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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-8339

2. Registrant Information.

Registrant Reference Number: PROSAR Case 1-15131420

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.

Domestic Animal

4. Date registrant was first informed of the incident.


5. Location of incident.


Prov / State: NEBRASKA

6. Date incident was first observed.


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.


PMRA Registration No. 9167      PMRA Submission No.       EPA Registration No.

Product Name: Ant-B-Gon Max Ant Killer Liquid09167

  • Active Ingredient(s)
    • BORAX
      • Unknown

7. b) Type of formulation.


Application Information

8. Product was applied?


9. Application Rate.


10. Site pesticide was applied to (select all that apply).

Site: Res. - Out Home / Rés - à l'

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?


Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed


4. Number of animals affected


5. Sex


6. Age (provide a range if necessary )


7. Weight (provide a range if necessary )



8. Route(s) of exposure


9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms


  • Gastrointestinal System
    • Symptom - Diarrhea
    • Symptom - Anorexia

12. How long did the symptoms last?

Unknown / Inconnu

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


14. a) Was the animal hospitalized?


14. b) How long was the animal hospitalized?

15. Outcome of the incident


16. How was the animal exposed?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

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

Caller resides in the US History: Placed 10 large drops (Liquid drops were size of Large Nickels). Put product out Thurs (7/19/2007). Dog on chain, able to ingest 2 spots of product. Other spots soaked into cement. Unknown when actually ingested. Dog developed Diarrhea Thursday. Anorexia seen Friday. Diarrhea was greenish. Still with symptoms at time of call. Dog is drinking some water per caller. Assessment: Do ensure adequate PO intake of water, as compared to output. If Not eating, or with normal BM's in 4-6 hrs-to Veterinarian. AI can be very irritating to GI tract. Primary concern with 100 lb dog now is adequate nutrition and fluid intake. To Veterinarian in no improvement in 4-6 hrs. 07/24/2007 Follow-Up: The dog was not taken to the Veterinarian. The stools are still kind of loose but the other symptoms have resolved and she is eating and drinking well again. Assessment: See Veterinarian if symptoms do not completely resolve soon as there may be something else going on that caused the symptoms and their duration. Note: Given the limited history provided, the relationship between the alleged contact and the effect in the incident description is indeterminable.

To be determined by Registrant

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


19. Provide supplemental information here