Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2017-7282
2. Registrant Information.
Registrant Reference Number: ProPharma Group case #: 1-50065383
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.
15-OCT-17
5. Location of incident.
Country: UNITED STATES
Prov / State: TEXAS
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. 90780-10
Product Name: TOMCAT MOUSE KILLER CHILD AND DOG RESISTANT
- Active Ingredient(s)
- BROMETHALIN
- Guarantee/concentration .01 %
7. b) Type of formulation.
Bait
Application Information
8. Product was applied?
Unknown
9. Application Rate.
10. Site pesticide was applied to (select all that apply).
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
American Pit Bull Terrier
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
1
7. Weight (provide a range if necessary )
35
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
- Nervous and Muscular Systems
- Symptom - Muscle tremors
- Symptom - Muscle weakness
- Symptom - Ataxia
- Gastrointestinal System
- Symptom - Fecal incontinence
- Renal System
- Symptom - Lack of control of urination
12. How long did the symptoms last?
Persisted until death
13. Was medical treatment provided? Provide details in question 17.
Yes
14. a) Was the animal hospitalized?
Yes
14. b) How long was the animal hospitalized?
Unknown
15. Outcome of the incident
Died
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
1-50065383 - The reporter, a pet owner, indicated his dog was exposed to pesticide containing the active ingredient bromethalin. One day before the day of initial contact with the registrant, the reporter indicated his 1-year-old, 35-pound, male American Pit Bull Terrier dog ate an unknown amount of the product and was currently asymptomatic. The reporter was advised to seek immediate veterinary evaluation for the dog as it likely ingested a toxic amount of the product. On follow-up call two days later, the reporter indicated he brought the dog to an emergency veterinarian who induced vomiting and gave activated charcoal. While hospitalized, the dog developed muscle tremors, weakness and ataxia in the hind limbs and occasional loss of bowel and bladder function. The reporter stated he took the dog home at this point due to financial concerns. On follow up call five days after the day of initial contact, the reporter stated the dog had died at home. No additional information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here