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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2014-4228
2. Registrant Information.
Registrant Reference Number: PROSAR case number: 1-38050359
Registrant Name (Full Legal Name no abbreviations): Syngenta Canada Inc.
Address: 140 Research Lane, Research Park
City: Guelph
Prov / State: Ontario
Country: Canada
Postal Code: N1G4Z3
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
06-AUG-145. Location of incident.
Country: CANADA
Prov / State: QUEBEC
6. Date incident was first observed.
05-AUG-14Product 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. 31300 PMRA Submission No. EPA Registration No.
Product Name: Masterline Lambdacy Insecticide
- Active Ingredient(s)
- LAMBDA-CYHALOTHRIN
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. - 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).
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
Other
2. Type of animal affected
Dog / Chien
3. Breed
Unknown
4. Number of animals affected
1
5. Sex
Unknown
6. Age (provide a range if necessary )
Unknown
7. Weight (provide a range if necessary )
Unknown
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
- Gastrointestinal System
- Symptom - Vomiting
12. How long did the symptoms last?
Unknown / Inconnu
13. Was medical treatment provided? Provide details in question 17.
Unknown
14. a) Was the animal hospitalized?
Unknown
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Unknown/Inconnu
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
1-38050359 - The reporter, a pest control operator, indicated that a customers dog and cat were exposed to an insecticide containing the active ingredient Lambda-cyhalothrin. The reporter stated that he applied the diluted product outside a customers home one day prior to initial contact with the registrant. The customers dog and cat entered the application site for the first time the following morning and while in the site the dog ate a flower. After the exposure the dog vomited one time and the cat seemed quieter than normal. The reporter was advised that once dried symptoms are not expected from exposure. In rare cases ingestion of the dried residue could result in transient gastrointestinal irritation but there are numerous possible causes for vomiting and lethargy. Veterinary care was recommended for any severe or persistent symptoms. The reporter could not be reached on follow-up. No further information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
19. Provide supplemental information here
Subform III: Domestic Animal Incident Report
1. Source of Report
Other
2. Type of animal affected
Cat / Chat
3. Breed
Unknown
4. Number of animals affected
1
5. Sex
Unknown
6. Age (provide a range if necessary )
Unknown
7. Weight (provide a range if necessary )
Unknown
8. Route(s) of exposure
Unknown
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
Unknown / Inconnu
11. List all symptoms
System
- General
- Symptom - Lethargy
12. How long did the symptoms last?
Unknown / Inconnu
13. Was medical treatment provided? Provide details in question 17.
Unknown
14. a) Was the animal hospitalized?
Unknown
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Unknown/Inconnu
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
1-38050359 - The reporter, a pest control operator, indicated that a customers dog and cat were exposed to an insecticide containing the active ingredient Lambda-cyhalothrin. The reporter stated that he applied the diluted product outside a customers home one day prior to initial contact with the registrant. The customers dog and cat entered the application site for the first time the following morning and while in the site the dog ate a flower. After the exposure the dog vomited one time and the cat seemed quieter than normal. The reporter was advised that once dried symptoms are not expected from exposure. In rare cases ingestion of the dried residue could result in transient gastrointestinal irritation but there are numerous possible causes for vomiting and lethargy. Veterinary care was recommended for any severe or persistent symptoms. The reporter could not be reached on follow-up. No further information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
