Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2022-0915

2. Registrant Information.

Registrant Reference Number: ProPharma Group case #: 2021SCCA00034282

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.

04-JAN-22

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)

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PMRA Registration No. 30472      PMRA Submission No.       EPA Registration No.

Product Name: ORTHO HOME DEFENSE MAX PERIMETER AND INDOOR INSECT CONTROL RTU

• Active Ingredient(s)
  • PERMETHRIN

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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).

2021SCCA00034282 - The reporter stated they used bleach and Custer's soap while attempting to clean the pesticide from the application area.

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

• Nervous and Muscular Systems
  • Symptom - Headache

• General
  • Symptom - Malaise

• Skin
  • Symptom - Discolouration
  • Symptom - Dry skin

4. How long did the symptoms last?

Unknown / Inconnu

5. Was medical treatment provided? Provide details in question 13.

Unknown

6. a) Was the person hospitalized?

Unknown

6. b) For how long?

7. Exposure scenario

Non-occupational

8. How did exposure occur? (Select all that apply)

Contact with treated area

What was the activity? cleaning the area where the pesticide was applied

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

Unknown

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.)

2021SCCA00034282 - The reporter indicates an exposure to a pesticide containing the active ingredient permethrin. An unknown amount of time before the day of initial contact, the reporter indicated the product had been applied to their apartment by another tenant before they moved in. While attempting to clean the apartment, the reporter stated they believed they were inhaling fumes from the already applied pesticide and subsequently developed headaches, malaise, dry skin around their eyes, and red, blue and brown discoloration of the skin around their eyes. The reporter was advised the symptoms would be unusual for an exposure to this pesticide, and to seek medical evaluation. No additional information is available.

To be determined by Registrant

14. Severity classification.

Moderate

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.