Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-4209

2. Registrant Information.

Registrant Reference Number: PROSAR case #: 1-37986772

Registrant Name (Full Legal Name no abbreviations): The Scotts Company LLC

Address: 14111 Scottslawn Road

City: Marysville

Prov / State: Ohio

Country: USA

Postal Code: 43041

3. Select the appropriate subform(s) for the incident.

Domestic Animal

4. Date registrant was first informed of the incident.

01-AUG-14

5. Location of incident.

Country: UNITED STATES

Prov / State: NEW YORK

6. Date incident was first observed.

Unknown

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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 228-424-239

Product Name: Weed B Gon Max Kills Weeds Not Lawns

• Active Ingredient(s)
  • DICAMBA (PRESENT AS ACID, AMINE SALT, ESTER, OR SODIUM SALT)
    • Guarantee/concentration 1.35 %
  • MCPA (PRESENT AS AMINE SALTS: DIETHANOLAMINE, DIMETHYLAMINE, OR MIXED AMINES)
    • Guarantee/concentration 13.72 %
  • TRICLOPYR
    • Guarantee/concentration 1.56 %

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7. b) Type of formulation.

Liquid

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

Other / Autre

specify Rabbit

3. Breed

Unknown

4. Number of animals affected

3

5. Sex

Unknown

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

• General
  • Symptom - Death

12. How long did the symptoms last?

Persisted until death

13. Was medical treatment provided? Provide details in question 17.

No

14. a) Was the animal hospitalized?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

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

1-37986772 - The reporter, a pet owner, indicated that his three rabbits were exposed to an herbicide containing the active ingredients MCPA, triclopyr and dicamba. The reporter applied the product to his lawn about one week prior to initial contact with the registrant. The reporters domestic rabbits were allowed on the application site after the product was dry. A couple of days after application three of his rabbits passed away. No symptoms were seeing prior to their death. The reporter was advised that the product has a wide margin of safety and death is not consistent with the described exposure. A necropsy was recommended to determine an underlying cause for death. No further information is available.

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To be determined by Registrant

18. Severity classification (if there is more than 1 possible classification

Death

19. Provide supplemental information here