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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-5543

2. Registrant Information.

Registrant Reference Number: 282244

Registrant Name (Full Legal Name no abbreviations): S.C. Johnson and Son, Limited

Address: 1 Webster Street

City: Brantford

Prov / State: ON

Country: Canada

Postal Code: N3T 5R1

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

Domestic Animal

4. Date registrant was first informed of the incident.

24-JAN-08

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

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)

PMRA Registration No. 26909      PMRA Submission No.       EPA Registration No.

Product Name: Raid EarthBlends Multi-Bug Killer Aerosol Canada

  • Active Ingredient(s)
    • PIPERONYL BUTOXIDE
    • PYRETHRINS

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).

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

Yes

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Miniature Pinscher

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

.30

7. Weight (provide a range if necessary )

7.00

lbs

8. Route(s) of exposure

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>2 hrs <=8 hrs / > 2 h < = 8 h

11. List all symptoms

System

  • General
    • Symptom - Lethargy
  • Nervous and Muscular Systems
    • Symptom - Ataxia
    • Symptom - Paralysis

12. How long did the symptoms last?

>8 hrs <=24 hrs / > 8 h < = 24 h

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

Yes

14. a) Was the animal hospitalized?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Fully Recovered / Complètement rétabli

16. How was the animal exposed?

Other / Autre

specify No known exposure was witnessed or verifiable.

17. Provide any additional details about the incident

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

1/24/2008 Caller used product around her home 2 days ago. She suspects that dog may have somehow been exposed to it. Caller is inquiring if this product contains an organophosphate. The dog experienced lethargy, ataxia, and hind leg paralysis on the same day. She took the dog to the ED DVM last evening and had a evaluation. Dog was released and now this morning is ASX. It is unclear what treatments the dog received, but something had been given. DVM was not sure of the diagnosis. The caller was advised that the product is not an organophosphate nor would it be expected to cause such profound illness even if dog licked a surface that had recently been sprayed.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here

The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified in the telephone interviews. This product appears to be implicated in this case simply based on a temporal but coincidental product use scenario, however, there appears to be a disregard for all exposure quantification and objective data to the contrary. The information as provided does not provide any reliable means of verifying that an exposure occurred, with the events being purely speculative. When considering the body of regulatory data as well as the weight of scientific peer reviewed evidence such a causal relationship appears to be scientifically implausible. Even had the dog licked a surface that had been sprayed with this pesticide, there would be not expectation of the type of illness developing as reported in this case.