Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-3451

2. Registrant Information.

Registrant Reference Number: PROSAR Case#: 1-34066004

Registrant Name (Full Legal Name no abbreviations): Scotts Canada Ltd.

Address: 2000 Argentina Road, Plaza 5, Suite 101

City: Mississauga

Prov / State: Ontario

Country: Canada

Postal Code: L5N 2R7

3. Select the appropriate subform(s) for the incident.

Human

4. Date registrant was first informed of the incident.

29-MAY-13

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

29-MAY-13

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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2009025

Product Name: Turf Builder Lawn Fertilizer 10-0-0 with Weed Prevent

• Active Ingredient(s)
  • CORN GLUTEN MEAL

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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: Male

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

3. List all symptoms, using the selections below.

System

• Gastrointestinal System
  • Symptom - Diarrhea
  • Symptom - Vomiting

4. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

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)

Unknown

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.)

1-34066004- The reporter indicated he may have been exposed to an herbicidal product containing the active ingredient corn gluten meal. The reporter indicated he had applied the product to his residential lawn. He stated later four hours after mowing his lawn he was experiencing vomiting and diarrhea. The caller did not clarify when he had applied the product or by what route he was exposed. It would not be typical to apply the product and mown the lawn later the same day so it is assumed he applied the product some time earlier. It would not be expected that vomiting and diarrhea should be experienced following contact with an application site or following routine product use. This caller was not reached for follow up. No additional information is available.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.