Stryker reports third quarter 2021 operating results


Kalamazoo, MI, Oct. 28, 2021 (GLOBE NEWSWIRE) -- Stryker (NYSE:SYK) reported operating results for the third quarter of 2021:

Third Quarter Results

  • Reported net sales increased 11.3% from 2020 and 16.0% from 2019 to $4.2 billion
  • Organic net sales increased 4.5% from 2020 and 8.4% from 2019
  • Reported operating income margin of 13.8%
  • Adjusted operating income margin(1) contracted 260 bps to 25.4%
  • Reported EPS decreased 30.1% to $1.14
  • Adjusted EPS(1) increased 2.8% to $2.20

In addition to sales growth analysis versus 2020, we are including sales growth versus 2019 as 2019 provides a more normal baseline for comparison given the variability caused by the COVID-19 pandemic throughout 2020.

 Third Quarter Net Sales Growth Overview
 From 2020 From 2019
 Reported Foreign Currency Exchange Constant Currency Acquisitions / Divestitures Organic Reported Foreign Currency Exchange Constant Currency Acquisitions / Divestitures Organic
Orthopaedics16.1 % 0.6 % 15.5 % 17.3 % (1.8)% 21.3 % 1.4 % 19.9 % 17.9 % 2.0 %
MedSurg9.4   0.5   8.9   0.1   8.8    12.8   0.8   12.0   0.1   11.9  
Neurotechnology and Spine7.3   0.9   6.4   0.3   6.1    13.7   1.5   12.2   0.4   11.8  
Total11.3 % 0.6 % 10.7 % 6.2 % 4.5  % 16.0 % 1.2 % 14.8 % 6.4 % 8.4 %


"Our teams showed strong resilience and delivered solid quarterly financial results despite a resurgence of COVID-19 that intensified through the quarter,” said Kevin Lobo, Chair and Chief Executive Officer. “This latest spike mostly impacted our U.S. implant related businesses as scheduled procedures were deferred. Despite those impacts, we delivered strong growth in our MedSurg and NeuroTech businesses and are ready to support our customers as the pandemic recedes."

Sales Analysis Compared to 2020 and 2019

Consolidated net sales of $4.2 billion increased 11.3% in the quarter and 10.7% in constant currency from 2020. Organic net sales increased 4.5% in the quarter including 5.2% from increased unit volume partially offset by 0.7% from lower prices. From 2019 consolidated net sales increased 16.0% in the quarter and 14.8% in constant currency. Organic net sales increased 8.4% in the quarter including 10.6% from increased unit volume partially offset by 2.2% from lower prices.

Orthopaedics net sales of $1.5 billion increased 16.1% in the quarter and 15.5% in constant currency from 2020. Organic net sales decreased 1.8% in the quarter including 1.2% from decreased unit volume and 0.6% from lower prices. From 2019 Orthopaedics net sales increased 21.3% in the quarter and 19.9% in constant currency. Organic net sales increased 2.0% in the quarter including 4.8% from increased unit volume partially offset by 2.8% from lower prices.

MedSurg net sales of $1.8 billion increased 9.4% in the quarter and 8.9% in constant currency from 2020. Organic net sales increased 8.8% in the quarter including 9.6% from increased unit volume partially offset by 0.8% from lower prices. From 2019 MedSurg net sales increased 12.8% in the quarter and 12.0% in constant currency. Organic net sales increased 11.9% in the quarter including 13.4% from increased unit volume partially offset by 1.5% from lower prices.

Neurotechnology and Spine net sales of $0.9 billion increased 7.3% in the quarter and 6.4% in constant currency from 2020. Organic net sales increased 6.1% in the quarter including 6.7% from increased unit volume partially offset by 0.6% from lower prices. From 2019 Neurotechnology and Spine net sales increased 13.7% in the quarter and 12.2% in constant currency. Organic net sales increased 11.8% in the quarter including 14.2% from increased unit volume partially offset by 2.4% from lower prices.

Earnings Analysis Compared to 2020

Reported net earnings of $438 million decreased 29.5% in the quarter. Reported net earnings per diluted share of $1.14 decreased 30.1% in the quarter. Reported gross profit margin and reported operating income margin were 63.5% and 13.8% in the quarter. In the quarter, an impairment charge of $105 million was recorded for certain long-lived and intangible assets resulting from price reductions on our trauma and joint replacement products in China based on the outcome of the regional and national volume-based procurement programs. Reported net earnings include certain items, such as charges for acquisition and integration-related activities, the amortization of purchased intangible assets, 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 66.3% in the quarter, and adjusted operating income margin(1) was 25.4% in the quarter. Adjusted net earnings(1) of $842 million increased 3.7% in the quarter. Adjusted net earnings per diluted share(1) of $2.20 increased 2.8% in the quarter.

2021 Outlook

We continue to monitor and evaluate the impact the global response to the COVID-19 pandemic has had, and will continue to have, on our operations and financial results. Based on third quarter performance, the volatility experienced as a result of COVID as well as the labor and staffing environment in healthcare potentially hindering an accelerated recovery, we now expect 2021 organic net sales growth to be in the range of 7% to 8% from 2019, and now expect adjusted net earnings per diluted share(2) to be in the range of $9.08 to $9.15, including the full year impact of the acquisition of Wright Medical. If foreign currency exchange rates hold near current levels, we expect EPS will be positively impacted by approximately $0.05 to $0.10 for the full year.

(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 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 Thursday, October 28, 2021

As previously announced, Stryker will host a conference call on Thursday, October 28, 2021 at 4:30 p.m., Eastern Time, to discuss the Company's operating results for the quarter ended September 30, 2021 and provide an operational update.

To participate in the conference call dial (833) 979-2711 (domestic) or (236) 714-2206 (international) and enter passcode 7351349.

A simultaneous webcast of the call will be accessible via the Company's website at www.stryker.com. The call will be archived on the Investor Relations page of this site.

A recording of the call will also be available from 8:00 p.m., Eastern Time, on Thursday, October 28, 2021, until 11:59 p.m., Eastern Time, on Thursday, November 4, 2021. To hear this recording, you may dial (800) 585-8367 (domestic) or (416) 621-4642 (international) and enter passcode 7351349.

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 laws 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 Wright Medical Group N.V. ("Wright"); the effects of the Wright acquisition on the parties' relationships 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 U.S. Food and Drug Administration approval of new products, including Wright products; potential supply 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 Wright; and our ability to realize anticipated cost savings. Additional information concerning these and other factors is contained in our filings with the U.S. 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 Orthopaedics, Medical and Surgical, and Neurotechnology and Spine that help improve patient and hospital outcomes. More information is available at www.stryker.com.

For investor inquiries please contact:

Preston Wells, Vice President, Investor Relations at 269-385-2600 or preston.wells@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
 2021 2020 % Change 2021 2020 % Change
Net sales$4,160    $3,737    11.3  % $12,407    $10,089    23.0  %
Cost of sales1,518    1,276    19.0    4,484    3,749    19.6   
Gross profit$2,642    $2,461    7.4  % $7,923    $6,340    25.0  %
% of sales63.5  % 65.9  %   63.9  % 62.8  %  
Research, development and engineering expenses306    242    26.4    904    729    24.0   
Selling, general and administrative expenses1,602    1,244    28.8    4,682    3,799    23.2   
Recall charges16       nm 98    (4)  nm
Amortization of intangible assets144    114    26.3    474    342    38.6   
Total operating expenses$2,068    $1,602    29.1  % $6,158    $4,866    26.6  %
Operating income$574    $859    (33.2)% $1,765    $1,474    19.7  %
% of sales13.8  % 23.0  %   14.2  % 14.6  %  
Other income (expense), net(79)  (79)  —    (241)  (191)  26.2   
Earnings before income taxes$495    $780    (36.5)% $1,524    $1,283    18.8  %
Income taxes57    159    (64.2)  192    252    (23.8) 
Net earnings$438    $621    (29.5)% $1,332    $1,031    29.2  %
Net earnings per share of common stock:           
Basic$1.17    $1.66    (29.5)% $3.54    $2.75    28.7  %
Diluted$1.14    $1.63    (30.1)% $3.48    $2.71    28.4  %
Weighted-average shares outstanding (in millions):           
Basic377.1 375.7   376.8 375.3  
Diluted382.7 380.2   382.3 380.0  


CONDENSED CONSOLIDATED BALANCE SHEETS
 September 30 December 31
 2021 2020
Assets   
Cash and cash equivalents$2,563   $2,943  
Marketable securities76   81  
Accounts receivable, net2,817   2,701  
Inventories3,434   3,494  
Prepaid expenses and other current assets570   488  
Total current assets$9,460   $9,707  
Property, plant and equipment, net2,746   2,752  
Goodwill and other intangibles, net17,951   18,332  
Noncurrent deferred income tax assets1,860   1,530  
Other noncurrent assets2,128   2,009  
Total assets$34,145   $34,330  
Liabilities and shareholders' equity   
Current liabilities$4,449   $5,041  
Long-term debt, excluding current maturities12,629   13,230  
Income taxes929   990  
Other noncurrent liabilities1,960   1,985  
Shareholders' equity14,178   13,084  
Total liabilities and shareholders' equity$34,145   $34,330  


CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
 Nine Months
 2021 2020
Operating activities   
Net earnings$1,332    $1,031   
Depreciation278    247   
Amortization of intangible assets474    342   
Changes in operating assets, liabilities, income taxes payable and other, net179    420   
Net cash provided by operating activities$2,263    $2,040   
Investing activities   
Acquisitions, net of cash acquired$(226)  $(26) 
Purchases of property, plant and equipment(319)  (322) 
Change in marketable securities, net   10   
Other investing, net(5)  (11) 
Net cash used in investing activities$(545)  $(349) 
Financing activities   
Borrowings (payments) of debt, net$(1,139)  $1,796   
Payments of dividends(713)  (647) 
Other financing, net(225)  (103) 
Net cash provided by (used in) financing activities$(2,077)  $1,046   
Effect of exchange rate changes on cash and cash equivalents(21)    
Change in cash and cash equivalents$(380)  $2,746   

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
 20212020 As ReportedConstant
Currency
 20212020 As ReportedConstant
Currency
Geographic:           
United States$3,019  $2,748   9.9 %9.9 % $8,903  $7,357   21.0 %21.0 %
International1,141  989   15.3  12.8   3,504  2,732   28.2  21.1  
Total$4,160  $3,737   11.3 %10.7 % $12,407  $10,089   23.0 %21.0 %
Segment:           
Orthopaedics$1,529  $1,317   16.1 %15.5 % $4,641  $3,433   35.2 %33.0 %
MedSurg1,755  1,600   9.4  8.9   5,124  4,546   12.7  11.2  
Neurotechnology and Spine876  820   7.3  6.4   2,642  2,110   25.2  22.8  
Total$4,160  $3,737   11.3 %10.7 % $12,407  $10,089   23.0 %21.0 %


SUPPLEMENTAL SALES GROWTH ANALYSIS
 Three Months
      United States International
   Percentage Change
 20212020 As ReportedConstant Currency As Reported As ReportedConstant Currency
Orthopaedics:          
Knees$439  $435   0.8  %0.3  % (3.3)% 13.9  %11.7  %
Hips328  334   (1.6) (2.3)  (10.6)  16.7   14.5   
Trauma and Extremities639  430   49.0   48.2    56.9    33.4   30.9   
Other123  118   3.4   3.2    (0.2)  19.4   18.2   
 $1,529  $1,317   16.1  %15.5  % 13.6  % 22.4  %20.2  %
MedSurg:          
Instruments$525  $467   11.5  %10.9  % 12.4  % 7.9  %5.5  %
Endoscopy525  467   12.2   11.8    9.9    22.5   20.1   
Medical636  600   6.1   5.5    9.2    (3.5) (6.0) 
Sustainability69  66   4.2   4.1    3.9    25.8   19.0   
 $1,755  $1,600   9.4  %8.9  % 10.1  % 6.8  %4.4  %
Neurotechnology and Spine:          
Neurotechnology$594  $518   14.7  %13.6  % 10.6  % 21.4  %18.5  %
Spine282  302   (5.4) (5.9)  (8.0)  1.6   (0.3) 
 $876  $820   7.3  %6.4  % 3.1  % 15.7  %13.0  %
Total $4,160  $3,737   11.3  %10.7  % 9.9  % 15.3  %12.8  %


 
 Nine Months
      United States International
   Percentage Change
 20212020 As ReportedConstant Currency As Reported As ReportedConstant Currency
Orthopaedics:          
Knees$1,325  $1,108   19.5 %17.8 % 15.8 % 31.0  %23.6  %
Hips990  866   14.4  12.1   7.4   27.5   20.9   
Trauma and Extremities1,953  1,152   69.6  66.5   80.8   48.5   40.2   
Other373  307   21.6  20.6   11.0   82.2   74.3   
 $4,641  $3,433   35.2 %33.0 % 33.6 % 39.1  %31.6  %
MedSurg:          
Instruments$1,511  $1,308   15.4 %13.9 % 13.9 % 20.9  %13.8  %
Endoscopy1,512  1,238   22.1  20.7   18.2   38.4   31.0   
Medical1,898  1,819   4.4  2.7   7.0   (3.3) (9.6) 
Sustainability203  181   12.1  12.0   11.6   59.2   48.4   
 $5,124  $4,546   12.7 %11.2 % 12.3 % 14.0  %7.1  %
Neurotechnology and Spine:          
Neurotechnology$1,775  $1,370   29.6 %26.9 % 27.4 % 33.1  %26.2  %
Spine867  740   17.1  15.3   12.5   29.5   22.6   
 $2,642  $2,110   25.2 %22.8 % 21.5 % 32.2  %25.2  %
Total $12,407  $10,089   23.0 %21.0 % 21.0 % 28.2  %21.1  %


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
 20212019 As ReportedConstant
Currency
 20212019 As ReportedConstant
Currency
Geographic:           
United States$3,019  $2,644   14.2 %14.2 % $8,903  $7,918   12.4 %12.4 %
International1,141  943   21.0  16.6   3,504  2,835   23.6  18.5  
Total$4,160  $3,587   16.0 %14.8 % $12,407  $10,753   15.4 %14.0 %
Segment:           
Orthopaedics$1,529  $1,262   21.3 %19.9 % $4,641  $3,785   22.6 %21.1 %
MedSurg1,755  1,552   12.8  12.0   5,124  4,680   9.5  8.6  
Neurotechnology and Spine876  773   13.7  12.2   2,642  2,288   15.5  13.7  
Total$4,160  $3,587   16.0 %14.8 % $12,407  $10,753   15.4 %14.0 %


SUPPLEMENTAL SALES GROWTH ANALYSIS
 Three Months
       United States International
    Percentage Change
 20212019 As ReportedConstant Currency As Reported As ReportedConstant Currency
Orthopaedics:          
Knees$439  $426   3.0  %2.0  % 1.2  % 8.4 %4.5 %
Hips328  332   (1.1) (2.4)  (5.8)  7.2  3.5  
Trauma and Extremities639  407   57.4   55.2    71.1    32.7  27.2  
Other123  97   26.7   26.1    19.8    61.0  57.0  
 $1,529  $1,262   21.3  %19.9  % 22.2  % 19.2 %14.9 %
MedSurg:          
Instruments$525  $452   15.3  %14.3  % 15.9  % 12.9 %8.6 %
Endoscopy525  474   10.8   10.2    10.9    10.1  7.5  
Medical636  554   14.9   13.9    12.5    24.5  19.5  
Sustainability69  72   (4.9) (5.0)  (5.3)  34.5  27.7  
 $1,755  $1,552   12.8  %12.0  % 12.0  % 16.3 %12.3 %
Neurotechnology and Spine:          
Neurotechnology$594  $490   21.2  %19.3  % 12.6  % 36.7 %31.1 %
Spine282  283   0.8   (0.3)  (3.5)  13.1  8.8  
 $876  $773   13.7  %12.2  % 6.2  % 29.8 %24.6 %
Total $4,160  $3,587   16.0  %14.8  % 14.2  % 21.0 %16.6 %


 
 Nine Months
       United States International
    Percentage Change
 20212019 As ReportedConstant Currency As Reported As ReportedConstant Currency
Orthopaedics:          
Knees$1,325  $1,305   1.5  %0.3  % 0.3  % 5.0 %0.6 %
Hips990  1,011   (2.1) (3.6)  (5.8)  4.4  0.4  
Trauma and Extremities1,953  1,197   63.2   60.8    77.4    38.0  31.8  
Other373  272   37.3   36.4    30.4    68.6  63.3  
 $4,641  $3,785   22.6  %21.1  % 24.1  % 19.4 %14.4 %
MedSurg:          
Instruments$1,511  $1,417   6.6  %5.5  % 4.4  % 14.8 %9.7 %
Endoscopy1,512  1,424   6.2   5.6    3.8    15.7  12.7  
Medical1,898  1,627   16.7   15.5    13.1    30.2  24.3  
Sustainability203  212   (4.4) (4.5)  (4.8)  31.7  23.3  
 $5,124  $4,680   9.5  %8.6  % 6.7  % 20.7 %16.0 %
Neurotechnology and Spine:          
Neurotechnology$1,775  $1,443   23.0  %20.9  % 14.4  % 38.7 %32.6 %
Spine867  845   2.6   1.3    (4.1)  23.2  17.6  
 $2,642  $2,288   15.5  %13.7  % 6.8  % 34.3 %28.3 %
Total $12,407  $10,753   15.4  %14.0  % 12.4  % 23.6 %18.5 %

Note: Third quarter 2021 had the same number of selling days as 2020 and 2019. The nine months 2021 had one less selling day than 2020 and the same number of selling days as 2019.

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 results at prior year average foreign currency exchange rates 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 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 sales63.5 %38.5  %7.4  %13.8  %(1.9)%10.5  %  
Acquisition and integration-related charges (a)        
Inventory stepped-up to fair value94  —   —   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) —   (26) 27   —   23   (0.1) 0.06   
Recall-related matters (d)—  —   —   16   —   12   0.3   0.03   
Regulatory and legal matters (e)—    —   (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 sales66.3 %34.1  %6.7  %25.4  %(1.9)%20.2  %  


Three Months 2020Gross ProfitSelling, General & Administrative ExpensesResearch, Development & Engineering ExpensesOperating IncomeOther income (expense), netNet EarningsEffective
Tax Rate
Diluted EPS
Reported $2,461  $1,244   $242   $859  $(79) $621  20.4  %$1.63  
Reported percent net sales65.9 %33.3  %6.5  %23.0 %(2.1)%16.6 %  
Acquisition and integration-related charges (a)        
Inventory stepped-up to fair value—  —   —   —  —   —  —   —  
Other acquisition and integration-related—  (29) —   29  —   24  0.1   0.07  
Amortization of purchased intangible assets—  —   —   114  —   93  0.4   0.25  
Restructuring-related and other charges (b)—  (29) —   29  —   26  (0.1) 0.06  
Medical device regulations (c)—  —   (13) 14  —   11  0.1   0.03  
Recall-related matters (d)—  —   —    —    (0.2) 0.01  
Regulatory and legal matters (e)—  —   —   —  —   —  —   —  
Tax matters (f)—  —   —   —  —   35  (4.6) 0.09  
Adjusted $2,461  $1,186   $229   $1,047  $(79) $812  16.1  %$2.14  
Adjusted percent net sales65.9 %31.7  %6.1  %28.0 %(2.1)%21.7 %  


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 sales63.9 %37.7  %7.3  %14.2  %(1.9)%10.7  %  
Acquisition and integration-related charges (a)        
Inventory stepped-up to fair value231  —   —   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) —   (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 sales65.9 %34.2  %6.7  %25.0  %(1.9)%19.7  %  


Nine Months 2020Gross ProfitSelling, General & Administrative ExpensesResearch, Development & Engineering ExpensesOperating IncomeOther income (expense), netNet EarningsEffective
Tax Rate
Diluted EPS
Reported $6,340  $3,799   $729   $1,474   $(191) $1,031   19.6  %$2.71  
Reported percent net sales62.8 %37.7  %7.2  %14.6  %(1.9)%10.2  %  
Acquisition and integration-related charges (a)        
Inventory stepped-up to fair value —   —     —     0.1   0.02  
Other acquisition and integration-related—  (76) —   76   —   60   0.4   0.16  
Amortization of purchased intangible assets—  —   —   342   —   277   1.0   0.73  
Restructuring-related and other charges (b)36  (256) —   292   —   238   0.8   0.62  
Medical device regulations (c) —   (59) 60   —   47   0.3   0.12  
Recall-related matters (d)—  —   —   (4) —   (2) (0.2) —  
Regulatory and legal matters (e)—  (5) —     —     (0.2) 0.02  
Tax matters (f)—  —   —   —     93   (6.6) 0.24  
Adjusted $6,386  $3,462   $670   $2,254   $(184) $1,756   15.2  %$4.62  
Adjusted percent net sales63.3 %34.3  %6.6  %22.3  %(1.8)%17.4  %  


(a)Charges represent certain acquisition and integration-related costs associated with acquisitions.
(b)Charges represent the costs associated with the termination of sales relationships in certain countries, workforce reductions, elimination of product lines, certain long-lived asset 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 and China.
(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 Tax Cuts and Jobs Act of 2017, and the transfer of certain intellectual properties between tax jurisdictions.


Nine Months2021 2020
Cash provided by operating activities$2,263    $2,040   
Net earnings1,332    1,031   
Conversion169.9  % 197.9  %
    
Cash provided by operating activities$2,263    $2,040   
Purchases of property, plant and equipment(319)  (322) 
Proceeds from long-lived asset disposals   —   
Recall payments180    13   
Free cash flow$2,131    $1,731   
Adjusted net earnings2,440    1,756   
Free cash flow conversion87.3  % 98.6  %