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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2021-4174

2. Registrant Information.

Registrant Reference Number: ProPharma Group case #: 2021SCCA00019276

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.

Human

4. Date registrant was first informed of the incident.

5. 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.

PMRA Registration No. 29695      PMRA Submission No.       EPA Registration No.

Product Name: SCOTTS WEED B GON MAX READY-TO-USE WEED CONTROL WITH QUICK CONNECT

• Active Ingredient(s)
  • IRON (PRESENT AS FEHEDTA)
    • Guarantee/concentration .25 %

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 II: Human Incident Report (A separate form for each person affected)

1. Source of Report.

Data Subject

2. Demographic information of data subject

Sex: Female

Age: >19 <=64 yrs / >19 <=64 ans

3. List all symptoms, using the selections below.

System

• Eye
  • Symptom - Irritated eye

• Gastrointestinal System
  • Symptom - Other
  • Specify - Increased bowel movements

• Renal System
  • Symptom - Frequent urination

• Nervous and Muscular Systems
  • Symptom - Headache

• Renal System
  • Symptom - Other
  • Specify - Kidney infection

4. How long did the symptoms last?

Unknown / Inconnu

5. Was medical treatment provided? Provide details in question 13.

Yes

6. a) Was the person hospitalized?

Unknown

6. b) For how long?

7. Exposure scenario

Non-occupational

8. How did exposure occur? (Select all that apply)

Application

9. If the exposure occured during application or re-entry, what protective clothing was worn? (select all that apply)

Unknown

10. Route(s) of exposure.

Respiratory

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

Unknown / Inconnu

13. Provide any additional details about the incident (eg. description of the frequency and severity of the symptoms, type of medical treatment, results from medical tests, outcome of the incident, amount of pesticide exposed to, etc.)

2021SCCA00019276 - The reporter indicates an exposure to a pesticide containing the active ingredient iron (present as FEHEDTA). Approximately one month before the day of initial contact with the registrant, the reporter indicated they might have inhaled the product during application. Approximately three weeks before the day of initial contact, the reporter stated they developed irritated eyes. Approximately two weeks before the day of initial contact, the reporter indicated they experienced increased bowel movements, increased urination, and migraine headaches which prompted them to consult with their doctor. An unknown amount of time later, the reporter indicated they were treated for a kidney infection. The reporter was advised to continue to work with their doctor, but the described symptoms would not be expected from an exposure to the pesticide. No additional information is available.

To be determined by Registrant

14. Severity classification.

Moderate

15. 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.