Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-5662

2. Registrant Information.

Registrant Reference Number: PROSAR Case 1-14960216

Registrant Name (Full Legal Name no abbreviations): Syngenta Crop Protection 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.

Human

4. Date registrant was first informed of the incident.

01-JUN-07

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

26-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)

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PMRA Registration No. 27055      PMRA Submission No.       EPA Registration No.

Product Name: Subdue Maxx Fungicide

• Active Ingredient(s)
  • METALAXYL-M (MEFENOXAM)

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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: Pub. Area - Outdoor/Zone publique - ext

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

Applied to a Golf Course on 06/24/07, unknown size of the area of application

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.

Data Subject

2. Demographic information of data subject

Sex: Female

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Skin
  • Symptom - Discolouration

4. How long did the symptoms last?

Unknown / Inconnu

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

Non-occupational

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

Contact with treated area

Amount of time between application and contact 2

Day(s) / Jour(s)

What was the activity? Golfing

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

Unknown

10. Route(s) of exposure.

Skin

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

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

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 plays golf, when she went golfing she developed a rash on her ankles. This happened on Saturday the 26th. The product was applied two days before (Thursday the 24th) to the ground. Her friend then went golfing and developed the same reaction. It is a dark violet ring, about 2 inches in height, all around her ankles. The area does not burn, and does not itch. Caller is wondering if she used the correct product for the symptoms. She has used calamine lotion. The rash/discoloration is getting better by the day and continues to diminish; she still has about 2 inches around each ankle. Caller would like to report the incident as well.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.

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

1. Source of Report.

Other

2. Demographic information of data subject

Sex: Female

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Skin
  • Symptom - Discolouration

4. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

6. a) Was the person hospitalized?

Unknown

6. b) For how long?

7. Exposure scenario

Non-occupational

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

Contact with treated area

Amount of time between application and contact 2

Day(s) / Jour(s)

What was the activity? Golfing

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

Unknown

10. Route(s) of exposure.

Skin

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

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

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 plays golf, when she went golfing she developed a rash on her ankles. This happened on Saturday the 26th. The product was applied two days before (Thursday the 24th) to the ground. Her friend then went golfing and developed the same reaction. It is a dark violet ring, about 2 inches in height, all around her ankles. The area does not burn, and does not itch. Caller is wondering if she used the correct product for the symptoms. She has used calamine lotion. The rash/discoloration is getting better by the day and continues to diminish; she still has about 2 inches around each ankle. Caller would like to report the incident as well.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.

Prosar's response to caller - product exposure can cause dermal irritation/redness/drying/itching . This is not an expected result of routine product contact.