Exhibit 10.19

AMENDMENT NO. 1 TO FIVE-YEAR SENIOR CREDIT AGREEMENT

(HEALTHCARE BUSINESSES)

AMENDMENT NO. 1 TO FIVE-YEAR SENIOR CREDIT AGREEMENT (Healthcare Businesses)
(this “Amendment”), dated as of November 6, 2007, among COVIDIEN INTERNATIONAL
FINANCE S.A., a Luxembourg company (the “Borrower”), COVIDIEN LTD., a Bermuda
company (the “Guarantor”), each Person executing this Amendment as a Lender, and
CITIBANK, N.A., as Administrative Agent.

PRELIMINARY STATEMENTS

(1) The Borrower, the Guarantor, the Lenders and the Administrative Agent are
parties to the Five-Year Senior Credit Agreement, dated as of April 25, 2007 (as
amended, supplemented or otherwise modified from time to time through the date
of this amendment, the “Credit Agreement”).

(2) The parties desire to amend the Credit Agreement to clarify certain
provisions relating to the ratings used to determine the interest rate margin
and facility fee payable under the terms of the existing Credit Agreement.

NOW, THEREFORE, in consideration of the mutual covenants and agreements
contained in this Amendment, and for other good and valuable consideration, the
receipt and sufficiency of which hereby are acknowledged, the parties hereto
agree as follows:

ARTICLE I

DEFINITIONS

Section 1.01 Defined Terms. Capitalized terms used but not defined in this
Amendment shall have the meaning set forth in the Credit Agreement.

Section 1.02 Rules of Construction. The rules of construction set forth in
Section 1.03 of the Credit Agreement shall apply to this Amendment as if fully
set forth herein.

ARTICLE II

AMENDMENTS TO CREDIT AGREEMENT

Section 2.01 Amendment to the Section 1.01: Defined Terms. Section 1.01 of the
Credit Agreement is hereby amended by deleting the definitions for each of
“Fitch Rating”, “Moody’s Rating” and “S&P Rating” and inserting the definitions
set forth below for each of the defined terms:

“Fitch Rating” means, at any time, the rating published by Fitch of the
Borrower’s Index Debt, or, if prior to the date that the initial Index Debt
ratings are available with respect to the Borrower, the ratings of the senior,
unsecured long-term indebtedness for borrowed money of the Guarantor issued by
Fitch.

“Moody’s Rating” means, at any time, the rating published by Moody’s of the
Borrower’s Index Debt, or, if prior to the date that the initial Index Debt
ratings are available with respect to the Borrower, the ratings of the senior,
unsecured long-term indebtedness for borrowed money of the Guarantor issued by
Moody’s.

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“S&P Rating” means, at any time, the rating published by S&P of the Borrower’s
Index Debt, or, if prior to the date that the initial Index Debt ratings are
available with respect to the Borrower, the ratings of the senior, unsecured
long-term indebtedness for borrowed money of the Guarantor issued by S&P.

Section 2.02 Amendment to Schedule 1.01; Pricing Grid. Schedule 1.01 of the
Credit Agreement is hereby amended by deleting the text following the pricing
grid contained on such schedule and inserting the text attached as Exhibit A
hereto in lieu thereof.

ARTICLE III

REPRESENTATIONS AND WARRANTIES

Section 3.01 Representations and Warranties. Each Obligor represents and
warrants to the Administrative Agent and each Lender that this Amendment has
been duly authorized, executed and delivered by each Obligor and constitutes the
legal, valid and binding obligation of such Obligor enforceable against such
Obligor in accordance with its terms, subject to applicable bankruptcy,
insolvency, fraudulent conveyance, reorganization, moratorium and similar laws
affecting creditors’ rights and remedies generally and subject to general
principles of equity, regardless of whether considered in a proceeding in equity
or at law.

Section 3.02 No Default. Each of the Obligors represents and warrants to the
Administrative Agent and each Lender that as of the date hereof, and after
giving effect to this Amendment, no Default has occurred and is continuing.

ARTICLE IV

EFFECTIVENESS

Section 4.01 Conditions to Effectiveness. This Amendment shall be deemed
effective as of the date of the Spin Distributions (the “Amendment Effective
Date”) provided that the following conditions precedent shall have been
satisfied on or as of the date hereof (unless waived by the Required Lenders):

(a) The Administrative Agent (or its counsel) shall have received this
Amendment, duly executed and delivered by the Borrower, the Guarantor, the
Administrative Agent and the Required Lenders.

(b) As of the date hereof, and after giving effect to this Amendment, the
representations and warranties set forth in Section 3.01 of this Amendment are
true and correct in all material respects on and as of the date hereof with the
same effect as though made on and as of such date, except to the extent such
representations and warranties expressly relate to an earlier date, in which
case such representations and warranties were true and correct in all material
respects on and as of such earlier date.

(c) As of the date hereof, and after giving effect to this Amendment, no Default
or Event of Default shall have occurred and be continuing.

Section 4.02 References to Agreement. The Credit Agreement and this Amendment
shall be read, taken and construed as one and the same instrument from and after
the Amendment Effective Date. Any references in the Credit Agreement to “this
Agreement”, “hereunder”,

 

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“herein” or words of like import, and each reference in any other document
executed in connection with the Credit Agreement (including, without limitation,
the Notes), to “the Agreement”, “thereunder”, “therein” or words of like import,
shall, from and after the Amendment Effective Date, mean and be a reference to
the Credit Agreement as amended hereby.

Section 4.03 Continued Effectiveness; Ratification of Loan Documents. The Credit
Agreement and the other Loan Documents, each as modified by this Amendment, are
and shall continue to be in full force and effect and are hereby ratified and
confirmed in all respects.

ARTICLE V

MISCELLANEOUS

Section 5.01 Execution in Counterparts. This Amendment may be executed in
counterparts (and by different parties hereto on different counterparts), each
of which shall constitute an original, but all of which when taken together
shall constitute a single contract. Delivery of an executed counterpart of a
signature page of this Amendment by facsimile or any electronic means that
reproduces an image of the actual executed signature page shall be effective as
delivery of a manually executed counterpart of this Amendment.

Section 5.02 Fees, Costs and Expenses. The Borrower agrees to pay all reasonable
out of pocket expenses incurred by the Administrative Agent, including the
reasonable fees, charges and disbursements of counsel for the Administrative
Agent, in connection with the preparation, negotiation, execution, delivery and
administration of this Amendment and the other Loan Documents or any amendments,
modifications or waivers of the provisions hereof and thereof (whether or not
the transactions contemplated hereby or thereby shall be consummated).

Section 5.03 Loan Document. This Amendment shall be deemed to be a Loan
Document.

Section 5.04 Binding Effect. Upon the satisfaction of the conditions set forth
in Section 4.01, this Amendment shall be binding upon and inure to the benefit
of the Borrower, the Guarantor, the Lenders and the Administrative Agent and, in
each case, their respective successors and assigns.

Section 5.05 Governing Law. This Amendment shall be governed by, and construed
in accordance with, the law of the State of New York.

[Remainder of page intentionally left blank]

 

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly
executed by their respective authorized officers as of the day and year first
above written.

 

COVIDIEN INTERNATIONAL FINANCE S.A.

By:

 

/s/ Michelangelo F. Stefani

Name:

  Michelangelo F. Stefani

Title:

  Managing Director

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

COVIDIEN LTD.

By:

 

/s/ Charles J. Dockendorff

Name:

  Charles J. Dockendorff

Title:

  Executive Vice President and Chief Financial Officer

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

CITIBANK, N.A., as a Lender and as Administrative Agent

By:

 

/s/ Kevin A. Ege

Name:

  Kevin A. Ege

Title:

  Vice President

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

UBS LOAN FINANCE LLC

By:

 

/s/ Irja R. Otsa

Name:

  Irja R. Otsa

Title:

  Associate Director

By:

 

/s/ Richard L. Tavrow

Name:

  Richard L. Tavrow

Title:

  Director

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

BANK OF AMERICA, N.A.

By:

 

/s/ Gabriela B. Millhorn

Name:

  Gabriela B. Millhorn

Title:

  Senior Vice President

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

BNP PARIBAS

By:

 

/s/ Richard Pace

Name:

  Richard Pace

Title:

  Managing Director

By:

 

/s/ Berangere Allen

Name:

  Berangere Allen

Title:

  Vice President

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

DEUTSCHE BANK AG NEW YORK BRANCH

By:

 

/s/ Ming K. Chu

Name:

  Ming K. Chu

Title:

  Vice President

By:

 

/s/ Heidi Sandquist

Name:

  Heidi Sandquist

Title:

  Vice President

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

MORGAN STANLEY SENIOR FUNDING, INC.

By:

 

/s/ Daniel Twenge

Name:

  Daniel Twenge

Title:

  Vice President

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

WILLIAM STREET COMMITMENT CORPORATION

By:

 

/s/ Mark Walton

Name:

  Mark Walton

Title:

  Assistant Vice President

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

BARCLAYS BANK PLC

By:

 

/s/ David Barton

Name:

  David Barton

Title:

  Associate Director

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

JPMORGAN CHASE BANK, N.A.

By:

 

/s/ Stephanie Parker

Name:

  Stephanie Parker

Title:

  Executive Director

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

LEHMAN BROTHERS BANK, FSB

By:

 

/s/ Janine M. Shugan

Name:

  Janine M. Shugan

Title:

  Authorized Signatory

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

ABN AMRO BANK N.V.

By:

 

/s/ Alexander M. Bloo

Name:

  Alexander M. Bloo

Title:

  Managing Director

By:

 

/s/ Marc Brandylee

Name:

  Marc Brandylee

Title:

  Associate

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

MIZUHO CORPORATE BANK (USA)

By:

 

/s/ Raymond Ventura

Name:

  Raymond Ventura

Title:

  Deputy General Manager

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

SUMITOMO MITSUI BANKING CORPORATION, NEW YORK

By:

 

/s/ Yoshihiro Hyakutome

Name:

  Yoshihiro Hyakutome

Title:

  General Manager

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

BAYERISCHE LANDESBANK, NEW YORK BRANCH

By:

 

/s/ Matthew DeCarlo

Name:

  Matthew DeCarlo

Title:

  Vice President

By:

 

/s/ Nikolai von Mengden

Name:

  Nikolai von Mengden

Title:

  Senior Vice President

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

ING CAPITAL LLC

By:

 

/s/ John Kippax

Name:

  John Kippax

Title:

  Managing Director

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

INTESA SANPAOLO S.P.A., NEW YORK BRANCH (AS SUCCESSOR TO SANPAOLO IMI S.P.A.)

By:

 

/s/ Luca Sacchi

Name:

  Luca Sacchi

Title:

  Vice President

By:

 

/s/ D. Mara Lowenstein

Name:

  D. Mara Lowenstein

Title:

  General Counsel

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

MELLON BANK, N.A. By:  

/s/ Daniel J. Lenckos

Name:   Daniel J. Lenckos Title:   First Vice President

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

SOCIETE GENERALE

By:  

/s/ Nigel Elvey

Name:   Nigel Elvey Title:   Vice President

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

THE BANK OF NOVA SCOTIA By:  

[signature illegible]

Name:   Title:  

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

BANCO BILBAO VIZCAYA ARGENTARIA, S.A.

By:  

/s/ Jay Levit

Name:   Jay Levit Title:   Vice President By:  

/s/ John Martini

Name:   John Martini Title:   Vice President

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

THE NORTHERN TRUST COMPANY By:  

/s/ Courtney L. O’Connor

Name:   Courtney L. O’Connor Title:   2nd Vice President

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

WESTPAC BANKING CORPORATION By:  

/s/ H. Jensen

Name:   H. Jensen Title:   Vice President

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[Signature Page to Amendment No. 1 to Revolving Credit Agreement]

 

THE GOVERNOR AND COMPANY OF THE BANK OF IRELAND

By:  

/s/

Name:   Title:  

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Exhibit A

The Facility Fee and the Applicable Margin for Eurodollar Loans shall be, at any
time, the rate per annum set forth in the Pricing Grid opposite the Index Debt
Rating of the Borrower By: S&P, Moody’s and Fitch; provided, however that prior
to the date that initial Index Debt Ratings are available from each of S&P,
Moody’s and Fitch with respect to the Borrower, the rating of the senior,
unsecured long-term indebtedness for borrowed money of the Guarantor (“Guarantor
Debt”) issued by S&P, Moody’s and Fitch (which may be called the “corporate
credit rating”, “issuer rating”, “issuer default rating”, or some similar term)
and not the Index Debt Rating shall be used to determine the Facility Fee and
Applicable Margin for Eurodollar Loans (and for such period all references in
the body of this Agreement to an Index Debt Rating or a rating of Index Debt
shall be deemed to be references instead to such ratings of the Guarantor Debt
as applicable); provided, however, that if the S&P Rating, the Moody’s Rating
and the Fitch Rating fall within different levels, then (i) if two of the
ratings are at the same level and the other rating is one level higher or one
level lower than the two same ratings, then the Facility Fee and the Applicable
Margin will be based on the two ratings at the same level, (ii) if two of the
ratings are at the same level and the other rating is two or more levels above
the two same ratings, then the Facility Fee and the Applicable Margin will be
based on the rating that is one level above the two same ratings, (iii) if two
of the ratings are at the same level and the other rating is two or more levels
below the two same ratings, then the Facility Fee and the Applicable Margin will
be based on the rating that is one level below the two same ratings, and (iv) if
each of the three ratings fall within different levels, then the Facility Fee
and the Applicable Margin will be determined based on the rating level that is
in between the highest and the lowest ratings. If, at any time, a rating of the
Borrower’s Index Debt (or Guarantor Debt, if applicable) is available from only
two of S&P, Moody’s and Fitch, then the Facility Fee and the Applicable Margin
shall be based on the Index Debt Rating available from such two rating agencies.
If the immediately preceding sentence is applicable and the two available
ratings referred to in such preceding sentence fall within different levels, the
Facility Fee and the Applicable Margin shall be determined based on the higher
rating and if the ratings differ by more than one level, the Facility Fee and
the Applicable Margin shall be determined based on the rating one level lower
than the higher rating. If, at any time, a rating of the Borrower’s Index Debt
(or the Guarantor Debt, if applicable as provided above) is available from only
one of or none of S&P, Moody’s, Fitch or any other nationally recognized
statistical rating organization designated by the Borrower and approved in
writing by the Required Lenders (an “Approved Agency”), then the Facility Fee
and the Applicable Margin for each period commencing during the 30 days
following the time there ceased to be at least two such ratings available shall
be the Facility Fee and the Applicable Margin in effect immediately prior to
such cessation. Thereafter, the rating to be used until ratings from at least
two of S&P, Moody’s, Fitch or such other Approved Agency become available shall
be as agreed between the Borrower and the Required Lenders, and the Borrower and
the Required Lenders shall use good faith efforts to reach such agreement within
such 30-day period; provided, however, that if no such agreement is reached
within such 30-day period, then the Facility Fee and the Applicable Margin

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thereafter, until such agreement is reached, shall be (a) if any such rating has
become unavailable as a result of S&P, Moody’s, Fitch or any other Approved
Agency ceasing its business as a rating agency, the Facility Fee and the
Applicable Margin in effect immediately prior to such cessation or
(b) otherwise, the Facility Fee and the Applicable Margin as set forth opposite
the Index Debt Rating “(BBB-/Baa3/BBB- or lower)” on the Pricing Grid. If the
rating of the Guarantor Debt is used to determine the Applicable Margin and the
Facility Fee, the provisions set forth in the second proviso hereof through the
end of this paragraph shall apply with respect to any split rating or lack of
any rating of the Guarantor Debt to the same effect as such provisions apply to
the Borrower’s Index Debt.