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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-3412

2. Registrant Information.

Registrant Reference Number: PROSAR Case#: 1-23009297

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.

13-JUN-10

5. Location of incident.

Country: UNITED STATES

Prov / State: MINNESOTA

6. Date incident was first observed.

11-MAY-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.       PMRA Submission No.       EPA Registration No. 228-424-239

Product Name: Weed-B-Gon MAX Ready Spray

  • Active Ingredient(s)
    • DICAMBA (PRESENT AS ACID, AMINE SALT, ESTER, OR SODIUM SALT)
      • Guarantee/concentration 1.35 %
    • MECOPROP (PRESENT AS AMINE SALT)
      • Guarantee/concentration 13.72 %
    • TRICLOPYR TRIETHYLAMINE SALT
      • Guarantee/concentration 1.56 %

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).

Applied to residential lawn via hose end sprayer, no additional information is available

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

Bird - Poultry / Oiseau - Volaille

3. Breed

Chicken

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 )

3

lbs

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>1 wk <=1 mo / > 1 sem < = 1 mois

11. List all symptoms

System

  • General
    • 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?

Contact treat.area/Contact surf. traitée

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

1-23009297- The reporter calls to indicate possible exposure of her animal to an herbicide containing the active ingredients MCPA, Triclopyr, and Dicamba. The caller indicates her neighbor sprayed the product on his lawn 17 days before the initial contact with the registrant. The caller indicates she has poultry which may forage for insects on the lawn. The caller classifies the animals as ¿¿¿pets¿¿¿ and indicates they are not destine for human consumption. The caller indicates her animals consist of four chickens and one duck. The animals are allowed free range on the neighbor¿¿¿s lawn. She reports one chicken (sub-form III, #1) was found dead two days prior to the contact with the registrant and no symptoms have been observed in the remaining animals. The caller was told sudden death would not be expected two weeks after application following contact with application areas. She was advised to seek veterinary assistance to determine the cause of death in her animal. The reporter spontaneously called back one day later. She had been told by a lay person that the product had caused her animals death and the animals could not enter the area of application for one year. The caller was advised of published toxicity data for the listed active ingredients in poultry. The active ingredients have a very low order of toxicity. No harm would be expected to occur if her animals were allowed to forage on application areas two weeks after application. The caller was advised to seek a necropsy on the dead animal to determine its cause of death. No further information is known.


To be determined by Registrant

18. Severity classification (if there is more than 1 possible classification

Death

19. Provide supplemental information here