Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2007-4448
2. Registrant Information.
Registrant Name (Full Legal Name no abbreviations): Dow AgroSciences Canada Inc.
Address: Suite 2100, 450 - 1st Street SW
City: Calgary
Prov / State: AB
Country: Canada
Postal Code: T2P 5H1
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
23-MAY-07
5. Location of incident.
Country: CANADA
Prov / State: ALBERTA
6. Date incident was first observed.
19-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)
PMRA Registration No. 22764
PMRA Submission No.
EPA Registration No.
Product Name: Curtail M
- Active Ingredient(s)
- CLOPYRALID
- MCPA (PRESENT AS ESTERS)
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: Agricultural-Outdoor/Agricole-extérieur
Préciser le type: n/a
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
May 23-07 Exposure involved unknown amount orally and dermally. The exposure was accidental and occurred at animal owner's yard. Owner used the product on the yard but thinks he may have mixed it more strongly than the label recommends. May 28-07 Owner reported that when she took the cat to the vet, the cat vomited up a tapeworm. So she was treated at the vet, and is now doing fine
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
No
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 )
9
7. Weight (provide a range if necessary )
Unknown
8. Route(s) of exposure
Skin
Oral
9. What was the length of exposure?
>15 min <=2 hrs / >15 min <=2 h
10. Time between exposure and onset of symptoms
>30 min <=2 hrs / >30 min <=2 h
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
Fully Recovered / Complètement rétabli
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
May 28 -07 Owner reported that when she took the cat to the vet, the cat vomited up a tapeworm. So she was treated at the vet, and now she is doing fine. (ASPCA report May 29, 2007)
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
19. Provide supplemental information here