Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2017-3680
2. Registrant Information.
Registrant Reference Number: ProPharma Group case #: 1-48757443
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.
27-JUN-17
5. Location of incident.
Country: UNITED STATES
Prov / State: COLORADO
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)
PMRA Registration No.
PMRA Submission No.
EPA Registration No. 239-2640-538
Product Name: LIQUID TURF BUILDER WITH PLUS 2 WEED CONTROL
- Active Ingredient(s)
- 2,4-D (PRESENT AS AMINE SALTS : DIMETHYLAMINE SALT, DIETHANOLAMINE SALT, OR OTHER AMINE SALTS)
- Guarantee/concentration 2.29 %
- DICHLORPROP (PRESENT AS DIMETHYLAMINE SALT)
- Guarantee/concentration 1.13 %
- MECOPROP-P (PRESENT AS DIMETHYLAMINE SALT)
- Guarantee/concentration 1.15 %
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?
Yes
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
2
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
12. How long did the symptoms last?
Persisted until death
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
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
1-48757443 - The reporter, a pet owner, indicates an exposure to a pesticide containing the active ingredients 2,4-D (present as amine salts: dimethylamine salt, diethanolamine salt, or other amine salts), dichlorprop (present as dimethylamine salt), and mecoprop-p (present as dimethylamine salt). One day before the day of initial contact with the registrant, the reporter indicated two of his rabbits of unknown weight, age, breed and gender had died after having contact on an unknown date with a lawn that had been sprayed with the product. The reporter was advised the product has a low level of toxicity and death would not be expected. No follow-up was done. 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