Nouvelle déclaration d'incident
No de la demande: 2012-1827
Numéro de référence du titulaire d'homologation: 965523
Nom du titulaire (nom légal complet, aucune abbréviation): McLaughlin Gormley King Company
Adresse: 8810 Tenth Ave North
Ville: Minneapolis
État: MN
Pays: USA
Code postal /Zip: 55427-4319
Incident chez l'humain
Défaillance de l'emballage
Pays: UNITED STATES
État: TEXAS
ARLA No d'homologation ARLA No de la demande d'homologation EPA No d'homologation. 1021-1866-53853
Nom du produit: Black Flag Fogging Insecticide Formula 2
ARLA No d'homologation ARLA No de la demande d'homologation EPA No d'homologation. Inconnu
Nom du produit: Black Flag Propane Powered Insect Fogger Machine
Liquide
Oui
Inconnu
Site: Res. - Out Home / Rés - à l'ext.maison
Personne affectée
Sexe: Homme
Âge: >19 <=64 yrs / >19 <=64 ans
Système
Unknown / Inconnu
Oui
Oui
2
Day(s) / Jour(s)
Non professionnel
Application
Aucun
Peau
<=15 min / <=15 min
<=30 min / <=30 min
April 27, 2012 Caller states that he was using the propane powered fogging machine in his back yard 3 days ago when the apparatus somehow malfunctioned resulting in flames bursting out around the fogging apparatus and up his right hand and arm. The apparatus consists of a reservoir containing the liquid insecticide that is attached to a hand held device that is also attached to a mini portable propane tank. He is not able to elucidate any further on how exactly the flame from the propane torched ended up spreading out from the heating elements and up his arm. He was immediately transferred to a local hospital where he was admitted and hospitalized for 2 days. He was diagnosed with and treated for 3rd degree burns. The caller was reluctant to go into details regarding the extent of treatment.
Majeure
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. Extent of injury appears to be directly attributed to the propane powered heating element and not the actual insecticide.
Other / Autre
préciser Black Flag Propane Powered Insect Fogger Machine
L'utilisation du produit
une blessure potentielle
April 27, 2012 Caller states that he was using the propane powered fogging machine in his back yard 3 days ago when the apparatus somehow malfunctioned resulting in flames bursting out around the fogging apparatus and up his right hand and arm. The apparatus consists of a reservoir containing the liquid insecticide that is attached to a hand held device that is also attached to a mini portable propane tank. He is not able to elucidate any further on how exactly the flame from the propane torched ended up spreading out from the heating elements and up his arm. He was immediately transferred to a local hospital where he was admitted and hospitalized for 2 days. He was diagnosed with and treated for 3rd degree burns. The caller was reluctant to go into details regarding the extent of treatment.
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. Extent of injury appears to be directly attributed to the propane powered heating element and not the actual insecticide.