Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2007-5057
2. Registrant Information.
Registrant Reference Number: SJB
Registrant Name (Full Legal Name no abbreviations): Spectrum Brands IP Inc.
Address: P.O. Box 21001
City: Brantford
Prov / State: ON
Country: Canada
Postal Code: N3R 7W9
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
13-JUL-07
5. Location of incident.
Country: CANADA
Prov / State: ONTARIO
6. Date incident was first observed.
08-JUN-07
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)
PMRA Registration No. 179
PMRA Submission No.
EPA Registration No.
Product Name: Green Leaf Meta Slug Killer Bait
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
Unknown
10. Site pesticide was applied to (select all that apply).
Site: Res. - Out Home / Rés - à l'ext.maison
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
Product was placed in garden, approximately 1/4 of a 1kg box. Was applied a week before the incident in small amounts .
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
Yes
Subform III: Domestic Animal Incident Report
1. Source of Report
Animal's Owner
2. Type of animal affected
Dog / Chien
3. Breed
German Shepard
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
9
7. Weight (provide a range if necessary )
95
lbs
8. Route(s) of exposure
Oral
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
Unknown / Inconnu
11. List all symptoms
System
12. How long did the symptoms last?
Unknown / Inconnu
13. Was medical treatment provided? Provide details in question 17.
No
14. a) Was the animal hospitalized?
No
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Died
16. How was the animal exposed?
Contact treat.area/Contact surf. traitée
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
Dog was found dead the morning of June 8th, 2007
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here
Consulting agency indicated that roughly 6.5 ounces of this concentration (2.3%) would provide 100 mg/kg (MLDdog) to a 95 pound dog. This dog would have had to ingest approximately 180 grams out of the roughly 250 grams placed around the garden in several smaller amounts. Because the time between product application and the dog¿¿¿s death, as well as an undetermined amount of product possibly having been consumed, the caller was advised by the agency that this product was not likely the cause of the clinical situation reported.