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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2016-2281
2. Registrant Information.
Registrant Reference Number: ProPharma case #: 1-43406818
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.
Domestic Animal
4. Date registrant was first informed of the incident.
04-MAR-165. Location of incident.
Country: CANADA
Prov / State: BRITISH COLUMBIA
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. 2009025 PMRA Submission No. EPA Registration No.
Product Name: Turf Builder Lawn Fertilizer 10-0-0 with Weed Prevent
- Active Ingredient(s)
- CORN GLUTEN MEAL
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 III: Domestic Animal Incident Report
1. Source of Report
Animal's Owner
2. Type of animal affected
Dog / Chien
3. Breed
Mixed breed
4. Number of animals affected
1
5. Sex
Unknown
6. Age (provide a range if necessary )
7
7. Weight (provide a range if necessary )
16.5
lbs
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 - Diarrhea
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
1-43406818 - The reporter, a pet owner, indicated that her dog was exposed to a weed preventer containing the active ingredient corn gluten meal. The reporter indicated that the product had been applied to her lawn 2 days prior to initial contact with the registrant and just prior to her call she saw her 16.5 pound, 7-year-old mixed breed dog eating the product from the lawn. The reporter believes her dog may have been eating the product off of the lawn since it had been applied 2 days earlier. At the time of the call the reporter stated that her dog had diarrhea. The reporter was advised that the product has a wide margin of safety but with ingestion transient gastrointestinal irritation is possible. On follow-up call, three days later, the reporter indicated that the dog had diarrhea for a few days and then symptoms resolved. No medical attention was needed. No additional information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
