INTRODUCTION: Recent outbreaks of brodifacoum-induced coagulopathy resulting 
from the use of synthetic cannabinoids represents a growing public health 
concern. Brodifacoum is a commonly used and commercially available rodenticide 
that has anticoagulant properties. As new, unregulated synthetic cannabinoids 
enter the market, the potential for further outbreaks continues to rise.
CASE PRESENTATION: We report a case of severe bleeding secondary to inhalation 
of synthetic cannabinoids contaminated with brodifacoum. The patient had been 
evaluated for several months of ongoing, unexplained vaginal bleeding and 
developed hematemesis and rectal bleeding 2 weeks after her last reported use.
DISCUSSION: There have been previous reports of hemorrhage after exposure to 
synthetic marijuana in rare cases, including an outbreak of severe bleeding and 
reported synthetic marijuana use in the Midwestern region of the United States 
in 2018.
CONCLUSION: While hemorrhaging after exposure to synthetic cannabinoids has been 
reported previously, we use this case to increase awareness of the potentially 
deadly exposures to brodifacoum from synthetic cannabinoids use in Wisconsin. By 
increasing awareness, emergency department physicians and state agencies can 
collaborate more effectively when responding in these cases.