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: 2011-2627

2. Registrant Information.

Registrant Reference Number: PROSAR Case #: 1-26277395

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.

25-MAY-11

5. Location of incident.

Country: UNITED STATES

Prov / State: CALIFORNIA

6. Date incident was first observed.

18-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.       PMRA Submission No.       EPA Registration No. 2217-570-239

Product Name: Weed-B-Gon Lawn Weed Killer 2 (Concentrate)

  • Active Ingredient(s)
    • 2,4-D (PRESENT AS AMINE SALTS : DIMETHYLAMINE SALT, DIETHANOLAMINE SALT, OR OTHER AMINE SALTS)
      • Guarantee/concentration 3.05 %
    • DICAMBA (PRESENT AS ACID, AMINE SALT, ESTER, OR SODIUM SALT)
      • Guarantee/concentration 1.3 %
    • MECOPROP (PRESENT AS AMINE SALT)
      • Guarantee/concentration 10.6 %

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).

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

domestic shorthair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

9.5

7. Weight (provide a range if necessary )

9

lbs

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>3 days <=1 wk / >3 jours <=1 sem

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Seizure
  • Gastrointestinal System
    • Symptom - Weight loss
  • General
    • Symptom - Death

12. How long did the symptoms last?

Persisted until death

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

Unknown

14. a) Was the animal hospitalized?

Unknown

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

1-26277395- The reporter, a pet owner, indicates her animal may have been exposed to an herbicide containing the active ingredients mecoprop (dimethylamine salt), 2,4-d(dimethylamine salt), and dicamba (dimethylamine salt). The pet owner was very guarded about information provided but did reveal she had applied the product to her residential lawn one week prior to her initial contact with the registrant. She indicated her nine and one half year nine pound male domestic shorthair cat may have had access to the application area. She would not specify when the animal was allowed access with respect to application. She indicated her animal had lost an estimated nine pounds in an unspecified time frame, it had a seizure two days following application and had died the same day as the seizure. She would not say if she had brought the animal to the veterinarian. The caller was advised small ingestions via grooming coat that had come in contact with the application area and dermal contact with the application area itself would not be expected to elicit the signs seen or the outcome seen. The caller would provide no further information regarding the exposure.


To be determined by Registrant

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

Death

19. Provide supplemental information here