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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2012-2270

2. Registrant Information.

Registrant Reference Number: PROSAR Case#: 1-30033210

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: 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.

PMRA Registration No. 29695      PMRA Submission No.       EPA Registration No.

Product Name: Ecosense Weed B Gon RTU Weed Control-non-specific

• Active Ingredient(s)
  • IRON (PRESENT AS FEHEDTA)

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.

Medical Professional

2. Demographic information of data subject

Sex: Female

Age: >19 <=64 yrs / >19 <=64 ans

3. List all symptoms, using the selections below.

System

• Cardiovascular System
  • Symptom - Hypertension
  • Symptom - Tachycardia

4. How long did the symptoms last?

>24 hrs <=3 days / >24 h <=3 jours

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

Yes

6. a) Was the person hospitalized?

Yes

6. b) For how long?

3

Day(s) / Jour(s)

7. Exposure scenario

Unknown

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

Poisoning from ingestion of the pesticide

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.

Oral

11. What was the length of exposure?

>24 hrs <=3 days / >24 h <=3 jours

12. Time between exposure and onset of symptoms.

Unknown / Inconnu

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.)

1-30033210- The reporter, a physician, describes and exposure to an herbicide containing the active ingredient Ferric HEDTA. The caller stated he works with a poison control call center and is aware of an incident within the previous 6-12 months involving a woman [age] that ingested a liquid containing Iron EDTA in efforts to harm herself. He reported the patient was hospitalized for three days developing tachycardia and hypertension but ultimately resolved. He was unable to provide further detail about the case. His motive to call was to discuss exposures to the active ingredient to improve his response to similar cases going forward. The caller was advised of standards of care associated with ingestion of the AI. No further information is available.

To be determined by Registrant

14. Severity classification.

Major

15. Provide supplemental information here.