Health Canada
Symbol of the Government of Canada
Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-7341

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.

18-JUN-07

5. Location of incident.

Country: CANADA

Prov / State: BRITISH COLUMBIA

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. 23069      PMRA Submission No.       EPA Registration No.

Product Name: WILSON AMBUSH TREE & GARDEN INSECT 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).

The product was mixed and applied over some blackberries.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

Yes

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: >19 <=64 yrs / >19 <=64 ans

3. List all symptoms, using the selections below.

System

  • Gastrointestinal System
    • Symptom - Vomiting
  • Respiratory System
    • Symptom - Coughing

4. How long did the symptoms last?

>1 wk <=1 mo / > 1 sem < = 1 mois

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)

Application

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

Long-sleeve shirt

Chemical resistant gloves

10. Route(s) of exposure.

Respiratory

11. What was the length of exposure?

>2 hrs <=8 hrs / >2 h <=8 h

12. Time between exposure and onset of symptoms.

>24 hrs <=3 days / >24 h <=3 jours

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.)

After the application of the product to the crop of Blackberries, the gentlemen indicated that 2 days later his lungs began to feel heavy. Dry cough and sore ribs developing from constantly coughing which eventually lead to vomiting. As indicated the date the incident was first observed is unknown, however a third party agency fielded the call where the caller indicated that the application happened 2-3wks prior to June 7, 2007. The operator also noted that the caller was still experiencing some symptoms such as a cough, sore ribs and even vomiting. Medical evaluation was suggested by the operator, it is unknown as to whether the caller went to seek medical attention, however the operator is not convinced that the symptoms are indicative of an exposure to a permethrin based product.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.

We don't believe that the symptoms expressed in this report are a direct result of an exposure to this particular product and active. Pemethrin and even pyrethrin based products have been found to have low toxicity and even a fairly short half life. Would not expect symptoms to appear 2 days after exposure, let alone still be persistent 2-3 weeks later.