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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2017-7285
2. Registrant Information.
Registrant Reference Number: ProPharma Group case #: 1-50219019
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.
28-OCT-175. Location of incident.
Country: UNITED STATES
Prov / State: HAWAII
6. Date incident was first observed.
28-OCT-17Product 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. 90780-11
Product Name: TOMCAT RAT & MOUSE KILLER CHILD & DOG RESISTANT
- Active Ingredient(s)
- BROMETHALIN
- Guarantee/concentration .01 %
- BROMETHALIN
7. b) Type of formulation.
Bait
Application Information
8. Product was applied?
Unknown
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
Pit Bull Terrier
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
10
7. Weight (provide a range if necessary )
80
lbs
8. Route(s) of exposure
Oral
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
- General
- Symptom - Death
- Nervous and Muscular Systems
- Symptom - Muscle weakness
- Symptom - Paralysis
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
1-50219019 - The reporter, a pet owner, indicated her dog was exposed to a pesticide containing the active ingredient bromethalin. Approximately 10 hours before the time of initial contact with the registrant, the reporter indicated her 10-year-old, 80-pound, male, Pit Bull Terrier dog ate an unknown amount of the product. At the time of initial contact, the reporter indicated the dog was having hind limb muscle weakness and she wanted to know what to do as she could not afford veterinary care. The reporter was advised to seek immediate veterinary care for the dog as the symptom could be from product ingestion. The reporter was advised there was no home treatment, and a dog that was already symptomatic was in critical condition. On follow-up call two days later, the reporter stated the dog was paralyzed from the neck down, but was eating and drinking from a syringe. The reporter was again advised to get immediate veterinary care for the dog as his prognosis was grave. On follow-up call four days after initial contact, the reporter was not available. On follow-up call seven days after initial contact, the reporter indicated the dog had died at home and had not received veterinary care. No additional information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
