Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-4307

2. Registrant Information.

Registrant Reference Number: 4397905

Registrant Name (Full Legal Name no abbreviations): Sure-Gro Inc.

Address: 150 Savannah Oaks Dr.

City: Brantford

Prov / State: Ontario

Country: Canada

Postal Code: N3V 1E7

3. Select the appropriate subform(s) for the incident.

Domestic Animal

4. Date registrant was first informed of the incident.

11-MAY-10

5. Location of incident.

Country: CANADA

Prov / State: UNKNOWN

6. Date incident was first observed.

14-APR-10

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)

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PMRA Registration No. 8169      PMRA Submission No.       EPA Registration No.

Product Name: Meta Slug and Snail Pellets

• Active Ingredient(s)
  • METALDEHYDE

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7. b) Type of formulation.

Application Information

8. Product was applied?

Unknown

9. Application Rate.

10. Site pesticide was applied to (select all that apply).

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

Unknown

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 )

0.75

7. Weight (provide a range if necessary )

67.3

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

• Nervous and Muscular Systems
  • Symptom - Muscle tremors

12. How long did the symptoms last?

>30 min <=2 hrs / >30 min <=2 h

13. Was medical treatment provided? Provide details in question 17.

Yes

14. a) Was the animal hospitalized?

Yes

14. b) How long was the animal hospitalized?

5

Day(s) / Jour(s)

15. Outcome of the incident

Fully Recovered / Complètement rétabli

16. How was the animal exposed?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

The owner reported to the DVM that the dog may have ingested some of the product last pm. The owner was advised that Metaldehyde will cause seizures in dogs and cats. 1 teaspoon can be lethal in a 5-pound dog. Our level of concern starts at a dosage of 2 mg/kg. Other clinical effects include tremors, anxiety, mydriasis, hyperthermia, depression, ataxia, and tachycardia. Liver failure may occur 2-3 days after exposure. At 8:40 the case was discussed with the DVM. DVM has not yet examined the dog. Discussed the management of metaldehyde cases. Because of the time frame and signs AC is most likely not indicated. Tx is symptomatic. Signs may persist for 24-48 hours. On April 19th per clinic update, pet was discharged on 4/15/10 doing well. Called owners on 4/17/10 and the pet had fully recovered

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To be determined by Registrant

18. Severity classification (if there is more than 1 possible classification

Moderate

19. Provide supplemental information here

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.