Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-2528

2. Registrant Information.

Registrant Reference Number: Prosar 1-18664828

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.

01-JUN-09

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

31-MAY-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. 27809      PMRA Submission No.       EPA Registration No.

Product Name: Killex Ready to Spray Lawn Weed Control (Green Cross)

• Active Ingredient(s)
  • 2,4-D (PRESENT AS AMINE SALTS : DIMETHYLAMINE SALT, DIETHANOLAMINE SALT, OR OTHER AMINE SALTS)
  • DICAMBA (PRESENT AS ACID, AMINE SALT, ESTER, OR SODIUM SALT)
  • MECOPROP P-ISOMER PRESENT AS DIMETHYLAMINE SALT

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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).

The product was applied on 05/31/2009.

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: >19 <=64 yrs / >19 <=64 ans

3. List all symptoms, using the selections below.

System

• Gastrointestinal System
  • Symptom - Nausea
  • Symptom - Vomiting
  • Symptom - Diarrhea

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)

Application

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.)

1-18664828: A reporter called on 06/01/2009 to report the possible exposure of her husband to an herbicide containing the active ingredients 2,4-D, Dicamba, and Mecoprop. According to the reporter, her husband was not wearing gloves while he was applying the product on 05/31/2009. He may have inhaled some product mist, but actual product exposure is unclear. Sometime during the night following product application, her husband developed nausea, vomiting, and diarrhea. The reporter was advised that the signs described are not expected following the possible exposure described. A recommendation was made to ensure adequate hydration and to seek medical attention if needed. No further information was obtained.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.