in addition , the affordable care act imposed a 2.3 % excise tax on sales of medical devices , beginning in 2013. for the years ended december 31 , 2014 and 2013 , we paid medical device excise taxes of $ 12.7 million and $ 11.5 million , respectively , which is included in selling , general and administrative expenses . global economic conditions global economic conditions in recent years have had adverse impacts on market activities including , among other things , failure of financial institutions , falling asset values , diminished liquidity , reduced demand for products and services and significant fluctuations in foreign currency exchange rates . in response , we adjusted production levels and engaged in new restructuring activities . we continue to review and evaluate our manufacturing , warehousing and distribution processes to maximize efficiencies through the elimination of redundancies in our operations and the consolidation of facilities . although , on a consolidated basis , the economic conditions did not have a significant adverse impact on our financial position , results of operations or liquidity , healthcare policies and practice trends vary by country , and the impact of the global economic downturn was felt to varying degrees in each of our regional markets over the last several years . the continuation of the present broad economic trends of weak economic growth , constricted credit , public sector austerity measures in response to public budget deficits and foreign currency volatility , particularly the euro , could have a material adverse effect on our results of operations and our liquidity . hospitals in some regions of the united states experienced a decline in admissions , a weaker payor mix , and a reduction in elective procedures . consequently , hospitals took actions to reduce their costs , including limiting their capital spending . more recently , the economic environment has improved somewhat , but has not returned to pre-recession levels , and challenges persist , particularly in some european countries , as discussed below . approximately 94 % of our net revenues come from single-use products primarily used in critical care and surgical applications , and our sales volume could be negatively impacted if hospital admission rates or payor mix change as a result of continuing higher than normal unemployment rates ( and subsequent loss of insurance coverage by consumers ) . conversely , our sales volume could be positively impacted due to increases in the number of insured individuals as a result of the affordable care act , which has had the effect of facilitating medical insurance coverage for many persons who previously were not covered . europe continues to contend with considerable government debt and annual deficits , high levels of unemployment and the risk of deflation . these factors have resulted in austerity programs that have affected the healthcare sector in european countries . these austerity programs have resulted in delays in elective surgeries in a number of countries and reductions in health budgets . it is likely that funding for publicly funded healthcare institutions will continue to be affected if governments make further spending adjustments and enact healthcare reform measures to lower overall healthcare costs . the public healthcare systems in certain countries in western europe , most notably greece , spain , portugal and italy , have experienced significantly reduced liquidity due to recessionary conditions , which has resulted in a slowdown in payments to us . the slowdown has continued to affect the timing of collections from these customers . in asia , recovery from the global recession has varied by country . china announced plans for major healthcare investment directed to second tier cities ( newer cities resulting from china 's urbanization of the north and west regions of the country ) and hospitals , which may provide future growth opportunities for us . despite these growth opportunities , distributor sales to third parties slowed in 2014 , particularly in china , which could have an impact on this future growth . additionally , slow economic growth and continued pursuit of reimbursement cuts by the public hospital sector in japan is expected to limit growth in that market . in latin america , some highly regulated economies such as argentina and venezuela have experienced unusually high inflation rates and weakening currencies . this has impacted the budgets of the public healthcare systems resulting in delays in the importation of medical devices . although not a significant portion of our business , our operations in this region may be impacted by these factors . 36 results of operations the following comparisons exclude the impact of discontinued operations ( see note 18 to the consolidated financial statements included in this annual report on form 10-k for discussion of discontinued operations ) . certain financial information is presented on a rounded basis , which may cause minor differences . revenues replace_table_token_6_th comparison of 2014 and 2013 net revenues for the twelve months ended december 31 , 2014 increased 8.5 % to $ 1,839.8 million from $ 1,696.3 million in the twelve months ended december 31 , 2013. the $ 143.5 million increase in net revenues is largely due to the businesses acquired during 2013 and 2014 , which generated net revenues of $ 98.6 million , including $ 79.9 million , $ 16.6 million and $ 2.2 million generated by vidacare , mayo healthcare and ultimate , respectively . net revenues further benefited from price increases of $ 23.9 million , primarily in the asia , emea and surgical north america segments , new product sales of $ 14.8 million , primarily in the emea , anesthesia/respiratory north america , vascular north america and asia segments and higher sales volume of $ 12.3 million , primarily in the oem and emea segments . story_separator_special_tag in the first quarter of 2013 , we recorded a $ 4.5 million ipr & d charge pertaining to a research and development project associated with our acquisition of substantially all of the assets of axiom technology partners llc because technological feasibility had not yet been achieved and we determined that the subject technology had no future alternative use . long-lived asset impairment in the third quarter of 2013 , we recorded $ 3.5 million in impairment charges related to assets held for sale that had a carrying value in excess of their appraised fair value . for additional information regarding our restructuring programs and impairment charges , see note 4 to the consolidated financial statements included in this annual report on form 10-k. 41 interest income and expense replace_table_token_11_th interest expense increased for the twelve months ended december 31 , 2014 , compared to the corresponding period in 2013 , due to an increase of $ 96 million in average outstanding debt and an increase of 18 basis points in the average interest rate on outstanding debt during 2014. interest expense decreased for the twelve months ended december 31 , 2013 , compared to the corresponding period in 2012 , primarily because 2012 interest expense included amortization expense related to our termination of an interest rate swap ( approximately $ 11.1 million for the twelve months ended december 31 , 2012 ) . we terminated our agreement related to the interest rate swap , covering a notional amount of $ 350 million , in 2011. the unrealized losses within accumulated other comprehensive income associated with our interest rate swap were reclassified into our statement of income ( loss ) during 2012. story_separator_special_tag style= `` line-height:120 % ; padding-top:8px ; font-size:10pt ; `` > vascular north america vascular north america net revenues for the twelve months ended december 31 , 2013 increased $ 8.4 million compared to the corresponding period in 2012 , an increase of 3.8 % . the increase was primarily due to new product sales of $ 7.7 million , businesses acquired in 2013 , which added $ 2.4 million and price increases of $ 2.3 million . these increases in net revenues were partly offset by decreases in sales volume of existing products of $ 3.7 million and the unfavorable impact of foreign currency exchange rates of $ 0.3 million . vascular north america operating profit for the twelve months ended december 31 , 2013 decreased $ 2.2 million compared to the corresponding period in 2012 , a decrease of 8.6 % . the decrease was primarily due to the decline in sales volume of existing products , higher warehouse and freight costs , a decrease in sales of higher margin products and the excise tax associated with the affordable care act , partially offset by an increase in sales of new products , price increases and operating profit generated from businesses acquired in 2013. anesthesia/respiratory north america anesthesia/respiratory north america net revenues for the twelve months ended december 31 , 2013 increased $ 48.1 million compared to the corresponding period in 2012 , an increase of 26.7 % . the increase was primarily due to lma product sales of $ 52.0 million and new product sales of $ 3.0 million , partially offset by lower sales volume of $ 6.9 million . anesthesia/respiratory north america operating profit for the twelve months ended december 31 , 2013 increased $ 7.9 million compared to the corresponding period in 2012 , an increase of 56.0 % . the increase was primarily due to operating profit generated by lma product sales and an increase in sales of new products , partially offset by the decline in sales volume of existing products , higher raw material and manufacturing costs and the excise tax associated with the affordable care act . surgical north america surgical north america net revenues for the twelve months ended december 31 , 2013 increased $ 2.2 million compared to the corresponding period in 2012 , an increase of 1.5 % . the increase was primarily due to price increases of $ 4.4 million and sales of new products of $ 1.3 million , partially offset by a decline in sales volume of existing products of $ 2.7 million and the unfavorable impact of foreign currency exchange rates of $ 0.5 million . 45 surgical north america operating profit for the twelve months ended december 31 , 2013 decreased $ 0.2 million compared to the corresponding period in 2012 , a decrease of 0.6 % . the decrease was primarily due to a decline in volume of sales of existing products and the excise tax associated with the affordable care act , partially offset by improved pricing , sales of higher margin products and the favorable impact from the reversal of contingent consideration related to our axiom acquisition . emea emea net revenues for the twelve months ended december 31 , 2013 increased $ 47.1 million compared to the corresponding period in 2012 , an increase of 9.2 % . the increase was primarily due to businesses acquired in 2012 and 2013 , which added net revenues of $ 25.6 million , including $ 24.2 million generated by the lma business ; the favorable impact of foreign currency exchange rates of $ 11.6 million , price increases of $ 5.7 million , including increases resulting from distributor-to-direct conversions , new product sales of $ 2.9 million and higher sales volume of existing products of $ 1.3 million . emea segment operating profit for the twelve months ended december 31 , 2013 increased $ 22.1 million compared to the corresponding period in 2012 , an increase of 33.5 % . the increase in operating profit reflects lower manufacturing costs due to improved absorption and lower overhead costs as a result of process improvements , margin improvements driven by price increases resulting from distributor-to-direct conversions , as well as other price increases , the operating profit generated by the

loss on extinguishments of debt replace_table_token_12_th during the third quarter of 2013 , we refinanced our $ 775.0 million senior credit facility , which was comprised of a $ 375.0 million term loan and a $ 400.0 million revolving credit facility with a new $ 850.0 million senior credit facility consisting solely of a revolving credit facility . in connection with the refinancing , we recognized debt extinguishment costs of $ 1.3 million related to unamortized debt issuance costs resulting from the early repayment of the $ 375.0 million term loan . see note 8 to the consolidated financial statements included in this annual report on form 10-k for further information . taxes on income from continuing operations replace_table_token_13_th the effective income tax rate in 2014 was 13.0 % compared to 13.4 % in 2013. taxes on income from continuing operations in 2014 were $ 28.7 million compared to $ 23.5 million in 2013. the effective income tax rate for 2014 was impacted by a benefit from a shift in the mix of income to jurisdictions with lower statutory tax rates , tax benefits associated with u.s. federal tax return filings and , although to a lesser extent than 2013 , the realization of net tax benefits resulting from the expiration of statutes of limitation for u.s. state and foreign matters . the effective income tax rate in 2013 was 13.4 % compared to ( 9.9 ) % in 2012. taxes on income from continuing operations in 2013 were $ 23.5 million compared to $ 16.4 million in 2012. the effective income tax rate for 2013 was impacted by the realization of net tax benefits resulting from the expiration of statutes of limitation for u.s. federal and state and for foreign matters , tax benefits associated with u.s. and foreign tax return filings and the realization of tax benefits resulting from the resolution of a foreign tax matter . the effective income tax rate for 2012 was impacted by a $ 332 million goodwill impairment charge recorded in the first quarter 2012 , for which only $ 45 million was tax deductible .


 Write a concise suspicious activity report of the following text delimited by triple backquotes. Return your response as a formal report which covers the key points highlighting the location,dates,entity names and account holder information in chronological order of the text.
     ```loss on extinguishments of debt replace_table_token_12_th during the third quarter of 2013 , we refinanced our $ 775.0 million senior credit facility , which was comprised of a $ 375.0 million term loan and a $ 400.0 million revolving credit facility with a new $ 850.0 million senior credit facility consisting solely of a revolving credit facility . in connection with the refinancing , we recognized debt extinguishment costs of $ 1.3 million related to unamortized debt issuance costs resulting from the early repayment of the $ 375.0 million term loan . see note 8 to the consolidated financial statements included in this annual report on form 10-k for further information . taxes on income from continuing operations replace_table_token_13_th the effective income tax rate in 2014 was 13.0 % compared to 13.4 % in 2013. taxes on income from continuing operations in 2014 were $ 28.7 million compared to $ 23.5 million in 2013. the effective income tax rate for 2014 was impacted by a benefit from a shift in the mix of income to jurisdictions with lower statutory tax rates , tax benefits associated with u.s. federal tax return filings and , although to a lesser extent than 2013 , the realization of net tax benefits resulting from the expiration of statutes of limitation for u.s. state and foreign matters . the effective income tax rate in 2013 was 13.4 % compared to ( 9.9 ) % in 2012. taxes on income from continuing operations in 2013 were $ 23.5 million compared to $ 16.4 million in 2012. the effective income tax rate for 2013 was impacted by the realization of net tax benefits resulting from the expiration of statutes of limitation for u.s. federal and state and for foreign matters , tax benefits associated with u.s. and foreign tax return filings and the realization of tax benefits resulting from the resolution of a foreign tax matter . the effective income tax rate for 2012 was impacted by a $ 332 million goodwill impairment charge recorded in the first quarter 2012 , for which only $ 45 million was tax deductible .
```    
 Suspicious Activity Report : in addition , the affordable care act imposed a 2.3 % excise tax on sales of medical devices , beginning in 2013. for the years ended december 31 , 2014 and 2013 , we paid medical device excise taxes of $ 12.7 million and $ 11.5 million , respectively , which is included in selling , general and administrative expenses . global economic conditions global economic conditions in recent years have had adverse impacts on market activities including , among other things , failure of financial institutions , falling asset values , diminished liquidity , reduced demand for products and services and significant fluctuations in foreign currency exchange rates . in response , we adjusted production levels and engaged in new restructuring activities . we continue to review and evaluate our manufacturing , warehousing and distribution processes to maximize efficiencies through the elimination of redundancies in our operations and the consolidation of facilities . although , on a consolidated basis , the economic conditions did not have a significant adverse impact on our financial position , results of operations or liquidity , healthcare policies and practice trends vary by country , and the impact of the global economic downturn was felt to varying degrees in each of our regional markets over the last several years . the continuation of the present broad economic trends of weak economic growth , constricted credit , public sector austerity measures in response to public budget deficits and foreign currency volatility , particularly the euro , could have a material adverse effect on our results of operations and our liquidity . hospitals in some regions of the united states experienced a decline in admissions , a weaker payor mix , and a reduction in elective procedures . consequently , hospitals took actions to reduce their costs , including limiting their capital spending . more recently , the economic environment has improved somewhat , but has not returned to pre-recession levels , and challenges persist , particularly in some european countries , as discussed below . approximately 94 % of our net revenues come from single-use products primarily used in critical care and surgical applications , and our sales volume could be negatively impacted if hospital admission rates or payor mix change as a result of continuing higher than normal unemployment rates ( and subsequent loss of insurance coverage by consumers ) . conversely , our sales volume could be positively impacted due to increases in the number of insured individuals as a result of the affordable care act , which has had the effect of facilitating medical insurance coverage for many persons who previously were not covered . europe continues to contend with considerable government debt and annual deficits , high levels of unemployment and the risk of deflation . these factors have resulted in austerity programs that have affected the healthcare sector in european countries . these austerity programs have resulted in delays in elective surgeries in a number of countries and reductions in health budgets . it is likely that funding for publicly funded healthcare institutions will continue to be affected if governments make further spending adjustments and enact healthcare reform measures to lower overall healthcare costs . the public healthcare systems in certain countries in western europe , most notably greece , spain , portugal and italy , have experienced significantly reduced liquidity due to recessionary conditions , which has resulted in a slowdown in payments to us . the slowdown has continued to affect the timing of collections from these customers . in asia , recovery from the global recession has varied by country . china announced plans for major healthcare investment directed to second tier cities ( newer cities resulting from china 's urbanization of the north and west regions of the country ) and hospitals , which may provide future growth opportunities for us . despite these growth opportunities , distributor sales to third parties slowed in 2014 , particularly in china , which could have an impact on this future growth . additionally , slow economic growth and continued pursuit of reimbursement cuts by the public hospital sector in japan is expected to limit growth in that market . in latin america , some highly regulated economies such as argentina and venezuela have experienced unusually high inflation rates and weakening currencies . this has impacted the budgets of the public healthcare systems resulting in delays in the importation of medical devices . although not a significant portion of our business , our operations in this region may be impacted by these factors . 36 results of operations the following comparisons exclude the impact of discontinued operations ( see note 18 to the consolidated financial statements included in this annual report on form 10-k for discussion of discontinued operations ) . certain financial information is presented on a rounded basis , which may cause minor differences . revenues replace_table_token_6_th comparison of 2014 and 2013 net revenues for the twelve months ended december 31 , 2014 increased 8.5 % to $ 1,839.8 million from $ 1,696.3 million in the twelve months ended december 31 , 2013. the $ 143.5 million increase in net revenues is largely due to the businesses acquired during 2013 and 2014 , which generated net revenues of $ 98.6 million , including $ 79.9 million , $ 16.6 million and $ 2.2 million generated by vidacare , mayo healthcare and ultimate , respectively . net revenues further benefited from price increases of $ 23.9 million , primarily in the asia , emea and surgical north america segments , new product sales of $ 14.8 million , primarily in the emea , anesthesia/respiratory north america , vascular north america and asia segments and higher sales volume of $ 12.3 million , primarily in the oem and emea segments . story_separator_special_tag in the first quarter of 2013 , we recorded a $ 4.5 million ipr & d charge pertaining to a research and development project associated with our acquisition of substantially all of the assets of axiom technology partners llc because technological feasibility had not yet been achieved and we determined that the subject technology had no future alternative use . long-lived asset impairment in the third quarter of 2013 , we recorded $ 3.5 million in impairment charges related to assets held for sale that had a carrying value in excess of their appraised fair value . for additional information regarding our restructuring programs and impairment charges , see note 4 to the consolidated financial statements included in this annual report on form 10-k. 41 interest income and expense replace_table_token_11_th interest expense increased for the twelve months ended december 31 , 2014 , compared to the corresponding period in 2013 , due to an increase of $ 96 million in average outstanding debt and an increase of 18 basis points in the average interest rate on outstanding debt during 2014. interest expense decreased for the twelve months ended december 31 , 2013 , compared to the corresponding period in 2012 , primarily because 2012 interest expense included amortization expense related to our termination of an interest rate swap ( approximately $ 11.1 million for the twelve months ended december 31 , 2012 ) . we terminated our agreement related to the interest rate swap , covering a notional amount of $ 350 million , in 2011. the unrealized losses within accumulated other comprehensive income associated with our interest rate swap were reclassified into our statement of income ( loss ) during 2012. story_separator_special_tag style= `` line-height:120 % ; padding-top:8px ; font-size:10pt ; `` > vascular north america vascular north america net revenues for the twelve months ended december 31 , 2013 increased $ 8.4 million compared to the corresponding period in 2012 , an increase of 3.8 % . the increase was primarily due to new product sales of $ 7.7 million , businesses acquired in 2013 , which added $ 2.4 million and price increases of $ 2.3 million . these increases in net revenues were partly offset by decreases in sales volume of existing products of $ 3.7 million and the unfavorable impact of foreign currency exchange rates of $ 0.3 million . vascular north america operating profit for the twelve months ended december 31 , 2013 decreased $ 2.2 million compared to the corresponding period in 2012 , a decrease of 8.6 % . the decrease was primarily due to the decline in sales volume of existing products , higher warehouse and freight costs , a decrease in sales of higher margin products and the excise tax associated with the affordable care act , partially offset by an increase in sales of new products , price increases and operating profit generated from businesses acquired in 2013. anesthesia/respiratory north america anesthesia/respiratory north america net revenues for the twelve months ended december 31 , 2013 increased $ 48.1 million compared to the corresponding period in 2012 , an increase of 26.7 % . the increase was primarily due to lma product sales of $ 52.0 million and new product sales of $ 3.0 million , partially offset by lower sales volume of $ 6.9 million . anesthesia/respiratory north america operating profit for the twelve months ended december 31 , 2013 increased $ 7.9 million compared to the corresponding period in 2012 , an increase of 56.0 % . the increase was primarily due to operating profit generated by lma product sales and an increase in sales of new products , partially offset by the decline in sales volume of existing products , higher raw material and manufacturing costs and the excise tax associated with the affordable care act . surgical north america surgical north america net revenues for the twelve months ended december 31 , 2013 increased $ 2.2 million compared to the corresponding period in 2012 , an increase of 1.5 % . the increase was primarily due to price increases of $ 4.4 million and sales of new products of $ 1.3 million , partially offset by a decline in sales volume of existing products of $ 2.7 million and the unfavorable impact of foreign currency exchange rates of $ 0.5 million . 45 surgical north america operating profit for the twelve months ended december 31 , 2013 decreased $ 0.2 million compared to the corresponding period in 2012 , a decrease of 0.6 % . the decrease was primarily due to a decline in volume of sales of existing products and the excise tax associated with the affordable care act , partially offset by improved pricing , sales of higher margin products and the favorable impact from the reversal of contingent consideration related to our axiom acquisition . emea emea net revenues for the twelve months ended december 31 , 2013 increased $ 47.1 million compared to the corresponding period in 2012 , an increase of 9.2 % . the increase was primarily due to businesses acquired in 2012 and 2013 , which added net revenues of $ 25.6 million , including $ 24.2 million generated by the lma business ; the favorable impact of foreign currency exchange rates of $ 11.6 million , price increases of $ 5.7 million , including increases resulting from distributor-to-direct conversions , new product sales of $ 2.9 million and higher sales volume of existing products of $ 1.3 million . emea segment operating profit for the twelve months ended december 31 , 2013 increased $ 22.1 million compared to the corresponding period in 2012 , an increase of 33.5 % . the increase in operating profit reflects lower manufacturing costs due to improved absorption and lower overhead costs as a result of process improvements , margin improvements driven by price increases resulting from distributor-to-direct conversions , as well as other price increases , the operating profit generated by the

