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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-4452

2. Registrant Information.

Registrant Reference Number: 2007-12

Registrant Name (Full Legal Name no abbreviations): BASF Canada

Address: 100 Milverton, 5th

City: Mississauga

Prov / State: ON

Country: Canada

Postal Code: L5R4H1

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

Domestic Animal

4. Date registrant was first informed of the incident.

22-JUN-07

5. Location of incident.

Country: UNITED STATES

Prov / State: CALIFORNIA

6. Date incident was first observed.

22-JUN-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.       PMRA Submission No.       EPA Registration No.

Product Name: Raptor Herbicide

  • Active Ingredient(s)
    • IMAZAMOX
      • Unknown

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: Agricultural-Outdoor/Agricole-extérieur

Préciser le type: alfalfa

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

Owner says that earlier today (22nd) Raptor was sprayed on alfalfa field. Four hours after the field was sprayed the dog went through that area.

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

Parson russel terrier mix

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

0.25

7. Weight (provide a range if necessary )

5

lbs

8. Route(s) of exposure

Unknown

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

  • General
    • Symptom - Listless
  • Gastrointestinal System
    • Symptom - Salivating excessively
  • Renal System
    • Symptom - Lack of control of urination
  • General
    • Symptom - Death
  • Nervous and Muscular Systems
    • Symptom - Difficulty getting up
    • Specify - unable to stand

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.

No

14. a) Was the animal hospitalized?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

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

earlier in day product sprayed on alfalfa field. four hours after field was sprayed dog went through the area. About 1.5 hors ago dog collapsed, became listless, began to foam at mouth and lost control of bladder. After collapse, not able to stand, died.Puppy had been playing normally, was on walk with family to the river, played there and hiking party was returning home.Puppy had habit of playing hard then flopping down to rest-she flopped down and when family turned to call her home, she did not respond.Puppy did not have any chance for inhalation of the herbicide.


To be determined by Registrant

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

Death

19. Provide supplemental information here

Exposure under these conditions, proper dilution,application dry at time of potential exposure, no signs would be expected.Conclusion is that Raptor was considered to have not related likelihood of causing the clinical situation.Family vet reviewed case with owner-feel anaphylaxis fits situation, not herbicide.