Exhibit (d)(4)

                     First Amended U.S. Service Agreement

This Agreement is made by Tutogen Medical, Inc., a Florida corporation with
offices at 925 Allwood Road, Clifton, NJ 07012, U.S.A. ("Tutogen") and Sulzer
Spine-Tech Inc., a Delaware corporation with offices at 7375 Bush Lake Road,
Minneapolis, Minnesota 55439-2027, U.S.A. ("Sulzer").

                              W I T N E S S E T H:

WHEREAS, Tutogen collects xenograft and donated allograft tissue from sources
throughout Europe and within the United States, processes such tissue itself or
provides such tissue for processing by others, and makes processed tissue
available to users through various distributors throughout the world, including
the United States;

WHEREAS, Tutogen's distribution of processed bone tissue for spinal applications
in the United States is not extensive at the present time;

WHEREAS, Tutogen entered into a Shaft Recovery and Service Reimbursement
Agreement with Regeneration Technologies Inc. ("RTI"), as successor to the
University of Florida Tissue Bank, effective as of 29 September 1998, including
an amendment thereto dated 28 June 1999 (collectively, the "RTI Agreement"),
pursuant to which Tutogen supplies certain human donor bone tissue to RTI, which
RTI processes for use in spinal applications;

WHEREAS, Tutogen has the right under the RTI Agreement "to develop and
distribute products, which products may or may not compete with RTI";

WHEREAS, Tutogen desires to process and distribute for itself allograft bone
tissue products for spinal applications in the United States;

WHEREAS, Sulzer manufactures and sells worldwide a line of products used in the
spine and maintains an understanding and expertise of the market for products
used in the spine, including products manufactured from processed xenograft and
allograft bone tissue;

WHEREAS, Tutogen desires to process such tissue itself and make the processed
bone tissues available in the United States using Sulzer's expertise and support
services,

WHEREAS, Sulzer is willing to provide its expertise and support services to
Tutogen in consideration of Tutogen's agreement to process for itself xenograft
and donated allograft bone tissue and to make the processed tissue available to
users in the US, using exclusively Sulzer's expertise and support services and
as much of the donated allograft bone tissue currently provided to RTI under the
RTI Agreement as Tutogen is able to disseminate with the assistance of Sulzer
according to the demand therefor;

WHEREAS, Tutogen and Sulzer entered into an agreement styled "US Service
Agreement," dated March 8, 2000, pursuant to which Sulzer agreed to provide
exclusive services to enable Tutogen to make processed bone tissues available to
users in the United States; and

CONFIDENTIAL                      First Amended U.S. Service Agreement - Page 1


WHEREAS, Tutogen and Sulzer desire to make a new agreement that will supersede
the US Service Agreement dated March 8, 2000;

NOW, THEREFORE, in consideration of the foregoing premises and the terms and
conditions set forth below, the parties hereby agree as follows:

1.   Definitions

1.1  "Affiliate" shall mean an entity that controls, is controlled by, or is
      ---------
     under common control with a party.  For purposes of this definition,
     "control" shall mean the possession, directly or indirectly, of a majority
     of the voting power of such entity (whether through ownership of securities
     or partnership or other ownership interests, by contract or otherwise);
     provided that, such entity shall be deemed an Affiliate only so long as
     such control continues.

1.2  "Average Aging Date" shall have the meaning set forth in Section 4.2.
      ------------------

1.3  "Contract Year" shall mean the one-year period following the Effective Date
      -------------
     of this Agreement and each one-year period following each anniversary of
     the Effective Date of this Agreement.

1.4  "Effective Date" shall mean March 8, 2000.
      --------------

1.5  "Field of Use" shall mean all uses of processed xenograft and allograft
      ------------
     bone tissue in and adjoining the human spine.

1.6. "Permitted Successor" shall mean any individual, corporation, partnership,
      -------------------
     joint venture, association, trust, or any other entity or organization of
     any kind or character that assumes the obligations of a party under this
     Agreement as permitted according to the terms of this Agreement.

1.7  "Processed Tissues" shall mean xenograft and allograft bone tissue
      -----------------
     processed by Tutogen or an Affiliate of Tutogen or a Permitted Successor of
     Tutogen, as listed in Schedule A attached hereto.  The parties shall
     mutually agree as to the addition of processed tissues to Schedule A.  To
     the extent that a Processed Tissue is not available from Tutogen at the
     time of its listing on Schedule A, the parties agree to collaborate on its
     final design and development in accordance with Sections 2 and 3 of the
     First Amended Processed Tissue Development and License Agreement of even
     date between Sulzer and an Affiliate of Tutogen.

1.8  "Services" shall have the meaning set forth in Section 2.2.
      --------

1.9  "Territory" shall mean the United States, including its territories and
      ---------
     possessions.

1.10 "Third Party" shall mean a person or entity other than Tutogen, any
      -----------
     Tutogen Affiliate, Sulzer, any Sulzer Affiliate or any officer, director,
     or employee of Tutogen, any Tutogen Affiliate, Sulzer, or any Sulzer
     Affiliate.

CONFIDENTIAL                      First Amended U.S. Service Agreement - Page 2


2.   Grant of Rights

2.1  Supply of Processed Tissue.  During the term of this Agreement, to the
     --------------------------
     extent that it can do so without breaching an obligation under a pre-
     existing agreement, including the RTI Agreement, Tutogen agrees to collect
     xenograft and donated allograft bone tissue, process such bone tissue
     itself using its proprietary Tutoplast(R) process, manufacture the
     Processed Tissues, and make the Processed Tissues available in the
     Territory for the Field of Use using the Services of Sulzer.

2.2  Sulzer's Services.  Sulzer shall use reasonable efforts to provide the
     -----------------
     following services (the "Services") to Tutogen, as soon as is reasonably
     possible following the Effective Date, for the purpose of making Processed
     Tissues available to users in the Territory for the Field of Use:

       2.2.1   providing and training all field support personnel necessary to
               meet and communicate with surgeons regarding the Processed
               Tissues and their use and to provide case support for surgeons;

       2.2.2   providing a Processed Tissue order entry system accessible by
               Sulzer for the purpose of entering orders for Processed Tissues
               and accessible by Tutogen for the purpose of receiving Processed
               Tissue orders and shipment instructions and for the purpose of
               checking the status of an order at any time;

       2.2.3   providing and training all telephone and order entry support
               personnel necessary for collecting and transmitting Processed
               Tissue orders from surgeons and patient care providers and for
               answering questions regarding the Processed Tissues;

       2.2.4   developing surgical instruments and surgical techniques for
               implantation of the Processed Tissues and manufacturing and
               distributing sets of surgical instruments;

       2.2.5   preparing and distributing printed materials, including surgical
               procedures, promoting and describing proper use and surgical
               implantation of the Processed Tissues; and

       2.2.6   training surgeons as necessary regarding the proper surgical
               technique for implanting the Processed Tissues.

2.3  Exclusive Right. Tutogen hereby grants Sulzer the exclusive right during
     ---------------
     the term of this Agreement to provide the Services for the Processed
     Tissues in the Territory for the Field of Use. So long as donated allograft
     bone tissue continues to be available to Tutogen or any of its Affiliates
     or its Permitted Successors during the term of this Agreement, including
     tissues collected from sources available to Tutogen or its Affiliates as of
     the Effective Date, as well as tissues collected from sources developed by
     Tutogen or its Affiliates or its Permitted Successors during the term of
     this Agreement, Tutogen or its Permitted Successors shall make the
     Processed Tissues available to users in the Territory using exclusively the
     Services of Sulzer. During the term of this Agreement, neither Tutogen, nor
     any Affiliate of Tutogen, nor any Permitted Successor of Tutogen shall
     permit or engage an entity other than Sulzer to provide the Services in the
     Territory for the Field of Use.

CONFIDENTIAL                      First Amended U.S. Service Agreement - Page 3


2.4  Consignment Inventory.  Tutogen shall have the option to consign inventory
     ---------------------
     of the Processed Tissues to Sulzer for the benefit of Processed Tissue
     users in circumstances in which users could not timely obtain the Processed
     Tissues directly from Tutogen. In no event shall Sulzer acquire title to
     the consigned Processed Tissues. Sulzer shall mark the consigned Processed
     Tissues as the sole property of Tutogen.

3.   Sulzer's Obligations

3.1  Service Fees for Processed Tissues.  Tutogen shall specify the appropriate
     ----------------------------------
     fee for Tutogen's services in making each of the Processed Tissues
     available to users in the Territory.  Based on its knowledge and
     understanding of spine-related matters, Sulzer shall advise Tutogen on
     appropriate fees and recommend such fees for Tutogen's services for each
     Processed Tissue, including adjustments in such fees as necessary in
     Sulzer's opinion.  In no event shall any payment be made to Tutogen or
     Sulzer for any donated human tissue.

3.2  Forecasting.  Within 30 days following execution of this Agreement, Sulzer
     -----------
     shall provide Tutogen with a monthly forecast of demand for the Processed
     Tissues during the succeeding six-month period.  Commencing with the third
     calendar quarter of 2000 and continuing quarterly thereafter, Sulzer shall
     provide Tutogen, no later than 15 days prior to each calendar quarter, with
     a rolling monthly forecast of demand for the Processed Tissues for the
     succeeding 12 months.  Sulzer's forecasts shall specify the anticipated
     demand by Processed Tissue and by month.  Sulzer shall incur no liability
     to Tutogen in the event that actual demand for the Processed Tissues
     differs from Sulzer's forecasts.  As soon as is reasonably possible
     following execution of this Agreement, Sulzer and Tutogen shall meet and
     discuss in good faith a possible agreement regarding a means by which to
     avoid, or assist Tutogen with the cost of, excessive inventory carrying
     cost.

3.3  Minimum Annual Demand.  As consideration for the exclusive right to provide
     ---------------------
     the Services, commencing with the ninth month of the second Contract Year
     (a partial annual minimum demand) and continuing with each Contract Year
     thereafter, Sulzer and Tutogen will establish minimum annual demand goals
     for the Processed Tissues for the Contract Year as a means of ensuring that
     Sulzer is using reasonable efforts to provide the Services in the
     Territory.  Sulzer and Tutogen agree to confer and mutually agree upon the
     minimum annual demand goals for each Contract Year, which shall be recorded
     on Schedule B, during the three-month period commencing with the sixth
     month of the second Contract Year.  In the event that the demand for the
     Processed Tissues in any Contract Year is less than the goals established
     under Schedule B, provided that Sulzer's failure to meet the minimum goals
     is not a result of a Force Majeure as described in Section 9.2, Tutogen
     shall have the right, in its sole discretion, to undertake for itself or to
     employ the services of an additional third party to provide the Services
     for the Processed Tissues in the Territory for the Field of Use.  Tutogen
     shall exercise its option, if at all, by giving Sulzer written notice of
     its election no later than 60 days following the end of the Contract Year
     in question.  In the event that Tutogen elects to exercise its option,
     Sulzer shall nonetheless retain its right, on a non-exclusive basis, to
     make provide the Services in the Territory for the Field of Use.

CONFIDENTIAL                      First Amended U.S. Service Agreement - Page 4


4.   Tutogen's Obligations

4.1  Processed Tissue Supply.  Tutogen agrees to use reasonable efforts to
     -----------------------
     procure xenograft and donor allograft bone tissue, process the tissue using
     the Tutoplast(R) process according to Sulzer's forecasts of demand for
     Processed Tissues (Section 3.2), deliver the Processed Tissues to users in
     a timely manner, and invoice the users for Tutogen's services in a timely
     manner.   In no event shall Tutogen or an Affiliate of Tutogen or a
     Permitted Successor of Tutogen during the term of this Agreement supply
     allograft bone tissue, whether processed or unprocessed, to a Third Party
     for further distribution in the Territory for the Field of Use; provided
     that, Tutogen shall be obligated, as contemplated by Section 2.1 of this
     Agreement, to supply Processed Tissues directly to users, and Tutogen shall
     be permitted to deliver unprocessed allograft bone tissue pursuant to the
     RTI Agreement so long as Tutogen's supply of allograft bone tissue exceeds
     the demand for Processed Tissues under this Agreement.

4.2  Sulzer's Service Fee.  Tutogen agrees to pay Sulzer a fee (the "Service
     --------------------
     Fee") for Sulzer's services as set forth in Schedule C.  The Service Fee
     shall be paid by Tutogen monthly no later than the Average Aging Date.  The
     "Average Aging Date" shall be fixed annually at the onset of each new
     Contract Year and shall be the last business day of the month during which
     Tutogen invoices the user for its services, plus the average aging period
     for Tutogen's invoices for services during the preceding Contract Year.
     The Average Aging Date shall be 90 days for the first Contract Year. The
     Service Fee shall be deemed to cover all services rendered by Sulzer under
     this Agreement, irrespective of whether such services are encompassed by
     the Services specified in Section 2.2 above, whether they are expressly
     mentioned elsewhere in this Agreement, or whether they are not mentioned.

4.3  Report.  Tutogen shall prepare and deliver to Sulzer within 15 days
     ------
     following the end of each month a report detailing for each order completed
     during the preceding month: the user, the number of Processed Tissue units
     delivered, the fee for Tutogen's services invoiced in connection with each
     such Processed Tissue unit, and the amount of Sulzer's Service Fee for each
     Processed Tissue unit.

4.4  Audit.  Upon reasonable notice to Tutogen, Sulzer shall have the right to
     -----
     have an independent certified public accountant, selected by Sulzer and
     reasonably acceptable to Tutogen, audit Tutogen's records during normal
     business hours to verify all records pertaining to the calculation of the
     Service Fee; provided, however, that such audit shall not take place more
     frequently than once a year and shall not cover records for more than the
     preceding four (4) years.  Any such audit shall be at the expense of the
     Sulzer unless such audit concludes that Tutogen has underpaid the Service
     Fee by more than five percent, in which case such audit shall be at the
     expense of Tutogen.

CONFIDENTIAL                      First Amended U.S. Service Agreement - Page 5


5.   Regulatory Matters

5.1  Import Compliance.  Tutogen agrees to comply with and maintain compliance
     -----------------
     with all governmental rules, regulations, statutes and other laws of any
     kind necessary to import into and distribute the Processed Tissues within
     the Territory.

5.2  Regulatory Responsibilities.
     ---------------------------

       5.2.1   The parties understand that as of the Effective Date of this
               Agreement, xenograft processed tissues, but not allograft
               processed tissues, are regulated by the U.S. Food and Drug
               Administration ("FDA") as a medical device. In the event that a
               regulated xenograft processed tissue is added as a Processed
               Tissue, or in the event that the FDA commences regulation of a
               Processed Tissue as a medical device or other matter subsequent
               to the Effective Date, Sulzer, as agent for Tutogen, shall be
               responsible for obtaining and maintaining approval from the FDA
               to make such regulated Processed Tissue available in the
               Territory for the Field of Use, including the conduct of
               preclinical studies and clinical trials and the preparation and
               filing of all applications, reports, and other documents for the
               FDA; provided that, Sulzer may elect within 90 days following the
               effective date of such FDA regulation to remove such regulated
               Processed Tissue from Schedule A rather than to seek approval
               therefor from the FDA. Sulzer's election to remove a regulated
               Processed Tissue from Schedule A shall not be a basis for
               termination of the Agreement by Tutogen.

       5.2.2   In the event that Sulzer elects to remove a regulated Processed
               Tissue from Schedule A, Tutogen shall have the right to seek FDA
               approval therefor at its own expense and to make such processed
               tissue available to users without obligation to Sulzer under this
               Agreement.

5.3  Regulatory Costs.  Tutogen agrees to bear all costs related to pre-clinical
     ----------------
     studies in support of Sulzer's efforts to obtain FDA approvals for
     Processed Tissues.  Sulzer agrees to bear all other costs, including the
     costs for all clinical trials and the costs for preparation and filing of
     all applications, reports, and other documents for obtaining and
     maintaining the approvals.

5.4  Ownership of Approvals.  Tutogen shall be the record owner of all FDA
     ----------------------
     approvals to make regulated Processed Tissues available in the Territory
     for the Field of Use.

5.5  Assistance to Sulzer.  Tutogen, at its own expense, agrees to provide such
     --------------------
     assistance and support to Sulzer, as Sulzer may reasonably request in the
     performance of Sulzer's obligations under this Section 5.

6.   Trademark License

6.1  License Grant.  Tutogen grants Sulzer a nonexclusive license under
     -------------
     Tutogen's trademarks, Tutoplast(R) and Spine Line(R) (the "Trademarks"), to
     use the Trademarks solely in connection with the Processed Tissues in the
     performance of Sulzer's Services within the Territory for the Field of Use.

CONFIDENTIAL                      First Amended U.S. Service Agreement - Page 6


6.2  Publication Approvals.  Sulzer shall provide Tutogen with samples of all
     ---------------------
     printed materials utilizing a Trademark in advance of publication of the
     same. Tutogen shall be deemed to have approved such samples for actual use
     unless it objects in writing within 10 business days following Sulzer's
     delivery of same.

7.   Term and Termination

7.1  Term.  This Agreement shall be effective on the Effective Date and shall
     ----
     remain in effect for an initial term of 10 Contract Years, unless sooner
     terminated according to the terms set forth in this Agreement.  At the end
     of the tenth Contract Year and each succeeding anniversary of the Effective
     Date, this Agreement shall renew automatically for a successive one-year
     term unless one party gives the other party written notice of termination
     at least 12 months in advance of the renewal date.

7.2  Material Breach.  If either party is in material breach of any obligation
     ---------------
     in this Agreement, the non-breaching party may give written notice to the
     breaching party of its intention to terminate this Agreement, and this
     Agreement will terminate 60 days after the giving of such notice unless
     during the 60-day period (i) the breach has been cured, or (ii) if a breach
     is incapable of cure within the 60-day period, the breaching party has
     commenced action which is calculated to result in a cure of the breach to
     the reasonable satisfaction of the non-breaching party within 120 days
     after the giving of notice.  If at the end of the 60-day or 120-day period
     following a notice of termination the parties disagree as to whether the
     Agreement has terminated as provided in this paragraph, the parties shall
     continue to perform under this Agreement until an arbitration tribunal
     constituted as provided in this Agreement has ruled on the matter.

7.3  Insolvency.  Either party may terminate this Agreement immediately on
     ----------
     delivery of written notice to the other party (i) upon the institution by
     or against such other party of insolvency, receivership, or bankruptcy
     proceedings or any other proceedings for the settlement of such party's
     debts; provided that, with respect to involuntary proceedings, such
     proceedings are not dismissed within 120 days, (ii)  upon such other
     party's making an assignment for the benefit of creditors, or (iii) upon
     such other party's dissolution or ceasing to do business.

7.4  Termination Without Cause.  Sulzer shall have the right to terminate this
     -------------------------
     Agreement with or without cause at any time on or after January 15, 2002;
     provided that, Sulzer shall have given Tutogen written notice of
     termination at least 12 months in advance of the termination date.  In the
     event that Sulzer shall terminate this Agreement without cause as provided
     in this Section 7.4, neither Sulzer nor any Affiliate of Sulzer shall for a
     period of one year following the effective date of termination enter into
     an agreement, either directly or indirectly, to own, operate, advise, or
     have any interest in any business relating to the Processed Tissues in the
     Territory for the Field of Use.

7.5  Termination for Material Adverse Effect.  Sulzer shall have the right to
     ---------------------------------------
     terminate this Agreement on 60 days written notice to Tutogen in the event
     that: (i) Tutogen declines to follow Sulzer's recommendation in setting the
     amount of the fee for Tutogen's services in making a Processed Tissue
     available to users in the Territory, and (ii) sales of Sulzer's BAK
     interbody fusion cage (or successor product) decline over any consecutive
     three-month period; provided that, the

CONFIDENTIAL                      First Amended U.S. Service Agreement - Page 7


     Agreement shall not terminate according to this Section 7.5 if Tutogen,
     during the 60-day notice period prior to termination, shall adjust the
     amount of its fee to the fee recommended by Sulzer.

7.6  Interruption of Donor Availability.  Notwithstanding the Force Majeure
     ----------------------------------
     provision in Section 9.2, in the event that Tutogen is unable to supply
     Processed Tissues for a continuous period of six months because Tutogen,
     for whatever reason, is unable to obtain tissue donors, Sulzer shall have
     the right to terminate this Agreement.  In the event that Sulzer terminates
     this Agreement pursuant to this Section 7.6, Tutogen shall be entitled to
     retain any payments made by Sulzer.

7.7  Reimbursement of Regulatory Expenses.  In the event that the Agreement
     ------------------------------------
     terminates (i) by reason of Tutogen's notice of termination under Section
     7.1, or (ii) by reason of Tutogen's material breach under Section 7.2, then
     Tutogen shall be obligated to reimburse Sulzer's out-of-pocket
     expenditures, or a portion thereof as determined in this Section 7.7, in
     obtaining or attempting to obtain regulatory approval for Processed Tissues
     under Section 5.2, including the out-of-pocket cost of all pre-clinical, if
     any, and clinical trials and other expenses directly related to the
     regulatory approval process (the "Clinical Expenses").  For each Processed
     Tissue as to which Sulzer has obtained or attempted to obtain a regulatory
     approval, Tutogen shall be obligated to reimburse an amount determined by
     multiplying the Clinical Expenses for that Processed Tissue by the
     Reimbursement Ratio.  The "Reimbursement Ratio" is

                   10 yrs - (t\\exp\\ - t\\app\\) / 10 yrs,

     where t\\exp\\ is the effective date of termination of the Agreement and
     t\\app\\ is the date of regulatory approval for the Processed Tissue. For
     example, if Sulzer obtains a regulatory approval for a Processed Tissue at
     the beginning of the second Contract Year after incurring $100,000 of
     Clinical Expenses and the Agreement terminates at the beginning of the
     fifth Contract Year, the Reimbursement Ratio is

                       10 yrs - (3 yrs) / 10 yrs  =  0.7

     and Tutogen owes Sulzer $70,000.  The reimbursement amount shall be paid in
     three equal annual installments due within 60 days of the date of
     termination, one year after termination, and two years after termination,
     without interest.

8.   Representations, Warranties, Indemnities, and Limitation of Liabilities

8.1  Tutogen.  Tutogen represents and warrants to Sulzer, as follows:
     -------

       8.1.1   Tutogen has the corporate power and authority to execute and
               deliver this Agreement and to perform its obligations hereunder,
               and the execution, delivery, and performance of this Agreement
               have been validly authorized by Tutogen.

       8.1.2   Tutogen has the right to grant to Sulzer the rights and licenses
               granted in this Agreement.

       8.1.3   As of the date of this Agreement, and to the best of its
               knowledge and belief, neither the processing of, nor the use of,
               nor the collection of fees related to the Processed Tissues in
               the Territory constitutes a misuse or misappropriation of
               confidential information or trade secrets

CONFIDENTIAL                       First Amended U.S. Service Agreement - Page 8


               or a breach of confidence, and does not infringe or violate any
               valid patent, trademark, or copyright or any other intellectual
               property rights of any third party. Tutogen has disclosed to
               Sulzer all patents and other intellectual property rights which,
               to Tutogen's knowledge, may have a material effect on Sulzer's
               ability to make available the Processed Tissues.

       8.1.4   Tutogen has not received notice that the processing of, use of,
               or collection of service fees related to the Processed Tissues
               violates any patent rights or any other intellectual property
               right or constitutes a misappropriation or misuse of trade
               secrets or proprietary information.

       8.1.5   Tutogen shall promptly notify Sulzer of any claim of infringement
               or misappropriation relating to the Processed Tissues.

       8.1.6   To the best of Tutogen's knowledge and belief, Tutogen's
               procurement of donor allograft tissue complies fully with all
               laws of the country in which the donor tissue is collected,
               including all national, regional, and local laws.

       8.1.7   To the best of Tutogen's knowledge and belief, Tutogen possesses
               all governmental and other approvals required for the collection
               and processing of donor allograft tissue, and Tutogen shall use
               reasonable efforts to maintain all such approvals throughout the
               term of this Agreement.

       8.1.8   To the best of Tutogen's knowledge and belief, Tutogen's
               distribution of the Processed Tissues as contemplated under this
               Agreement complies fully with the United States National Organ
               Transplant Act ("NOTA"), 42 U.S.C. section 274e. Tutogen shall
               give Sulzer immediate notice in the event that Tutogen becomes
               aware of an investigation or inquiry from any regulatory or
               governmental authority of a potential violation of NOTA.

       8.1.9   For a period of 12 months from the date of Tutogen's delivery to
               a user, each Processed Tissue shall be free from defects in
               material, manufacturing, and workmanship, including, but not
               limited to, disease, excluding defects caused by the abuse,
               misuse, neglect, or by improper testing, handling, storage, or
               use by a party other than Tutogen.

       8.1.10  During the term of this Agreement, except as required by law or
               by a pre-existing contractual obligation of Tutogen, Tutogen will
               not, directly or through an Affiliate, assign, sell, transfer,
               convey, or otherwise alienate in whole or in part any right to
               receive donated allograft bone tissue without the prior written
               agreement of Sulzer.

8.2  Liability for Breach of Processed Tissue Warranty.  If any failure to
     -------------------------------------------------
     conform to the representation and warranty set forth in Section 8.1.9
     appears within the applicable warranty period, Tutogen will, at its option
     and expense, correct any such failure either by replacing the defective or
     non-conforming Processed Tissue or by repairing such Processed Tissue.  In
     no event shall the liability of Tutogen in connection with such warranty
     exceed the cost of replacing or repairing the defective Processed Tissue.
     The foregoing shall constitute the

CONFIDENTIAL                       First Amended U.S. Service Agreement - Page 9


     exclusive remedy of Sulzer and the sole liability of Tutogen whether in
     contract or in tort or otherwise relating to a defect of a Processed
     Tissue.

8.3  Exclusion of Other Warranties.  The representations and warranties stated
     -----------------------------
     in Section 8.1 are expressly in lieu of all other warranties, including,
     but not limited to, any implied warranty of merchantability or of fitness,
     and constitute the only warranties made with respect to any Processed
     Tissue.

8.4  Sulzer.  Sulzer represents and warrants to Tutogen, as follows:
     ------

       8.4.1   Sulzer has the corporate power and authority to execute and
               deliver this Agreement and to perform its obligations hereunder,
               and the execution, delivery, and performance of this Agreement
               have been validly authorized by Sulzer.

8.5  Indemnity by Tutogen.
     --------------------

       8.5.1   Tutogen shall defend, indemnify, and hold harmless Sulzer against
               any liability or damages from any third party claims, suits,
               proceedings, demands, recoveries, or expenses ("Claims") to the
               extent that such Claims arise from or are based upon: (i)
               material breach by Tutogen of any of its representations or
               warranties contained herein; or (ii) negligence, gross
               negligence, or intentionally wrongful acts or omissions on the
               part of Tutogen; provided that Sulzer: (a) promptly notifies
               Tutogen in writing of any such Claim which comes to its
               attention; (b) allows Tutogen to control the defense or
               settlement of such Claim; (c) does not enter into any settlement
               or compromise of such Claim without the express authorization of
               Tutogen; and (d) reasonably cooperates with Tutogen in the
               defense of such Claim, subject to Tutogen's payment of all
               reasonable out-of-pocket expenses associated with such
               cooperation by Sulzer. Sulzer shall have the right to participate
               in a non-controlling fashion in such legal proceeding at its sole
               expense.

       8.5.2   No undertaking of Tutogen under this section shall extend to any
               such alleged infringement or violation to the extent that it: (a)
               arises from adherence to design modifications, specifications,
               drawings, or written instructions which Tutogen is directed by
               Sulzer to follow, but only if such alleged infringement or
               violation does not reside in corresponding Processed Tissue of
               Tutogen's design or selection; or (b) arises from adherence to
               instructions to apply Sulzer's trademark, trade name, or other
               company identification; or (c) resides in a Processed Tissue
               which is not of Tutogen's origin and which is furnished by Sulzer
               to Tutogen for use under this Agreement; or (d) relates to use of
               Processed Tissues or other items provided by Tutogen in
               combination with other Processed Tissues or items furnished
               either by Tutogen or others, which combination was not installed,
               recommended, or otherwise approved by Tutogen. In the foregoing
               cases numbered (a) through (d), Sulzer will defend and hold
               Tutogen harmless, subject to the same terms and conditions and
               exceptions stated above, with respect to Tutogen's rights and
               obligations under this clause.


CONFIDENTIAL                      First Amended U.S. Service Agreement - Page 10


8.6  Indemnity by Sulzer.
     -------------------

       8.6.1   Sulzer shall defend, indemnify, and hold harmless Tutogen against
               any liability or damages from any third party claims, suits,
               proceedings, demands, recoveries, or expenses ("Claims") to the
               extent that such Claims arise from or are based upon: (i)
               material breach by Sulzer of any of its representations or
               warranties contained herein; or (ii) negligence, gross
               negligence, or intentionally wrongful acts or omissions on the
               part of Sulzer; provided that Tutogen: (a) promptly notifies
               Sulzer in writing of any such Claim which comes to its attention;
               (b) allows Sulzer to control the defense or settlement of such
               Claim; (c) does not enter into any settlement or compromise of
               such Claim without the express authorization of Sulzer; and (d)
               reasonably cooperates with Sulzer in the defense of such Claim,
               subject to Sulzer's payment of all reasonable out-of-pocket
               expenses associated with such cooperation by Tutogen. Tutogen
               shall have the right to participate in a non-controlling fashion
               in such legal proceeding at its sole expense.

       8.6.2   No undertaking of Sulzer under this section shall extend to any
               such alleged infringement or violation to the extent that it: (a)
               arises from adherence to design modifications, specifications,
               drawings, or written instructions which Sulzer is directed by
               Tutogen to follow, but only if such alleged infringement or
               violation does not reside in corresponding Processed Tissue of
               Sulzer's design or selection; or (b) arises from adherence to
               instructions to apply Tutogen's trademark, trade name, or other
               company identification; or (c) resides in a Processed Tissue
               which is not of Sulzer's origin and which is furnished by Tutogen
               to Sulzer for use under this Agreement; or (d) relates to use of
               Processed Tissues or other items provided by Sulzer in
               combination with other Processed Tissues or other items,
               furnished either by Sulzer or others, which combination was not
               installed, recommended or otherwise approved by Sulzer. In the
               foregoing cases numbered (a) through (d), Tutogen will defend and
               hold Sulzer harmless, subject to the same terms and conditions
               and exceptions stated above with respect to Sulzer's rights and
               obligations under this clause.

8.7  Limitation of Liability to Third Parties. The liability of Tutogen and
     ----------------------------------------
     Sulzer with respect to any and all claims, actions, proceedings, or suits
     by any third party alleging infringement of patents, trademarks, or
     copyrights or violation of trade secrets or proprietary rights because of,
     or in connection with, any items furnished pursuant to this Agreement shall
     be limited to the specific undertakings contained in this Section 8.

8.8  Exclusion of Consequential Damages.  Neither Tutogen nor Sulzer shall in
     ----------------------------------
     any event or under any circumstances, including, but not limited to
     liability, delay, or warranty, be liable to the other for special or
     consequential damages, including but not limited to, loss of profit or
     revenue, loss of use of production line, or claims by customers for service
     interruptions. The remedies for the parties set forth in this Agreement are
     exclusive.

8.9  RTI Agreement.  Notwithstanding anything herein to the contrary, nothing in
     -------------
     this Agreement is intended to be, or shall be construed as being, a breach,

CONFIDENTIAL                      First Amended U.S. Service Agreement - Page 11


     anticipatory or otherwise, of the RTI Agreement as it existed following
     amendment on 28 June 1999.

9.   Miscellaneous Provisions

9.1  Entire Agreement.
     ----------------

       9.1.1   This Agreement, together with the First Amended Umbrella
               Agreement, the First Amended Option Agreement, the First Amended
               International Distribution Agreement, and the First Amended
               Processed Tissue Development and License Agreement, all between
               the parties or their Affiliates, embodies the final, complete,
               and exclusive understanding between the parties and supersedes
               all previous agreements, understandings, or arrangements between
               the parties with respect to its subject matter, including the US
               Service Agreement dated March 8, 2000.

       9.1.2   The US Service Agreement dated March 8, 2000 is hereby cancelled
               entirely and superseded by this Agreement.

       9.1.3   No modification or waiver of any terms or conditions hereof, nor
               any representations or warranties will be of any force or effect
               unless such modification or waiver is in writing and signed by an
               authorized officer of the party against whom enforcement is
               sought.

9.2  Force Majeure.  Neither party will be liable to the other for its failure
     -------------
     to perform any of its obligations under this Agreement only during any
     period in which such performance is delayed because of, or rendered
     impracticable or impossible due to, circumstances beyond its reasonable
     control, including but not limited to, strike, fire, flood, earthquake,
     windstorm, governmental acts or orders or restrictions (including acts of
     regulatory authorities and changes in the regulatory scheme for a Processed
     Tissue), failure of suppliers, or any other reason to the extent that the
     failure to perform is beyond the reasonable control and not caused by the
     negligence or willful misconduct of the non-performing party, provided that
     the party experiencing the delay promptly notifies the other of the delay.

9.3  Notices.  All notices concerning this Agreement will be written in the
     -------
     English language and will be deemed to have been received (a) two days
     after being properly sent by commercial overnight courier, or (b) one day
     after being transmitted by confirmed facsimile, in each case addressed to
     the address below:

      If to Tutogen:

      Tutogen Medical, Inc.
      Industriestrae 6,
      D-91077 Neunkirchen am Brand
      GERMANY
      Attention:  President and CEO
      Telephone:  49 9131 7901-10
      Facsimile:  49 9131 7901-12

CONFIDENTIAL                      First Amended U.S. Service Agreement - Page 12


      With a copy to:

      Dr. Dirk Lange
      Foerster + Rutow
      Irrerstr. 17-19
      90403 Nurnberg
      GERMANY
      Telephone:  49 (911) 23 569 00
      Facsimile:  49 (911) 23 569 11

      If to Sulzer:

      Sulzer Spine-Tech Inc.
      7375 Bush Lake Road
      Minneapolis, Minnesota 55439-2027
      U.S.A.
      Attention:  President
      Telephone:  1 (612) 832-5600
      Facsimile:  1 (612) 832-6874

      With a copy to:

      Sulzer Medica USA Inc.
      3 East Greenway Plaza, Suite 1600
      Houston, Texas 77046
      U.S.A.
      Attention:  General Counsel
      Telephone:  1 (713) 561-6365
      Facsimile:  1 (713) 561-6380

9.4  Governing Law.  Recognizing that the laws within the United States and
     -------------
     international jurisdictions vary in their content and effect with respect
     to similar subject matter, and that the parties desire uniformity and
     predictability in interpretation and enforcement of this Agreement and
     related agreements with international scope made contemporaneously by the
     parties and their Affiliates, the parties have agreed to the following
     provisions regarding applicable law to govern this Agreement: All matters
     affecting the interpretation, form, validity, and performance of this
     Agreement shall be decided under the laws of Switzerland (without
     application of the United Nations Convention on the International Sale of
     Goods).

9.5  Partial Invalidity.  In the event that any provision of this Agreement will
     ------------------
     be unenforceable or invalid under any applicable law or be so held by
     applicable court decision, such unenforceability or invalidity will not
     render this Agreement unenforceable or invalid as a whole, and, in such
     event, such provision will be changed and interpreted so as best to
     accomplish the objectives of such unenforceable or invalid provision within
     the limits of applicable law or applicable court decisions.

9.6  Independent Contractors.  Each party will act as an independent contractor
     -----------------------
     under the terms of this Agreement.  Except as otherwise provided in this
     Agreement,

CONFIDENTIAL                      First Amended U.S. Service Agreement - Page 13


     neither party is, nor will it be deemed to be, an employee, agent, partner,
     co-venturer, or legal representative of the other for any purpose.

9.7  Nonassignability.  Neither this Agreement nor any of the rights, interests,
     ----------------
     duties, or obligations under this Agreement shall be assigned or delegated,
     in whole or in part, by operation of law or otherwise by any party without
     the prior written consent of the other party, except that either party may
     assign this Agreement to an Affiliate of such party; provided that, in no
     event shall a party assign to an Affiliate less than the entirety of its
     rights and obligations under this Agreement. Any assignment made in
     violation of this Section 9.7 will be void and of no effect.  Subject to
     this Section 9.7, this Agreement shall be binding upon, inure to the
     benefit of, and be enforceable by and against, the parties and their
     Permitted Successors.

9.8  Compliance With Laws.  Notwithstanding other provisions in this Agreement
     --------------------
     regarding a failure to comply with laws, in performing this Agreement, each
     Party shall comply with all applicable laws and government regulations at
     all times, including but not limited to any applicable laws and regulations
     of the United States regarding the export or re-export or release of
     technology and technical data.

9.9  Arbitration.
     -----------

       9.9.1   In the event the Parties are unable to resolve any dispute or
               conflict arising from or relating to this Agreement within thirty
               (30) days after it is formally presented for resolution by
               written notice, any party may submit such conflict for resolution
               to the Chief Executive Officers of the parties.

       9.9.2   In the event the Chief Executive Officers of the parties are
               unable to resolve such conflict within thirty (30) days after
               having such conflict submitted to them for resolution, the
               dispute shall be finally settled under the Rules of Conciliation
               and Arbitration of the International Chamber of Commerce in Paris
               ("Rules") by three arbitrators appointed in accordance with the
               Rules.

       9.9.3   The place of arbitration shall be Zurich.  The procedural law of
               this place shall apply where the Rules are silent.

       9.9.4   The arbitral award shall be substantiated in writing. The
               arbitral tribunal shall decide on the matter of costs of the
               arbitration.

       9.9.5   The language to be used in the arbitral proceedings shall be
               English.

9.10 Confidentiality.  The parties acknowledge that by reason of their
     ---------------
     relationship hereunder, each has had and will continue to have access to
     certain information and materials concerning the other's business, plans,
     customers, technology, and/or Processed Tissues that is considered by a
     party to be confidential ("Confidential Information") and of substantial
     value to that party, which value would be impaired if such information were
     disclosed to third parties.  To the extent that such information is
     considered confidential, the disclosing party will so indicate to the
     receiving party, in the case of information in documentary or other
     tangible form, by labeling it conspicuously as "CONFIDENTIAL" (or words of
     similar import) and in the case of information conveyed verbally, by
     identifying same in writing within ten days after the first verbal
     disclosure.  Each party

CONFIDENTIAL                      First Amended U.S. Service Agreement - Page 14


     agrees that it will not use in any way other than as expressly authorized
     or contemplated under this Agreement, nor disclose to any third party, any
     such Confidential Information revealed to it by the other party, and will
     take reasonable precautions (and will cause its Affiliates to take
     reasonable precautions) to protect the confidentiality of such information
     and with no less restrictive precautions than it takes to protect its own
     confidential information. Each party will disclose Confidential Information
     only to those of its employees who have a need to know such information. If
     Confidential Information is required to be disclosed in response to an
     order by a court or other government body, or if otherwise required to be
     disclosed by law, or if necessary to establish the rights of a party under
     this Agreement, the receiving party shall use reasonable efforts to provide
     the disclosing party with advance notice of such required disclosure to
     give the disclosing party sufficient time to seek a protective order or
     other protective measures, if any are available, for such Confidential
     Information. "Confidential Information" does not include information,
     materials, technical data or know-how which: (i) is rightfully in the
     possession of the receiving party at the time of disclosure as shown by the
     receiving party's files and records immediately prior to the time of
     disclosure; (ii) prior to or after the time of disclosure becomes part of
     the public knowledge or literature, not as a result of any inaction or
     action of the receiving party; (iii) is independently developed by a party
     without the use of any Confidential Information of the other parties; (iv)
     is obtained from any third party who is authorized to disclose such data
     and information without obligation of confidentiality, or (v) is approved
     for release by the disclosing party. This Section 9.10 shall survive
     termination of this Agreement for a period of two years.

9.11 Public Relations and Announcements.  The parties shall agree upon and
     ----------------------------------
     issue a press release upon the signing of this Agreement including a
     summary of the relationship established under this Agreement.  No party
     shall issue a press release or any other published statement that refers to
     another party, its Affiliates or the other party's Processed Tissues
     without first obtaining the agreement of such other party as to the form
     and content of the statement, which approval shall be timely and not
     unreasonably withheld.

     In witness whereof, the parties have each caused this Agreement to be
signed and delivered by their duly authorized representatives on the dates set
forth below in duplicate, each of which will be treated for all purposes as an
original.


          Tutogen Medical, Inc.      Sulzer Spine-Tech, Inc.



By: /s/ Manfred Kruger               By: /s/ P. Richard Lunsford
    ------------------                   -----------------------
     Manfred Kruger, President           P. Richard Lunsford, President
     and Chief Executive Officer


Date: September 29, 2000             Date: September 29, 2000
      ------------------                   ------------------

CONFIDENTIAL                      First Amended U.S. Service Agreement - Page 15


                        Schedule A - Processed Tissues

Category 1 Tissues



  REF Number           Product Description                          A=       B=     C=   D=
                                                                          
  01.14000.001  Tricortical Wedge, Iliac (8-0x24x6x0degrees)        8-10     24       6     0degrees
  01.14000.002  Tricortical Wedge, Iliac (8-0x24x7x0degrees)        8-10     24       7     0degrees
  01.14000.003  Tricortical Wedge, Iliac (8-0x24x8x0degrees)        8-10     24       8     0degrees
  01.14000.004  Tricortical Wedge, Iliac (8-0x24x9x0degrees)        8-10     24       9     0degrees
  01.14000.005  Tricortical Wedge, Iliac (8-x24x10x0degrees)        8-10     24      10     0degrees
  01.14000.006  Tricortical Wedge, Iliac (8-0x24x12x0degrees)       8-10     24      12     0degrees
  01.14000.007  Tricortical Wedge, Iliac (8-0x24x14x0degrees)       8-10     24      14     0degrees
  01.14000.008  Tricortical Wedge, Iliac (8-0x24x16x0degrees)       8-10     24      16     0degrees
  01.14000.009  Tricortical Wedge, Iliac (8-0x24x50x0degrees)       8-10     24      50     0degrees
  01.14000.010  Tricortical Wedge, Iliac (8-0x24x100x0degrees)      8-10     24     100     0degrees
  01.14000.011  Tricortical Wedge, Iliac (8-10x24x8x4degrees)       8-10     24       8     4degrees
  01.14000.012  Tricortical Wedge, Iliac (8-10x24x9x4degrees)       8-10     24       9     4degrees
  01.14000.013  Tricortical Wedge, Iliac (8-10x24x11x4degrees)      8-10     24      11     4degrees
  01.14000.014  Tricortical Wedge, Iliac (8-10x24x13x4degrees)      8-10     24      13     4degrees
  01.14000.015  Tricortical Wedge, Iliac (8-10x24x15x4degrees)      8-10     24      15     4degrees
  01.14000.016  Tricortical Wedge, Iliac (*10x12x6x0degrees)         *10     12       6     0degrees
  01.14000.017  Tricortical Wedge, Iliac (*10x12x7x0degrees)         *10     12       7     0degrees
  01.14000.018  Tricortical Wedge, Iliac (*10x12x8x0degrees)         *10     12       8     0degrees
  01.14000.019  Tricortical Wedge, Iliac (*10x12x9x0degrees)         *10     12       9     0degrees
  01.14000.020  Tricortical Wedge, Iliac (*10x24x10x0degrees)        *10     24      10     0degrees
  01.14000.021  Tricortical Wedge, Iliac (*10x24x12x0degrees)        *10     24      12     0degrees
  01.14000.022  Tricortical Wedge, Iliac (*10x24x14x0degrees)        *10     24      14     0degrees
  01.14000.023  Tricortical Wedge, Iliac (*10x24x16x0degrees)        *10     24      16     0degrees
  01.14000.024  Tricortical Wedge, Iliac (*10x24x50x0degrees)        *10     24      50     0degrees
  01.14000.025  Tricortical Wedge, Iliac (*10x24x100x0degrees)       *10     24     100     0degrees
  01.14000.026  Tricortical Wedge, Iliac (*10x12x8x4degrees)         *10     12       8     4degrees
  01.14000.027  Tricortical Wedge, Iliac (*10x12x9x4degrees)         *10     12       9     4degrees
  01.14000.028  Tricortical Wedge, Iliac (*10x12x11x4degrees)        *10     12      11     4degrees
  01.14000.029  Tricortical Wedge, Iliac (*10x24x11x4degrees)        *10     24      11     4degrees
  01.14000.030  Tricortical Wedge, Iliac (*10x24x13x4degrees)        *10     24      13     4degrees
  01.14000.031  Tricortical Wedge, Iliac (*10x24x15x4degrees)        *10     24      15     4degrees


REF Number               Product Description                 A=        B=
01.14001.001  Tricortical Dowel, Iliac (12.5x24x   13)    12.5       13
01.14001.002  Tricortical Dowel, Iliac (12.5x24x   15)    12.5       15
01.14001.003  Tricortical Dowel, Iliac (12.5x24x   17)    12.5       17
01.14001.004  Tricortical Dowel, Iliac (12.5x24x   19)    12.5       19

* more than

CONFIDENTIAL                       Schedule A to U.S. Service Agreement - Page 1


REF Number           Product Description           A=               B=
01.14002.001  Bone Dowel, Patella (  10x13)      10              13
01.14002.002  Bone Dowel, Patella (  12x13)      12              13
01.14002.003  Bone Dowel, Patella (  14x13)      14              13
01.14002.004  Bone Dowel, Patella (  16x13)      16              13
01.14002.005  Bone Dowel, Patella (  10x*16)     10             *16
01.14002.006  Bone Dowel, Patella (  12x*16)     12             *16
01.14002.007  Bone Dowel, Patella (  14x*16)     14             *16
01.14002.008  Bone Dowel, Patella (  16x*16)     16             *16

REF Number         Product Description             A=               B=
01.14003.001  Wedge, Fibula (6x0degrees)         6          0degrees
01.14003.002  Wedge, Fibula (7x0degrees)         7          0degrees
01.14003.003  Wedge, Fibula (8x0degrees)         8          0degrees
01.14003.004  Wedge, Fibula (9x0degrees)         9          0degrees
01.14003.005  Wedge, Fibula (10x0degrees)        10         0degrees
01.14003.006  Wedge, Fibula (50x0degrees)        50         0degrees
01.14003.007  Wedge, Fibula (100x0degrees)       100        0degrees
01.14003.008  Wedge, Fibula (8x4degrees)         8          4degrees
01.14003.009  Wedge, Fibula (9x4degrees)         9          4degrees

REF Number          Product Description            A=               B=
01.14004.001  Ring Graft, Femur (8x0degrees)     8          0degrees
01.14004.002  Ring Graft, Femur (10x0degrees)    10         0degrees
01.14004.003  Ring Graft, Femur (12x0degrees)    12         0degrees
01.14004.004  Ring Graft, Femur (14x0degrees)    14         0degrees
01.14004.005  Ring Graft, Femur (16x0degrees)    16         0degrees
01.14004.006  Ring Graft, Femur (30x0degrees)    30         0degrees
01.14004.007  Ring Graft, Femur (50x0degrees)    50         0degrees
01.14004.008  Ring Graft, Femur (100x0degrees)   100        0degrees
01.14004.009  Ring Graft, Femur (11x6degrees)    11         6degrees
01.14004.010  Ring Graft, Femur (13x6degrees)    13         6degrees
01.14004.011  Ring Graft, Femur (15x6degrees)    15         6degrees
01.14004.012  Ring Graft, Femur (17x6degrees)    17         6degrees

* more than

CONFIDENTIAL                       Schedule A to U.S. Service Agreement - Page 2




REF Number                   Product Description                       A=       B=      C=     D=
                                                                               
01.14005.001  Tricortical wedge, Calcaneus (9.5x24x6x0degrees)         9.5     24      6      0(degrees)
01.14005.002  Tricortical wedge, Calcaneus (9.5x24x7x0degrees)         9.5     24      7      0(degrees)
01.14005.003  Tricortical wedge, Calcaneus (9.5x24x8x0degrees)         9.5     24      8      0(degrees)
01.14005.004  Tricortical wedge, Calcaneus (9.5x24x9x0degrees)         9.5     24      9      0(degrees)
01.14005.005  Tricortical wedge, Calcaneus (9.5x24x10x0degrees)        9.5     24      10     0(degrees)
01.14005.006  Tricortical wedge, Calcaneus (9.5x24x12x0degrees)        9.5     24      12     0(degrees)
01.14005.007  Tricortical wedge, Calcaneus (9.5x24x14x0degrees)        9.5     24      14     0(degrees)
01.14005.008  Tricortical wedge, Calcaneus (9.5x24x16x0degrees)        9.5     24      16     0(degrees)
01.14005.009  Tricortical wedge, Calcaneus (9.5x24x8x4degrees)         9.5     24      8      4(degrees)
01.14005.010  Tricortical wedge, Calcaneus (9.5x24x9x4degrees)         9.5     24      9      4(degrees)
01.14005.011  Tricortical wedge, Calcaneus (9.5x24x11x4degrees)        9.5     24      11     4(degrees)
01.14005.012  Tricortical wedge, Calcaneus (9.5x24x13x4degrees)        9.5     24      13     4(degrees)
01.14005.013  Tricortical wedge, Calcaneus (9.5x24x15x4degrees)        9.5     24      15     4(degrees)
01.14005.014  Tricortical wedge, Calcaneus (12.5x12x6x0degrees)       12.5     12      6      0(degrees)
01.14005.015  Tricortical wedge, Calcaneus (12.5x12x7x0degrees)       12.5     12      7      0(degrees)
01.14005.016  Tricortical wedge, Calcaneus (12.5x12x8x0degrees)       12.5     12      8      0(degrees)
01.14005.017  Tricortical wedge, Calcaneus (12.5x12x9x0degrees)       12.5     12      9      0(degrees)
01.14005.018  Tricortical wedge, Calcaneus (12.5x24x10x0degrees)      12.5     24      10     0(degrees)
01.14005.019  Tricortical wedge, Calcaneus (12.5x24x12x0degrees)      12.5     24      12     0(degrees)
01.14005.020  Tricortical wedge, Calcaneus (12.5x24x14x0degrees)      12.5     24      14     0(degrees)
01.14005.021  Tricortical wedge, Calcaneus (12.5x24x16x0degrees)      12.5     24      16     0(degrees)
01.14005.022  Tricortical wedge, Calcaneus (12.5x12x8x4degrees)       12.5     12      8      4(degrees)
01.14005.023  Tricortical wedge, Calcaneus (12.5x12x9x4degrees)       12.5     12      9      4(degrees)
01.14005.024  Tricortical wedge, Calcaneus (12.5x12x11x4degrees)      12.5     12      11     4(degrees)
01.14005.025  Tricortical wedge, Calcaneus (12.5x24x11x4degrees)      12.5     24      11     4(degrees)
01.14005.026  Tricortical wedge, Calcaneus (12.5x24x13x4degrees)      12.5     24      13     4(degrees)
01.14005.027  Tricortical wedge, Calcaneus (12.5x24x15x4degrees)      12.5     24      15     4(degrees)


REF Number                   Product Description                       A=     B=      C=     D=
                                                                               
01.14006.001  Tricortical Wedge, Patella (8-10x24x6x0degrees)         8-10     24       6     0(degrees)
01.14006.002  Tricortical Wedge, Patella (8-10x24x7x0degrees)         8-10     24       7     0(degrees)
01.14006.003  Tricortical Wedge, Patella (8-10x24x8x0degrees)         8-10     24       8     0(degrees)
01.14006.004  Tricortical Wedge, Patella (8-10x24x9x0degrees)         8-10     24       9     0(degrees)
01.14006.005  Tricortical Wedge, Patella (8-10x24x10x0degrees)        8-10     24      10     0(degrees)
01.14006.006  Tricortical Wedge, Patella (8-10x24x12x0degrees)        8-10     24      12     0(degrees)
01.14006.007  Tricortical Wedge, Patella (8-10x24x14x0degrees)        8-10     24      14     0(degrees)
01.14006.008  Tricortical Wedge, Patella (8-10x24x16x0degrees)        8-10     24      16     0(degrees)
01.14006.009  Tricortical Wedge, Patella (8-10x24x8x4degrees)         8-10     24       8     4(degrees)
01.14006.010  Tricortical Wedge, Patella (8-10x24x9x4degrees)         8-10     24       9     4(degrees)
01.14006.011  Tricortical Wedge, Patella (8-10x24x11x4degrees)        8-10     24      11     4(degrees)
01.14006.012  Tricortical Wedge, Patella (8-10x24x13x4degrees)        8-10     24      13     4(degrees)
01.14006.013  Tricortical Wedge, Patella (8-10x24x15x4degrees)        8-10     24      15     4(degrees)
01.14006.014  Tricortical Wedge, Patella (*10x12x6x0degrees)           *10     12       6     0(degrees)
01.14006.015  Tricortical Wedge, Patella (*10x12x7x0degrees)           *10     12       7     0(degrees)
01.14006.016  Tricortical Wedge, Patella (*10x12x8x0degrees)           *10     12       8     0(degrees)
01.14006.017  Tricortical Wedge, Patella (*10x12x9x0degrees)           *10     12       9     0(degrees)
01.14006.018  Tricortical Wedge, Patella (*10x24x10x0degrees)          *10     24      10     0(degrees)
01.14006.019  Tricortical Wedge, Patella (*10x24x12x0degrees)          *10     24      12     0(degrees)
01.14006.020  Tricortical Wedge, Patella (*10x24x14x0degrees)          *10     24      14     0(degrees)


* more than

CONFIDENTIAL                       Schedule A to U.S. Service Agreement - Page 3





                                                                    
01.14006.021  Tricortical Wedge, Patella (*10x24x16x0degrees)   *10   24    16     0(degrees)
01.14006.022  Tricortical Wedge, Patella (*10x12x8x4degrees)    *10   12    8      4(degrees)
01.14006.023  Tricortical Wedge, Patella (*10x12x9x4degrees)    *10   12    9      4(degrees)
01.14006.024  Tricortical Wedge, Patella (*10x12x11x4degrees)   *10   12    11     4(degrees)
01.14006.025  Tricortical Wedge, Patella (*10x24x11x4degrees)   *10   24    11     4(degrees)
01.14006.026  Tricortical Wedge, Patella (*10x24x13x4degrees)   *10   24    13     4(degrees)
01.14006.027  Tricortical Wedge, Patella (*10x24x15x4degrees)   *10   24    15     4(degrees)

REF Number             Product Description                       A=    B=
01.14007.001  Bone Dowel, Calcaneus (  10x13)                   10    13
01.14007.002  Bone Dowel, Calcaneus (  12x13)                   12    13
01.14007.003  Bone Dowel, Calcaneus (  14x13)                   14    13
01.14007.004  Bone Dowel, Calcaneus (  16x13)                   16    13
01.14007.005  Bone Dowel, Calcaneus (  10x20)                   10    20
01.14007.006  Bone Dowel, Calcaneus (  12x20)                   12    20
01.14007.007  Bone Dowel, Calcaneus (  14x20)                   14    20
01.14007.008  Bone Dowel, Calcaneus (  16x20)                   16    20

REF Number             Product Description                       A=    B=
01.14008.001  Bone Dowel, Iliac (  10x13)                       10    13
01.14008.002  Bone Dowel, Iliac (  12x13)                       12    13
01.14008.003  Bone Dowel, Iliac (  14x13)                       14    13
01.14008.004  Bone Dowel, Iliac (  16x13)                       16    13

REF Number             Product Description                       A=    B=
01.14009.001  Wedge, Ulna (6x0degrees)                          6     0(degrees)
01.14009.002  Wedge, Ulna (7x0degrees)                          7     0(degrees)
01.14009.003  Wedge, Ulna (8x0degrees)                          8     0(degrees)
01.14009.004  Wedge, Ulna (9x0degrees)                          9     0(degrees)
01.14009.005  Wedge, Ulna (10x0degrees)                         10    0(degrees)
01.14009.006  Wedge, Ulna (50x0degrees)                         50    0(degrees)
01.14009.007  Wedge, Ulna (100x0degrees)                        100   0(degrees)
01.14009.008  Wedge, Ulna (8x4degrees)                          8     4(degrees)
01.14009.009  Wedge, Ulna (9x4degrees)                          9     4(degrees)

REF Number             Product Description                         A=    B=
01.14010.001  Wedge, Radius (6x0degrees)                        6     0degrees
01.14010.002  Wedge, Radius (7x0degrees)                        7     0degrees
01.14010.003  Wedge, Radius (8x0degrees)                        8     0degrees
01.14010.004  Wedge, Radius (9x0degrees)                        9     0degrees
01.14010.005  Wedge, Radius (10x0degrees)                       10    0degrees
01.14010.006  Wedge, Radius (50x0degrees)                       50    0degrees
01.14010.007  Wedge, Radius (100x0degrees)                      100   0degrees
01.14010.008  Wedge, Radius (8x4degrees)                        8     4degrees
01.14010.009  Wedge, Radius (9x4degrees)                        9     4degrees


* more than

CONFIDENTIAL                       Schedule A to U.S. Service Agreement - Page 4


REF Number               Product Description        A=        B=
01.14011.001  Ring Graft, Tibia (8x0degrees)       8        0degrees
01.14011.002  Ring Graft, Tibia (10x0degrees)      10       0degrees
01.14011.003  Ring Graft, Tibia (12x0degrees)      12       0degrees
01.14011.004  Ring Graft, Tibia (14x0degrees)      14       0degrees
01.14011.005  Ring Graft, Tibia (16x0degrees)      16       0degrees
01.14011.006  Ring Graft, Tibia (30x0degrees)      30       0degrees
01.14011.007  Ring Graft, Tibia (50x0degrees)      50       0degrees
01.14011.008  Ring Graft, Tibia (100x0degrees)     100      0degrees
01.14011.009  Ring Graft, Tibia (11x6degrees)      11       6degrees
01.14011.010  Ring Graft, Tibia (13x6degrees)      13       6degrees
01.14011.011  Ring Graft, Tibia (15x6degrees)      15       6degrees
01.14011.012  Ring Graft, Tibia (17x6degrees)      17       6degrees

REF Number             Product Description         A=          B=
01.14012.001  Ring Graft, Humerus (8x0degrees)     8        0degrees
01.14012.002  Ring Graft, Humerus (10x0degrees)    10       0degrees
01.14012.003  Ring Graft, Humerus (12x0degrees)    12       0degrees
01.14012.004  Ring Graft, Humerus (14x0degrees)    14       0degrees
01.14012.005  Ring Graft, Humerus (16x0degrees)    16       0degrees
01.14012.006  Ring Graft, Humerus (30x0degrees)    30       0degrees
01.14012.007  Ring Graft, Humerus (50x0degrees)    50       0degrees
01.14012.008  Ring Graft, Humerus (100x0degrees)   100      0degrees
01.14012.009  Ring Graft, Humerus (11x6degrees)    11       6degrees
01.14012.010  Ring Graft, Humerus (13x6degrees)    13       6degrees
01.14012.011  Ring Graft, Humerus (15x6degrees)    15       6degrees
01.14012.012  Ring Graft, Humerus (17x6degrees)    17       6degrees

REF Number                 Product Description          Size=       Volume=
01.14014.001  Cortico-Cancellous Chips (2-4mm x 15cc)       2-4        15cc
01.14014.002  Cortico-Cancellous Chips (2-4mm x 30cc)       2-4        30cc
01.14014.003  Cortico-Cancellous Chips (4-10mm x 15cc)     4-10        15cc
01.14014.004  Cortico-Cancellous Chips (4-10mm x 30cc)     4-10        30cc
01.14014.005  Cortico-Cancellous Chips (4-10mm x 60cc)     4-10        60cc

CONFIDENTIAL                       Schedule A to U.S. Service Agreement - Page 5


Category 2 Tissues

Posterior Lateral Interbody Fusion Spacer (allograft bone tissue)

Anterior Lateral Interbody Fusion Spacer (allograft bone tissue)

Cervical Dowel (allograft bone tissue), 10 mm and 14 mm

Cervical Wedge (allograft bone tissue)



Category 3 Tissues

Lumbar and cervical spacers formed of a composite of cancellous and cortical
allograft bone machined and combined in proprietary shapes and designs.

CONFIDENTIAL                      Schedule A to U.S. Service Agreement - Page 6


                      Schedule B - Minimum Annual Demand


Contract Year      Minimum Demand (Total Units of Processed Tissue)


     1                                 0


     2 (3 months)                    ______


     3                               ______


     4                               ______


     5                               ______


     6                               ______


     7                               ______


     8                               ______


     9                               ______


     10                              ______

CONFIDENTIAL                      Schedule B to U.S. Service Agreement - Page 1


                                  Schedule C

                             Sulzer's Service Fees


- --------------------------------------------------------------------------------
Type of Processed Tissue                  Service Fee as a Percentage of
                                          Tutogen's Fee to Tissue User
- --------------------------------------------------------------------------------
Category 1 Tissues                                    *
- --------------------------------------------------------------------------------
Category 2 Tissues (Lumbar)                           *
- --------------------------------------------------------------------------------
Category 2 Tissues (Cervical)                         *
- --------------------------------------------------------------------------------
Category 3 Tissues                                    *
- --------------------------------------------------------------------------------


"Tutogen's Fee to Tissue User" shall be defined as the gross amount of the fee
invoiced to the user for Tutogen's services in making the Processed Tissues
available, less discounts and allowances, returns, taxes and other levies by a
governmental authority, and unreimbursed shipping charges. In the event that
"Tutogen's Fee to Tissue User" for any particular Category 2 Tissue or Category
3 Tissue does not exceed the Minimum Fee specified therefor in the table below,
then Sulzer's Service Fee for that particular tissue shall not be the fee
specified therefor above and the parties shall negotiate a new Service Fee for
Sulzer for the particular tissue, taking account of changed circumstances.



- --------------------------------------------------------------------------------
Type of Processed Tissue                 Minimum Tutogen Fee to Tissue User
- --------------------------------------------------------------------------------
Category 2 Tissues (Lumbar)
- --------------------------------------------------------------------------------
Category 2 Tissues (Cervical)
- --------------------------------------------------------------------------------
Category 3 Tissues
- --------------------------------------------------------------------------------



            *CONFIDENTIAL TREATMENT REQUEST BY SHEARMAN & STERLING.

CONFIDENTIAL                       Schedule C to U.S. Service Agreement - Page 2