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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2012-2651

2. Registrant Information.

Registrant Reference Number: PROSAR Case#:1-30444695

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: BRITISH COLUMBIA

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. 29834      PMRA Submission No.       EPA Registration No.

Product Name: Ecosense Weed B Gon Weed Control with Pull N Spray Applicator

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

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?

Unknown

Subform II: Human Incident Report (A separate form for each person affected)

1. Source of Report.

Data Subject

2. Demographic information of data subject

Sex: Female

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

3. List all symptoms, using the selections below.

System

• Skin
  • Symptom - Edema

4. How long did the symptoms last?

Unknown / Inconnu

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

Yes

6. a) Was the person hospitalized?

Unknown

6. b) For how long?

7. Exposure scenario

Non-occupational

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

Application

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.

Unknown

11. What was the length of exposure?

Unknown / Inconnu

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.)

1-30444695 - The reporter indicated a possible exposure to an herbicide containing the active ingredient iron. The reporter indicated she had applied the product to her lawn about one month prior to her initial contact with the registrant. The reporter indicated exposure may have occurred about one month ago when she was weeding the yard; but she is not sure if she weeded before or after product application. She reported that for the past month she has been experiencing some swelling between her fingers and some skin discoloration. She has seen her doctor for her symptoms who reportedly indicated that the inflammation in her hand is likely from 'other things'. The reporter was advised of transitory irritation that may follow topical exposure. Ongoing and persistent inflammation would not be expected. She was advised to follow up with is physician. No further information is available.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.