Polite Dissent

The Plot
Renee Montoya deduces that Intergang has stockpiled rat poison to build a deadly bomb. She explains the rat poison to her companion:

It’s an anticoagulant, Charlie! Suicide bombers use it to coat their shrapnel so their victims who aren’t blown apart will bleed to death!

History of the Rat-Poison Bomb (Real World)
In late 2001 and early 2002, there were reports that Palestinian suicide bombers in Israel had been adding anticoagulant rat poison to the shrapnel in their bombs. High levels of rat poison were detected at one bombing site, and an anonymous doctor was quoted as saying that patients arrived at the hospital “bleeding profusely” from the poison. These reports were originally printed in Israeli newspapers but then were picked up by American papers. Political columnists took the news of the rat poison bombs and ran with it.

However, the truth behind these reports of rat poison bombs is not clear cut. At best the evidence is anecdotal, and even then is there are many questions. For instance, that bombing site that tested positive for rat poison? It had sprayed by the exterminator just a few days before the bombing. There have been no police, military, law enforcement, or government reports documenting this type of bomb. There is at least one hospital that claims to have some rat-poison tainted shrapnel, but the sample has never been independently verified. The doctor’s report about profusely bleeding patients is not consistent with medical facts of anticoagulant poisoning. It would not surprise me to find that terrorists did indeed use some sort of toxin in their suicide bombs, but at this point the rat poison bomb seems more of an urban legend than a reality.

But Would It Even Work?
I. The Explosion. For starters, I question whether the anticoagulant would even survive the explosion. Most medications are sensitive to high temperature and I suspect the extreme heat and force of the explosion would destroy the toxin.

II. Delivery. Warfarin (the most common and most potent anticoagulant in rat poison — it is the main ingredient in the prescription blood thinner ‘Coumadin’) is usually given orally, but is equally effective when given intravenously or intramuscularly. Shrapnel is a brutal way of delivering medication, but it would theoretically be effective for warfarin.

III. Dosing. Rat poison is more dilute than medical anticoagulants, so it would take a high dose to have any effect on humans. According to experts on bioterrorism at the University of Miami, it would take 3 ounces of rat poison (85 grams) to equal a human dose. That’s an incredibly large amount of toxin to deliver, particularly by shrapnel.

IV. Biology. The plan falls further to pieces when the pharmacodynamics of warfarin are examined. It takes about two days for the effects of a single dose of warfarin to be seen, and full effects aren’t seen for five days — and that’s five days of daily doses of the medication. It is not a fast acting drug and there would be no “bleeding profusely” in the ER — at least not from the rat poison.

V. Conclusion. For a rat-poison bomb to work, the poison would have to survive the explosion and an incredibly large dose would have to be delivered to the victim. Then, in several days, if the shrapnel is not removed promptly, and repeat doses of the poison were somehow slipped to the victim, and the antidote is not given, then the victim may show some increased bleeding.