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I just reported this error to GOG.com
However I was wondering if other users were having the same problem and/or have any solutions for it.
(I did search for the solution myself and couldn't find it so far)
This question / problem has been solved by Ekraanimage
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Ekraan: ok .. i solved it.
1. download / install 3D-Analyze (http://www.3dfxzone.it/files?object=3dfx&objid=100)
2. select painkiller.exe
3. check Emulate HW TnL
4. check Force SW TnL Caps
5. click run

This worked for me!!
Okay, if I hit Painkiller.exre, it doesn't give me anything, no options no nothing, just the same crazy ERROR: Could not Initialize Directx9 Renderer... HELP!! :( Oh, and I ran the dxdiag, and it reported no problems found...
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Ekraan: ok .. i solved it.
1. download / install 3D-Analyze (http://www.3dfxzone.it/files?object=3dfx&objid=100)
2. select painkiller.exe
3. check Emulate HW TnL
4. check Force SW TnL Caps
5. click run
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Mikey360: This worked for me!!
Post edited February 26, 2010 by boote65
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Ekraan: ok .. i solved it.
1. download / install 3D-Analyze (http://www.3dfxzone.it/files?object=3dfx&objid=100)
2. select painkiller.exe
3. check Emulate HW TnL
4. check Force SW TnL Caps
5. click run
avatar
Mikey360: This worked for me!!
Thanks Mikey360!
It worked for me.
OK I'm having the same issue with my copy of painkiller gold. I installed it and patched to the latest (1.64?). Then I got the same error message as listed in the thread title. Only problem: I have a NICE graphics card so the emulation of hardware T & L simply doesn't work. Any ideas would be very appertained.
Oh, i have tried to run the game in XP compatibility mode but still no joy.

Detailed Specs
AMD Phenom II x4 920
ASRock 780a SLI
Nvidia Geforce GTX 480 (EVGA)
6gb DDR2 800
Windows 7 Pro 64bit
Ya.. how to run it with win7 64bit? I have it too and no solutions ;/
I was getting the "It is not possible to create the Direct3D rendering device" too and after a search found a post with a fix that worked for me in Win7 – quoted below is the post I found:

Isis said…
… if anyone is having trouble playing this, and is getting an error "It was not possible to create the Direct3D rendering device. You may need to reinstall DirectX and/or update drivers for your graphics card"
Then you are missing a file, that only a certain version of directx 9 has. It is called d3dx9_35.dll and you can download it here;
http://www.dll-files.com/dllindex/dll-files.shtml?d3dx9_35
Once downloaded, cut and paste it into your system32 folder. Reboot and the game will work.

Instead of placing in Windows system32 folder I simply pasted a copy into the bin directory for Painkiller Black as well as the bin directory for Ressurection and Overdose – did not reboot and both ran fine
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oysterstew: I was getting the "It is not possible to create the Direct3D rendering device" too and after a search found a post with a fix that worked for me in Win7 – quoted below is the post I found:

Isis said…
… if anyone is having trouble playing this, and is getting an error "It was not possible to create the Direct3D rendering device. You may need to reinstall DirectX and/or update drivers for your graphics card"
Then you are missing a file, that only a certain version of directx 9 has. It is called d3dx9_35.dll and you can download it here;
http://www.dll-files.com/dllindex/dll-files.shtml?d3dx9_35
Once downloaded, cut and paste it into your system32 folder. Reboot and the game will work.

Instead of placing in Windows system32 folder I simply pasted a copy into the bin directory for Painkiller Black as well as the bin directory for Ressurection and Overdose – did not reboot and both ran fine
No need to do this. Just go to Microsoft's download site and get the latest DirectX redistributable or use the web updater. Both Vista and 7 use multiple versions of DirectX and the version of DX9 they have is DX9L. This isn't the full DX9 library, so use the redist or web updater and it'll get you all the missing DX9 files and put them in the right place in your system. What you've done has only duplicated the file in question and made it only work for those games where you've put the file.
Thank you Ekraan! I am so happy that Painkiller works on my computer now!
I'm having this exact same error. Got the DX redistributable, didn't solve it. Used 3D-Analyze, didn't solve it. Tried running it in compatibility mode for XP, didn't solve it. What else can I do?