Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2016-7712

2. Registrant Information.

Registrant Reference Number: ProPharma Group case #: 1-45857649

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.

07-OCT-16

5. Location of incident.

Country: CANADA

Prov / State: SASKATCHEWAN

6. Date incident was first observed.

07-OCT-16

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. 31453      PMRA Submission No.       EPA Registration No.

Product Name: CRUISER VIBRANCE QUATTRO

• Active Ingredient(s)
  • DIFENOCONAZOLE
  • FLUDIOXONIL
  • METALAXYL-M AND S-ISOMER
  • SEDAXANE
  • THIAMETHOXAM

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7. b) Type of formulation.

Application Information

8. Product was applied?

No

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

Other

2. Type of animal affected

Cow / Vache

3. Breed

Unknown

4. Number of animals affected

4

5. Sex

Male

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 - Diarrhea

• General
  • Symptom - Malaise

12. How long did the symptoms last?

>3 days <=1 wk / >3 jours <=1 sem

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

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

1-45857649 - The reporter, the product retailer, indicated that cows may have been exposed to seed treated with the active ingredients thiamethoxam, fludioxonil, difenoconazole, and sedaxane. On the day of initial contact with the registrant, the reporter indicated his customers four male cattle of unknown age, weight, and breed ate about fifteen bushel of the treated seed. All of the animals are experiencing diarrhea and malaise. The reporter was advised that the product was not a concern for toxicity for the animals, but the amount of seed ingested could cause abdominal discomfort and other gastrointestinal symptoms. The reporter was advised to seek veterinary attention for the animals as they were already symptomatic. On follow-up call four days later, the reporter indicated the animals symptoms lasted about four days. No additional information is available.

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To be determined by Registrant

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

Minor

19. Provide supplemental information here