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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-2202

2. Registrant Information.

Registrant Reference Number: PROSAR Case # 1-25993948

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.

5. Location of incident.

Country: CANADA

Prov / State: BRITISH COLUMBIA

6. Date incident was first observed.

Unknown

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.

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2217-896-239

Product Name: Weed-B-Gon Max Plus Crabgrass Control Concentrate

• Active Ingredient(s)
  • 2,4-D (PRESENT AS AMINE SALTS : DIMETHYLAMINE SALT, DIETHANOLAMINE SALT, OR OTHER AMINE SALTS)
  • DICAMBA (PRESENT AS ACID, AMINE SALT, ESTER, OR SODIUM SALT)
  • QUINCLORAC

7. b) Type of formulation.

Application Information

8. Product was applied?

No

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: >1 <=6 yrs / > 1 < = 6 ans

3. List all symptoms, using the selections below.

System

• Gastrointestinal System
  • Symptom - Diarrhea

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?

Unknown

6. b) For how long?

7. Exposure scenario

Non-occupational

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

Other

9. If the exposure occured during application or re-entry, what protective clothing was worn? (select all that apply)

None

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.)

1-25993948- The reporter, a parent, indicates her child may have been exposed to an herbicide containing the active ingredients 2,4-D, quinclorac, and dicamba. The parent stated she had spilled a container of the product in her car 1.5 weeks ago. She had driven with the spilled product in the back of her car for 2-3 hours before she realized the product was spilled. She reports her (age) daughter and (age) daughter were both in the car with her at the time. She does not indicate a discreet exposure incident, but indicates her (age) daughter (Sub form III, #1) experienced two bouts of diarrhea later the same night following the incident. The mother asks if the incident and the diarrhea seen in the child could be related. The mother was advised that diarrhea would not be expected following the described incident. Respiratory irritation, nausea, and headache may be encountered in sensitive individuals if the aroma was considered offensive. Diarrhea is inconsistent with the exposure described. No further information is available.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.