Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-5547

2. Registrant Information.

Registrant Reference Number: 298760

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.

17-MAR-08

5. Location of incident.

Country: CANADA

Prov / State: BRITISH COLUMBIA

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. 28347      PMRA Submission No.       EPA Registration No. 4822-538

Product Name: Raid Outdoor Ant Spikes - Canada

• Active Ingredient(s)
  • ABAMECTIN

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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. - 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).

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

Unknown

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

4

7. Weight (provide a range if necessary )

39.00

lbs

8. Route(s) of exposure

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

• General
  • Symptom - Edema
  • Symptom - Joint pain
  • Symptom - Lethargy

• Respiratory System
  • Symptom - Shortness of breath

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown/Inconnu

16. How was the animal exposed?

Other / Autre

specify Chewed up ant bait station found outside, but dog never actually witnessed to be the animal that chewed up this bait station.

17. Provide any additional details about the incident

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

3/17/2008 1:55:57 PM Consumer reports that her dog has been suffering from a peculiar illness over the past 3 weeks and has been in and out of the vet clinic. The dog has been suffering from edema of the neck and legs. She has also been suffering from unspecified respiratory issues. The DVM suspects she is suffering from some type of vasculitis. The consumer recently found a chewed up ant bait station in her yard, so she suspects her dog could have chewed on this station. She also acknowledges that some other animal could have potentially chewed on this spike.

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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

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. The potential dose of abamectin this dog could have received from a single ant bait station is well below any dose of this compound that could potentially lead to illness in a dog this size and is unlikely to have been the cause of this dog's death. The dose of abamectin used within the ant bait station is significant smaller than the dose of ivermectin, a similar compound to abamectin, used therapeutically by veterinarians to treat heartworm in dogs.