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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2020-3774

2. Registrant Information.

Registrant Reference Number: 019958739A

Registrant Name (Full Legal Name no abbreviations): S.C. Johnson and Son, Limited

Address: 1 Webster Street

City: Brantford

Prov / State: ON

Country: Canada

Postal Code: N3T 5R1

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

Packaging Failure

4. Date registrant was first informed of the incident.


5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.


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.


PMRA Registration No. 27112      PMRA Submission No.       EPA Registration No.

Product Name: OFF! Deep Woods Pump Spray Insect Repellent

  • Active Ingredient(s)

7. b) Type of formulation.

Application Information

8. Product was applied?


9. Application Rate.


10. Site pesticide was applied to (select all that apply).

Site: Personal use / Usage personnel

Préciser le type: Human skin

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

Product was applied to the arms, legs, and neck.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?


Subform VI: Packaging Failure

1. What is the type of packaging that failed?

Spray Bottle / Flacon pulvérisateur

2. Did packaging failure occur during?

Use of Product

3. Did packaging failure result in?

potential injury

4. Describe how the packaging failed and the surrounding circumstances, including a description of the potential injury or exposure.

Consumer reports they applied the product to their arms, legs and neck, but the majority of the spray was dribbling down the plastic container all over the hand used to pump the mixture from the bottle.

For Registrant use only

5. Provide supplemental information here.

No adverse effects were reported by the consumer. The information contained in this report is based on self-reported statements provided to the registrant during e-mail communications and/or 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.