Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2014-0655
2. Registrant Information.
Registrant Reference Number: 1-35344918
Registrant Name (Full Legal Name no abbreviations): Scotts Canada Ltd.
Address: 2000 Argentia Road, Plaza 5, Suite 101
City: Mississauga
Prov / State: Ontario
Country: Canada
Postal Code: L5N2R7
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
26-OCT-13
5. Location of incident.
Country: CANADA
Prov / State: ALBERTA
6. Date incident was first observed.
25-OCT-13
Product Description
7. a) Provide the active ingredient and, if available, the registration number and product name (include all tank mixes). If the product is not registered provide a submission number.
Active(s)
PMRA Registration No. 29301
PMRA Submission No.
EPA Registration No.
Product Name: Ecosense Path Clear Herbicidal Soap Concentrate Grass and Weed Killer
- Active Ingredient(s)
- AMMONIUM SALT OF FATTY ACID
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
Unknown
10. Site pesticide was applied to (select all that apply).
Site: Res. - Out Home / Rés - à l'ext.maison
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
Unknown
Subform III: Domestic Animal Incident Report
1. Source of Report
Animal's Owner
2. Type of animal affected
Dog / Chien
3. Breed
Saint Bernard
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
0.29
7. Weight (provide a range if necessary )
60
lbs
8. Route(s) of exposure
Unknown
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
>8 hrs <=24 hrs / > 8 h < = 24 h
11. List all symptoms
System
- Gastrointestinal System
- Symptom - Anorexia
- Symptom - Vomiting
12. How long did the symptoms last?
Unknown / Inconnu
13. Was medical treatment provided? Provide details in question 17.
Unknown
14. a) Was the animal hospitalized?
Unknown
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Unknown/Inconnu
16. How was the animal exposed?
Contact treat.area/Contact surf. traitée
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
1-35344918 - The reporter, a pet owner, indicated that his dog was exposed to an insecticidal product containing the active ingredient Ammonium soaps of higher fatty acids. The reporter applied the product to his yard two days prior to initial contact with the registrant and about 20 minutes after application, before the product had dried, the callers 3.5-month-old, 60 pound, female Saint Bernard entered the application area. One day after product application the reporters dog was vomiting, not eating, and quieter than normal. The reporter was advised that the product has a wide margin of safety but ingestion of the product may cause transient gastro-intestinal irritation. Veterinary care was recommended for any persistent symptoms. The reporter could not be reached on follow-up. No further information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
19. Provide supplemental information here