Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-5683

2. Registrant Information.

Registrant Reference Number: Prosar 1-16817401

Registrant Name (Full Legal Name no abbreviations): FMC Corporation

Address: 1735 Market Street

City: Philadelphia

Prov / State: Pennsylvania

Country: USA

Postal Code: 19103

3. Select the appropriate subform(s) for the incident.

Domestic Animal

4. Date registrant was first informed of the incident.

29-SEP-08

5. Location of incident.

Country: UNITED STATES

Prov / State: CALIFORNIA

6. Date incident was first observed.

25-SEP-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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 279-3062

Product Name: Dragnet FT Termiticide/Insecticide

• Active Ingredient(s)
  • PERMETHRIN
    • Guarantee/concentration 36.8 %

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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).

The diluted product was applied to the home on 09/25/2008. The pest control operator was not informed prior to product application that the chameleon was present in the home.

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

Other / Autre

specify Reptile

3. Breed

Chameleon

4. Number of animals affected

1

5. Sex

Unknown

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>2 hrs <=8 hrs / > 2 h < = 8 h

11. List all symptoms

System

• Nervous and Muscular Systems
  • Symptom - Ataxia

• Eye
  • Symptom - Other
  • Specify - "Eyes partially closed"

• Nervous and Muscular Systems
  • Symptom - Convulsions

• Respiratory System
  • Symptom - Respiratory distress

• Gastrointestinal System
  • Symptom - Fecal incontinence
  • Specify - "Difficulty controlling bowel activity"
  • Symptom - Foaming at mouth
  • Specify - "Foam in its mouth"

• General
  • Symptom - Death

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?

Spray drift / Dérive de pulvérisation

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

1-16817401: On 09/29/2008, a reporter (the Safety Coordinator for a pest control company) reported the exposure of a chameleon to a pesticide containing the active ingredient Permethrin. According to the reporter, the pest control operator (PCO) treated a home with the diluted product (0.05% solution) on 09/25/2008. The PCO was not made aware that the chameleon was present in the home prior to starting product application. The PCO treated exposed baseboards in the home. When the PCO noticed the chameleon in a room of the home, he closed the door to that room and discontinued product application. The room that the chameleon was in was not treated. The home owner was not present during product application so the PCO made a note regarding discontinuation of the treatment and left the home. According to the home owners, they returned to the home about 2.5 hours following product application. At that time, they noticed that the chameleon was ataxic and had its eyes partially closed. On 09/26/2008, the chameleon was having convulsions, gasping for air, and had fecal incontinence. By the end of the day on 09/26/2008, the chameleon had died and was found to have foam in its mouth. It does not appear that the chameleon was evaluated by a veterinarian after signs were noted. No further information was provided.

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To be determined by Registrant

18. Severity classification (if there is more than 1 possible classification

Death

19. Provide supplemental information here