Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-2875

2. Registrant Information.

Registrant Reference Number: Prosar 1-19095808

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.

08-JUL-09

5. Location of incident.

Country: CANADA

Prov / State: MANITOBA

6. Date incident was first observed.

08-JUL-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)

---

PMRA Registration No. 27521      PMRA Submission No.       EPA Registration No.

Product Name: Home Defense Max Perimeter/Indoor Insect Control Ready To Use (Ortho)

• Active Ingredient(s)
  • PERMETHRIN

---

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: Unknown / Inconnu

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

The product was applied to an unknown area on 07/07/2009.

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.

Medical Professional

2. Demographic information of data subject

Sex: Female

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

3. List all symptoms, using the selections below.

System

• Eye
  • Symptom - Burning eye
  • Symptom - Corneal abrasion

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?

No

6. b) For how long?

7. Exposure scenario

Unknown

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.

Skin

Eye

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.)

1-19095808: A reporter (nurse) called on 07/08/2009 to report the exposure of a patient to an insecticide containing the active ingredient Permethrin. According to the reporter, the patient had been applying the product on 07/07/2009 when it got on her hands and then she rubbed her eye. She developed a burning sensation in her eyes at an unknown time following product exposure. The reporter was advised that the product is an irritant but is not expected to result in corneal burns. A recommendation was made to irrigate the patient's eyes and perform a fluorescein stain should irritation persist. General recommendations were made regarding skin exposure (irrigation and application of topical vitamin E oil) if dermal signs exist. On follow up, the reporter stated that the patient was diagnosed with a right corneal abrasion. She was given saline eye drops and Tylenol 3 and was advised to follow up with an ophthalmologist to determine whether further treatment is warranted. No further information was obtained.

To be determined by Registrant

14. Severity classification.

Moderate

15. Provide supplemental information here.