Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-1408

2. Registrant Information.

Registrant Reference Number: Prosar case 1-15769575

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.

08-FEB-08

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

08-FEB-08

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. 26638      PMRA Submission No.       EPA Registration No.

Product Name: Helix Xtra Seed Treatment

• Active Ingredient(s)
  • DIFENOCONAZOLE
  • FLUDIOXONIL
  • METALAXYL-M (MEFENOXAM)
  • THIAMETHOXAM

---

7. b) Type of formulation.

Application Information

8. Product was applied?

Unknown

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

• Eye
  • Symptom - Irritated eye
  • Symptom - Foreign body sensation in eye

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

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.

Eye

11. What was the length of exposure?

<=15 min / <=15 min

12. Time between exposure and onset of symptoms.

<=30 min / <=30 min

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.)

1-15769575: The reporter called on 2/8/08 to report that his (age) year old male co-worker got either a seed treated with a fungicide/insecticide product or the actual fungicide/insecticide product in his eye. The product is a mixture of 3 fungicides and 1 insecticide, and includes the active ingredients Difenoconazole, Fludioxonil, Metalaxyl-M, and Thiamethoxam. The patient flushed his eye with water for at least 5 minutes but still felt as if there was something stuck in his eye. The caller requested toxicology information, which was given along with additional first-aid recommendations. These included rinsing the eye for at least 20 minutes and consulting with a physician in case there was a foreign body in the eye, since it could cause corneal injury. A follow-up call was placed but never returned so additional details are unknown.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.