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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-7337

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.

Human

4. Date registrant was first informed of the incident.

16-AUG-07

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

29-JUL-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. 26632      PMRA Submission No.       EPA Registration No.

Product Name: WILSON READY-TO-USE SPIDERCIDE SPIDER KILLER

  • Active Ingredient(s)
    • PERMETHRIN

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. - Out Home / Rés - à l'ext.maison

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

Unknown

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: Male

Age: >64 yrs / > 64 ans

3. List all symptoms, using the selections below.

System

  • Eye
    • Symptom - Irritated eye
    • Symptom - Conjunctivitis
    • Symptom - Red eye
    • Symptom - Swollen eye

4. How long did the symptoms last?

>8 hrs <=24 hrs / > 8 h < = 24 h

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

No

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)

Application

9. If the exposure occured during application or re-entry, what protective clothing was worn? (select all that apply)

None

10. Route(s) of exposure.

Eye

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

>8 hrs <=24 hrs / > 8 h < = 24 h

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.)

Caller sprayed the product the night before. He indicated to the operator that he sprayed it high into the air late at night. The next morning his eye was red, lacrimating with some swelling and irritation. Caller wanted to know whether or not he should go to see his doctor and if so he would go the next morning. The operator recommended the following steps to be taken: Transient ocular irritation is possible. Tissue injury is not expected if eye is promptly and adequately irrigated. Irrigate eye(s) for 15 - 20 minutes under a gentle stream of tepid water. Do not hold eyelid(s) open, but slowly blink. - Rest eye(s) after irrigating. - No eye drops or ointments. - Cool compress to closed eyes as needed. - If symptoms continue or worsen over the next 1 to 2 hours, then an eye exam will be indicated - Call us back if sxs persist after irrigation. A follow up call was schedule for a day later , where the exposed caller indicated that he went into see his family physician and was treated with drops: Voltaren. No further effects.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.