Nouvelle déclaration d'incident
No de la demande: 2016-2082
Numéro de référence du titulaire d'homologation: 5524983
Nom du titulaire (nom légal complet, aucune abbréviation): Sure-Gro IP Inc.
Adresse: 1900 Minnesota Crt
Ville: Mississauga
État: Ontario
Pays: Canada
Code postal /Zip: L5N 3C9
Incident chez l'humain
Pays: CANADA
État: ONTARIO
ARLA No d'homologation 30535 ARLA No de la demande d'homologation EPA No d'homologation.
Nom du produit: Wilsarin Rat and Mouse Killer
Oui
Inconnu
Site: Res. - In Home / Rés. - à l'int. maison
Inconnu
Personne affectée
Sexe: Femme
Âge: >19 <=64 yrs / >19 <=64 ans
Système
Unknown / Inconnu
Inconnu
Non
Non professionnel
Contact avec la zone traitée
Temps écoulé entre l'application et l'exposition (contact) 2
Week(s) / Semaine(s)
Quelle était l'activité? re-entering trailer
Aucun
Respiratoire
Unknown / Inconnu
Unknown / Inconnu
Caller states that they placed at and Mouse Killer in trailer underbed x 1 to 2 weeks ago.Product: Wilsarin by Wilson, Rat and Mouse Killer,pink crystals put 3 to 4 bags of the product around.Callers concerned on the box it says to not inhale it.Denies actual mice in the trailer.Both caller and sister have symptoms O:caller not feeling well today,feels like she's having a "heart attack".sob,dizzy Sister is achey and has cough A: chronic adult inhalation of Wilsarin by Wilson Rat and Mouse Killer crystals, symptomatic R: hang up and call 911 seek care Should remove the product, call 911, and don't go back in home until know it is safe call back as needed pc will follow. Unable to follow as follow up calls did not connect, outcome unknown.
Mineure
The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified. Also product is composed from corn cellulose, one would not expect chest pain type symptoms from corn.
Autre
Sexe: Femme
Âge: >19 <=64 yrs / >19 <=64 ans
Système
Unknown / Inconnu
Inconnu
Non
Non professionnel
Contact avec la zone traitée
Temps écoulé entre l'application et l'exposition (contact) 2
Week(s) / Semaine(s)
Quelle était l'activité? re-entering the trailer
Aucun
Respiratoire
Unknown / Inconnu
Unknown / Inconnu
Caller states that they placed at and Mouse Killer in trailer underbed x 1 to 2weeks ago.Product: Wilsarin by Wilson, Rat and Mouse Killer,pink crystals put 3 to 4 bags of the product around.Callers concerned on the box it says to not inhale it.Denies actual mice in the trailer.Both caller and sister have symptoms O:caller not feeling well today,feels like she's having a "heart attack".sob,dizzy Sister is achey and has cough A: chronic adult inhalation of Wilsarin by Wilson Rat and Mouse Killer crystals, symptomatic R: hang up and call 911 seek care Should remove the product, call 911, and don't go back in home until know it is safe call back as needed pc will follow. Unable to follow as follow up calls did not connect, outcome unknown.
Mineure
The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified. Also product is composed from corn cellulose, one would not expect chest pain type symptoms from corn.