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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-8353

2. Registrant Information.

Registrant Reference Number: PROSAR Case 1-15234917

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: N1G4Z3

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

Human

4. Date registrant was first informed of the incident.

20-AUG-07

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

20-AUG-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. 25878      PMRA Submission No.       EPA Registration No.

Product Name: Bug-B-Gon Max Hornet + Wasp Eliminator Spray

  • Active Ingredient(s)
    • RESMETHRIN

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).

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: Female

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

  • Gastrointestinal System
    • Symptom - Irritated throat
    • Symptom - Burning throat

4. How long did the symptoms last?

Unknown / Inconnu

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)

Drift from the application site

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.

Respiratory

11. What was the length of exposure?

>15 min <=2 hrs / >15 min <=2 h

12. Time between exposure and onset of symptoms.

<=30 min / <=30 min

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: Caller states she sprayed product to the back of her house approx 20min ago. Caller states product fumes are now coming inside the house. Caller states within the last 15 min she and 2 other family members complained of dry throat along with a burning sensation. Caller states all 3 family members have drank water since incident. Caller is looking for product safety information. Assessment: - Inhalation of this product may lead to irritation of the eyes and upper respiratory tract as well as cough, difficulty breathing, and shortness of breath. - Adverse health effects are typically limited to the upper respiratory tract and resolve without affecting other body functions. - You should be removed from the source of the fumes and placed in an area with fresh air and adequate ventilation. - Seek medical attention if your symptoms do not resolve within the next 30 minutes. - Please call back with any additional questions or concerns. Note: Based on the toxicologic profile of the product and the alleged contact/effect in the incident description, the symptoms alleged would be consistent with what would be expected from the described product contact.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.

Subform II: Human Incident Report (A separate form for each person affected)

1. Source of Report.

Other

2. Demographic information of data subject

Sex: Unknown

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

  • Gastrointestinal System
    • Symptom - Irritated throat
    • Symptom - Burning throat

4. How long did the symptoms last?

Unknown / Inconnu

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)

Drift from the application site

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.

Respiratory

11. What was the length of exposure?

>15 min <=2 hrs / >15 min <=2 h

12. Time between exposure and onset of symptoms.

<=30 min / <=30 min

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: Caller states she sprayed product to the back of her house approx 20min ago. Caller states product fumes are now coming inside the house. Caller states within the last 15 min she and 2 other family members complained of dry throat along with a burning sensation. Caller states all 3 family members have drank water since incident. Caller is looking for product safety information. Assessment: - Inhalation of this product may lead to irritation of the eyes and upper respiratory tract as well as cough, difficulty breathing, and shortness of breath. - Adverse health effects are typically limited to the upper respiratory tract and resolve without affecting other body functions. - You should be removed from the source of the fumes and placed in an area with fresh air and adequate ventilation. - Seek medical attention if your symptoms do not resolve within the next 30 minutes. - Please call back with any additional questions or concerns. Note: Based on the toxicologic profile of the product and the alleged contact/effect in the incident description, the symptoms alleged would be consistent with what would be expected from the described product contact.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.

Subform II: Human Incident Report (A separate form for each person affected)

1. Source of Report.

Other

2. Demographic information of data subject

Sex: Unknown

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

  • Gastrointestinal System
    • Symptom - Irritated throat
    • Symptom - Burning throat

4. How long did the symptoms last?

Unknown / Inconnu

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)

Drift from the application site

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.

Respiratory

11. What was the length of exposure?

>15 min <=2 hrs / >15 min <=2 h

12. Time between exposure and onset of symptoms.

<=30 min / <=30 min

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: Caller states she sprayed product to the back of her house approx 20min ago. Caller states product fumes are now coming inside the house. Caller states within the last 15 min she and 2 other family members complained of dry throat along with a burning sensation. Caller states all 3 family members have drank water since incident. Caller is looking for product safety information. Assessment: - Inhalation of this product may lead to irritation of the eyes and upper respiratory tract as well as cough, difficulty breathing, and shortness of breath. - Adverse health effects are typically limited to the upper respiratory tract and resolve without affecting other body functions. - You should be removed from the source of the fumes and placed in an area with fresh air and adequate ventilation. - Seek medical attention if your symptoms do not resolve within the next 30 minutes. - Please call back with any additional questions or concerns. Note: Based on the toxicologic profile of the product and the alleged contact/effect in the incident description, the symptoms alleged would be consistent with what would be expected from the described product contact.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.