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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-3177

2. Registrant Information.

Registrant Reference Number: PROSAR Case #: 1-26345369

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.

Domestic Animal

4. Date registrant was first informed of the incident.

01-JUN-11

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

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.

Active(s)

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 228-424-239

Product Name: Ortho Weed-B-Gon Max Concentrate

  • Active Ingredient(s)
    • DICAMBA (PRESENT AS ACID, AMINE SALT, ESTER, OR SODIUM SALT)
    • MCPA (PRESENT AS AMINE SALTS: DIETHANOLAMINE, DIMETHYLAMINE, OR MIXED AMINES)
    • TRICLOPYR TRIETHYLAMINE SALT

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. - 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?

No

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Chinese crested

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

4

7. Weight (provide a range if necessary )

14

lbs

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

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

11. List all symptoms

System

  • Gastrointestinal System
    • Symptom - Vomiting
  • General
    • Symptom - Lethargy
    • Symptom - Other
    • Specify - Failure to respond to verbal cues
  • Gastrointestinal System
    • Symptom - Anorexia
  • Liver
    • Symptom - Hepatic failure

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?

Unknown

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

1-26345369-The reporter, a pet owner, indicates her animal may have been exposed to an herbicide containing the active ingredient MCPA (dimethylamine salt), triclopyr (triethylamine salt), and dicamba (dimethylamine salt). The reporter indicated the product was brought into Canada from the USA by herself and applied to her lawn approximately 2.5 weeks prior to her initial report. She reports about the same time she applied this product her four year fourteen pound male Chinese crested dog became ill. No observed exposure was indicated, and no access to application area was described. The pet owner described vomiting, lethargy, anorexia, failure to respond to verbal cues, and a diagnosis of hepatic failure by the veterinarian. The caller asks the signs that might be seen following ingestion exposure to the product if it were to occur. The pet owner was advised of the primary gastro-intestinal irritant effect of the product following small scale to moderate ingestion exposures. The pet owner was advised hepatic failure was inconsistent with the toxicity profile of the active ingredients. No further information is available.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here