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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-4532

2. Registrant Information.

Registrant Reference Number: 190112

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.

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.

21-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. 27692      PMRA Submission No.       EPA Registration No.

Product Name: RAXIL MD FUNGICIDE

  • Active Ingredient(s)
    • METALAXYL
    • TEBUCONAZOLE

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: Pesticide was used on treated grain seed.

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

Pesticide was used on treated grain seed.

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

Cow / Vache

3. Breed

Angus

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

6

7. Weight (provide a range if necessary )

636

kg

8. Route(s) of exposure

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>24 hrs <=3 days / >24 h <=3 jours

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Difficulty getting up
    • Specify - down animal, unable to rise
  • General
    • Symptom - Death
  • Nervous and Muscular Systems
    • Symptom - Recumbent
    • Specify - down animal, unable to rise

12. How long did the symptoms last?

Persisted until death

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

Not recovered / Non 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

5/23/2007 11:22:55 AM Farmer reports stated that a pile of treated seeds was in a pasture and that this cow was seen to have ingested an unknown amount 2 two days ago. On 5/23/2007, the cow was found down and not acting normally. The owner was instructed to contact a DVM right away because of he serious risk for grain overload and that the pesticide used on the grain does not pose any risk for poisoning. The seed itself can be very dangerous. Follow-up on 5/30/2007 Owner states that the cow ended up dying. He stated that he tried to get a hold of the DVM, but was not able to before the cow died. Caller was unable to remember how long symptoms occurred until death. Cow was never evaluated by a DVM. Cow was destroyed and no necropsy performed. Unknown what the cause of death was.


To be determined by Registrant

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

Death

19. Provide supplemental information here