per share)			$ (0.56)		$ (1.40)
Net loss per share attributable to common stockholders - diluted (in dollars per share)			$ (0.56)		$ (1.40)
Weighted average number of common shares outstanding - basic (in shares)			8,805,190		8,675,428
Weighted average number of common shares outstanding - diluted (in shares)			8,805,190		8,675,428
[1] See Note 3 for more detail related to Basic and Diluted Weighted Average Shares Outstanding

v3.23.2

Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements - Schedule of Basic and Diluted Net Loss Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands		3 Months Ended				6 Months Ended
		Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2023	Jun. 30, 2022
Numerator:
Net loss		$ (3,305)	$ (1,750)	$ (4,967)	$ (7,162)	$ (5,055)	$ (12,128)
Net loss attributable to common stockholders for basic loss per share		(3,305)		(4,967)		(5,055)	(12,128)
Net loss attributable to common stockholders for diluted loss per share		$ (3,305)		$ (4,967)		$ (5,055)	$ (12,128)
Denominator:
Weighted average number of common shares outstanding - basic (in shares)	[1]	18,496,640		11,591,768		18,480,248	10,076,415
Weighted average number of common shares outstanding - diluted (in shares)	[1]	18,496,640		11,591,768		18,480,248	10,076,415
Net loss per share attributable to common stockholders - diluted (in dollars per share)		$ (0.18)		$ (0.43)		$ (0.27)	$ (1.20)
Net loss per share attributable to common stockholders - basic (in dollars per share)		$ (0.18)		$ (0.43)		$ (0.27)	$ (1.20)
[1] See Note 3 for more detail related to Basic and Diluted Weighted Average Shares Outstanding

v3.23.2

Basis of Presentation, Summary of Significant Accounting Policies and Recent Accounting Pronouncements (Details) - shares	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Net Earnings per Share
Antidilutive securities (in shares)	13,444,459	14,216,276
Registered Direct Offering Warrants
Net Earnings per Share
Warrants outstanding (in shares)	1,793,000	9,056,377
Options to purchase common stock
Net Earnings per Share
Antidilutive securities (in shares)	1,570,599	423,317
Unvested restricted stock awards
Net Earnings per Share
Antidilutive securities (in shares)	891	891
Unvested restricted stock units
Net Earnings per Share
Antidilutive securities (in shares)	313,065	125,000
Convertible Preferred Stock
Net Earnings per Share
Antidilutive securities (in shares)	1,363,636	1,363,636
Warrants to purchase common stock
Net Earnings per Share
Antidilutive securities (in shares)	10,196,268	12,303,432

v3.23.2

Revenue Recognition - Nature of Goods and Services (Details)	6 Months Ended
	Jun. 30, 2023 agreement Segment
Revenue Recognition [Line Items]
Number of operating market segments | Segment	1
Number of distribution and license agreements | agreement	5
Customers average payment term	30 days
Distributors average payment term	60 days
Da Vita Healthcare Partners Inc | Revenue Benchmark | Customer Concentration Risk
Revenue Recognition [Line Items]
Customer concentration, percentage	50.00%
Da Vita Healthcare Partners Inc | Accounts Receivable | Customer Concentration Risk
Revenue Recognition [Line Items]
Customer concentration, percentage	33.00%

v3.23.2

Revenue Recognition - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Disaggregation of Revenue [Line Items]
Net Revenue	$ 18,080	$ 18,682	$ 37,748	$ 34,806
Drug products
Disaggregation of Revenue [Line Items]
Net Revenue	65	547	130	768
Concentrates Products
Disaggregation of Revenue [Line Items]
Net Revenue	18,015	18,135	37,618	34,038
U.S.
Disaggregation of Revenue [Line Items]
Net Revenue	16,125	16,595	34,057	31,039
U.S. | Drug products
Disaggregation of Revenue [Line Items]
Net Revenue	0	209	0	368
U.S. | Concentrates Products
Disaggregation of Revenue [Line Items]
Net Revenue	16,125	16,386	34,057	30,671
Rest of World
Disaggregation of Revenue [Line Items]
Net Revenue	1,955	2,087	3,691	3,767
Rest of World | Drug products
Disaggregation of Revenue [Line Items]
Net Revenue	65	338	130	400
Rest of World | Concentrates Products
Disaggregation of Revenue [Line Items]
Net Revenue	1,890	1,749	3,561	3,367
Product Sales – Point-in-time | Drug product sales
Disaggregation of Revenue [Line Items]
Net Revenue	0	482	0	641
Product Sales – Point-in-time | Concentrates product sales
Disaggregation of Revenue [Line Items]
Net Revenue	18,015	17,655	36,146	33,082
Product Sales – Point-in-time | U.S. | Drug product sales
Disaggregation of Revenue [Line Items]
Net Revenue	0	209	0	368
Product Sales – Point-in-time | U.S. | Concentrates product sales
Disaggregation of Revenue [Line Items]
Net Revenue	16,125	15,906	32,585	29,715
Product Sales – Point-in-time | Rest of World | Drug product sales
Disaggregation of Revenue [Line Items]
Net Revenue	0	273	0	273
Product Sales – Point-in-time | Rest of World | Concentrates product sales
Disaggregation of Revenue [Line Items]
Net Revenue	1,890	1,749	3,561	3,367
License Fee – Over time | Drug license fee
Disaggregation of Revenue [Line Items]
Net Revenue	65	65	130	127
License Fee – Over time | Concentrates product license fee
Disaggregation of Revenue [Line Items]
Net Revenue	0	480	1,472	956
License Fee – Over time | U.S. | Drug license fee
Disaggregation of Revenue [Line Items]
Net Revenue	0	0	0	0
License Fee – Over time | U.S. | Concentrates product license fee
Disaggregation of Revenue [Line Items]
Net Revenue	0	480	1,472	956
License Fee – Over time | Rest of World | Drug license fee
Disaggregation of Revenue [Line Items]
Net Revenue	65	65	130	127
License Fee – Over time | Rest of World | Concentrates product license fee
Disaggregation of Revenue [Line Items]
Net Revenue	$ 0	$ 0	$ 0	$ 0

v3.23.2

Revenue Recognition - Contract Balances (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Revenue from Contract with Customer [Abstract]
Accounts Receivable, net	$ 5,411	$ 6,259
Contract liabilities, which are included in deferred revenue	$ 2,729	$ 4,331

v3.23.2

Revenue Recognition - Narrative (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Revenue Recognition [Line Items]
Impairment losses	$ 0	$ 0	$ 0	$ 0
Contract assets	0		0		$ 0
Revenue performance obligation	2,700,000		2,700,000
Concentrates Products
Revenue Recognition [Line Items]
Reserve for returns	$ 0		$ 0		$ 0

v3.23.2

Investments - Available-for-Sale (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Investments, Debt and Equity Securities [Abstract]
Amortized Cost	$ 5,852	$ 11,315
Unrealized Gain	54	75
Unrealized Loss	0	0
Accrued Interest	0	0
Fair Value	$ 5,906	$ 11,390

v3.23.2

Inventory (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Inventory - Current Portion
Raw Materials	$ 2,805	$ 3,351
Work in Process	411	351
Finished Goods	2,598	2,112
Total Current Inventory	5,814	5,814
Inventory - Long Term	1,276	1,276
Total Inventory	7,090	7,090
Triferic Inventory
Inventory - Current Portion
Inventory - Long Term	1,300	1,300
Inventory, gross	5,800	5,800
Inventory, reserve	$ 25	$ 25

v3.23.2

Property and Equipment, net (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Property and equipment
Gross property and equipment	$ 10,056		$ 10,056		$ 9,830
Accumulated Depreciation	(7,963)		(7,963)		(7,636)
Property and Equipment, net	2,093		2,093		2,194
Depreciation expense	200	$ 100	300	$ 300
Leasehold Improvements
Property and equipment
Gross property and equipment	1,398		1,398		1,256
Machinery and Equipment
Property and equipment
Gross property and equipment	6,006		6,006		5,922
Information Technology & Office Equipment
Property and equipment
Gross property and equipment	1,845		1,845		1,845
Laboratory Equipment
Property and equipment
Gross property and equipment	$ 807		$ 807		$ 807

v3.23.2

Accrued Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Accrued Research & Development Expense	$ 0	$ 43
Accrued Compensation and Benefits	1,574	2,568
Accrued Unvouchered Receipts	552	585
Accrued Workers Compensation	173	306
Other Accrued Liabilities	1,464	4,200
Total Accrued Liabilities	$ 3,763	$ 7,702

v3.23.2

Deferred Revenue (Details) - USD ($)	1 Months Ended					3 Months Ended			6 Months Ended		12 Months Ended
	May 31, 2022	Jun. 30, 2021	Sep. 30, 2020	Jan. 31, 2020	Oct. 31, 2014	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2016	Dec. 31, 2022
Deferred Revenue Arrangement [Line Items]
Deferred revenue						$ 2,729,000			$ 2,729,000			$ 4,331,000
Baxter Healthcare Organization
Deferred Revenue Arrangement [Line Items]
Term of agreement					10 years
Upfront payment					$ 20,000,000
Recognized deferred revenue							$ 1,500,000
Wanbang Biopharmaceutical
Deferred Revenue Arrangement [Line Items]
Upfront payment											$ 4,000,000
Recognized deferred revenue						53,000		$ 53,000	100,000	$ 100,000
Deferred revenue						2,200,000			2,200,000			2,300,000
Sun Pharma Agreements
Deferred Revenue Arrangement [Line Items]
Upfront payment				$ 100,000
Recognized deferred revenue						2,500		2,500	5,000	5,000
Deferred revenue						65,000			65,000			70,000
Jeil Pharma Agreements
Deferred Revenue Arrangement [Line Items]
Upfront payment			$ 200,000
Recognized deferred revenue						5,200		5,200	10,400	10,400
Deferred revenue						400,000			400,000			400,000
Milestone consideration	$ 200,000
Drogsan Agreements
Deferred Revenue Arrangement [Line Items]
Upfront payment		$ 150,000
Recognized deferred revenue						3,750		$ 3,750	7,500	$ 7,500
Deferred revenue						$ 120,000			$ 120,000			$ 127,500

v3.23.2

Stockholders’ Equity (Details)							3 Months Ended		6 Months Ended
	Jul. 10, 2023 shares	Jul. 05, 2023 $ / shares shares	May 23, 2023 shares	Jun. 16, 2022 USD ($) shares	May 30, 2022 $ / shares shares	Apr. 06, 2022 USD ($) $ / shares shares	Jun. 30, 2023 USD ($) $ / shares shares	Jun. 30, 2022 shares	Jun. 30, 2023 USD ($) $ / shares shares	Jun. 30, 2022 USD ($) shares	Dec. 31, 2022 $ / shares shares	Apr. 08, 2022 USD ($)
Class of Stock [Line Items]
Stock issuance costs | $									$ 0	$ 106,000
Preferred shares, shares authorized (in shares)							2,000,000		2,000,000		2,000,000
Preferred shares, par value (in dollars per share) | $ / shares							$ 0.0001		$ 0.0001		$ 0.0001
Preferred shares, shares issued (in shares)							15,000		15,000		15,000
Preferred shares, shares outstanding (in shares)							15,000		15,000		15,000
Common shares, shares authorized (in shares)							170,000,000		170,000,000		170,000,000
Common shares, par value (in dollars per share) | $ / shares							$ 0.0001		$ 0.0001		$ 0.0001
Common shares, shares outstanding (in shares)							16,795,673	9,407,296	16,795,673	9,407,296	12,163,673
Common shares, shares issued (in shares)							16,795,673		16,795,673		12,163,673
Exercise of Employee Stock Options, Net of Tax (in shares)							0	0	0	0
2018 Long Term Incentive Plan
Class of Stock [Line Items]
Additional common stock issuable (in shares)			1,600,000
Subsequent event
Class of Stock [Line Items]
Common shares, shares outstanding (in shares)	28,489,663
PIPE Purchase Agreement Pre-Funded Warrant
Class of Stock [Line Items]
Warrants exercised (in shares)							4,118,000	0	4,507,000	0
Number of shares of common stock for which warrant is exercisable (in shares)					1,267,897
Discount from stock price (dollars per share) | $ / shares					$ 0.0001
Exercise price of warrant (in dollars per share) | $ / shares					$ 0.0001
PIPE Purchase Agreement Pre-Funded Warrant | Subsequent event
Class of Stock [Line Items]
Warrants exercised (in shares)		1,793,000
Exercise price of warrant (in dollars per share) | $ / shares		$ 0.0001
Registered Direct Offering Warrants
Class of Stock [Line Items]
Number of shares of common stock for which warrant is exercisable (in shares)					7,788,480
Discount from stock price (dollars per share) | $ / shares					$ 0.0001
Exercise price of warrant (in dollars per share) | $ / shares					$ 0.0001
Ownership threshold					9.99%
Warrants outstanding (in shares)							1,793,000	9,056,377	1,793,000	9,056,377
PIPE Purchase Agreement Warrant
Class of Stock [Line Items]
Number of shares of common stock for which warrant is exercisable (in shares)					9,900,990
Exercise price of warrant (in dollars per share) | $ / shares					$ 1.39
Warrants outstanding (in shares)							9,900,990		9,900,990
Warrant price (dollars per share) | $ / shares					$ 0.125
PIPE Purchase Agreement Warrant | Subsequent event
Class of Stock [Line Items]
Warrants exercised (in shares)	9,900,990
Registered Direct Offering
Class of Stock [Line Items]
Number of shares issued					844,613
Common stock trading price (in dollars per share) | $ / shares					$ 1.39
Series X Convertible Preferred Stock
Class of Stock [Line Items]
Interest rate percentage						1.00%
Common stock trading price (per share) | $ / shares						$ 22.00
Accreted amount | $							$ 150,000		$ 150,000
Common stock trading period						30 days
Conversion price (per share) | $ / shares						$ 11.00
Convertible preferred stock (in shares)						91
Outstanding common stock, percentage						9.90%
Outstanding common stock, not to exceed, percentage						19.90%
Percentage of investment owned						50.00%
Maximum working capital line | $						$ 5,000,000
Consideration received | $						15,000,000
Stock issuance costs | $						100,000
Proceeds from sale of equity, net | $						14,900,000
Da Vita Healthcare Partners Inc | Share Issuance, Tranche One
Class of Stock [Line Items]
Proceeds from issuance of convertible preferred stock | $				$ 7,500,000		7,500,000
Da Vita Healthcare Partners Inc | Series X Convertible Preferred Stock | Private Placement
Class of Stock [Line Items]
Sale of stock, aggregate consideration authorized | $						$ 15,000,000
Common stock trading price (in dollars per share) | $ / shares						$ 1,000
Da Vita Healthcare Partners Inc | Series X Convertible Preferred Stock | Private Placement | Share Issuance, Tranche One
Class of Stock [Line Items]
Number of shares issued				7,500		7,500
Cantor Fitzgerald & Co | Controlled Equity Offering
Class of Stock [Line Items]
Sale of stock, aggregate consideration authorized | $												$ 12,200,000

v3.23.2

Stockholder's Equity - Summary of Common Stock Reserved for Issuance (Details) - shares	Jun. 30, 2023	Dec. 31, 2022	Jun. 30, 2022	Dec. 31, 2021
Common stock and common stock equivalents:
Common shares, shares outstanding (in shares)	16,795,673	12,163,673	9,407,296
Common stock and pre-funded stock warrants (in shares)	18,588,673		18,463,673
Options to purchase common stock (in shares)	1,570,599		423,317
Convertible preferred stock (in shares)	1,363,636		1,363,636
Total (in shares)	32,033,132		30,572,785
Registered Direct Offering Warrants
Common stock and common stock equivalents:
Warrants outstanding (in shares)	1,793,000		9,056,377
Private Placement Warrants
Common stock and common stock equivalents:
Warrants outstanding (in shares)	10,196,268		10,196,268
Unvested restricted stock awards
Common stock and common stock equivalents:
Unvested restricted stock awards/units (in shares)	891		891
Unvested restricted stock units
Common stock and common stock equivalents:
Unvested restricted stock awards/units (in shares)	313,065	125,000	125,000	29,289

v3.23.2

Stock-Based Compensation - Share-Based Compensation Expense (Details) - USD ($)	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total share based compensation expense	$ 309,000	$ 98,000	$ 502,000	$ (82,000)
Service based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total share based compensation expense	309,000	98,000	502,000	309,000
Unvested restricted stock units
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total share based compensation expense	119,000	25,554	164,000	37,000
Stock option awards - service based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total share based compensation expense	190,000	72,000	338,000	272,000
Restricted stock awards - performance based awards
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total share based compensation expense	$ 0	$ 0	$ 0	$ (391,000)	$ (400,000)

v3.23.2

Stock-Based Compensation - Restricted Stock Awards (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Number of Shares
Forfeited (in shares)					(6,227)
Weighted Average Grant-Date Fair Value
Forfeited (in shares)					(6,227)
Stock based compensation expenses	$ 309	$ 98	$ 502	$ (82)
Restricted stock awards
Number of Shares
Unvested at end of period (in shares)	891	891	891	891
Weighted Average Grant-Date Fair Value
Vesting period			20 months
Unvested, number of shares (in shares)	891	891	891	891
Restricted stock awards - performance based awards
Number of Shares
Unvested at beginning of period (in shares)			891	7,118	7,118
Forfeited (in shares)				(6,227)
Unvested at end of period (in shares)	891	891	891	891	891
Weighted Average Grant-Date Fair Value
Unvested at beginning of period (in dollars per share)			$ 62.70	$ 62.70	$ 62.70
Forfeited (in dollars per share)				62.70
Unvested at end of period (in dollars per share)	$ 62.70	$ 62.70	$ 62.70	$ 62.70	$ 62.70
Unvested, number of shares (in shares)	891	891	891	891	891
Forfeited (in shares)				(6,227)
Stock based compensation expenses	$ 0	$ 0	$ 0	$ (391)	$ (400)

v3.23.2

Stock-Based Compensation - Service Based Restricted Stock Units (Details) - USD ($)	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Number of Shares
Forfeited (in shares)					(6,227)
Weighted Average Grant-Date Fair Value
Stock based compensation expenses	$ 309,000	$ 98,000	$ 502,000	$ (82,000)
Restricted stock units - service based awards
Number of Shares
Unvested at beginning of period (in shares)			125,000	29,289	29,289
Granted (in shares)			313,065	125,000
Vested (in shares)			(125,000)	(23,515)
Forfeited (in shares)				(5,774)
Unvested at end of period (in shares)	313,065	125,000	313,065	125,000	125,000
Weighted Average Grant-Date Fair Value
Unvested at beginning of period (in dollars per share)			$ 1.47	$ 12.87	$ 12.87
Granted (in dollars per share)			1.87	1.47
Vested (in dollars per share)			1.47	11.33
Forfeited (in dollars per share)				(19.00)
Unvested at end of period (in dollars per share)	$ 1.87	$ 1.47	$ 1.87	$ 1.47	$ 1.47
Stock based compensation expenses	$ 119,000	$ 25,554	$ 164,000	$ 37,000
Unrecognized stock-based compensation expense	$ 500,000		$ 500,000
Unrecognized stock-based compensation expense, weighted average remaining term (in years) (less than)			1 year 8 months 12 days
Restricted stock units - service based awards | Minimum
Weighted Average Grant-Date Fair Value
Vesting period			1 year
Restricted stock units - service based awards | Maximum
Weighted Average Grant-Date Fair Value
Vesting period			3 years

v3.23.2

Stock-Based Compensation - Service Based Stock Options (Details) - $ / shares	6 Months Ended		12 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022	Dec. 31, 2021
Shares Underlying Options
Outstanding at the end of the period (in shares)	1,570,599	423,317
Stock option awards - service based awards
Shares Underlying Options
Outstanding at the beginning of the period (in shares)	1,206,905	528,591	528,591
Granted (in shares)	382,745	909
Forfeited (in shares)	(13,447)	(24,488)
Expired (in shares)	(5,604)	(81,695)
Outstanding at the end of the period (in shares)	1,570,599	423,317	1,206,905	528,591
Exercisable at end of period (in shares)	301,986	227,412
Weighted Average Exercise Price
Outstanding at the beginning of the period (in dollars per share)	$ 8.32	$ 32.01	$ 32.01
Granted (in dollars per share)	1.48	4.07
Forfeited (in dollars per share)	4.02	15.00
Expired (in dollar per share)	19.01	83.32
Outstanding at the end of the period (in dollars per share)	6.65	23.03	$ 8.32	$ 32.01
Exercisable at end of the period (in dollars per share)	$ 26.15	$ 31.19
Weighted Average Remaining Contractual Term
Outstanding	8 years 8 months 12 days	7 years 9 months 18 days	8 years 10 months 24 days	7 years 6 months
Granted	5 years 6 months	9 years 6 months
Exercisable at end of the period	6 years 6 months	5 years 9 months 18 days

v3.23.2

Stock-Based Compensation - Service Based Stock Options - Others (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock based compensation expenses	$ 309	$ 98	$ 502	$ (82)
Stock option awards - service based awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)			382,745	909
Forfeited (in shares)			13,447	24,488
Expirations (in shares)			5,604	81,695
Stock based compensation expenses	190	$ 72	$ 338	$ 272
Unrecognized stock-based compensation expenses	$ 900		$ 900
Unrecognized stock-based compensation expense, weighted average remaining term (in years)			8 years 8 months 12 days

v3.23.2

Stock-Based Compensation - Service Based Stock Options - Fair Value Assumptions (Details) - Stock option awards - service based awards	6 Months Ended
	Jun. 30, 2023 $ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected stock price volatility, minimum	81.64%
Expected stock price volatility, maximum	81.90%
Risk-free interest rate, minimum	3.41%
Risk-free interest rate, maximum	3.55%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price (in dollars per share)	$ 1.37
Term (years)	4 years
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price (in dollars per share)	$ 2.83
Term (years)	6 years

v3.23.2

Licensing Agreements (Details)	Oct. 07, 2018 agreement	Jun. 30, 2023 USD ($)	Dec. 31, 2022 USD ($)
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Number of additional agreements | agreement	3
Master Services And Ip Agreement
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Collaborative arrangement, accrued reimbursement of IP expenses and sublicense royalty fees		$ 85,400	$ 85,400
Milestone payments		$ 0	$ 0

v3.23.2

Leases - Narrative (Details) $ in Millions	Jun. 30, 2023 USD ($) ft²	Dec. 31, 2022 USD ($)
Lessee, Lease, Description [Line Items]
Operating lease and finance lease liabilities | $	$ 5.9	$ 6.7
Operating lease and finance lease, right of use assets, net | $	$ 5.7	$ 6.4
Wixom, Michigan | Wixom, Michigan Property One
Lessee, Lease, Description [Line Items]
Facility sqft.	51,000
Wixom, Michigan | Wixom, Michigan Property Two
Lessee, Lease, Description [Line Items]
Facility sqft.	17,500
Grapevine, Texas
Lessee, Lease, Description [Line Items]
Facility sqft.	51,000
Greer, South Carolina
Lessee, Lease, Description [Line Items]
Facility sqft.	57,000
Hackensack, New Jersey
Lessee, Lease, Description [Line Items]
Facility sqft.	4,100
Maximum
Lessee, Lease, Description [Line Items]
Lease term	6 years

v3.23.2

Leases - Summary of Lease Costs (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Operating leases
Operating lease cost	$ 391	$ 366	$ 735	$ 745
Interest on lease obligations	64	65	124	135
Variable lease cost	109	92	224	187
Operating lease expense	564	523	1,083	1,067
Finance leases
Non-cash lease expense from right-of-use assets	141	141	282	282
Interest on lease obligations	38	45	77	92
Finance lease expense	179	186	359	374
Short-term lease rent expense	4	4	8	8
Total lease expense	747	713	1,450	1,449
Other information
Payments for principal from operating leases	478	447	902	911
Payments for interest from finance leases	38	45	77	92
Payments for principal from finance leases	$ 129	$ 119	$ 258	$ 237
Weighted-average remaining lease term – operating leases	2 years 8 months 12 days	3 years 2 months 12 days	2 years 8 months 12 days	3 years 2 months 12 days
Weighted-average remaining lease term – finance leases	3 years 10 months 24 days	4 years 10 months 24 days	3 years 10 months 24 days	4 years 10 months 24 days
Weighted-average discount rate – operating leases	6.50%	6.30%	6.50%	6.30%
Weighted-average discount rate – finance leases	6.40%	6.40%	6.40%	6.40%

v3.23.2

Leases - Finance Lease and Operating Lease Maturities (Details) $ in Thousands	Jun. 30, 2023 USD ($)
Operating
Year ending December 31, 2023 (remaining)	$ 875
Year ending December 31, 2024	1,511
Year ending December 31, 2025	1,021
Year ending December 31, 2026	362
Year ending December 31, 2027	131
Total	3,900
Less present value discount	(318)
Operating lease liabilities	3,582
Finance
Year ending December 31, 2023 (remaining)	335
Year ending December 31, 2024	672
Year ending December 31, 2025	676
Year ending December 31, 2026	666
Year ending December 31, 2027	311
Total	2,660
Less present value discount	(308)
Finance lease liabilities	$ 2,352

v3.23.2

Loans and Security Agreement - Narrative (Details) - Term loan		1 Months Ended	3 Months Ended		6 Months Ended
	Mar. 16, 2020 USD ($) $ / shares shares	Sep. 30, 2021 USD ($) installment	Jun. 30, 2023 USD ($)	Jun. 30, 2022 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2022 USD ($)	Nov. 10, 2022 USD ($)
Term loan
Debt Instrument [Line Items]
Aggregate principal amount	$ 35,000,000	$ 7,500,000					$ 5,000,000
Calculation for number of shares of common stock able to be purchased by warrant, percentage of principal amount of relevant term loan funded funded	3.50%
Warrant exercise price calculation, period immediately preceding execution of loan agreement, number of trading days	5 days
Interest rate, base percentage	4.75%
Interest rate, additional percentage added to base percentage	4.00%
Initial interest rate percentage	8.75%
Effective interest rate	10.90%
Option to add interest rate amount to outstanding principal balance in lieu of paying such amount in cash, percentage	1.00%
Interest expense			$ 300,000	$ 400,000	$ 600,000	$ 800,000
Number of monthly installments | installment		10
Prepayment premium percentage		5.00%
Minimum liquidity floor		$ 5,000,000
Minimum principal amount pursuant to liquidity covenant		$ 15,000,000
Outstanding balance, net of unamortized issuance costs and unaccreted discount			9,400,000		9,400,000
Unamortized issuance costs and unaccreted discount			$ 600,000		$ 600,000
Term loan | Minimum
Debt Instrument [Line Items]
Period for which company is entitled to make interest-only payments	30 months
Term loan | Maximum
Debt Instrument [Line Items]
Period for which company is entitled to make interest-only payments	36 months
Term loan, first tranche
Debt Instrument [Line Items]
Aggregate principal amount	$ 22,500,000
Net draw down proceeds	21,200,000
Closing costs	$ 1,300,000
Exercise price of warrant (in dollars per share) | $ / shares	$ 18.15
Number of shares of common stock for which warrant is exercisable (in shares) | shares	43,388
Additional debt discount recognized	$ 500,000
Term loan, second and third tranches
Debt Instrument [Line Items]
Warrant exercise price calculation, period immediately preceding relevant funding, number of trading days	5 days
Term loan, second and third tranches | Maximum
Debt Instrument [Line Items]
Exercise price of warrant (in dollars per share) | $ / shares	$ 18.15
Term loan, second tranche
Debt Instrument [Line Items]
Aggregate principal amount	$ 5,000,000
Term loan, third tranche
Debt Instrument [Line Items]
Aggregate principal amount	$ 7,500,000

v3.23.2

Loans and Security Agreement - Schedule of Principal Payments on Term Loan (Details) - Term loan - Term loan $ in Thousands	Jun. 30, 2023 USD ($)
Debt Instrument [Line Items]
2023 (remaining)	$ 2,000
2024	6,000
2025	2,000
Principal Payments	$ 10,000

v3.23.2

Insurance Financing Note Payable (Details) - 5.40% Note Payable - Notes Payable to Banks - USD ($) $ in Millions	Jun. 03, 2023	Jun. 30, 2023
Short-term Debt [Line Items]
Short-term note payable	$ 0.7
Interest rate, base percentage	9.59%
Amortization period (in months)	9 months
Outstanding amount		$ 0.7

v3.23.2

Subsequent Events (Details)			3 Months Ended		6 Months Ended
	Jul. 10, 2023 USD ($) $ / shares shares	Jul. 05, 2023 USD ($) $ / shares shares	Jun. 30, 2023 shares	Jun. 30, 2022 shares	Jun. 30, 2023 shares	Jun. 30, 2022 shares	Dec. 31, 2022 shares	May 30, 2022 $ / shares shares
Subsequent Event [Line Items]
Common shares, shares outstanding (in shares)			16,795,673	9,407,296	16,795,673	9,407,296	12,163,673
PIPE Purchase Agreement Pre-Funded Warrant
Subsequent Event [Line Items]
Warrants exercised (in shares)			4,118,000	0	4,507,000	0
Exercise price of warrant (in dollars per share) | $ / shares								$ 0.0001
Number of shares of common stock for which warrant is exercisable (in shares)								1,267,897
Subsequent event
Subsequent Event [Line Items]
Common shares, shares outstanding (in shares)	28,489,663
Subsequent event | Evoqua Water Technologies LLC
Subsequent Event [Line Items]
Cash paid | $	$ 11,000,000
Milestone payments | $	$ 2,500,000
Subsequent event | PIPE Purchase Agreement Pre-Funded Warrant
Subsequent Event [Line Items]
Warrants exercised (in shares)		1,793,000
Exercise price of warrant (in dollars per share) | $ / shares		$ 0.0001
Gross proceeds | $		$ 179
Subsequent event | Armistice Warrant Agreement
Subsequent Event [Line Items]
Exercise price of warrant (in dollars per share) | $ / shares	$ 1.39
Gross proceeds | $	$ 13,800,000
Number of shares of common stock for which warrant is exercisable (in shares)	9,900,990
Subsequent event | Armistice Reload Warrant Agreement
Subsequent Event [Line Items]
Exercise price of warrant (in dollars per share) | $ / shares	$ 5.13
Number of shares of common stock for which warrant is exercisable (in shares)	3,750,000
Warrant expiration period	54 months
Ownership limitation percentage	0.0999
Subsequent event | Letter Agreement
Subsequent Event [Line Items]
Period after issuance, shares cannot be sold	45 days
Minimum purchase price (dollars per share) | $ / shares	$ 6.25
Extended expiration date	1 year

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