Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2023-5145

2. Registrant Information.

Registrant Reference Number: 3532556

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

Address: 202-6835 Century Ave

City: Mississauga

Prov / State: ON

Country: Canada

Postal Code: L5N 7K2

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

Human

4. Date registrant was first informed of the incident.

27-FEB-23

5. Location of incident.

Country: UNITED STATES

Prov / State: ALABAMA

6. Date incident was first observed.

23-FEB-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. Unknown

Product Name: TomCat Mouse Killer Pre-filled Ready to Use Bait Station

• Active Ingredient(s)
  • BROMETHALIN

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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. - In Home / Rés. - à l'int. 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?

Yes

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 - Tongue numb
  • Symptom - Tingling in mouth
  • Specify - Tongue tingling

• General
  • Symptom - Metallic taste in the mouth

• Nervous and Muscular Systems
  • Symptom - Other
  • Specify - Nerve damage

• Eye
  • Symptom - Other
  • Specify - Burning sensation

4. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

6. a) Was the person hospitalized?

No

6. b) For how long?

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

Other

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.

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.)

2/27/2023 Consumer reporting that she experienced her tongue feeling numb and tingly after smelling the odor of the product. The consumer set the trap out on the night of 02/23/23. Immediately she noticed the odor of the product was very strong to her. She states the odor of the product is so strong, that she can taste it in her mouth. She does note that she is highly sensitive to odors, fragrances, and chemicals. On the morning of 02/24/23, she noticed a very small amount of the chunk inside the the station had spilled out onto the floor beside the trap, which she assumed was a sign that a mouse came up to the station. She cleaned up the little bit of crumbs from the floor using disposable gloves. She is positive she did not breathe in any of the powder, but she did notice the odor was still very strong. She denies touching any of the product inside the station directly and she was using disposable gloves when she set out the trap as well. She has not noticed any loose powder from the product, only the few crumbs that fell out that morning. After cleaning up the mess, she called Customer Service to ask them about her tongue being numb and an unknown agent told her that this is normal and some people experience their tongue feeling numb after being overly exposed to the product. Today she called Customer Service again and told them her symptoms have remained constant and unchanged since the night of 02/23/23, so they told her to contact us. Consumer accidentally disconnected while on hold. After being connected back with the consumer, she clarifies that her Depakote is not taken for treatment of seizures and is for an unspecified reason. 3/1/2023 Attempted call back. Left a detailed message requesting a call back. Case and call back numbers provided. 3/2/2023 Attempted call back. No answer. Left message with reason for call, and case and callback numbers. 3/3/2023 Call back: Consumer is returning our call. She states she has not seen her doctor. She reports the symptoms are ongoing. When she spoke with the company they told her some people have reported numbness and tingling with product use. She would like to speak with Customer Service about how long it will last. She stated that she knows the product caused the numbness/tingling. 8/29/2023 Call back from consumer. The caller is inquiring about any prognosis for nerve damage caused by the product. The caller reported that she did experience a burning sensation to the eyes at the time of placement of product and subsided within 5 minutes and that she experienced a metallic taste in mouth that lasted for weeks, but did not know the exact time frame. She is now stating that the product was wet on the floor on 24Feb2023 when she cleaned it up and that she was advised by Customer Service that the product was dangerous if it became wet. The caller stated that she was seen by a specialist a few weeks later as she thought the symptoms would go away. She was seen by an Ear, Nose, & Throat Doctor on 03March2023 and was diagnosed nerve damage by product. The caller believed that the symptoms were from the product and stated that the doctor was 100 percent sure that the product was the cause as well. No further information is available.

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.