Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2010-4606
2. Registrant Information.
Registrant Reference Number: PROSAR Case# 1-23656760
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.
02-AUG-10
5. Location of incident.
Country: UNITED STATES
Prov / State: ALABAMA
6. Date incident was first observed.
01-AUG-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. 239-2682
Product Name: Weed-B-Gon Kills Weeds, Not Lawns (RTU)
- Active Ingredient(s)
- 2,4-D (PRESENT AS AMINE SALTS : DIMETHYLAMINE SALT, DIETHANOLAMINE SALT, OR OTHER AMINE SALTS)
- Guarantee/concentration .12 %
- DICAMBA (PRESENT AS ACID, AMINE SALT, ESTER, OR SODIUM SALT)
- Guarantee/concentration .05 %
- MECOPROP-P (PRESENT AS AMINE SALT)
- Guarantee/concentration .22 %
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).
The caller indicated he sprayed the product two days. He did not clarify in what capacity, the nature of the use, rate or location. Based on context of the call it is likely residential outdoor, but that is unknown.
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
unknown
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
10
7. Weight (provide a range if necessary )
80
lbs
8. Route(s) of exposure
Unknown
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
Unknown / Inconnu
11. List all symptoms
System
- Gastrointestinal System
- Symptom - Diarrhea
- Symptom - Vomiting
- Nervous and Muscular Systems
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
1-23656760- The reporter, a pet owner, indicates his animal may have been exposed to a herbicide containing the active ingredients Mecoprop-p, 2,4-D, and Dicamba. The reporter indicates he sprayed the product two days prior to the initial contact with the registrant. He reports the ten year male eighty pound dog may have ingested some foliage to which the product had been applied one to two days after the product had been applied. No discreet exposure incident was described. The night prior to the initial contact with the registrant the animal demonstrated signs of diarrhea, vomiting, lethargy and tremor. The symptoms persisted through the night until the animal died a two AM. The caller did not seek veterinary assistance. The caller indicated he had used three lawn care products in his yard only one of which was produced by this registrant. He did not provide information on the remaining products. The caller was advised the symptoms described and out come are inconsistent with the exposure described. He was advised necropsy may be the best tool to discover the cause of death in his animal. No further information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here