Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-6076

2. Registrant Information.

Registrant Reference Number: 216067

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.

25-JUL-07

5. Location of incident.

Country: UNITED STATES

Prov / State: ARIZONA

6. Date incident was first observed.

Unknown

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: Suspend SC

• Active Ingredient(s)
  • DELTAMETHRIN
    • Guarantee/concentration 4.75 %

---

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).

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

Yes

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: Male

Age: >6 <=12 yrs / > 6 < = 12 ans

3. List all symptoms, using the selections below.

System

• General
  • Symptom - Malaise

• Nervous and Muscular Systems
  • Symptom - Memory loss
  • Symptom - Difficulty talking

• Respiratory System
  • Symptom - Nose bleed

4. How long did the symptoms last?

>2 mos and <=6mos />2 mois et <=6mois

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

Yes

6. a) Was the person hospitalized?

No

6. b) For how long?

7. Exposure scenario

Non-occupational

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

Other

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.

Unknown

11. What was the length of exposure?

>1 mo <= 6 mos / > 1 mois < = 6 mois

12. Time between exposure and onset of symptoms.

>1 mo <=2 mos / > 1 mois < = 2 mois

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 states her apt was sprayed in 2005 with Suspend for bird mites. She has no label information but found the Bayer number off the internet.She states that within 6 weeks of moving into this apartment in 2005 she and her son developed:Flu like sxs. She also thinks that she and her son may not have been thinking as clearly as they used to. She claims her son's memory and speech appear to be impaired. About a year later she developed some type of anemia, and a doctor saw what appears to be a lung nodule that he did not think was significant. She also recalls experiencing periods of unspecified vision problems and a bloody nose. Her son also has had an occasional bloody nose.Both were seen by MDs over the last 2 years and no definitive diagnosis was made other than child may have early stage asthma (and she had anemia). No specific therapies were ever done. Both patients sxs have improved over the last 2 years and they are currently living in (state). She states her son had tests that indicated "pesticides" were in his body but could not be more specificCaller states the pesticide was used in her home while she lived in (state).

To be determined by Registrant

14. Severity classification.

Major

15. Provide supplemental information here.

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

3. List all symptoms, using the selections below.

System

• Blood
  • Symptom - Anemia

• Eye
  • Symptom - Decreased vision

• General
  • Symptom - Malaise

• Nervous and Muscular Systems
  • Symptom - Memory loss
  • Symptom - Other
  • Specify - Speech impairment

• Respiratory System
  • Symptom - Other
  • Specify - Lung nodules

4. How long did the symptoms last?

>2 mos and <=6mos />2 mois et <=6mois

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

Yes

6. a) Was the person hospitalized?

No

6. b) For how long?

7. Exposure scenario

Non-occupational

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

Other

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

10. Route(s) of exposure.

Unknown

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

>1 mo <=2 mos / > 1 mois < = 2 mois

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 states her apt was sprayed in 2005 with Suspend for bird mites. She has no label information but found the Bayer number off the internet.She states that within 6 weeks of moving into this apartment in 2005 she and her son developed:Flu like sxs. She also thinks that she and her son may not have been thinking as clearly as they used to. She claims her son's memory and speech appear to be impaired. About a year later she developed some type of anemia, and a doctor saw what appears to be a lung nodule that he did not think was significant. She also recalls experiencing periods of unspecified vision problems and a bloody nose. Her son also has had an occasional bloody nose.Both were seen by MDs over the last 2 years and no definitive diagnosis was made other than child may have early stage asthma (and she had anemia). No specific therapies were ever done. Both patients sxs have improved over the last 2 years and they are currently living in (state). She states her son had tests that indicated "pesticides" were in his body but could not be more specificCaller states the pesticide was used in her home while she lived in (state).

To be determined by Registrant

14. Severity classification.

Major

15. Provide supplemental information here.