Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2017-0296
2. Registrant Information.
Registrant Reference Number: ProPharma Group case #: 1-46471522
Registrant Name (Full Legal Name no abbreviations): Scotts Canada Ltd.
Address: 2000 Argentia Road, Plaza 2, Suite 300
City: Mississauga
Prov / State: Ontario
Country: Canada
Postal Code: L5N1V8
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
06-DEC-16
5. Location of incident.
Country: UNITED STATES
Prov / State: ARKANSAS
6. Date incident was first observed.
06-DEC-16
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.
PMRA Submission No.
EPA Registration No. 279-3240-239
Product Name: BUG-B-GON MAX INSECT KILLER FOR LAWNS
7. b) Type of formulation.
Granular
Application Information
8. Product was applied?
No
9. Application Rate.
10. Site pesticide was applied to (select all that apply).
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
Mixed Breed
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
3
7. Weight (provide a range if necessary )
20
lbs
8. Route(s) of exposure
Oral
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
>30 min <=2 hrs / >30 min <=2 h
11. List all symptoms
System
- Nervous and Muscular Systems
- Symptom - Ataxia
- Symptom - Muscle tremors
- Symptom - Seizure
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?
Accidental ingestion/Ingestion accident.
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
1-46471522 - The reporter, a pet owner, indicates his dog was exposed to a pesticide containing the active ingredient bifenthrin. On the day of initial contact with the registrant, the reporter indicated his 3-year-old, 20-pound, female, mixed breed dog chewed into a bag of the product about two hours before the call, and ingested an unknown amount of the product. At the time of the call, the dog was experiencing tremors and ataxia. The reporter was instructed to immediately seek veterinary care for the dog as ingestions of large amounts of the product can cause these symptoms. On follow-up call one day later, the reporter could not be reached. On follow-up call two days later, the reporter indicated the dog had died after developing seizures one day after the day of initial contact. No veterinary care was sought. No additional information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here