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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2008-5867
2. Registrant Information.
Registrant Reference Number: Prosar 1-16819643
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.
Domestic Animal
4. Date registrant was first informed of the incident.
05-NOV-085. Location of incident.
Country: CANADA
Prov / State: QUEBEC
6. Date incident was first observed.
04-NOV-08Product 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. 27428 PMRA Submission No. EPA Registration No.
Product Name: Demand CS Insecticide
- Active Ingredient(s)
- LAMBDA-CYHALOTHRIN
7. b) Type of formulation.
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 product was applied inside the home on 11/04/2008.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
Animal's Owner
2. Type of animal affected
Dog / Chien
3. Breed
Unknown breed
4. Number of animals affected
2
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
Unknown / Inconnu
11. List all symptoms
System
- Gastrointestinal System
- Symptom - Vomiting
12. How long did the symptoms last?
Unknown / Inconnu
13. Was medical treatment provided? Provide details in question 17.
Unknown
14. a) Was the animal hospitalized?
Unknown
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Unknown/Inconnu
16. How was the animal exposed?
Other / Autre
specify Entry into treated area
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
1-16819643: A reporter called on 11/05/2008 to report the exposure of an unknown number of dogs (1st Subform III) and cats (2nd Subform III) to an insecticide containing the active ingredient Lambda-Cyhalothrin. According to the reporter, the product was applied to the home on 11/04/2008. The dogs and cats re-entered the home about 1 hour after product application. The animals began vomiting at some unknown time on 11/04/2008 and the signs were persistent at the time of the report. The reporter was advised that the diluted product contains a very low concentration of active ingredient. The reporter was also advised that GI signs would not be expected unless a large amount of the concentrated product had been ingested. A recommendation was made to clean treated surfaces with a mild soap and water solution and remove the animals from the area until the cleaning has been completed. A recommendation was also made to seek veterinary care should the signs persist. An attempt at follow up was unsuccessful. No further information was obtained.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
19. Provide supplemental information here
Not consistent with symptoms expected from exposure to Lambda-Cyhalothrin. No evidence of direct exposure.
Subform III: Domestic Animal Incident Report
1. Source of Report
Animal's Owner
2. Type of animal affected
Cat / Chat
3. Breed
Unknown breed
4. Number of animals affected
2
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
Unknown / Inconnu
11. List all symptoms
System
- Gastrointestinal System
- Symptom - Vomiting
12. How long did the symptoms last?
Unknown / Inconnu
13. Was medical treatment provided? Provide details in question 17.
Unknown
14. a) Was the animal hospitalized?
Unknown
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Unknown/Inconnu
16. How was the animal exposed?
Other / Autre
specify Entry into treated area
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
1-16819643: A reporter called on 11/05/2008 to report the exposure of an unknown number of dogs (1st Subform III) and cats (2nd Subform III) to an insecticide containing the active ingredient Lambda-Cyhalothrin. According to the reporter, the product was applied to the home on 11/04/2008. The dogs and cats re-entered the home about 1 hour after product application. The animals began vomiting at some unknown time on 11/04/2008 and the signs were persistent at the time of the report. The reporter was advised that the diluted product contains a very low concentration of active ingredient. The reporter was also advised that GI signs would not be expected unless a large amount of the concentrated product had been ingested. A recommendation was made to clean treated surfaces with a mild soap and water solution and remove the animals from the area until the cleaning has been completed. A recommendation was also made to seek veterinary care should the signs persist. An attempt at follow up was unsuccessful. No further information was obtained.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
19. Provide supplemental information here
Not consistent with symptoms expected from exposure to Lambda-Cyhalothrin. No evidence of direct exposure.
