Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-3827

2. Registrant Information.

Registrant Reference Number: PROSAR Case #: 1-23461294

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.

15-JUL-10

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

13-JUL-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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. Unknown

Product Name: Ortho Home Defense Max

• Active Ingredient(s)
  • PERMETHRIN

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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).

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 - Vomiting

• Nervous and Muscular Systems
  • Symptom - Headache

4. How long did the symptoms last?

>30 min <=2 hrs / >30 min <=2 h

5. Was medical treatment provided? Provide details in question 13.

Unknown

6. a) Was the person hospitalized?

Unknown

6. b) For how long?

7. Exposure scenario

Non-occupational

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.

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.)

1-23461294- The reporter calls to indicate exposure to an insecticide containing the active ingredient permethrin. The caller indicates her husband applied the product inside a ski chalet three days prior to the initial contact with the registrant. The caller indicates she inhaled a few drops of the product during application. She reports she awoke in the morning one day after the exposure with a headache and vomiting. The symptoms persisted for less than two hours. The reporter calls one day after the resolution of her symptoms to determine if they could be related to the exposure described. The caller was told inhalation exposure may result in respiratory irritation that may exacerbate any underlying respiratory disease. Symptoms encountered would be expected to be limited to the respiratory tract and in most cases self limiting requiring symptomatic care if individuals are prone to respiratory irritation. The caller was told her symptoms were inconsistent with the exposure described and to consult her doctor if they recur or persist. No further information is available.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.