Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2023-1436

2. Registrant Information.

Registrant Reference Number: 3563499

Registrant Name (Full Legal Name no abbreviations): Scotts Canada Ltd.

Address: 2000 Argentia Road - Plaza 2 Suite 300

City: Mississauga

Prov / State: ON

Country: Canada

Postal Code: L5N1V8

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

Human

4. Date registrant was first informed of the incident.

03-APR-23

5. Location of incident.

Country: UNITED STATES

Prov / State: INDIANA

6. Date incident was first observed.

29-MAR-23

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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 90780-2

Product Name: TOMCAT MOLE KILLER GRUBS

• Active Ingredient(s)
  • BROMETHALIN
    • Unknown

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7. b) Type of formulation.

Bait

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).

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

To be determined by Registrant

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

No

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: Male

Age: >64 yrs / > 64 ans

3. List all symptoms, using the selections below.

System

• Cardiovascular System
  • Symptom - Abnormally high blood pressure

• Gastrointestinal System
  • Symptom - Nausea

• General
  • Symptom - Dehydration
  • Symptom - Malaise

• Nervous and Muscular Systems
  • Symptom - Dizziness
  • Symptom - Slurred speech

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?

24

Hour(s) / Heure(s)

7. Exposure scenario

Non-occupational

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

Application

What was the activity? Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding the activity

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.

Skin

11. What was the length of exposure?

<=15 min / <=15 min

12. Time between exposure and onset of symptoms.

<=30 min / <=30 min

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.)

4/3/2023 Consumer is reaching out to report dizziness, malaise, and nausea after a dermal exposure to the TomCat Mole Killer Grubs. On 3/29/2023, he placed the grubs in his yard while not wearing gloves. He was handling them for 5-10 minutes when he suddenly became sick, dizzy, and almost lost his balance. He went inside the house but does not remember if he washed his hands at the time. He started to feel nauseous that night and that his signs and symptoms worsened over the next 2 days. He has not taken anything to manage his signs and symptoms, which he reports at the time of the call have slightly improved. Consumer denies having open wounds on his hands at the time of exposure. 4/7/2023 Follow up with the caller revealed that he sought evaluation for himself at the Emergency Room on 03/30/2023, where he was admitted to the hospital and kept for 24 hours, before being discharged on 03/31/2023. Caller states that while in the hospital he given intravenous fluids, but no other treatments initiated. He was given fluids because providers thought he may have been dehydrated. He also had an magnetic resonance imagining, a computed tomography scan, electrocardiogram, a speech test due to slurred speech, and other "blood tests" that he could not further clarify. All testing came back within normal limits, but he did not provide exact test values. Caller has a history of hypertension, although this was not reported previously. He had been taking Lisinopril for his hypertension, and the hospital changed him to Amlodipine. At the hospital, providers told him that they thought he may have potentially had a stroke, but the testing did not reflect this and no specific diagnosis was provided. Caller was told to follow-up with his primary care provider upon discharge, which he did on 04/03/2023. He had his blood pressure and temperature taken. His temperature came back within normal limits. His blood pressure was slightly elevated, with a reading of 160/80, which was elevated from his baseline of 140/70. Caller was given a prescription for Meclizine from his primary care provider to help with dizziness. Caller was referred to a neurologist for follow-up of symptoms, has yet to make this appointment, but plans to do so today. He has been monitoring his blood sugar at home daily, unclear as to why, and has been receiving results within normal limits. He did not provide exact values, but states results were never over 109. His symptoms are still present at time of report, but continuing to improve. He states that he did not discuss exposure to product with providers at the emergency room or his primary care provider.

To be determined by Registrant

14. Severity classification.

Major

15. Provide supplemental information here.

The information contained in this report is based on self-reported statements provided to the registrant during 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. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified in the telephone interviews.