Top 5 Takeaways

  1. Incident Overview: In December 2021, the Florida Department of Health was alerted to three patients with unexplained bleeding, linked to synthetic cannabinoid (SCB) use. This mirrored a similar nationwide incident in 2018.
  2. Epidemiologic Investigation: A comprehensive investigation was launched across multiple counties and healthcare facilities, focusing on SCB use and bleeding symptoms.
  3. Case Findings: 52 cases were identified, primarily in north and east Tampa. Most patients were male, with an average age of 36. Common symptoms included hematuria, abdominal pain, and hematemesis.
  4. Treatment Challenges: Patients were treated with high doses of vitamin K1, facing issues like high treatment costs and limited availability. Cooperation with healthcare and pharmaceutical entities was critical.
  5. Preventive Measures and Public Health Response: Effective communication and collaboration among various stakeholders were pivotal in managing the incident and formulating strategies to prevent similar future events.

Original Article Author and Citation

Corresponding Author

Nikki Coble,

Suggested Citation

Coble N, Mulay P, Funk A, Arnold J, Wiese M. Notes from the Field: Coagulopathy Associated with Brodifacoum Poisoning — Florida, December 2021. MMWR Morb Mortal Wkly Rep 2022;71:1288–1290. DOI: .


The Florida Department of Health reported three cases of unexplained bleeding in patients who used SCBs, resembling a 2018 nationwide coagulopathy incident. An investigation was initiated across several counties and healthcare facilities to track similar cases and provide appropriate medical guidance.


Data from Florida’s syndromic surveillance database and patient interviews were utilized to identify cases. Medical records were reviewed to gather information on demographics, symptoms, drug use, and exposure to brodifacoum, a vitamin K oxidoreductase antagonist found in SCBs.


The incident highlighted the dangers of SCB use and the difficulty in diagnosing specific coagulopathies. It underscored the importance of rapid, coordinated response among healthcare providers, law enforcement, and pharmaceutical companies to manage such public health emergencies.


This incident demonstrates the need for ongoing surveillance, public awareness, and collaboration among various sectors to effectively address public health crises. Ensuring access to affordable treatment and managing drug safety are critical components of public health strategies.

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