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Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2022-2822

2. Registrant Information.

Registrant Reference Number: ProPharma Group case #: 2022SCUS00045937

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: UNITED STATES

Prov / State: MICHIGAN

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.       PMRA Submission No.       EPA Registration No. 2217-896-239

Product Name: ORTHO WEED B GON MAX PLUS CRABGRASS CONTROL READY SPRAY

• Active Ingredient(s)
  • 2,4-D (PRESENT AS AMINE SALTS : DIMETHYLAMINE SALT, DIETHANOLAMINE SALT, OR OTHER AMINE SALTS)
    • Guarantee/concentration 6.42 %
  • DICAMBA (PRESENT AS ACID, AMINE SALT, ESTER, OR SODIUM SALT)
    • Guarantee/concentration .6 %
  • QUINCLORAC
    • Guarantee/concentration 2.13 %

7. b) Type of formulation.

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

1. Source of Report.

Other

2. Demographic information of data subject

Sex: Female

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Skin
  • Symptom - Rash

• Nervous and Muscular Systems
  • Symptom - Slurred speech
  • Symptom - Paralysis
  • Symptom - Muscle weakness
  • Symptom - Other
  • Specify - Undefined neurological issues

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?

Yes

6. b) For how long?

Unknown

7. Exposure scenario

Non-occupational

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

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

None

10. Route(s) of exposure.

Unknown

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.)

2022SCUS00045937 - The reporter indicates an exposure to a pesticide containing the active ingredients 2,4-D(present as amine salts: dimethylamine salt, diethanolamine salt, or other amine salts), dicamba(present as acid, amine salt, ester, or sodium salt), and quinclorac. Three to four days before the day of initial contact with the registrant, the reporter indicated their daughter was exposed to the product. One to two days before the day of initial contact, the reporter stated their daughter developed a rash. One day before the day of initial contact, the reporter stated their daughter developed slurred speech, weakness, and paralysis in half her body and sought medical attention. The reporter was advised the severity of symptoms would not be anticipated from the described exposure. Five days after the day of initial contact, the reporter stated their daughter was discharged from the hospital after an unknown number of days and still has a slurred speech and undefined neurological issues. No additional information is available.

To be determined by Registrant

14. Severity classification.

Major

15. Provide supplemental information here.