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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-3699

2. Registrant Information.

Registrant Reference Number: PROSAR case #: 1-41256663

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

Address: 2000 Argentia Road, Plaza 2, Suite 300

City: Mississauga

Prov / State: Ontario

Country: Canada

Postal Code: L5N1V8

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

Human

Domestic Animal

4. Date registrant was first informed of the incident.

14-JUL-15

5. Location of incident.

Country: CANADA

Prov / State: UNKNOWN

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. Unknown

Product Name: Scotts Ecosense Weed B Gon (unspecified)

  • Active Ingredient(s)
    • IRON (PRESENT AS FEHEDTA)

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

  • Skin
    • Symptom - Red skin
    • Symptom - Burning skin
  • Respiratory System
    • Symptom - Nose bleed
  • Gastrointestinal System
    • Symptom - Bloody vomit

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 in bare feet on the application site

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.)

1-41256663 - The reporter indicated that she and her three cats were exposed to an herbicide containing the active ingredient ferric HEDTA. The product was applied on the lawn one day prior to initial contact with the registrant. The reporter (Subform II #1) stepped on the application site with bare feet at some unspecified time and after the exposure her feet burned and turned red. Her skin was still burning at the time of the initial call. The reporter also indicated that she has had nose bleeds and she vomited blood after the exposure. The reporter states that her three cats licked up some of the product when it was still wet. All three cats have vomited and are not eating and one of the cats (Subform III #1) is also hiding. The reporter was advised that dermal contact may cause transient skin irritation but nose bleeds and hematemesis is not consistent with dermal exposure to the product. The reporter was further advised that small ingestions of the wet product may result in transient gastro-intestinal irritation. No additional information is available.

To be determined by Registrant

14. Severity classification.

Moderate

15. Provide supplemental information here.

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

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

  • Gastrointestinal System
    • Symptom - Vomiting
    • Symptom - Anorexia
  • General
    • Symptom - Hiding

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown/Inconnu

16. How was the animal exposed?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

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

1-41256663 - The reporter indicated that she and her three cats were exposed to an herbicide containing the active ingredient ferric HEDTA. The product was applied on the lawn one day prior to initial contact with the registrant. The reporter (Subform II #1) stepped on the application site with bare feet at some unspecified time and after the exposure her feet burned and turned red. Her skin was still burning at the time of the initial call. The reporter also indicated that she has had nose bleeds and she vomited blood after the exposure. The reporter states that her three cats licked up some of the product when it was still wet. All three cats have vomited and are not eating and one of the cats (Subform III #1) is also hiding. The reporter was advised that dermal contact may cause transient skin irritation but nose bleeds and hematemesis is not consistent with dermal exposure to the product. The reporter was further advised that small ingestions of the wet product may result in transient gastro-intestinal irritation. No additional information is available.


To be determined by Registrant

18. Severity classification (if there is more than 1 possible classification

Minor

19. Provide supplemental information here

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Unknown

4. Number of animals affected

2

5. Sex

Unknown

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • Gastrointestinal System
    • Symptom - Vomiting
    • Symptom - Anorexia

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown/Inconnu

16. How was the animal exposed?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

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

1-41256663 - The reporter indicated that she and her three cats were exposed to an herbicide containing the active ingredient ferric HEDTA. The product was applied on the lawn one day prior to initial contact with the registrant. The reporter (Subform II #1) stepped on the application site with bare feet at some unspecified time and after the exposure her feet burned and turned red. Her skin was still burning at the time of the initial call. The reporter also indicated that she has had nose bleeds and she vomited blood after the exposure. The reporter states that her three cats licked up some of the product when it was still wet. All three cats have vomited and are not eating and one of the cats (Subform III #1) is also hiding. The reporter was advised that dermal contact may cause transient skin irritation but nose bleeds and hematemesis is not consistent with dermal exposure to the product. The reporter was further advised that small ingestions of the wet product may result in transient gastro-intestinal irritation. No additional information is available.


To be determined by Registrant

18. Severity classification (if there is more than 1 possible classification

Minor

19. Provide supplemental information here