Nouvelle déclaration d'incident
No de la demande: 2017-5841
Numéro de référence du titulaire d'homologation: 2097328
Nom du titulaire (nom légal complet, aucune abbréviation): S.C. Johnson and Son, Limited
Adresse: 1 Webster Street
Ville: Brantford
État: ON
Pays: Canada
Code postal /Zip: N3T 5R1
Incident chez l'humain
Pays: CANADA
État: ONTARIO
Inconnu
ARLA No d'homologation 24723 ARLA No de la demande d'homologation EPA No d'homologation.
Nom du produit: OFF! Deep Woods 3 Insect Repellent 230g - Canada
Oui
Inconnu
Site: Personal use / Usage personnel
Personne affectée
Sexe: Femme
Âge: >19 <=64 yrs / >19 <=64 ans
Système
Unknown / Inconnu
Oui
Oui
2
Day(s) / Jour(s)
Non professionnel
Application
Quelle était l'activité? Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding the activity
Inconnu
Peau
>1 wk <=1 mo / > 1 sem < = 1 mois
<=30 min / <=30 min
8/22/2017 Caller applied this product to her legs on 8/12/2017. Approximately 15 minutes later, her legs started to itch. She then got into the shower to wash the product off. After her shower, her legs and back started to turn purple. During the morning of 8/13/2017 she woke up with difficulty breathing and hives on her legs and back. Her mother drove her to the emergency room. At the emergency room, she was given intravenous fluids with Morphine, Benadryl, and Penicillin. She was also given oral Benadryl. She stated her condition did not improve in the hospital. Her doctor diagnosed her with an allergic reaction to the product. She was admitted to the hospital. No further treatments were performed. She was observed until her discharge during the evening of 8/15/2017. No prescriptions were given. Caller had a follow up with her primary care doctor today, 8/22/2017. No treatments were performed and no prescriptions were given. Her doctor told her just to monitor herself. She states she is still itching and still has the skin discoloration. Caller has allergies to lactose, pollen and grass. Caller also has Celiac disease. 8/24/2017 Call back to the original caller for follow up. Caller states that itching and discoloration is still present. She has not had any other treatments, and has a follow up scheduled with her doctor.
Modérée
The differential diagnosis for a skin or allergic condition of this nature includes multiple potential etiologies which, in addition to this product include such factors as plant allergens, poison ivy, poison oak, food, medications, dietary supplements, household soaps, skin care products, infectious pathogens, heat exposure, insect bites, etc. Targeted allergy testing would be required before concluding that this product may be the causative agent. 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.