the item is only broken on ADCs in my opinion. bruisers/etc are strong with it, but the item doesn't actually reduce any damage, it just delays it for a few seconds making someone a tiny bit tankier. so thus unless you can out lifesteal/sustain the bleed you aren't reducing any damage and its a shitty item on you.
adcs can easily out sustain the bleed so long as they can keep auto attacking. it does make the feel of the item a rush though. you may survive that burst from syndra now but holy shit you better turn on someone and auto attack immediately or you are gonna die. its not a tank item in the sense that if you get chunked super hard you can just pussy out and come back at a good time. you have to stay in threat range and keep fighting.
that said, as a rush item on duelist adcs like Lucian, Draven its just filthy. you already can't duel them and the item just makes them effectively tanky in the mid game since they can outsustain the bleed.
DD/PD/Tabi combo with maybe a hexdrinker and you have everything you need to deal decent damage, sustain up, and survive burst so long as you don't play like a bitch and run when you get chunked.
that said, because it does have some counterplay I'd imagine its less good against better players. it feels broken in lower elos because most players try to keep bursting the person with death's dance and you don't even need to do that. just get your burst off and run. don't let them auto trade you back. if they have nothing to auto they will just bleed out.
like I had a game where I was syndra ulted for like 90% of my life and i knew if i didn't auto SOMETHING i was going to bleed out fast. she just flashed away immediately. she didnt try to finish me with Q or anything. she just walked away. she knew i was dead. thats how you play against it.
still probably broken, but its not quite as broken as some shit I've seen. (maw/steraks being stackable for example)