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In patch 2.0, Caduceus and ADS served as difficulty checks; a raid group unable to beat them would stand little chance against the rigors of Turn 4 and Turn 5. In subsequent patches the Binding Coil's difficulty was toned down and the Echo was applied at the start of each instance "to facilitate completion of [each] duty". These nerfs, along with higher average item levels, mean that Turn 1 can be cleared effortlessly by any Duty Finder group.
Every 30 seconds, Caduceus will receive a stacking buff to damage and certain platforms on the floor of the Megastructure will glow blue. If a player stands on the glowing platforms, a Dark Matter Slime will spawn and aggro the player that spawned it. If the player runs away from the slime, it will detonate, dealing heavy damage to the party. In addition, if the slime is brought to Caduceus, it will donate its health to the boss and remove all of the buff stacks. Meanwhile, the boss will attack the tank and launch a Tail Swipe that will damage any melee fighters that don't dodge it. Caduceus will also attack random players with Acid Spit, which creates a puddle of acid under the target, dealing damage over time.
Once Caduceus reaches 60% health, it will split into two snakes with 30% health each. If the snakes are allowed to fuse together, the resulting Caduceus will begin to gain stacks every 3 seconds, and both bosses must be destroyed around the same time.
The intended strategy for use against Caduceus is to designate a non-tank to spawn a single Dark Matter Slime every time the boss gains a stack, and DPS it down to very low health before feeding it to the boss, removing its stacks. When the second Caduceus spawns, the off-tank must pull it away, and two players must be responsible for pulling two Dark Matter Slimes, one for each snake. Two DPS will attack each snake, timing their attacks so that both are slain at the same time.
However, with nerfs to the original Binding Coil, it has become more popular for parties to avoid spawning Dark Matter Slimes at all, and allow the snakes to fuse at 60%. The heavily-stacked Caduceus will deal heavy damage to the main tank, and the healers must be prepared for the barrage of attacks that the boss will launch. However, with only 302,079 HP, the boss should fall before the party is overrun.
As with most Binding Coil bosses, the music that plays during the battle against Caduceus is "Calamity Unbound".