Advocates: CDC approves ‘floxing’ as reportable medical diagnosis

NORWOOD, Mass. — Talia Smith of Norwood, MA told 25 Investigates the proposal she drafted with the Fluoroquinolone Toxicity Study Foundation and patient advocate Audrey Reynolds, for the classification and coding of an illness that has consumed her life now has approval from the U.S. Centers for Disease Control (CDC).

Smith said the CDC informed her by email that ICD-10 codes will be created for physicians to report patients with Fluoroquinolone poisoning. Fluoroquinolones are a class of widely prescribed antibiotics that include popular brand-name medications like Cipro and Levaquin.

“ICD-10 is a medical coding system designed by the World Health Organization (WHO) to catalog health conditions by similar disease categories under which more specific conditions are listed, thus mapping complex diseases to broader morbidities,” according to the American Academy of Professional Coders.

The codes are also used to process health insurance claims and disability coverage.

“I’m so happy. This is like the best day of my life since I got sick. Maybe the best day of my life ever,” Smith exclaimed in a TikTok announcing the news to her followers.

“Floxing” is the term used to describe people who experience adverse effects to fluoroquinolone antibiotics. Smith said she became extremely sick in 2021 after a doctor prescribed her Ciprofloxacin for a routine urinary tract infection. Smith is confined to a wheelchair and says she experiences constant pain.

25 Investigates first reported on her condition in February.

“Fluoroquinolones are the drugs that have the most adverse effects of any drug, not antibiotics, of any drug. This is not any secret knowledge I have. This is right out there in the open through the open FDA reporting system,” Smith told investigative reporter Ted Daniel.

Smith said her doctor did not inform her that the FDA has a black box warning label for Cipro and other fluoroquinolones. The FDA puts black box warnings on medications known to cause serious side effects, including injury or death.

Dr. Stefan Pieper has treated around 1500 patients with fluoroquinolone poisoning at his practice in Germany. He presented the proposal to the CDC for the new ICD-10 codes in March.

“For the floxed patient, this something like landing on the moon,” Dr. Pieper said in a Zoom interview, “This is a lifelong severe disease and disability… Even now, lots of doctors, I would say most of them, they do not know about the clinical picture, although there are so many patients.”

Dr. Pieper and Smith said the CDC has yet to provide medical codes for people who suffer a long-term disability from Fluoroquinolone poisoning, and they will be advocating for that next.

Smith said she and fellow patient advocate Audrey Reynolds received support from all over the world and she’s excited to share the development with the “floxed” community.

“When it came out, they were crying. They were calling me. They were sending me messages saying I didn’t think this was ever going to happen,” she said.

In a statement, A CDC spokesperson told 25 Investigates, “The topic of fluoroquinolones was presented at the March 2024 ICD-10 Coordination and Maintenance Committee Meeting. CDC does not publish the codes that will be implemented in advance of their official release, as we must adhere to our internal clearance processes for final posting and release. The codes scheduled for implementation on October 1, 2025, will be made available on the CDC website sometime during the latter half of 2025.”

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