Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2021-6315
2. Registrant Information.
Registrant Reference Number: ProPharma Group case #: 2021SCCA00030694
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.
Human
4. Date registrant was first informed of the incident.
18-NOV-21
5. Location of incident.
Country: CANADA
Prov / State: ALBERTA
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. 32674
PMRA Submission No.
EPA Registration No. Unknown
Product Name: ORTHO BED BUG B GON DIATOM DIATOMACEOUS EARTH BED BUG KILLER
- Active Ingredient(s)
- SILICON DIOXIDE (PRESENT AS 100% DIATOMACEOUS EARTH) - FRESH WATER FOSSILS
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
Unknown
10. Site pesticide was applied to (select all that apply).
Site: Res. - In Home / Rés. - à l'int. maison
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
2021SCCA00030694 - The reporter stated they had four cans of the pesticide and applied one can per day over an unknown amount of time to an unoccupied bedroom in their home.
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
Unknown
Subform II: Human Incident Report (A separate form for each person affected)
1. Source of Report.
Data Subject
2. Demographic information of data subject
Sex: Female
Age: >19 <=64 yrs / >19 <=64 ans
3. List all symptoms, using the selections below.
System
- Liver
- Symptom - Elevated liver enzymes
- Nervous and Muscular Systems
- Symptom - Other
- Specify - Barely conscious
- General
- Symptom - Fatigue
- Symptom - Malaise
4. How long did the symptoms last?
Unknown / Inconnu
5. Was medical treatment provided? Provide details in question 13.
Yes
6. a) Was the person hospitalized?
Yes
6. b) For how long?
Unknown
7. Exposure scenario
Non-occupational
8. How did exposure occur? (Select all that apply)
Application
9. If the exposure occured during application or re-entry, what protective clothing was worn? (select all that apply)
Unknown
10. Route(s) of exposure.
Respiratory
11. What was the length of exposure?
Unknown / Inconnu
12. Time between exposure and onset of symptoms.
Unknown / Inconnu
13. Provide any additional details about the incident (eg. description of the frequency and severity of the symptoms, type of medical treatment, results from medical tests, outcome of the incident, amount of pesticide exposed to, etc.)
2021SCCA00030694 - The reporter indicates an exposure to a pesticide containing the active ingredient silicon dioxide (present as 100% diatomaceous earth). Approximately seven weeks before the day of initial contact with the registrant, the reporter applied the product in their home for several days. The reporter stated that one day after the last day of application, they developed lethargy and vomiting so they sought medical evaluation and were hospitalized for over one week during which they were barely conscious and had elevated liver values. The reporter indicated they were discharged from the hospital one month before the day of initial contact, but still did not feel well. Two days before the day of initial contact, the reporter stated that blood tests indicated their white blood cell count was elevated, but their liver values had returned to normal. The reporter stated their stomach bothers them every time they eat and they get exhausted with minimal exertion. The reporter was advised their symptoms are not an expected effect of exposure to the product. No additional information is available.
To be determined by Registrant
14. Severity classification.
Major
15. 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.