Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2021-4172
2. Registrant Information.
Registrant Reference Number: ProPharma Group case #: 2021SCCA00017646
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.
07-JUL-21
5. Location of incident.
Country: CANADA
Prov / State: BRITISH COLUMBIA
6. Date incident was first observed.
07-JUL-21
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. 23372
PMRA Submission No.
EPA Registration No.
Product Name: ORTHO ANT B GON MAX ANT TRAPS
- Active Ingredient(s)
- BORAX
- Guarantee/concentration 5 %
7. b) Type of formulation.
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
Miniature Dachshund
4. Number of animals affected
1
5. Sex
Unknown
6. Age (provide a range if necessary )
3
7. Weight (provide a range if necessary )
13
lbs
8. Route(s) of exposure
Oral
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?
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?
Accidental ingestion/Ingestion accident.
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
2021SCCA00017646- The reporter, a pet owner, indicates an exposure to a pesticide containing the active ingredient borax. Approximately two hours before the time of initial contact with the registrant, the reporter indicated their 13-pound, 3-year-old, miniature dachshund dog of unknown sex ingested some of the pesticide and started to vocalize. The reporter was advised this would be an unusual symptom after exposure to the product, but to seek veterinary evaluation should it persist. No additional 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
Please note that this submission in no way implies that Scotts Canada Ltd. agrees with the allegations contained within this incident report.