Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-5294

2. Registrant Information.

Registrant Reference Number: 1-34733169

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.

26-AUG-13

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

19-AUG-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. 27933      PMRA Submission No.       EPA Registration No.

Product Name: Ecosense Path Clear Grass/Weed Control Spray

• Active Ingredient(s)
  • ACETIC ACID

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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: Female

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

3. List all symptoms, using the selections below.

System

• General
  • Symptom - Swelling

• Skin
  • Symptom - Hives
  • Symptom - Red skin
  • Symptom - Blister

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?

No

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.

>24 hrs <=3 days / >24 h <=3 jours

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.)

1-34733169 - The reporter indicated that she was exposed to an herbicide containing the active ingredient acetic acid. The reporter applied the product in her yard seven days prior to initial contact with the registrant. No direct exposure to the product was noticed during application but caller indicates that within a couple of days of product application she developed a bump on her leg which then spread over her shin. The reporter went to the doctor who prescribed hydrocortisone cream which has not helped and she is now suffering from blisters and further spreading. The reporter was advised that the severity and persistence of her symptoms are not consistent with exposure to the product and she was encouraged to seek additional medical attention. On follow-up call, five days later, the reporter indicated that her symptoms had persisted. She went to the ER one day prior to the follow-up call and was told that they thought she was suffering from a staph infection. She was prescribed an antibiotic cream, oral antibiotics and an antihistamine. The reporter indicated that her symptoms no longer seem to be spreading. No further information is available.

To be determined by Registrant

14. Severity classification.

Moderate

15. Provide supplemental information here.