Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2008-2317
2. Registrant Information.
Registrant Reference Number: 2008May APSS 80048998
Registrant Name (Full Legal Name no abbreviations): Monsanto
Address: 800 N. Lindbergh Blvd.
City: Saint Louis
Prov / State: Missouri
Country: United States of America
Postal Code: 63167
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
12-JUN-08
5. Location of incident.
Country: UNITED STATES
Prov / State: OKLAHOMA
6. Date incident was first observed.
08-MAY-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.
PMRA Submission No.
EPA Registration No. 71995-33
Product Name: Roundup Weed and Grass Killer Ready to Use Plus Pump N Go Sprayer
- Active Ingredient(s)
- GLYPHOSATE (PRESENT AS ISOPROPYLAMINE SALT OR ETHANOLAMINE SALT)
- Guarantee/concentration 2 %
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: Agricultural-Outdoor/Agricole-extérieur
Préciser le type: Pasture
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
The horse was grazing in the area where the product was dried. The product was dried and it had rained after the application.
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
Other
2. Type of animal affected
Horse / Cheval
3. Breed
American Miniature Horse
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
10
7. Weight (provide a range if necessary )
400
lbs
8. Route(s) of exposure
Oral
9. What was the length of exposure?
>8 hrs <= 24 hrs / >8 h <= 24 h
10. Time between exposure and onset of symptoms
>24 hrs <=3 days / >24 h <=3 jours
11. List all symptoms
System
- Nervous and Muscular Systems
- Symptom - Ataxia
- Symptom - Staggering
- Nervous and Muscular Systems
12. How long did the symptoms last?
Persisted until death
13. Was medical treatment provided? Provide details in question 17.
Yes
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?
Contact treat.area/Contact surf. traitée
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
Owner had horse for about 2 weeks. Horse was normal the evening of the product application. The following evening, the horse was found with his head down; owner assumed the horse was grazing. The next day, horse had a locked jaw, was staggering when walking and is believed to have had a seizure; owner stated the seizure was continuous. DVM stated his symptoms occurred suddenly. Owner reports DVM gave an unknown injection. The horse died around 2am the next day. Horse taken to OSU for necropsy but case lost to followup as to necropsy results.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here
APSS Case ID: 80048998. Because the time course was poorly consistent, the amount was unknown consistent, and the findings were not consistent, this substance was considered to have not related likelihood of causing the clinical situation.