Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2012-1457
2. Registrant Information.
Registrant Reference Number: PROSAR Case#: 1-28697931
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.
16-JAN-12
5. Location of incident.
Country: UNITED STATES
Prov / State: MAINE
6. Date incident was first observed.
03-NOV-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. 239-2682
Product Name: Weed-B-Gon (non-specific)
- 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?
Unknown
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 III: Domestic Animal Incident Report
1. Source of Report
Animal's Owner
2. Type of animal affected
Dog / Chien
3. Breed
Mixed breed
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
17
7. Weight (provide a range if necessary )
Unknown
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
- Renal System
- Symptom - Urinary incontinence
- Gastrointestinal System
- Symptom - Salivating excessively
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?
Unknown
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Died
16. How was the animal exposed?
Intentional poison./Empois. intentionnel
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
1-28697931 The reporter, a pet owner, indicates her animal was exposed to an herbicide containing the active ingredients Mecoprop-p, 2, 4-d, and dicamba. The pet owner indicated she believed her neighbor was intentionally poisoning her seventeen year male mixed breed dog. The pet owner stated the pet had died two months prior to her initial contact with the registrant while at the veterinarian's office. The pet had demonstrated the signs of sneezing, salivation, and urinary incontinence prior to its death. The pet owner stated the veterinarian had expressed the opinion that the animal had died due to its advanced age, but the pet owner stated she believed the veterinarian was lying. The pet owner stated she believed her neighbor had been throwing the herbicide over the fence into her yard, but this had not been observed. No exposure was observed. The pet owner was advised ingestions of the active ingredients in the product would need to be massive to pose a risk to her pet. It was highly unlikely that this product was involved in the death of her pet. Typically ingestion exposures to domestic animals would be expected to elicit no more than mild gastrointestinal upset. 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