Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-1635

2. Registrant Information.

Registrant Reference Number: Prosar 1-18046303

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.

07-APR-09

5. Location of incident.

Country: CANADA

Prov / State: PRINCE EDWARD ISLAND

6. Date incident was first observed.

06-APR-09

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. 18687      PMRA Submission No.       EPA Registration No.

Product Name: Ecosense Indoor Outdoor Insecticide Dust (Scotts)

• Active Ingredient(s)
  • PIPERONYL BUTOXIDE
  • PYRETHRINS
  • SILICON DIOXIDE (PRESENT AS 100% DIATOMACEOUS EARTH) - FRESH WATER FOSSILS

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7. b) Type of formulation.

Application Information

8. Product was applied?

No

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 II: Human Incident Report (A separate form for each person affected)

1. Source of Report.

Other

2. Demographic information of data subject

Sex: Male

Age: >1 <=6 yrs / > 1 < = 6 ans

3. List all symptoms, using the selections below.

System

• Respiratory System
  • Symptom - Laboured breathing
  • Specify - "Sounded like he was not getting enough air/had bad croup"

• Gastrointestinal System
  • Symptom - Tongue swelling

• Respiratory System
  • Symptom - Wheezing

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?

Yes

6. b) For how long?

Unknown

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.

Unknown

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.)

1-18046303: A reporter called on 04/07/2009 to report the possible exposure of her neighbor's children to an insecticide dust containing the active ingredients Pyrethrins, Piperonyl Butoxide, Silicon Dioxide, Quartz, and Cristobalite. According to the reporter, Child #1 (1st Subform II) had been in the basement on 04/05/2009 where the product was stored. On 04/06/2009, Child #1's mother heard him breathing (presumably louder than normal). He sounded as if he was not getting enough air or like he had bad croup, and his tongue was swollen. Child #1 was taken to the emergency room and treated with oxygen and steroids. He was then transferred to a different facility where he was "stabilized" and released on 04/06/2009. Child #1 had no previous history of asthma or any respiratory issues. At the time of the report, Child #1 was still wheezing. On the night of the report, Child #1 and Child #2 were playing in the basement where the product was noted to be only partially closed. The product is normally completely closed and on a shelf. It was thought that the children were playing with it. Child #2 (2nd Subform II) developed chest congestion after being in the basement. No product exposure was witnessed. The reporter wanted to know whether the children's symptoms could have been from the product had they been playing with it. The reporter was advised that inhalation of the product may result in irritation of the eyes and respiratory tract as well as cough, difficulty breathing, and shortness of breath. Adverse health effects are typically limited to the upper respiratory tract and resolve without affecting other body functions. A recommendation was made to have Child #2 move to fresh air. It was also recommended that any symptoms that persist after 30 minutes in fresh air should be evaluated by a health care professional. An attempt at follow up was unsuccessful. No further information was obtained.

To be determined by Registrant

14. Severity classification.

Moderate

15. Provide supplemental information here.

Subform II: Human Incident Report (A separate form for each person affected)

1. Source of Report.

Other

2. Demographic information of data subject

Sex: Male

Age: >1 <=6 yrs / > 1 < = 6 ans

3. List all symptoms, using the selections below.

System

• Respiratory System
  • Symptom - Chest congestion

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.

Unknown

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.)

1-18046303: A reporter called on 04/07/2009 to report the possible exposure of her neighbor's children to an insecticide dust containing the active ingredients Pyrethrins, Piperonyl Butoxide, Silicon Dioxide, Quartz, and Cristobalite. According to the reporter, Child #1 (1st Subform II) had been in the basement on 04/05/2009 where the product was stored. On 04/06/2009, Child #1's mother heard him breathing (presumably louder than normal). He sounded as if he was not getting enough air or like he had bad croup, and his tongue was swollen. Child #1 was taken to the emergency room and treated with oxygen and steroids. He was then transferred to a different facility where he was "stabilized" and released on 04/06/2009. Child #1 had no previous history of asthma or any respiratory issues. At the time of the report, Child #1 was still wheezing. On the night of the report, Child #1 and Child #2 were playing in the basement where the product was noted to be only partially closed. The product is normally completely closed and on a shelf. It was thought that the children were playing with it. Child #2 (2nd Subform II) developed chest congestion after being in the basement. No product exposure was witnessed. The reporter wanted to know whether the children's symptoms could have been from the product had they been playing with it. The reporter was advised that inhalation of the product may result in irritation of the eyes and respiratory tract as well as cough, difficulty breathing, and shortness of breath. Adverse health effects are typically limited to the upper respiratory tract and resolve without affecting other body functions. A recommendation was made to have Child #2 move to fresh air. It was also recommended that any symptoms that persist after 30 minutes in fresh air should be evaluated by a health care professional. An attempt at follow up was unsuccessful. No further information was obtained.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.