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Arizona Robbins (Jessica Capshaw) survives the plane crash in spite of her leg injury, but upon return her wound becomes infected and her leg has to be amputated to save her life.Robbins reacts badly to this, becoming bitter and blaming her wife Callie and her former friend Alex Karev (Justin Chambers) and refuses to leave her bed or return to work.In May 2012, it was announced that six original cast mates, Ellen Pompeo, Patrick Dempsey, Sandra Oh, Chandra Wilson, Justin Chambers, and James Pickens, Jr.had renewed their contracts for another two seasons, as Meredith Grey, Derek Shepherd, Cristina Yang, Miranda Bailey, Alex Karev, and Richard Webber respectively.Despite contemplating a settlement, the doctors decide to continue with the lawsuit and eventually are awarded fifteen million dollars each, but the insurance company discovers an unexpected loophole and refuse to pay, resulting in the hospital itself becoming liable, putting its future in extreme doubt. Alana Cahill (Constance Zimmer) is appointed to cut costs at the hospital and she eventually decides the best course of action would be to seek out a new buyer and attracts the interest of a company named Pegasus.Later however, Torres and Richard Webber (James Pickens Jr.) discover the unpleasant consequences that would fall upon the hospital should they be taken over by Pegasus prompting the four crash survivors (and Torres on the behalf of Sloan) to pool their money together in a bid to purchase the hospital themselves and quit their jobs, resulting in Pegasus pulling out.

In November 2012 it was announced that Neve Campbell, known for her role in Scream, would be cast as one of Derek's sisters.

The season was produced by ABC Studios, in association with Shonda Land Production Company and The Mark Gordon Company; the showrunner being Shonda Rhimes.

The season was officially released on DVD as a six-disc boxset under the title of Grey's Anatomy: The Complete Ninth Season - Everything Changes on August 27, 2013 by Buena Vista Home Entertainment.

The doctors run into trouble when they fail to secure an extra benefactor, but at the last minute Catherine Avery (Debbie Allen) reveals that the Harper Avery Foundation is willing to provide a majority share in the company, on the condition that they have at least one member on the board of directors.

The doctors agree and their purchase is complete, only for Catherine to appoint her son Jackson Avery (Jesse Williams) to part of the board, effectively putting him in charge of the entire hospital.

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Later, Shepherd receives more good news when his wife Meredith Grey (Ellen Pompeo) discovers that she is pregnant, despite her previously being told that it was unlikely that she could conceive.

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