Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2008-3356
2. Registrant Information.
Registrant Reference Number: 2008Jul APSS 80078430
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.
14-AUG-08
5. Location of incident.
Country: UNITED STATES
Prov / State: OHIO
6. Date incident was first observed.
16-JUL-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. 71995-47
Product Name: Roundup RTU Extended Control Weed and Grass Killer Plus Weed Preventer
- Active Ingredient(s)
- GLYPHOSATE (PRESENT AS ISOPROPYLAMINE SALT OR ETHANOLAMINE SALT)
- Guarantee/concentration 1 %
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. - Out Home / Rés - à l'ext.maison
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
Pet sitter sprayed the Roundup on July 16, 2008.
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
Dog / Chien
3. Breed
Labrador Retriever
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
0.75
7. Weight (provide a range if necessary )
42
lbs
8. Route(s) of exposure
Unknown
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
>8 hrs <=24 hrs / > 8 h < = 24 h
11. List all symptoms
System
- Gastrointestinal System
- Symptom - Vomiting
- Symptom - Diarrhea
- Nervous and Muscular Systems
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?
Contact treat.area/Contact surf. traitée
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
About 4 hours after spraying the product, the pet sitter let the dog outside. The dog may have eaten or licked the grass but the pet sitter is unsure about that. About 30 minutes after going outside, the dog threw up 2 large piles of undigested food. That night the dog had watery diarrhea. The next morning the dog was lethargic and threw up once. The pet sitter did call several vet offices and one suggested that she give pepto and some pedi-lite. Sitter gave 30 cc of pepto but no pedi-lite. No vet would see the dog without the owners permission and billing information.
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: 80078430. Because the time course was poorly consistent, the amount was unknown consistent, and the findings were somewhat consistent, this substance was considered to have low likelihood of causing the clinical situation.