Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-3965

2. Registrant Information.

Registrant Reference Number: PROSAR Case # 1-34165506

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.

Human

4. Date registrant was first informed of the incident.

30-JUN-13

5. Location of incident.

Country: UNITED STATES

Prov / State: OKLAHOMA

6. Date incident was first observed.

30-JUN-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. 239-2342

Product Name: Weed-B-Gon Lawn Weed Killer (Concentrate)

• Active Ingredient(s)
  • 2,4-D (PRESENT AS AMINE SALTS : DIMETHYLAMINE SALT, DIETHANOLAMINE SALT, OR OTHER AMINE SALTS)
    • Guarantee/concentration 10.8 %
  • MECOPROP-P (PRESENT AS AMINE SALT)
    • Guarantee/concentration 11.6 %

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7. b) Type of formulation.

Liquid

Application Information

8. Product was applied?

Unknown

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.

Other

2. Demographic information of data subject

Sex: Male

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

3. List all symptoms, using the selections below.

System

• Eye
  • Symptom - Irritated eye
  • Symptom - Other
  • Specify - "lens melted"

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)

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.

Eye

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

<=30 min / <=30 min

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.)

1-34165506-The reporter indicated a friend had been exposed to an herbicide containing the active ingredients 2, 4-D and MCPP. The reporter indicated his adult male friend had been accidentally sprayed in the eye with a previously diluted formulation of the product just prior to the initial contact with the registrant. The reporter indicated his friend was flushing his eye with water during the call and he reported a stinging sensation. The caller was advised of the potential for ocular irritation, of standard decontamination technique and the threshold at which to see a doctor. On follow up three days later the reporter indicated his friend went to the doctor the day following the initial contact with the registrant. The caller indicated the patient had an ocular lens replacement surgery years prior and the physician had indicated the lens would again need to be replaced again. The caller stated the product had melted the lens. No further follow up was obtained from this caller. No additional information is available. Transient ocular irritation that should be mitigated by flushing the eye with water is the expectation of this product and active ingredient. It is inconsistent with the expectation that it should penetrate the cornea and melt the lens of the eye.

To be determined by Registrant

14. Severity classification.

Major

15. Provide supplemental information here.