Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-4044

2. Registrant Information.

Registrant Reference Number: Prosar 1-16616357

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

Address: 2000 Argentia Rd. 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.

09-SEP-08

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

09-SEP-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. 9167      PMRA Submission No.       EPA Registration No.

Product Name: Ant-B-Gon Max Ant Killer Liquid (Ortho)

• Active Ingredient(s)
  • BORAX

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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).

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 III: Domestic Animal Incident Report

1. Source of Report

Medical Professional

2. Type of animal affected

Dog / Chien

3. Breed

Jack Russell Terrier

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

2.5

7. Weight (provide a range if necessary )

18

lbs

8. Route(s) of exposure

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

• General
  • Symptom - Lethargy
  • Symptom - Pale mucous membrane colour

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

14. a) Was the animal hospitalized?

Unknown

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Unknown/Inconnu

16. How was the animal exposed?

Other / Autre

specify Unknown-actual product exposure was not witnessed but the dog "may have licked the product." It is unclear whether the product had been applied.

17. Provide any additional details about the incident

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

1-16616357: A reporter (veterinarian) called on 09/09/2008 to report the exposure of a dog to an insecticide containing the active ingredient Borax. According to the reporter, the dog owner had not witnessed actual exposure to the product but thought the dog may have licked the product 2 days prior to the report (09/07/2008). It is unclear based on the report whether the product had been applied. The reporter stated that the dog presented to the veterinary clinic with signs of lethargy and pale mucous membranes (unknown duration). The reporter was advised that the active ingredient has a low level of toxicity and a wide range of safety. The reporter was also advised that licking the area the product had been applied to after it had dried would not be expected to result in adverse effects. Ingestion of small amounts of the wet product could result in gastrointestinal upset. A recommendation was made to rule out other possible causes for the dog's signs given the unclear exposure to the product and inconsistency of the dog's signs. Attempts at follow up were unsuccessful and no further information was obtained.

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To be determined by Registrant

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

Moderate

19. Provide supplemental information here

Actual exposure to the product was not witnessed.