Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2009-2880
2. Registrant Information.
Registrant Reference Number: Prosar 1-19230261
Registrant Name (Full Legal Name no abbreviations): The Scotts Company LLC
Address: 14111 Scottslawn Road
City: Marysville
Prov / State: Ohio
Country: USA
Postal Code: 43041
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
20-JUL-09
5. Location of incident.
Country: UNITED STATES
Prov / State: CALIFORNIA
6. Date incident was first observed.
20-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.
PMRA Submission No.
EPA Registration No. 67702-21-239
Product Name: Ecosense Brand Insecticidal Soap 24fl oz
- Active Ingredient(s)
- POTASSIUM SALTS OF FATTY ACIDS
- Guarantee/concentration 1 %
7. b) Type of formulation.
Liquid
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 had been applied to a rose bush on 07/18/2009.
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
Other / Autre
specify Goat
3. Breed
Unknown breed
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
Unknown
7. Weight (provide a range if necessary )
40
lbs
8. Route(s) of exposure
Oral
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
<=30 min / <=30 min
11. List all symptoms
System
- General
- Symptom - Vocalizing
- Symptom - Death
12. How long did the symptoms last?
Persisted until death
13. Was medical treatment provided? Provide details in question 17.
No
14. a) Was the animal hospitalized?
No
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Died
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
1-19230261: A reporter (goat owner) called on 07/20/2009 to report the exposure of his goat to an insecticide containing the active ingredient Potassium Salts of Fatty Acids. According to the reporter, a rose bush had been sprayed with the product on 07/18/2009. On the day of the report, the rose bush was trimmed and the clippings were ingested by an unknown number of goats. Within 30 minutes, Goat #1 (1st Subform III) began vocalizing. She died 5 minutes later. None of the other goats developed any signs. The reporter was advised that ingestion of the product may result in minor gastrointestinal irritation but sudden death would not be anticipated. The reporter was advised that something else was likely the cause of death. A recommendation was made to consider necropsy to determine the cause of death. No further information was obtained.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here