Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-8336

2. Registrant Information.

Registrant Reference Number: PROSAR Case 1-15107972

Registrant Name (Full Legal Name no abbreviations): Scotts Canada Ltd

Address: 2000 Argentia Road, Plaza 5, Suite 101

City: Mississauga

Prov / State: Ontario

Country: Canada

Postal Code: L5N2R7

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

Human

4. Date registrant was first informed of the incident.

14-JUL-07

5. Location of incident.

Country: CANADA

Prov / State: NOVA SCOTIA

6. Date incident was first observed.

04-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)

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PMRA Registration No. 27520      PMRA Submission No.       EPA Registration No.

Product Name: Home Defense Max Perimeter + Indoor Insect Control

• 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).

To be determined by Registrant

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

No

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 - Nausea

• Nervous and Muscular Systems
  • Symptom - Numbness

• General
  • Symptom - Insomnia
  • Specify - Sleep Dificulties
  • Symptom - Malaise

4. How long did the symptoms last?

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

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.

Unknown

11. What was the length of exposure?

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

12. Time between exposure and onset of symptoms.

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

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.)

History: States that he did not read the directions when he used this and sprayed it throughout the home, flooring, furniture. Use was 1.5 weeks ago. Over the past 5 days has not felt right, not sleeping, nausea, and numbness in his left arm. States he woke this morning knowing that it must have been the insecticide that he used that is causing the illness. What can be done? Assessment: - Discussed product and ingredients. - Sx's described are not an expected result of the use that occurred in the home. - Rec seeing your MD for further eval and diagnosis, would consider other possible causes. - Rec CB PRN. Note: PMRA: Based on the toxicologic profile of the product and the alleged contact/effect in the incident description, the symptoms alleged would be inconsistent with what would be expected from the described product contact.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.