Nouvelle déclaration d'incident
No de la demande: 2018-2914
Numéro de référence du titulaire d'homologation: 2270570
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
Pays: UNITED STATES
État: PENNSYLVANIA
ARLA No d'homologation ARLA No de la demande d'homologation EPA No d'homologation. 1021-1674-8845
Nom du produit: HS BED BUG & FLEA KILLER FOGGER 3-2 OZ
Oui
Inconnu
Site: Res. - In Home / Rés. - à l'int. maison
Non
Professionnel de la santé
Sexe: Femme
Âge: >64 yrs / > 64 ans
Système
Persisted until death
Inconnu
Non
Inconnu
Non professionnel
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
Dérive du pesticide à partir de la zone traitée
Inconnu
Respiratoire
<=15 min / <=15 min
Unknown / Inconnu
7/13/2018 A report dated 7/10/2018 was forwarded for documentation. The report states that caller is from the coroner's office calling to report that product was used by an individual last night. The individual set off the product forgetting that their grandmother was in the other bedroom. The grandmother is now deceased from cardiac arrest. The individual has used foggers in the past and put a towel under the door. This time there was a hole in the door and product was able to drift into the bedroom. The grandmother was a smoker and had several lung issues including chronic obstructive pulmonary disease and emphysema.
Mort
AThe product use history is somewhat vague in that it lacks a well documented description of a known or defined point of direct exposure to this product. In most cases of casual or incidental contact with this product death would not be an expected and is not consistent with the toxicological profile of this product. Given this patients very significant underlying medical history there is a at least a theoretical risk of development of significant respiratory symptoms secondary to over-exposure to any substance that can significantly alter the air quality in the room in which she resided. 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.