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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-5940

2. Registrant Information.

Registrant Reference Number: PROSAR Case 1-15136335

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

Address: 410 Swing Road

City: Greensboro

Prov / State: North Carolina

Country: USA

Postal Code: 27419

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

Domestic Animal

4. Date registrant was first informed of the incident.

23-JUL-07

5. Location of incident.

Country: UNITED STATES

Prov / State: UTAH

6. Date incident was first observed.

18-JUL-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: Demand CS - EAP: 100-1066

  • Active Ingredient(s)
    • CYHALOTHRIN-LAMBDA
      • Guarantee/concentration 9.79 %

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: Res. - In Home / Rés. - à l'int. maison

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 III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Other / Autre

specify Hamster

3. Breed

Unknown

4. Number of animals affected

1

5. Sex

6. Age (provide a range if necessary )

0.5

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Unknown

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

  • General
    • Symptom - Death

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?

Other / Autre

specify Unknown Exposure Route

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

Unknown Additional Product History: Caller states that on Wednesday a company came in and sprayed the product. On Thursday they noticed an odd smell in the house. On Friday they found their hamster dead. Caller is wondering if the death of the hamster and the use of the product are related. The hamster seemed healthy on Wednesday. Assessment: Explained to caller that as far as the Demand CS goes, the AI is a pyrethroid. Rodents are not known to have any know sensitivity to them. However hamsters themselves can have some respiratory issues. With what you have explained, it is unlikely that the product is related to the death. You will have to contact the manufacturer of the other product in question to find out what the AI's are in it. Sorry that this happened. I will document your concerns.


To be determined by Registrant

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

Death

19. Provide supplemental information here