This case involves a female patient who fell and sustained a blow to the head. The patient was on Coumadin therapy for atrial fibrillation. When she arrived at the emergency room, CT head imaging showed an evolving subdural hematoma. The patient needed to be transferred to a tertiary care center for further treatment, but, in transit, the patient was never given vitamin K or fresh frozen plasma to reverse the effects of the anticoagulation. The patient’s bleed progressed rapidly before surgical intervention could be attempted. The patient suffered from brain herniation and death due to a massive hematoma.