EXHIBIT 10.3

EXECUTION COPY

SUPPLEMENTAL INDENTURE

SUPPLEMENTAL INDENTURE (this “Supplemental Indenture”), dated as of January 27,
2011, among Angiotech Pharmaceuticals, Inc., a corporation organized under the
Business Corporation Act of the Province of British Columbia (the “Company”),
the Guarantors under the Indenture (as defined and referred to below) and U.S.
Bank National Association, as successor to Deutsche Bank National Trust Company,
successor to Wells Fargo Bank, N.A., as trustee (the “Trustee”) under the
Indenture. All capitalized terms used but not otherwise defined herein shall
have the meaning assigned thereto in the Indenture.

W I T N E S S E T H :

WHEREAS, the Company and the Guarantors have heretofore executed and delivered
to the Trustee an Indenture, dated as of March 23, 2006 (as amended,
supplemented or otherwise modified from time to time, the “Indenture”),
providing for the issuance of the Company’s 7.75% Senior Subordinated Notes Due
2014 (the “Notes”);

WHEREAS, Section 9.02 of the Indenture provides that under certain circumstances
the Company and the Trustee, with the consent of the holders of at least a
majority in aggregate principal amount of the outstanding Notes, may amend or
supplement the Indenture;

WHEREAS, on October 29, 2010, the Company and the Guarantors entered into a
supplemental indenture in order to extend the grace period for payment of
interest due on the Notes from 30 days to 60 days prior to the occurrence of an
Event of Default;

WHEREAS, on November 29, 2010, the Company and the Guarantors entered into a
supplemental indenture in order to further extend the grace period for payment
of interest due on the Notes from 60 days to 90 days prior to the occurrence of
an Event of Default;

WHEREAS, on December 21, 2010, the Company and the Guarantors entered into a
supplemental indenture in order to further extend the grace period for payment
of interest due on the Notes from 90 days to 120 days prior to the occurrence of
an Event of Default;

WHEREAS, the Board of Directors of the Company has determined that it is in the
Company’s best interest to enter into, and has authorized the execution of, this
Supplemental Indenture in order to further extend the grace period for payment
of interest due on the Notes from 120 days to 211 days prior to the occurrence
of an Event of Default (the “Amendment”);

WHEREAS, the holders of at least a majority in aggregate principal amount of the
outstanding Notes have consented to the Amendment and the Company has filed with
the Trustee evidence of such consent satisfactory to the Trustee; and

WHEREAS, pursuant to Section 9.02 of the Indenture, the Trustee is authorized to
execute and deliver this Supplemental Indenture.

NOW THEREFORE, in consideration of the foregoing and for other good and valuable
consideration, the receipt of which is hereby acknowledged, the parties mutually
covenant and agree for the equal and ratable benefit of the Holders as follows:

1. Ratification of Indenture; Supplemental Indentures Part of Indenture. Except
as expressly amended hereby, the Indenture is in all respects ratified and
confirmed and all the terms, conditions and provisions thereof shall remain in
full force and effect. This Supplemental Indenture shall form a part of the
Indenture for all purposes, and every holder of Notes heretofore or hereafter
authenticated and delivered shall be bound hereby.

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2. Amendment to Indenture. Section 6.01(1) of the Indenture is hereby amended
and restated as follows:

“default for 211 days in the payment when due of interest on, or Additional
Interest, if any, with respect to, the Notes, whether or not prohibited by the
subordination provisions of this Indenture;”

3. Opinion of Counsel. Concurrently with the execution and delivery of this
Supplemental Indenture, the Company shall deliver to the Trustee an Officers’
Certificate and an Opinion of Counsel in accordance with the terms set forth in
Sections 7.02, 9.02, 13.04 and 13.05 of the Indenture.

4. Successors. All agreements of the Company and the Guarantors in this
Supplemental Indenture shall bind their respective successors. All agreements of
the Trustee in this Supplemental Indenture shall bind its successors.

5. Governing Law. THE LAW OF THE STATE OF NEW YORK SHALL GOVERN AND BE USED TO
CONSTRUE THIS SUPPLEMENTAL INDENTURE. The parties to this Supplemental Indenture
each hereby irrevocably submits to the non-exclusive jurisdiction of any New
York State or federal court sitting in the Borough of Manhattan in The City of
New York in any action or proceeding arising out of or relating to the Notes or
this Supplemental Indenture, and all such parties hereby irrevocably agree that
all claims in respect of such action or proceeding may be heard and determined
in such New York State or federal court and hereby irrevocably waive, to the
fullest extent that they may legally do so, the defense of an inconvenient forum
to the maintenance of such action or proceeding. EACH OF THE PARTIES HERETO
HEREBY IRREVOCABLY WAIVES, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW,
ANY AND ALL RIGHT TO TRIAL BY JURY IN ANY ACTION OR PROCEEDING ARISING OUT OF OR
RELATING TO THIS SUPPLEMENTAL INDENTURE, THE NOTES OR THE TRANSACTIONS
CONTEMPLATED HEREBY.

6. Counterparts. The parties may sign any number of copies of this Supplemental
Indenture. Each signed copy (including any facsimile) shall be an original, but
all of them together represent the same agreement.

7. Effect of Headings. The Section headings herein are for convenience only and
shall not effect the construction thereof.

8. Trustee. The Trustee makes no representations as to the validity or
sufficiency of this Supplemental Indenture. The recitals and statements herein
are deemed to be those of the Company and the Guarantors and not of the Trustee.

9. Severability. In case any provision in this Supplemental Indenture shall be
invalid, illegal or unenforceable, the validity, legality and enforceability of
the remaining provisions shall not in any way be affected or impaired thereby.

10. Trust Indenture Act Controls. If any provision of this Supplemental
Indenture limits, qualifies or conflicts with another provision that is required
to be included in this Supplemental Indenture or the Indenture by the Trust
Indenture Act of 1939, as amended, as in force at the date that this
Supplemental Indenture is executed, the provisions required by said Act shall
control.

[Remainder of Page Intentionally Left Blank; Signature Pages Follow]

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IN WITNESS WHEREOF, the parties hereto have caused this Supplemental Indenture
to be duly executed as of the date first above written.

 

ANGIOTECH PHARMACEUTICALS, INC. By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: Chief Financial Officer

 

[Signature Page to Supplemental Indenture]

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0741693 B.C. LTD. By:  

/s/ Jay Dent

  Name: Jay Dent   Title: President

 

[Signature Page to Supplemental Indenture]

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AFMEDICA, INC. By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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AMERICAN MEDICAL INSTRUMENTS HOLDINGS, INC. By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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ANGIOTECH AMERICA, INC. By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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ANGIOTECH BIOCOATINGS CORP. By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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ANGIOTECH DELAWARE, INC. (F/K/A AMERICAN MEDICAL INSTRUMENTS, INC.) By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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ANGIOTECH FLORIDA HOLDINGS, INC. By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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ANGIOTECH INTERNATIONAL HOLDINGS, CORP. By:  

/s/ Jay Dent

  Name: Jay Dent   Title: President

 

[Signature Page to Supplemental Indenture]

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ANGIOTECH PHARMACEUTICALS (US), INC. By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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B.G. SULZLE, INC. By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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MANAN MEDICAL PRODUCTS, INC. By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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MEDICAL DEVICE TECHNOLOGIES, INC. By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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NEUCOLL, INC. By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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QUILL MEDICAL, INC. By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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SURGICAL SPECIALTIES CORPORATION By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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SURGICAL SPECIALTIES PUERTO RICO, INC. By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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SURGICAL SPECIALTIES UK HOLDINGS LIMITED By:  

/s/ K. Thomas Bailey

  Name: K. Thomas Bailey   Title: President

 

[Signature Page to Supplemental Indenture]

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U.S. BANK NATIONAL ASSOCIATION, as Trustee By:  

/s/ Timothy Sandell

  Name: Timothy Sandell   Title: Vice President

 

[Signature Page to Supplemental Indenture]