Exhibit 10.9
Addendum No. 1
EXECUTION COPY

AMENDMENT NO. 1 TO DISTRIBUTOR AGREEMENT

This AMENDMENT NO. 1 TO DISTRIBUTOR AGREEMENT (the "Amendment") dated as of December 9, 2000 (the "Effective Date"), is by and between Ethicon
EndoSurgery, Inc., an Ohio corporation ("EES"), and Fischer Imaging Corporation, a Delaware corporation ("Fischer").

Preliminary Statement

Pursuant to a Distributor Agreement dated December 8, 1998 (the "Agreement") Fischer and EES set forth a commercial relationship including the grant by
Fischer to EES of the right to distribute Fischer's stereotactic X-ray imaging products on an exclusive basis in Germany and Italy and a non-exclusive basis in the remainder of
Europe. Fischer and EES wish to expand the exclusive territories and revise transfer pricing for the products as set forth below.

ACCORDINGLY,
in consideration of the foregoing and the mutual covenants, agreements and warranties herein contained, the parties hereby agree as follows:

ARTICLE I
DEFINITIONS

All defined terms used but not otherwise defined herein shall have the meanings given to such term in the Agreement.

ARTICLE II
EFFECTIVE DATE

Unless otherwise specified herein, all amendments to the Agreement shall be effective as of the Effective Date.

ARTICLE III
EXPANSION OF EXCLUSIVE TERRITORY

The definition of Exclusive Territory in Section 1.02 of the 1998 Agreement shall be amended by deleting the existing definition and substituting in lieu
thereof the following:

"Exclusive
Territory" shall mean the countries of the continent of Europe, the countries of the region known as the Middle East and the country of South Africa.

The
definition of Non-Exclusive Territory in Section 1.04 of the 1998 Agreement shall be deleted in its entirety.

Section 2.02(a)
of the 1998 Agreement "Appointment" shall be deleted in its entirety and the following substituted in lieu thereof:

"(a)
the authorized, independent Distributor of the Products in the Exclusive Territory. EES shall have exclusive distribution rights in the Exclusive Territory for the Products during
the Term so long as EES sells a minimum of twenty five (25) new stereotactic tables in the Exclusive Territory on an annual basis. If EES does not meet the requirements for exclusivity set
forth above, the right of EES to distribute the Products in the Exclusive Territory shall be converted to non-exclusive rights during the subsequent twelve month period. While EES meets
the requirement for exclusivity set forth above, Fischer and its Affiliates may not themselves, nor may they appoint a distributor or cause an existing distributor to sell or distribute new or used
Products in the Exclusive Territory."

---

Section 2.02(b)
of the 1998 Agreement regarding the distribution of Product in the Non-Exclusive Territory shall be deleted in its entirety and the following
substituted in lieu thereof:

"(b)
Fischer's exclusive agent to sell Products to Fischer's existing dealers in the Exclusive Territory who are described in the attached Schedule I, such Products to be sold at
List Prices less 30%."

ARTICLE IV
ELIMINATION OF REBATE IN EXCLUSIVE TERRITORIES

Section 2.07. of the 1998 Agreement "Rebate in Exclusive Territories" shall be deleted in its entirety.

ARTICLE V
PERFORMANCE BY FISCHER

Section 4.08 of the 1998 Agreement, "Fischer European Infrastructure" shall be amended by providing that Fischer shall expand the Fischer European
Infrastructure to include the following Employees:



ARTICLE VI
EES RENEWAL OPTIONS

Section 9.01 of the 1998 Agreement, "Term; Termination" shall be amended by adding the following to the end of Section 9.0 1(a):

"This
Agreement may be renewed at the option of ESS for up to two additional two-year periods (each, a "Renewal Period") if the following conditions are met:



2

---



ARTICLE VII
TRANSFER PRICING

Exhibit B of the Agreement is hereby deleted in its entirety and Exhibit B attached to this Amendment shall be substituted in lieu thereof.

ARTICLE VIII
AGREEMENT IN FULL FORCE AND EFFECT

Except as otherwise set out in this Amendment, all other provisions of the Agreement remain in full force and effect.

3

---

IN
WITNESS WHEREOF, the parties hereto have executed this Agreement by their officers thereunto duly authorized as of the date first-above written.

| |  | ETHICON ENDO-SURGERY, INC. 
| |  | ---------------------------
| |  | By:                        
| |  | Name:                      
| |  | Title:                     
| |  | FISCHER IMAGING CORPORATION
| |  | By:                        
| |  | Name:                      
| |  | Title:                     

EXHIBIT B
TRANSFER PRICES

Systems:

|Mammotest Plus:   |  | $[****]                                            
|----------------- |  | ---------------------------------------------------
|Mammotest Plus 5: |  | $[****]                                            
|MammoSound:       |  | (Pricing to be agreed prior to EES order placement)

|Options: |  | EES Transfer
Prices                                             |  | Fischer
List Prices |                     
|-------- |  | --------------------------------------------------------------- |  | ------------------- | --------------------
|a.       |  | Laser camera interface:                                         |  | $                   | [****               
|b.       |  | DICOM interface:                                                |  | $                   | [****               
|c.       |  | HFX two bucky system:                                           |  | $                   | [****               
|d.       |  | SiteSelect adapter:                                             |  | $                   | [****               
|e.       |  | Transport Option (enables roll-on/roll-off for mobile services) |  | $                   | [****               
|f.       |  | Bard Monopty Gun Holder Assembly                                |  |                     | Pricing to be agreed
|g.       |  | Manon PRO-MAG 2.2 Gun Holder Assembly                           |  |                     | Pricing to be agreed

****Represents
material which has been redacted and filed separately with the Securities and Exchange Commission pursuant to a request for confidential treatment under Rule 24b-2 of
the Securities Exchange Act of 1934, as amended.

4

---

QuickLinks