Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2021-0748
2. Registrant Information.
Registrant Reference Number: ProPharma Group case #: 1-62808579
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.
02-JAN-21
5. Location of incident.
Country: UNITED STATES
Prov / State: INDIANA
6. Date incident was first observed.
02-JAN-21
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: TOMCAT MOUSE KILLER CHILD & DOG RESISTANT, REFILLABLE STATION
- 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
Mixed
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
2
7. Weight (provide a range if necessary )
6
lbs
8. Route(s) of exposure
Oral
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
>2 hrs <=8 hrs / > 2 h < = 8 h
11. List all symptoms
System
- Nervous and Muscular Systems
12. How long did the symptoms last?
Persisted until death
13. Was medical treatment provided? Provide details in question 17.
No
14. a) Was the animal hospitalized?
No
14. b) How long was the animal hospitalized?
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
1-62808579 - The reporter, a pet owner, indicates an exposure to a pesticide containing the active ingredient bromethalin. On the day of initial contact with the registrant, the reporter stated her 6-pound, 2-year-old, male, mixed breed dog ingested an unknown amount of the bait approximately seven hours previous and was currently paralyzed. The reporter was advised to seek immediate veterinary evaluation of the dog as the symptom could be attributable to a toxicity to the bait. On follow-up call two days later, the reporter indicated she was unable to seek veterinary care for the dog and he died. 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
Please note that this submission in no way implies that Scotts Canada Ltd. agrees with the allegations contained within this incident report.