Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2008-1052
2. Registrant Information.
Registrant Reference Number: 256508
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.
03-NOV-07
5. Location of incident.
Country: UNITED STATES
Prov / State: ILLINOIS
6. Date incident was first observed.
30-OCT-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: 24-Hour Grub Killer Granules 15 lb
- Active Ingredient(s)
- TRICHLORFON
- Guarantee/concentration 6.2 %
7. b) Type of formulation.
Granular
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 III: Domestic Animal Incident Report
1. Source of Report
Medical Professional
2. Type of animal affected
Bird / Oiseau
3. Breed
Blue Macaw
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
18
7. Weight (provide a range if necessary )
2.46
lbs
8. Route(s) of exposure
Unknown
9. What was the length of exposure?
<=15 min / <=15 min
10. Time between exposure and onset of symptoms
>24 hrs <=3 days / >24 h <=3 jours
11. List all symptoms
System
- General
- Symptom - Death
- Symptom - Lethargy
- Liver
- Symptom - Hepatic failure
- Specify - hepatic necrosis
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
Died
16. How was the animal exposed?
Other / Autre
specify Defined point of exposure not evident or witnessed. Exposure based on speculation.
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
11/3/2007Caller is treating Veterinarian. Caller reports that the client purchased a bag of product four days ago. There was a tear in the bag, and some of the product contacted client's shirt on the shoulder. Client changed shirt upon returning home. Client's bird then sat on that shoulder later in the day. Within three days the bird became anorexic, listless, and died. The bird had no known direct exposure to product. Veterinarian performed a necropsy, and bird was found to have profound liver pathology. DVM was informed that toxicological profile of trichlorfon does not include significant hepatic necrosis as a primary pathology. Trichlorfon is an organophosphate such that serious poisoning would result in increase secretions, pulmonary edema, and potential neurotoxicity.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here