Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-3119

2. Registrant Information.

Registrant Reference Number: Prosar case 1-16428329

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.

22-JUL-08

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

21-JUL-08

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. 27207      PMRA Submission No.       EPA Registration No.

Product Name: Bug-B-Gon Max Ant and Chinch Bug Eliminator Ready to Spray (Ortho)

• Active Ingredient(s)
  • CARBARYL

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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: Unknown / Inconnu

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: Male

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

3. List all symptoms, using the selections below.

System

• Skin
  • Symptom - Irritated skin
  • Symptom - Red skin

4. How long did the symptoms last?

Unknown / Inconnu

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

Yes

6. a) Was the person hospitalized?

Unknown

6. b) For how long?

7. Exposure scenario

Unknown

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)

Unknown

10. Route(s) of exposure.

Skin

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.)

1-16428329: The reporter called on 7/22/08 to report his exposure the previous day to a product containing the active ingredient Carbaryl. According to the reporter, when he had used the product it had been attached to a hose. Some product had gotten on his right arm, so he had stopped and taken a shower. The affected area had become red and irritated, and the symptoms had persisted. The safety profile of the product was discussed in terms of dermal irritation. A recommendation was made to flush the area with water for 20 minutes, and to use cold compresses, Vitamin E or Aloe Vera. It was further recommended that the reporter should seek medical care if the symptoms persisted or worsened. A follow-up call revealed that the reporters symptoms had continued but were improving. The reporter had had several appointments with a physician and had been using an ointment. No additional information is available.

To be determined by Registrant

14. Severity classification.

Moderate

15. Provide supplemental information here.