Health Canada
Symbol of the Government of Canada
Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-2575

2. Registrant Information.

Registrant Reference Number: 4653562

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.

10-JUN-11

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

30-MAY-11

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. 16741      PMRA Submission No.       EPA Registration No.

Product Name: Wilson Super Mouse Treat

  • Active Ingredient(s)
    • BROMADIOLONE

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: Agricultural-Outdoor/Agricole-extérieur

Préciser le type: pasture field

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

50g box was placed out in the pasture field

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

No

Subform III: Domestic Animal Incident Report

1. Source of Report

Medical Professional

2. Type of animal affected

Horse / Cheval

3. Breed

Quarter horse mix

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

15

7. Weight (provide a range if necessary )

1200

lbs

8. Route(s) of exposure

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • General
    • Symptom - Abnormal behaviour
    • Specify - Behavior Change
    • Symptom - Death
  • Nervous and Muscular Systems
    • Symptom - Depression
    • Symptom - Ataxia
    • Symptom - Shaking

12. How long did the symptoms last?

Persisted until death

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

Died

16. How was the animal exposed?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

Sometime yesterday afternoon, the horse ingested about 50g of the product. The owner's wife put bait in the pasture where the horse was being kept. The horse has been acting odd recently and they believe that it is due to this bait. The owner called the clinic today for advice, but the horse is not currently at the clinic. Horse will stand up and walk around, but will start shaking every so often then his whole body will twitch. He is still alert through the episodes. The vet has not yet seen the horse yet, only has been in connect with the male/husband owner. The wife put the product out supposedly yesterday afternoon. While it is certain product was put out and at least some of it is now gone, DVM is not certain only 50 grams were placed out. Discussed that horses, possible to have abnormal PTT at 24 h post exposure. DVM's turnaround time on PTT will be about 24 hours. Discussed evaluating the horse today, checking PTT and CBC. Discussed if DVM does not feel hemorrhage can be ruled out as a potential cause for the horse's symptoms, then will need to start Vitamin K1 therapy. If DVM feels signs are unlikely to be related to hemorrhage, then would check another PTT in 24h. Also discussed stall rest and adding alfalfa hay to diet if not already present, keeping horse out of pasture until certain all of the bait has been removed. On June 2, 2011 during a follow up call, the treating vet informed that she had received the bloodwork results from the lab that were drawn when the horse presented. The PTT and PT were mildly elevated, and there were significant elevations in the liver values. She has already spoken with the clinical pathologist, and they felt the PTT and PT changes were likely secondary to the liver disease rather than suggestive of an anticoagulant exposure. In my opinion, I also would tend to agree with the pathologist. Typically I would expect an anticoagulant exposure to result in elevations greater than 2-3x the high limit for the PTT and PT times. Also, in horses the PTT tends to rise before the PT time. The liver enzyme changes are also not consistant. Reviewed toxins that can affect the liver in horses. This horse was housed with 2 other horses and had recently been moved to a new pasture. The 2 remaining horses have since been pulled off the pasture. The vet has recommended to have the pasture investigated with regard to toxic plants to help rule out that type of exposure.


To be determined by Registrant

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

Death

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.