Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-5715

2. Registrant Information.

Registrant Reference Number: 1-34978552

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.

18-SEP-13

5. Location of incident.

Country: CANADA

Prov / State: BRITISH COLUMBIA

6. Date incident was first observed.

31-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. 28404      PMRA Submission No.       EPA Registration No.

Product Name: Ecosense Bug B Gon Insecticide Concentrate

• Active Ingredient(s)
  • PYRETHRINS

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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

• Skin
  • Symptom - Tingling skin

• Nervous and Muscular Systems
  • Symptom - Muscle spasm

• Gastrointestinal System
  • Symptom - Nausea

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)

Contact with treated area

What was the activity? walked on treated lawn in his stocking feet

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.

Skin

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.)

1-34978552 - The reporter indicated that he was exposed to an insecticide containing the active ingredient pyrethrin. The reporter, an adult male, applied the product to his lawn eighteen days prior to initial contact with the registrant and after application the reporter walked on the lawn wearing only socks on his feet. The reporters socks became soaked with the product and he did remove them and wash his feet shortly after the exposure. Two days later the reporter developed numbness in his feet and muscle spasms in his calf and then at the time of the call, eighteen days after the exposure, the reporter began experiencing nausea. The reporter was advised that dermal contact with the wet product may cause transient parasthesia but nausea eighteen days after dermal contact is not consistent with exposure to the product. Medical care was recommended to help determine an underlying cause and appropriate treatment. No further information is available.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.