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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-4297

2. Registrant Information.

Registrant Reference Number: 4361877

Registrant Name (Full Legal Name no abbreviations): Sure-Gro Inc.

Address: 150 Savannah Oaks Dr.

City: Brantford

Prov / State: Ontario

Country: Canada

Postal Code: N3V 1E7

3. Select the appropriate subform(s) for the incident.

Domestic Animal

4. Date registrant was first informed of the incident.

11-MAR-10

5. Location of incident.

Country: CANADA

Prov / State: SASKATCHEWAN

6. Date incident was first observed.

14-FEB-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. 26679      PMRA Submission No.       EPA Registration No.

Product Name: Green Earth Ant and Roach Insect Dust

  • Active Ingredient(s)
    • SILICON DIOXIDE (PRESENT AS 100% DIATOMACEOUS EARTH) - FRESH WATER FOSSILS

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 caller moved into a new apartment 1 month ago. She put some of the powder on her baseboards and on some shelves

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

Cat / Chat

3. Breed

Siamese

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

9

7. Weight (provide a range if necessary )

13

lbs

8. Route(s) of exposure

Oral

Respiratory

9. What was the length of exposure?

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

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • Respiratory System
    • Symptom - Sneezing
  • Gastrointestinal System
    • Symptom - Anorexia

12. How long did the symptoms last?

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

13. Was medical treatment provided? Provide details in question 17.

Yes

14. a) Was the animal hospitalized?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Unknown/Inconnu

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

The caller moved into a new apartment 1 month ago. She put some of the powder on her baseboards and on some shelves. She is concerned the cats may have inhaled the powder. The PC advised the owner that because the amount was poorly consistent, the patient was considered to be at low risk of developing clinical signs. If signs develop, there is low risk that those signs will be life-threatening. The caller stated that silica is an issue by injection and inhalation. The caller read on the internet about silica causing tumors in the lungs. If the amount inhaled was large and the normal defense mechanisms of the lungs were overwhelmed, it is possible however this type of exposure is seen in miners and would not be expected in the type of exposures the cats had. Cats sneezing have gone on since the time she moved- could be viral and related to stress (but viruses usually only last 7 - 14 days) and could also be due to other environmental contaminants. On February 17, 2010 the PC called the animal's owner to update the case. She stated that Thomas is not doing well at home and is scheduled to be dropped off for hospitalization later today 2/17. Both cats are being treated with oral antibiotics. Gave the case number and the call back number in case their vet needs to contact us to consult. She stated that there was not a diagnosis at this time as to what is causing the problem. outcome unknown


To be determined by Registrant

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

Minor

19. Provide supplemental information here

The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified.

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Domestic shorthair

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

2

7. Weight (provide a range if necessary )

14

lbs

8. Route(s) of exposure

Respiratory

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • Respiratory System
    • Symptom - Sneezing

12. How long did the symptoms last?

Unknown / Inconnu

13. Was medical treatment provided? Provide details in question 17.

Yes

14. a) Was the animal hospitalized?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Unknown/Inconnu

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

The caller moved into a new apartment 1 month ago. She put some of the powder on her baseboards and on some shelves. She is concerned the cats may have inhaled the powder. The PC advised the owner that because the amount was poorly consistent, the patient was considered to be at low risk of developing clinical signs. If signs develop, there is low risk that those signs will be life-threatening. The caller stated that silica is an issue by injection and inhalation. The caller read on the internet about silica causing tumors in the lungs. If the amount inhaled was large and the normal defense mechanisms of the lungs were overwhelmed, it is possible however this type of exposure is seen in miners and would not be expected in the type of exposures the cats had. Cats sneezing have gone on since the time she moved- could be viral and related to stress (but viruses usually only last 7 - 14 days) and could also be due to other environmental contaminants. On February 17, 2010 the PC called the animal's owner to update the case. She stated that Thomas is not doing well at home and is scheduled to be dropped off for hospitalization later today 2/17. Both cats are being treated with oral antibiotics. Gave the case number and the call back number in case their vet needs to contact us to consult. She stated that there was not a diagnosis at this time as to what is causing the problem. outcome unknown


To be determined by Registrant

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

Minor

19. Provide supplemental information here

The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified.