Nouvelle déclaration d'incident
No de la demande: 2019-3870
Numéro de référence du titulaire d'homologation: 2462591
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: OHIO
Inconnu
ARLA No d'homologation ARLA No de la demande d'homologation EPA No d'homologation. 1021-2569
Nom du produit: Bedlam Plus
Oui
Inconnu
Site: Res. - In Home / Rés. - à l'int. maison
Professionnel de la santé
Sexe: Homme
Âge: >12 <=19 yrs / >12 <=19 ans
Système
Unknown / Inconnu
Oui
Oui
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
Autre
Aucun
Inconnu
>8 hrs <= 24 hrs / >8 h <= 24 h
Unknown / Inconnu
6/16/2019 Caller is the medical toxicologist for the hospital treating a patient that was taken to the emergency room after his parents found him unresponsive on the couch at home. The family states they used the product behind the couch and on the floor on 6/15/2016. The son stated he was not feeling well and had a headache. He has a history of migraines. He stayed home to take a nap on the couch while the others went out. When they returned, they found the son on the couch unresponsive. He had vomited everywhere and had abnormal movements. Once he arrived at the emergency room he did have a unilateral seizure. He was intubated and is now in hypercapnic respiratory failure. Computer tomography and lumbar puncture have been done, which shows lymphatic encephalopathy is possible. Non-specific labs have been drawn. The product was not sprayed directly on the patient and was not sprayed directly on the couch. The family states the patient may have been having some abnormal behavior for one week of not feeling well. The patient does not have any psychiatric history and has never had an indication of drug use. 6/17/2019 Call back to the original caller for follow up information. When caller left the hospital yesterday, the patient was improving and starting to wake up. Caller is not working today. Caller does not think the patient overdosed on anything and also does not think the symptoms were related to the use of the product. 6/18/2019 Attempted call back to the original caller. A message was left requesting follow up information. 6/20/2019 Attempted call back to the original caller. A message was left requesting follow up information.
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.