Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-9105

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.

12-OCT-07

5. Location of incident.

Country: CANADA

Prov / State: UNKNOWN

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)

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PMRA Registration No. 15958      PMRA Submission No.       EPA Registration No.

Product Name: Wilson Super Rat and Mouse Killer

• Active Ingredient(s)
  • BROMADIOLONE

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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).

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: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Gastrointestinal System
  • Symptom - Nausea
  • Symptom - Vomiting

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)

Contact with treated area

What was the activity? Landlord baited the rental unit

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

Unknown

10. Route(s) of exposure.

Unknown

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

Unknown / Inconnu

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.)

An unknown caller that would not divulge any information called in regarding a potential exposure to a rodenticide that his landlord used within the rental units. Caller states his landlord used the product in his residence and now he is vomiting and has nausea. Caller states no ingestion occurred. Exposure occurred an unknown time prior to calling the 1-800 line. The operator who fielded the called indicated that the exposed person is an unknown aged male, unknown weight. Patient takes no medications, has no known allergies, and is in good health. No other persons, pets, or products involved. Patient complains of nausea and vomiting. Caller was advised to seek medical examination based on type of symptoms

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.

This case should not be classified as a minor exposure as no ingestion was noted. The operator who fielded the call indicates that the symptoms are not related to the product without ingestion. Changing seasons, changing temperatures all indicative to the catching the flu, which this seems to be a case of.