Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2010-1493
2. Registrant Information.
Registrant Reference Number: PROSAR 1-22101600
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.
31-MAR-10
5. Location of incident.
Country: CANADA
Prov / State: ONTARIO
6. Date incident was first observed.
30-MAR-10
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. 28379
PMRA Submission No.
EPA Registration No.
Product Name: Ecosense Bug B Gon Insecticide Ready To Use (Scotts) 1L
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. - In Home / Rés. - à l'int. 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 to a houseplant on 03/30/2010.
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
Chihuahua
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
2.5
7. Weight (provide a range if necessary )
8
lbs
8. Route(s) of exposure
Oral
9. What was the length of exposure?
<=15 min / <=15 min
10. Time between exposure and onset of symptoms
<=30 min / <=30 min
11. List all symptoms
System
- Nervous and Muscular Systems
12. How long did the symptoms last?
>2 hrs <=8 hrs / > 2 h < = 8 h
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
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
1-22101600: A reporter (dog owner) called on 03/31/2010 to report the exposure of his dog to an insecticide containing the active ingredient Pyrethrins. According to the reporter, the product was applied to a houseplant on 03/30/2010. The dog licked the plant following product application, and almost immediately became disoriented and lethargic. The reporter was advised that small ingestions of the product may result in gastrointestinal upset such as nausea, vomiting, and diarrhea. A recommendation was made to ensure fluid replacement should gastrointestinal signs develop. The reporter was advised to have the dog evaluated by a veterinarian should the signs persist. On follow up, the reporter stated that the dog's signs resolved within 2-3 hours. No further information was obtained.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Moderate
19. Provide supplemental information here