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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-3397

2. Registrant Information.

Registrant Reference Number: PROSAR Case#: 1-33772613

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.

Domestic Animal

4. Date registrant was first informed of the incident.

23-MAY-13

5. Location of incident.

Country: UNITED STATES

Prov / State: ILLINOIS

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. 239-2689

Product Name: Weed-B-Gon Max Plus Crabgrass Control Ready-to-spray

  • 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 %
    • QUINCLORAC
      • Guarantee/concentration .1 %

7. b) Type of formulation.

Liquid

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 III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Bird - Poultry / Oiseau - Volaille

3. Breed

Duck specific species unknown

4. Number of animals affected

1

5. Sex

Unknown

6. Age (provide a range if necessary )

Unknown

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

  • General
    • Symptom - Death

12. How long did the symptoms last?

Persisted until death

13. Was medical treatment provided? Provide details in question 17.

Unknown

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?

Spray drift / Dérive de pulvérisation

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

1-33772613 - The reporter, a home owner, indicated that his neighbors duck was exposed to an herbicide containing the active ingredients 2,4-D, Mecoprop-p, Dicamba and Quinclorac. The reporter states that he applied the herbicide to his lawn three to four weeks prior to initial contact with the registrant. One week after product application, the reporters neighbor accused the reporter of poisoning and killing his domestic duck by applying the product in his yard. The reporter is unsure of when the duck died or if it had any symptoms prior to death. The reporter was advised that the product has a wide margin of safety; ingestion of the product may cause transient gastrointestinal irritation but death is not consistent with product exposure. 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