Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-3758

2. Registrant Information.

Registrant Reference Number: PROSAR Case 1-16479103

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

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.

03-AUG-08

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

20-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. 27809      PMRA Submission No.       EPA Registration No.

Product Name: Killex Ready to Spray Lawn Weed Control (Green Cross)

• Active Ingredient(s)
  • 2,4-D (PRESENT AS AMINE SALTS : DIMETHYLAMINE SALT, DIETHANOLAMINE SALT, OR OTHER AMINE SALTS)
  • DICAMBA (PRESENT AS ACID, AMINE SALT, ESTER, OR SODIUM SALT)
  • MECOPROP-P (PRESENT AS DIMETHYLAMINE SALT)

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7. b) Type of formulation.

Application Information

8. Product was applied?

Unknown

9. Application Rate.

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.

Other

2. Demographic information of data subject

Sex: Female

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

3. List all symptoms, using the selections below.

System

• Skin
  • Symptom - Erythema
  • Symptom - Pruritus
  • Symptom - Rash

4. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

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)

Other

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.)

1-16479103: The reporter, the patients husband, called on 8/3/2008, to report his wifes accidental exposure to an herbicide containing the active ingredients 2,4-D, Dicamba, Mecoprop. According to the reporter, his wife accidently exposed her arms, abdomen and face (BSA 20%) to the diluted solution approximately two weeks prior to the call. A few hours after the exposure, his wife developed a pruritic, erythematous rash on all expose areas. The symptoms continued without improvement for one and a half weeks. The patient started taking an unspecified antihistamine on 8/1/2008. The symptoms improved with treatment but had not yet resolved at the time of the call. The safety profile of the product was discussed including the fact that prolonged skin irritation or itching would not be an expected reaction to product exposure. Additionally, it was relayed that hypersensitivity could not be ruled out. The reporter was encouraged to discontinue use of the product. It was confirmed that an antihistamine would be an appropriate treatment for symptoms described. A recommendation was made to seek medical attention if symptoms did not continue to improve or if they worsened. Follow-up attempts were unsuccessful. No further information was provided.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.