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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-3520

2. Registrant Information.

Registrant Reference Number: PROSAR Case # 1-22766967

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.

26-MAY-10

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

26-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. Unknown

Product Name: Killex (Non-specific)

  • Active Ingredient(s)
    • 2,4-D (PRESENT AS ACID)
    • DICAMBA (PRESENT AS ACID, AMINE SALT, ESTER, OR SODIUM SALT)

7. b) Type of formulation.

Application Information

8. Product was applied?

Unknown

9. Application Rate.

10. Site pesticide was applied to (select all that apply).

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

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.

Data Subject

2. Demographic information of data subject

Sex: Female

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

3. List all symptoms, using the selections below.

System

  • Gastrointestinal System
    • Symptom - Sore throat
  • General
    • Symptom - Laryngitis

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?

No

6. b) For how long?

7. Exposure scenario

Non-occupational

8. How did exposure occur? (Select all that apply)

Application

Unknown

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.

Respiratory

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

>8 hrs <=24 hrs / > 8 h < = 24 h

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.)

1-22766967- The reporter calls to indicate she has been exposed to an herbicide containing the active ingredients 2-(4-Chloro-2-methylphenoxy) propanoic acid, 2,4-Dichlorophenoxyacetic acid, and Dicamba. The caller reports his wife was handling the product the day before the initial contact to the registrant. She was reported to have been wearing gloves while "handling" the product, no discreet exposure was described or indicated. The reporter indicated she was asymptomatic until the evening of 05-26-10 when she developed a sore throat and laryngitis. He posits inhalation exposure. The caller was told the symptoms described would not be expected 24 hours after exposure to the product. Upper airway irritation may be expected following inhalation exposure. But, the symptoms described and the time frame described are inconsistent with inhalation exposure.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.