Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-5050

2. Registrant Information.

Registrant Reference Number: 197414

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.

Human

4. Date registrant was first informed of the incident.

11-JUN-07

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

06-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)

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PMRA Registration No. 27566      PMRA Submission No.       EPA Registration No.

Product Name: Raxil T

• Active Ingredient(s)
  • TEBUCONAZOLE
  • THIRAM

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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 II: Human Incident Report (A separate form for each person affected)

1. Source of Report.

Other

2. Demographic information of data subject

Sex: Male

Age: >19 <=64 yrs / >19 <=64 ans

3. List all symptoms, using the selections below.

System

• Gastrointestinal System
  • Symptom - Diarrhea
  • Symptom - Melena
  • Symptom - Stomach pain

4. How long did the symptoms last?

>8 hrs <=24 hrs / > 8 h < = 24 h

5. Was medical treatment provided? Provide details in question 13.

No

6. a) Was the person hospitalized?

Unknown

6. b) For how long?

7. Exposure scenario

Occupational

8. How did exposure occur? (Select all that apply)

Application

9. If the exposure occured during application or re-entry, what protective clothing was worn? (select all that apply)

None

10. Route(s) of exposure.

Skin

11. What was the length of exposure?

>2 hrs <=8 hrs / >2 h <=8 h

12. Time between exposure and onset of symptoms.

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

13. Provide any additional details about the incident (eg. description of the frequency and severity of the symptoms, type of medical treatment, results from medical tests, outcome of the incident, amount of pesticide exposed to, etc.)

Caller's husband developed abdominal cramping, diarrhea, and blood in his stools over the past 24 hours. There are unsure what is causing this but are wondering if the Raxil T he had worked with 5 days ago may be responsible. He states he spilled some of the material on his arms and was not able to wash off for 4 hours. He thinks that some of the material could have reached his hands and that he may have ingested some of the residue when he grabbed a pinch of tobacco to place in his mouth.He felt fine until yesterday.He has not seen a doctor.Assessment: Explained that the Raxil T is not likely the cause of this profound gastrointestinal illness, especially given that his illness did not begin until 4 days later and exposure by ingestion appears to be suspect at best. He was instructed to be seen in the ER right away.Follow up completed on 6/15 revealed that the patient had apparently recovered within 24 hours of the original call. He chose not to see a doctor for this condition.

To be determined by Registrant

14. Severity classification.

Moderate

15. Provide supplemental information here.