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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-5997

2. Registrant Information.

Registrant Reference Number: Prosar 1-17007982

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.

02-DEC-08

5. Location of incident.

Country: UNITED STATES

Prov / State: MISSOURI

6. Date incident was first observed.

02-DEC-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.

Product Name: Brodifacoum Based Anticoagulant Rodenticide (Havoc non-specific)

  • Active Ingredient(s)
    • BRODIFACOUM
      • Guarantee/concentration .005 %

7. b) Type of formulation.

Bait

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 III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Mixed Breed

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.5

7. Weight (provide a range if necessary )

10

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

Unknown / Inconnu

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Stiffness
  • Gastrointestinal System
    • Symptom - Vomiting
  • General
    • Symptom - Death

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?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

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

1-17007982: A reporter called on 12/02/2008 to report the exposure of a dog to an anticoagulant rodenticide containing the active ingredient Brodifacoum. According to the reporter, the dog ingested an unknown amount of the product on 12/02/2008. The reporter had called the veterinarian prior to the report and was told that the dog should be fine. The dog was asymptomatic at the time of the report. The reporter was advised that the toxic dose based on her dog's weight is only 2.5 grams of bait. The mechanism of toxicity and signs of overexposure to the product were relayed to the reporter. The reporter was strongly encouraged to take her dog to the veterinarian for treatment with Vitamin K1. The reporter was advised that the treatment should be given daily for 21-30 days and a clotting time (PT test) should be done 48 hours following completion of treatment to ensure normal blood coagulation. On follow up on 12/04/2008, the reporter stated that the dog had developed signs of stiffness and vomiting (unknown how long following product ingestion). The dog was evaluated by a veterinarian on 12/03/2008. The dog was given a Vitamin K1 injection and the reporter was given two more to administer at home. The dog died at home on 12/03/2008. No further information was obtained.


To be determined by Registrant

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

Death

19. Provide supplemental information here

The time frame of symptom development is not consistent with ingestion of this anticoagulant rodenticide. Signs of toxicity secondary to product ingestion typically do not develop for 2-5 days following ingestion.