• Stryker reports third quarter 2022 operating results

    来源: Nasdaq GlobeNewswire / 31 10月 2022 15:05:01   America/Chicago

    Kalamazoo, Michigan, Oct. 31, 2022 (GLOBE NEWSWIRE) -- Stryker (NYSE:SYK) reported operating results for the third quarter of 2022:

    Third Quarter Results

    • Reported net sales increased 7.7% to $4.5 billion
    • Organic net sales increased 9.9%
    • Reported operating income margin of 18.0%
    • Adjusted operating income margin(1) contracted 310 bps to 22.3%
    • Reported EPS increased 87.7% to $2.14
    • Adjusted EPS(1) decreased 3.6% to $2.12
     Third Quarter Net Sales Growth Overview
     Reported Foreign Currency Exchange Constant Currency Acquisitions / Divestitures Organic
    MedSurg and Neurotechnology        10.2%         (3.3)   %         13.5%         2.7 %         10.8%
    Orthopaedics and Spine        4.4                           (4.3)               8.7          —           8.7 
    Total        7.7%         (3.7)   %         11.4%         1.5 %         9.9%

    "We delivered strong organic sales growth in the quarter, despite product shortages and disruptions to full return of surgeries," said Kevin A. Lobo, Chair and CEO. "Worsening foreign currency and ongoing inflation, including premiums on spot buys for key components, pressured our adjusted earnings and will impact our full year results. We are taking additional actions to address these persistent issues."

    Sales Analysis

    Consolidated net sales of $4.5 billion increased 7.7% in the quarter and 11.4% in constant currency. Organic net sales increased 9.9% in the quarter including 10.6% from increased unit volume partially offset by 0.7% from lower prices.

    MedSurg and Neurotechnology net sales of $2.6 billion increased 10.2% in the quarter and 13.5% in constant currency. Organic net sales increased 10.8% in the quarter including 9.8% from increased unit volume and 1.0% from higher prices.

    Orthopaedics and Spine net sales of $1.9 billion increased 4.4% in the quarter and 8.7% in constant currency. Organic net sales increased 8.7% in the quarter including 11.6% from increased unit volume partially offset by 2.9% from lower prices.

    Earnings Analysis

    Reported net earnings of $816 million increased 86.3% in the quarter. Reported net earnings per diluted share of $2.14 increased 87.7% in the quarter. Reported gross profit margin and reported operating income margin were 62.1% and 18.0% in the quarter. Reported net earnings include certain items, such as charges for acquisition and integration-related activities, the amortization of purchased intangible assets, asset write-offs and impairments and restructuring-related and other charges, costs to comply with certain medical device regulations, recall-related matters, regulatory and legal matters and tax matters. Excluding the aforementioned items, adjusted gross profit margin(1) was 62.6% in the quarter, and adjusted operating income margin(1) was 22.3% in the quarter. Adjusted net earnings(1) of $810 million decreased 3.8% in the quarter. Adjusted net earnings per diluted share(1) of $2.12 decreased 3.6% in the quarter.

    2022 Outlook

    Considering our third quarter results, the strong order book for capital equipment and the sales momentum in our implant and capital businesses, we now expect full year 2022 organic net sales growth(2) to be in the range of 8.5% to 9.0%. If foreign currency exchange rates hold near current levels, we now expect net sales in the full year to be adversely impacted by approximately 4% and adjusted net earnings per diluted share(2) to be adversely impacted by approximately $0.35 to $0.40 in the full year. Based on our performance in the third quarter including consideration of continued inflationary pressures, together with our strong sales and additional cost reduction actions, and most significantly, the anticipated future impact of foreign currency, we now expect adjusted net earnings per diluted share(2) in the range of $9.15 to $9.25 per share.

    (1) A reconciliation of the non-GAAP financial measures: adjusted gross profit margin, adjusted operating income and adjusted operating income margin, adjusted net earnings and adjusted net earnings per diluted share, to the most directly comparable GAAP measures: gross profit margin, operating income and operating income margin, net earnings and net earnings per diluted share, and other important information accompanies this press release.

    (2) We are unable to present a quantitative reconciliation of our expected net sales growth to expected organic net sales growth as we are unable to predict with reasonable certainty and without unreasonable effort the impact and timing of acquisitions and divestitures and the impact of foreign currency exchange rates. We are unable to present a quantitative reconciliation of our expected net earnings per diluted share to expected adjusted net earnings per diluted share as we are unable to predict with reasonable certainty and without unreasonable effort the impact and timing of restructuring-related and other charges, acquisition-related expenses and fair value adjustments to inventory and the outcome of certain regulatory, legal and tax matters. The financial impact of these items is uncertain and is dependent on various factors, including timing, and could be material to our Consolidated Statements of Earnings.

    Conference Call on Monday, October 31, 2022

    As previously announced, Stryker will host a conference call on Monday, October 31, 2022 at 4:30 p.m., Eastern Time, to discuss the Company's operating results for the quarter ended September 30, 2022 and provide an operational update.

    Please register for this conference call at: https://www.netroadshow.com/events/login?show=ef1f360c&confId=40138. After registering, a confirmation will be sent via email, including dial-in details and unique conference call access codes required for call entry. Registration is open throughout the live call. To ensure you are connected prior to the beginning of the call, the Company suggests registering a minimum of 15 minutes before the start of the call.

    A simultaneous webcast of the call will be accessible via the Investor Relations page of the Company's website at www.stryker.com. For those not planning to ask a question of management, the Company recommends listening via the webcast. Please allow 15 minutes to register, download and install any necessary software.

    Following the conference call, a replay will be available at (866) 813-9403 (Toll Free) or (929) 458-6194 (International). The replay passcode is 382708. An archive of the webcast will also be available on the Company's website two hours after the live call ends.

    Caution Concerning Forward-Looking Statements

    This press release contains information that includes or is based on forward-looking statements within the meaning of the federal securities law that are subject to various risks and uncertainties that could cause our actual results to differ materially from those expressed or implied in such statements. Such factors include, but are not limited to: the impact on our operations and financial results of the COVID-19 pandemic and any related policies and actions by governments or other third parties; unexpected liabilities, costs, charges or expenses in connection with the acquisition of Vocera Communications, Inc. (Vocera); the effects of the Vocera transaction on the relationships of the parties with employees, customers, other business partners or governmental entities; weakening of economic conditions that could adversely affect the level of demand for our products; pricing pressures generally, including cost-containment measures that could adversely affect the price of or demand for our products; changes in foreign exchange markets; legislative and regulatory actions; unanticipated issues arising in connection with clinical studies and otherwise that affect United States Food and Drug Administration approval of new products, including Vocera products; inflationary pressures; supply chain disruptions; changes in reimbursement levels from third-party payors; a significant increase in product liability claims; the ultimate total cost with respect to recall-related matters; the impact of investigative and legal proceedings and compliance risks; resolution of tax audits; the impact of the federal legislation to reform the United States healthcare system; costs to comply with medical device regulations; changes in financial markets; changes in the competitive environment; our ability to integrate and realize the anticipated benefits of acquisitions in full or at all or within the expected timeframes, including the acquisition of Vocera; our ability to realize anticipated cost savings; and potential negative impacts resulting from environmental, social and governance (ESG) and sustainability related matters. Additional information concerning these and other factors is contained in our filings with the United States Securities and Exchange Commission, including our Annual Report on Form 10-K and Quarterly Reports on Form 10-Q. We disclaim any intention or obligation to publicly update or revise any forward-looking statement to reflect any change in our expectations or in events, conditions or circumstances on which those expectations may be based, or that affect the likelihood that actual results will differ from those contained in the forward-looking statements.

    Stryker is one of the world's leading medical technology companies and, together with its customers, is driven to make healthcare better. The company offers innovative products and services in Medical and Surgical, Neurotechnology, Orthopaedics and Spine that help improve patient and hospital outcomes. Alongside its customers around the world, Stryker impacts more than 100 million patients annually. More information is available at www.stryker.com.

    For investor inquiries please contact:

    Jason Beach, Vice President, Investor Relations at 269-385-2600 or jason.beach@stryker.com

    For media inquiries please contact:

    Yin Becker, Vice President, Chief Corporate Affairs Officer at 269-385-2600 or yin.becker@stryker.com

    STRYKER CORPORATION
    For the Three and Nine Months September 30
    (Unaudited - Millions of Dollars, Except Per Share Amounts)
    CONSOLIDATED STATEMENTS OF EARNINGS
            
     Three Months Nine Months
      2022   2021  % Change  2022   2021  % Change
    Net sales$        4,479  $        4,160           7.7 % $        13,247  $        12,407          6.8%
    Cost of sales         1,697           1,518           11.8            4,905           4,484          9.4 
    Gross profit$        2,782  $        2,642           5.3 % $        8,342  $        7,923          5.3%
    % of sales         62.1%          63.5 %            63.0 %          63.9%  
    Research, development and engineering expenses         364            306           19.0            1,128            904           24.8 
    Selling, general and administrative expenses         1,455            1,602           (9.2)           4,704            4,682           0.5 
    Recall charges         (4 )            16  nm               14           98  nm      
    Amortization of intangible assets         159            144           10.4           469            474           (1.1) 
    Total operating expenses$        1,974   $        2,068           (4.5)  % $        6,315   $        6,158           2.5 %
    Operating income$        808  $        574           40.8% $        2,027   $        1,765           14.8 %
    % of sales         18.0 %          13.8 %            15.3 %          14.2 %  
    Other income (expense), net         8            (79)   nm                (105)           (241)          (56.4) 
    Earnings before income taxes$        816   $        495           64.8% $        1,922   $        1,524           26.1 %
    Income taxes         —            57           (100.0)           127            192           (33.9) 
    Net earnings$        816  $        438           86.3% $        1,795   $        1,332           34.8 %
    Net earnings per share of common stock:           
    Basic$        2.16  $        1.17           84.6% $        4.75   $        3.54           34.2%
    Diluted$        2.14  $        1.14           87.7% $        4.70   $        3.48           35.1%
    Weighted-average shares outstanding (in millions):           
    Basic 378.4   377.1     378.1   376.8   
    Diluted 381.8   382.7     382.2   382.3   


    CONDENSED CONSOLIDATED BALANCE SHEETS
     September 30 December 31
      2022  2021
    Assets   
    Cash and cash equivalents$        1,420 $        2,944
    Marketable securities         77          75
    Accounts receivable, net         3,103          3,022
    Inventories         3,883          3,314
    Prepaid expenses and other current assets         835          662
    Total current assets$        9,318 $        10,017
    Property, plant and equipment, net         2,798          2,833
    Goodwill and other intangibles, net         20,046          17,758
    Noncurrent deferred income tax assets         1,390          1,760
    Other noncurrent assets         2,431          2,263
    Total assets$        35,983 $        34,631
    Liabilities and shareholders' equity   
    Current liabilities$        4,571 $        4,549
    Long-term debt, excluding current maturities         12,751          12,472
    Income taxes         621          913
    Other noncurrent liabilities         1,577          1,820
    Shareholders' equity         16,463          14,877
    Total liabilities and shareholders' equity$        35,983 $        34,631


    CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
     Nine Months
      2022   2021 
    Operating activities   
    Net earnings$        1,795  $        1,332 
    Depreciation         276           278 
    Amortization of intangible assets         469           474 
    Changes in operating assets, liabilities, income taxes payable and other, net         (919)           179 
    Net cash provided by operating activities$        1,621  $        2,263 
    Investing activities   
    Acquisitions, net of cash acquired$        (2,563)  $        (226) 
    Purchases of property, plant and equipment         (400)           (319) 
    Other investing, net         201           —         
    Net cash used in investing activities$        (2,762)  $        (545) 
    Financing activities   
    Borrowings (payments) of debt, net$        622  $        (1,139) 
    Payments of dividends         (788)           (713) 
    Other financing, net         (137)           (225) 
    Net cash provided by (used in) financing activities$        (303)  $        (2,077) 
    Effect of exchange rate changes on cash and cash equivalents         (80)           (21) 
    Change in cash and cash equivalents$        (1,524)  $        (380) 

    nm - not meaningful

    STRYKER CORPORATION
    For the Three and Nine Months September 30
    (Unaudited - Millions of Dollars)


    SALES GROWTH ANALYSIS
     Three Months Nine Months
        Percentage Change    Percentage Change
      2022 2021 As ReportedConstant
    Currency
      2022 2021 As ReportedConstant
    Currency
    Geographic:           
    United States$        3,360$        3,019         11.3%        11.3% $        9,776$        8,903         9.8 %        9.8%
    International         1,119         1,141         (1.9)         11.7           3,471         3,504         (0.9)         9.1 
    Total$        4,479$        4,160         7.7 %        11.4% $        13,247$        12,407         6.8%        9.6%
    Segment:           
    MedSurg and Neurotechnology$        2,588$        2,349         10.2%        13.5% $        7,560$        6,899         9.6%        12.1%
    Orthopaedics and Spine         1,891         1,811         4.4         8.7           5,687         5,508         3.2         6.5 
    Total$        4,479$        4,160          7.7%        11.4% $        13,247$        12,407         6.8%        9.6%


    SUPPLEMENTAL SALES GROWTH ANALYSIS
     Three Months
          United States International
       Percentage Change
      2022 2021 As ReportedConstant Currency As Reported As ReportedConstant Currency
    MedSurg and Neurotechnology:          
    Instruments$        535$        525         1.8%        4.8%         2.3 %         — %        14.4%
    Endoscopy         590         525         12.4         14.9          14.8           3.1         15.6 
    Medical         765         636         20.1         22.9          25.8           —          12.7 
    Neurovascular         294         295         (0.3)         7.6          (2.0)          0.7         13.6 
    Neuro Cranial         332         299         11.3         13.9          12.7          5.0         19.6 
    Other         72         69         5.9         6.0          5.8          12.9         16.4 
     $        2,588$        2,349         10.2%        13.5%         13.2%         1.3%        14.4%
    Orthopaedics and Spine:          
    Knees$        481$        439                 9.6%        13.4%         13.7 %        (1.7)     %        12.3%
    Hips         347         328                 5.6         11.3          12.4           (5.0)         9.6 
    Trauma and Extremities         672         639                 5.1         9.5          10.4           (7.1)         7.3 
    Spine         280         282                 (1.0)         2.6           2.0           (8.7)         3.9 
    Other         111         123                 (9.2)         (5.6)          (11.2)          (1.7)         15.5 
     $        1,891        $        1,811                 4.4%        8.7 %         8.6%         (5.4)     %        8.8%
    Total $        4,479        $        4,160                 7.7%        11.4 %         11.3%         (1.9)     %        11.7%


     
     Nine Months
           United States International
        Percentage Change
      2022 2021 As ReportedConstant Currency As Reported As ReportedConstant Currency
    MedSurg and Neurotechnology:          
    Instruments


    $
            1,626$        1,511         7.6%        9.9%         10.1%         (1.0)%          9.4% 
    Endoscopy         1,728         1,512         14.3         16.6          16.3          7.2         17.8 
    Medical         2,095         1,898         10.4         12.4          15.7          (7.3)         1.2 
    Neurovascular         901         885         1.7         7.1          (1.7)          3.8         12.7 
    Neuro Cranial         992         890         11.5         13.4          13.2          4.2         14.3 
    Other         218         203         7.8         7.8          7.3          42.1         45.2 
     $        7,560$        6,899         9.6%        12.1%         12.7%         1.0  %        10.4%
    Orthopaedics and Spine:          
    Knees$        1,445$        1,325         9.1%        12.1%         11.8 %         1.6%        12.8%
    Hips         1,038         990         4.8         9.2          8.3           (0.7)         10.5 
    Trauma and Extremities         2,033         1,953         4.1         7.2          7.9           (4.8)         5.6 
    Spine         849         867         (2.1)         0.6          0.6           (8.5)         0.7 
    Other         322         373         (13.4)         (10.6)          (16.0)          (4.3)         9.0 
     $        5,687$        5,508         3.2%        6.5 %         6.0%         (3.0)        %        7.7%
    Total $        13,247$        12,407         6.8%        9.6 %         9.8%         (0.9)        %        9.1%

    Note: The three and nine months 2022 had the same number of selling days as 2021.

    SUPPLEMENTAL INFORMATION - RECONCILIATION OF GAAP TO NON-GAAP FINANCIAL MEASURES

    We supplement the reporting of our financial information determined under accounting principles generally accepted in the United States (GAAP) with certain non-GAAP financial measures, including: percentage sales growth; percentage sales growth in constant currency; percentage organic sales growth; adjusted gross profit; adjusted selling, general and administrative expenses; adjusted research, development and engineering expenses; adjusted operating income; adjusted other income (expense), net; adjusted effective income tax rate; adjusted net earnings; adjusted net earnings per diluted share (Diluted EPS); free cash flow; and free cash flow conversion. We believe these non-GAAP financial measures provide meaningful information to assist investors and shareholders in understanding our financial results and assessing our prospects for future performance. Management believes percentage sales growth in constant currency and the other adjusted measures described above are important indicators of our operations because they exclude items that may not be indicative of or are unrelated to our core operating results and provide a baseline for analyzing trends in our underlying businesses. Management uses these non-GAAP financial measures for reviewing the operating results of reportable business segments and analyzing potential future business trends in connection with our budget process and bases certain management incentive compensation on these non-GAAP financial measures.

    To measure percentage sales growth in constant currency, we remove the impact of changes in foreign currency exchange rates that affect the comparability and trend of sales. Percentage sales growth in constant currency is calculated by translating current and prior year results at the same foreign currency exchange rate. To measure percentage organic sales growth, we remove the impact of changes in foreign currency exchange rates, acquisitions and divestitures, which affect the comparability and trend of sales. Percentage organic sales growth is calculated by translating current year and prior year results at the same foreign currency exchange rate excluding the impact of acquisitions and divestitures. To measure earnings performance on a consistent and comparable basis, we exclude certain items that affect the comparability of operating results and the trend of earnings. To measure free cash flow, we adjust cash provided by operating activities by the amount of purchases of property, plant and equipment and proceeds from long-lived asset disposals and remove the impact of certain legal settlements and recall payments. To measure free cash flow conversion we divide free cash flow by adjusted net earnings.

    Because non-GAAP financial measures are not standardized, it may not be possible to compare these financial measures with other companies' non-GAAP financial measures having the same or similar names. These adjusted financial measures should not be considered in isolation or as a substitute for reported sales growth, gross profit, selling, general and administrative expenses, research, development and engineering expenses, operating income, other income (expense), net, effective income tax rate, net earnings and net earnings per diluted share, the most directly comparable GAAP financial measures. These non-GAAP financial measures are an additional way of viewing aspects of our operations that, when viewed with our GAAP results and the reconciliations to corresponding GAAP financial measures below, provide a more complete understanding of our business. We strongly encourage investors and shareholders to review our financial statements and publicly-filed reports in their entirety and not to rely on any single financial measure.

    The following reconciles the non-GAAP financial measures discussed above with the most directly comparable GAAP financial measures. The weighted-average diluted shares outstanding used in the calculation of non-GAAP net earnings per diluted share are the same as those used in the calculation of reported net earnings per diluted share for the respective period.

    STRYKER CORPORATION
    For the Three and Nine Months September 30
    (Unaudited - Millions of Dollars, Except Per Share Amounts)
    Reconciliation of Non-GAAP Financial Measures to the Most Directly Comparable GAAP Financial Measures
    Three Months 2022Gross ProfitSelling, General & Administrative ExpensesResearch, Development & Engineering ExpensesOperating IncomeOther Income (Expense), NetNet EarningsEffective
    Tax Rate
    Diluted EPS
    Reported $        2,782 $        1,455 $        364 $        808 $        8 $        816          %$        2.14 
    Reported percent net sales         62.1%         32.5%         8.1%         18.0%         0.2%         18.2%  
    Acquisition and integration-related costs (a)        
    Inventory stepped-up to fair value         —           —           —           —           —           —          —           — 
    Other acquisition and integration-related         —           78          —           (78)          —           (82)         2.0          (0.21) 
    Amortization of purchased intangible assets         —           —           —           159          —           132         0.5          0.34 
    Restructuring-related and other charges (b)         19          (31)          (8)          58          —           50         —           0.13 
    Medical device regulations (c)         1          2          (39)          38          —           32         0.1          0.08 
    Recall-related matters (d)         —           —           —           (4)          —           (4)         —           (0.01) 
    Regulatory and legal matters (e)         —           (20)          —           20          —           15          0.2          0.04 
    Tax matters (f)         —           —           —           —           (62)          (149)         11.7          (0.39) 
    Adjusted $        2,802 $        1,484 $        317 $        1,001 $        (54) $        810         14.5%$        2.12 
    Adjusted percent net sales         62.6%         33.1%         7.1%         22.3%        (1.2)     %         18.1%  


    Three Months 2021Gross ProfitSelling, General & Administrative ExpensesResearch, Development & Engineering ExpensesOperating IncomeOther Income (Expense), NetNet EarningsEffective
    Tax Rate
    Diluted EPS
    Reported $        2,642 $        1,602 $        306 $        574 $        (79) $        438         11.5%$        1.14 
    Reported percent net sales         63.5%         38.5%         7.4%         13.8%        (1.9) %         10.5%  
    Acquisition and integration-related costs (a)        
    Inventory stepped-up to fair value         94          —           —           94          —           73         1.9          0.19 
    Other acquisition and integration-related         —          (32)                  —           32          —           24         0.8          0.06 
    Amortization of purchased intangible assets         —          —           —           144          —           114         2.0          0.30 
    Restructuring-related and other charges (b)         20          (158)          —           178          —           165         (2.6)          0.44 
    Medical device regulations (c)         1          —           (26)          27          —           23         (0.1)          0.06 
    Recall-related matters (d)         —          —           —           16          —           12         0.3          0.03 
    Regulatory and legal matters (e)         —          7           —           (7)          —           (7)         0.2          (0.02) 
    Tax matters (f)         —          —           —           —           —           —          —           —  
    Adjusted $        2,757 $        1,419 $        280 $        1,058 $        (79) $        842         14.0%$        2.20 
    Adjusted percent net sales         66.3%         34.1 %         6.7%         25.4%        (1.9) %         20.2%  


    Nine Months 2022Gross ProfitSelling, General & Administrative ExpensesResearch, Development & Engineering ExpensesOperating IncomeOther Income (Expense), NetNet EarningsEffective
    Tax Rate
    Diluted EPS
    Reported$        8,342 $        4,704 $        1,128 $        2,027 $        (105) $        1,795         6.6%$        4.70 
    Reported percent net sales         63.0%         35.5%         8.5%         15.3%        (0.8) %         13.6 %  
    Acquisition and integration-related costs (a)        
    Inventory stepped-up to fair value         12          —           —           12          —           9         —           0.02 
    Other acquisition and integration-related         —           (96)          —           96          —           46         1.9          0.12 
    Amortization of purchased intangible assets         —           —           —           469          —           371         1.7          0.97 
    Restructuring-related and other charges (b)         29          (113)          (87)          229          —           190         0.4          0.50 
    Medical device regulations (c)         3          —           (95)          98          —           82         0.1          0.21 
    Recall-related matters (d)         —           —           —           14          —           10         0.1          0.03 
    Regulatory and legal matters (e)         —           (53)          —           53          —           39         0.3          0.10 
    Tax matters (f)         —           —           —           —           (74)          (120)         3.0          (0.31) 
    Adjusted$        8,386 $        4,442 $        946 $        2,998 $        (179) $        2,422         14.1%$        6.34 
    Adjusted percent net sales         63.3%         33.5%         7.1%         22.6%        (1.4) %         18.3%  


    Nine Months 2021Gross ProfitSelling, General & Administrative ExpensesResearch, Development & Engineering ExpensesOperating IncomeOther Income (Expense), NetNet EarningsEffective
    Tax Rate
    Diluted EPS
    Reported$        7,923 $        4,682 $        904 $        1,765 $        (241) $        1,332         12.6%$        3.48 
    Reported percent net sales         63.9%         37.7%         7.3%         14.2%        (1.9) %         10.7%  
    Acquisition and integration-related costs (a)        
    Inventory stepped-up to fair value         231          —           —           231          —           176         1.4          0.46 
    Other acquisition and integration-related         —           (264)          —           264          —           204         1.4          0.53 
    Amortization of purchased intangible assets         —           —           —           474          —           378         1.7           0.99 
    Restructuring-related and other charges (b)         20          (189)          —           209          11          198         (0.7)          0.52 
    Medical device regulations (c)         2          —           (70)          72          —           60         0.1          0.16 
    Recall-related matters (d)         —           —           —           98          —           85         (0.1)          0.22 
    Regulatory and legal matters (e)         —           16           —           (16)          (3)          (19)         0.2          (0.05)
    Tax matters (f)         —           —           —           —          —           26         (1.8)          0.07 
    Adjusted$        8,176 $        4,245 $        834 $        3,097 $        (233) $        2,440         14.8%$        6.38 
    Adjusted percent net sales         65.9%         34.2%         6.7%         25.0%        (1.9) %         19.7%  


    (a)Charges represent certain acquisition and integration-related costs associated with acquisitions including changes in the fair value of contingent consideration.
    (b)Charges represent the costs associated with the termination of sales relationships in certain countries, workforce reductions, elimination of product lines, certain long-lived and intangible asset write-offs and impairments and associated costs and other restructuring-related activities.
    (c)Charges represent the costs specific to updating our quality system, product labeling, asset write-offs and product remanufacturing to comply with the medical device reporting regulations and other requirements of the new medical device regulations in the European Union.
    (d)Charges represent changes in our best estimate of the minimum end of the range of probable loss to resolve certain recall-related matters.
    (e)Our best estimate of the minimum of the range of probable loss to resolve certain regulatory or other legal matters and the amount of favorable awards from settlements.
    (f)Benefits and charges represent the accounting impact of certain significant and discrete tax items, including adjustments related to the transfer of certain intellectual properties between tax jurisdictions and certain significant tax audit settlements.


    Nine Months 2022   2021 
    Cash provided by operating activities$        1,621  $        2,263 
    Net earnings         1,795           1,332 
    Conversion         90.3%          169.9%
        
    Cash provided by operating activities$        1,621  $        2,263 
    Purchases of property, plant and equipment         (400)           (319) 
    Proceeds from long-lived asset disposals         10           7 
    Recall payments         26           180 
    Free cash flow$        1,257  $        2,131 
    Adjusted net earnings         2,422           2,440 
    Free cash flow conversion         51.9%          87.3%


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