Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-4531

2. Registrant Information.

Registrant Reference Number: 187972

Registrant Name (Full Legal Name no abbreviations): Bayer CropScience, Inc.

Address: Suite 100, 3131 114 Avenue SE

City: Calgary

Prov / State: AB

Country: Canada

Postal Code: T2Z 3X2

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

Human

4. Date registrant was first informed of the incident.

17-MAY-07

5. Location of incident.

Country: UNITED STATES

Prov / State: OKLAHOMA

6. Date incident was first observed.

11-MAY-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)

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

Product Name: Tempo SC Ultra

• Active Ingredient(s)
  • CYFLUTHRIN
    • Guarantee/concentration 11.8 %

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7. b) Type of formulation.

Liquid

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

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

Site: Res. - In Home / Rés. - à l'int. maison

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

See main notes on subform II

To be determined by Registrant

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

No

Subform II: Human Incident Report (A separate form for each person affected)

1. Source of Report.

Data Subject

2. Demographic information of data subject

Sex: Female

Age: >19 <=64 yrs / >19 <=64 ans

3. List all symptoms, using the selections below.

System

• Respiratory System
  • Symptom - Coughing
  • Symptom - Pneumonia
  • Symptom - Shortness of breath

4. How long did the symptoms last?

>1 wk <=1 mo / > 1 sem < = 1 mois

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

Yes

6. a) Was the person hospitalized?

Yes

6. b) For how long?

2

Day(s) / Jour(s)

7. Exposure scenario

Non-occupational

8. How did exposure occur? (Select all that apply)

Application

9. If the exposure occured during application or re-entry, what protective clothing was worn? (select all that apply)

None

10. Route(s) of exposure.

Respiratory

11. What was the length of exposure?

>15 min <=2 hrs / >15 min <=2 h

12. Time between exposure and onset of symptoms.

>8 hrs <=24 hrs / > 8 h < = 24 h

13. Provide any additional details about the incident (eg. description of the frequency and severity of the symptoms, type of medical treatment, results from medical tests, outcome of the incident, amount of pesticide exposed to, etc.)

5/17/2007 Caller bought product and used product on May 11. She doused walls and floor with product in her garage. She states that there were 10,000 ticks on the wall of the garage to the point where the wall appeared to be moving. She was in the enclosed garage and sprayed the product heavily in the area. She admits that the air was filled with airborne mist which she inhaled as she was not wearing any respiratory protection. She developed SOB, coughing over the following 24 hours, and eventually went to see her doctor who decided she needed to be admitted the hospital. She was hospitalized for 2 days for pneumonia. Her treatment consisted of IV and oral antibiotics, albuterol nebulizer, humidified oxygen and IV steroids. She recovered of the subsequent 1-2 weeks. She denies have a history of allergies or asthma but does admit to smoking a cigar every now and again.

To be determined by Registrant

14. Severity classification.

Major

15. Provide supplemental information here.