Health Canada
www.hc-sc.gc.ca
Common menu bar links
Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2009-1639
2. Registrant Information.
Registrant Reference Number: Prosar 1-18294452
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.
Domestic Animal
4. Date registrant was first informed of the incident.
30-APR-095. Location of incident.
Country: CANADA
Prov / State: ONTARIO
6. Date incident was first observed.
26-APR-09Product 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. 29060 PMRA Submission No. EPA Registration No.
Product Name: Turf Builder Weed Prevent Corn Gluten Meal Herbicide (Scotts)
- Active Ingredient(s)
- CORN GLUTEN MEAL
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).
The product was applied on the neighbor's lawn on an unknown date.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
Animal's Owner
2. Type of animal affected
Dog / Chien
3. Breed
Yorkshire Terrier
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
2
7. Weight (provide a range if necessary )
4
lbs
8. Route(s) of exposure
Oral
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
>8 hrs <=24 hrs / > 8 h < = 24 h
11. List all symptoms
System
- Gastrointestinal System
- Symptom - Anorexia
- General
- Symptom - Adipsia
- Gastrointestinal System
- Symptom - Vomiting
- Symptom - Diarrhea
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
Fully Recovered / Complètement rétabli
16. How was the animal exposed?
Accidental ingestion/Ingestion accident.
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
1-18294452: A reporter called on 04/30/2009 to report the exposure of her dog to an herbicide containing the active ingredient corn gluten meal. According to the reporter, the product had been applied to a neighbor's lawn on an unknown date. The dog was seen eating the product off the lawn on 04/25/2009. On 04/26/2009, the dog was anorexic, not drinking, and vomiting. On 04/27/2009, she was eating but had diarrhea. She seemed better on 04/28/2009 but started having diarrhea and vomiting again on 04/29/2009. The reporter had an appointment scheduled with the veterinarian at the time of the report. The reporter was advised that the product has a low level of toxicity and a wide margin of safety. Ingestions of small quantities of product are unlikely to result in significant problems, but if enough is ingested, it may cause transient, minor gastrointestinal upset including nausea, vomiting, and diarrhea. A recommendation was made to discuss other possible causes of the signs with the dog's veterinarian. On follow up, the reporter stated that the dog was seen by her veterinarian. A diagnosis of bacterial overgrowth was made and the dog was started on medication. The dog was doing well at the time of follow up. No further information was obtained.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Moderate
