New incident report
Incident Report Number: 2016-2082
Registrant Reference Number: 5524983
Registrant Name (Full Legal Name no abbreviations): Sure-Gro IP Inc.
Address: 1900 Minnesota Crt
City: Mississauga
Prov / State: Ontario
Country: Canada
Postal Code: L5N 3C9
Human
Country: CANADA
Prov / State: ONTARIO
PMRA Registration No. 30535 PMRA Submission No. EPA Registration No.
Product Name: Wilsarin Rat and Mouse Killer
Yes
Unknown
Site: Res. - In Home / Rés. - à l'int. maison
Unknown
Data Subject
Sex: Female
Age: >19 <=64 yrs / >19 <=64 ans
System
Unknown / Inconnu
Unknown
No
Non-occupational
Contact with treated area
Amount of time between application and contact 2
Week(s) / Semaine(s)
What was the activity? re-entering trailer
None
Respiratory
Unknown / Inconnu
Unknown / Inconnu
Caller states that they placed at and Mouse Killer in trailer underbed x 1 to 2 weeks ago.Product: Wilsarin by Wilson, Rat and Mouse Killer,pink crystals put 3 to 4 bags of the product around.Callers concerned on the box it says to not inhale it.Denies actual mice in the trailer.Both caller and sister have symptoms O:caller not feeling well today,feels like she's having a "heart attack".sob,dizzy Sister is achey and has cough A: chronic adult inhalation of Wilsarin by Wilson Rat and Mouse Killer crystals, symptomatic R: hang up and call 911 seek care Should remove the product, call 911, and don't go back in home until know it is safe call back as needed pc will follow. Unable to follow as follow up calls did not connect, outcome unknown.
Minor
The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified. Also product is composed from corn cellulose, one would not expect chest pain type symptoms from corn.
Other
Sex: Female
Age: >19 <=64 yrs / >19 <=64 ans
System
Unknown / Inconnu
Unknown
No
Non-occupational
Contact with treated area
Amount of time between application and contact 2
Week(s) / Semaine(s)
What was the activity? re-entering the trailer
None
Respiratory
Unknown / Inconnu
Unknown / Inconnu
Caller states that they placed at and Mouse Killer in trailer underbed x 1 to 2weeks ago.Product: Wilsarin by Wilson, Rat and Mouse Killer,pink crystals put 3 to 4 bags of the product around.Callers concerned on the box it says to not inhale it.Denies actual mice in the trailer.Both caller and sister have symptoms O:caller not feeling well today,feels like she's having a "heart attack".sob,dizzy Sister is achey and has cough A: chronic adult inhalation of Wilsarin by Wilson Rat and Mouse Killer crystals, symptomatic R: hang up and call 911 seek care Should remove the product, call 911, and don't go back in home until know it is safe call back as needed pc will follow. Unable to follow as follow up calls did not connect, outcome unknown.
Minor
The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified. Also product is composed from corn cellulose, one would not expect chest pain type symptoms from corn.