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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-3395

2. Registrant Information.

Registrant Reference Number: PROSAR Case#: 1-33587267

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.


4. Date registrant was first informed of the incident.


5. Location of incident.


Prov / State: UTAH

6. Date incident was first observed.


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.       PMRA Submission No.       EPA Registration No. 538-282

Product Name: Turf Builder with Plus 2 Weed Control

  • Active Ingredient(s)
    • 2,4-D (PRESENT AS ACID)
      • Guarantee/concentration 1.21 %
      • Guarantee/concentration .61 %

7. b) Type of formulation.


Application Information

8. Product was applied?


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?


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

1. Source of Report.


2. Demographic information of data subject

Sex: Male

Age: <=1 yr / < = 1 an

3. List all symptoms, using the selections below.


  • Skin
    • Symptom - Peeling skin
    • Specify - hands peeling
  • Gastrointestinal System
    • Symptom - Vomiting
    • Symptom - Burning throat
    • Specify - esophageal burns
  • Nervous and Muscular Systems
    • Symptom - Seizure
    • Symptom - Muscle tremors
    • Specify - Rigors
  • General
    • Symptom - Fever
  • Renal System
    • Symptom - Blood in urine
  • Respiratory System
    • Symptom - Pneumonia
    • Specify - Something seen in lower lung lobe on x-rays
  • Skin
    • Symptom - Cracked skin
    • Specify - hands cracked

4. How long did the symptoms last?

Unknown / Inconnu

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


6. a) Was the person hospitalized?


6. b) For how long?


7. Exposure scenario


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


9. If the exposure occured during application or re-entry, what protective clothing was worn? (select all that apply)


10. Route(s) of exposure.


11. What was the length of exposure?

<=15 min / <=15 min

12. Time between exposure and onset of symptoms.

>8 hrs <=24 hrs / > 8 h < = 24 h

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.)

1-33587267 - The reporter indicated that her son was exposed to an herbicide containing the active ingredients 2,4-D and Mecoprop-p. The reporter states that six days prior to initial contact with the registrant her (age) year old son had access to this product for a period of about 30 seconds during that time frame he was seen putting his hands in the bag of herbicide and then throwing the product up in the air. No product ingestion was witnessed and the reporter did not see any product in her sons mouth after the exposure. The following day the skin on her sons hands was cracked and peeling and that evening her son started vomiting. She took her son to a doctor 24 hours after the exposure and the doctor indicated that the child had burns in his throat. At the time of initial contact, the reporter stated that her son had suffered from several seizures and she was currently on her way to the emergency room. The reporter was advised that the product has a wide margin of safety and seizures are not consistent with the described exposure. On follow-up call, one day later, the reporter indicated that her son has now been to 3 different doctors but he has not been admitted to the hospital. The most recent doctor indicated that he thought the patient was suffering from rigors not seizures. One of the doctors believes that her son has pneumonia based on x-ray findings of something in the lower lobe of one lung but the other two doctors do not agree with a diagnosis of pneumonia. There is some blood in her sons urine, the underlying cause for this is unknown, but the doctors do not believe the blood is from a urinary tract infection. Caller also states that her son has been suffering from an intermittent fever of 104F. He has been treated with an unknown antibiotic but per the reporter there does not seem to be much improvement with this medication. The reporter was advised that the described symptoms are not consistent with the described exposure. No further information is available.

To be determined by Registrant

14. Severity classification.


15. Provide supplemental information here.