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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-5054

2. Registrant Information.

Registrant Reference Number: SJB

Registrant Name (Full Legal Name no abbreviations): Spectrum Brands IP Inc.

Address: P.O. Box 21001

City: Brantford

Prov / State: ON

Country: Canada

Postal Code: N3R 7W9

3. Select the appropriate subform(s) for the incident.

Domestic Animal

4. Date registrant was first informed of the incident.

12-JUL-07

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

24-JUN-07

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. 27017      PMRA Submission No.       EPA Registration No.

Product Name: Wilson Ant Traps

  • Active Ingredient(s)
    • BORAX

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

Other

2. Type of animal affected

Dog / Chien

3. Breed

mixed breed

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

8

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>3 days <=1 wk / >3 jours <=1 sem

11. List all symptoms

System

  • Renal System
    • Symptom - Blood in urine
  • General
    • Symptom - Death

12. How long did the symptoms last?

Unknown / Inconnu

13. Was medical treatment provided? Provide details in question 17.

Yes

14. a) Was the animal hospitalized?

Unknown

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Not recovered / Non rétabli

16. How was the animal exposed?

Contact treat.area/Contact surf. traitée

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

Animal may or may not have been exposed to the three tins laid out around the house.


To be determined by Registrant

18. Severity classification (if there is more than 1 possible classification

Death

19. Provide supplemental information here

This incident was reported to us by a third party whose home this dog had visited several days prior to its demise. She called wondering whether perhaps the dog¿¿¿s death could have been related to her use of ant traps at her home. She did not relay that there was any actual evidence of the dog having come into contact with the product. Consulting agency advised caller of ingredients and that small concentration of active ingredient might cause Gastrointestinal symptoms but would likely take 4 days to become evident. Note, this product is not an anticoagulant. The agency advised the caller that with a fair degree of certainty that this product was not responsible for the reported symptoms