Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-1442

2. Registrant Information.

Registrant Reference Number: 80093430

Registrant Name (Full Legal Name no abbreviations): Dow AgroSciences Canada Inc.

Address: Suite 2100, 450 - 1st Street S.W.

City: Calgary

Prov / State: Alberta

Country: Canada

Postal Code: T2P 5H1

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

Domestic Animal

4. Date registrant was first informed of the incident.

18-SEP-08

5. Location of incident.

Country: CANADA

Prov / State: MANITOBA

6. Date incident was first observed.

18-AUG-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. 464-404

Product Name: Lorsban F Insecticidal Chemical

• Active Ingredient(s)
  • CHLORPYRIFOS

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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: Agricultural-Outdoor/Agricole-extérieur

Préciser le type: n/a

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

Field next to cows was sprayed with product. Possibly blown into their pasture.

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

Cow / Vache

3. Breed

Bovine

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

1200

lbs

8. Route(s) of exposure

Skin

Respiratory

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>24 hrs <=3 days / >24 h <=3 jours

11. List all symptoms

System

• Respiratory System
  • Symptom - Difficulty Breathing

• Gastrointestinal System
  • Symptom - Salivating excessively

• Cardiovascular System
  • Symptom - Abnormally fast heart rate
  • Specify - Heart rate is slightly higher than normal.

• Respiratory System
  • Symptom - Laboured breathing

• Nervous and Muscular Systems
  • Symptom - Muscle tremors
  • Symptom - Paresis

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown/Inconnu

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

Field next to cows was sprayed with product on Aug 18/08. Possibly blown into their pasture. Could have been ingested, on grass, or blown onto their skin. On Aug 22/08, one lactating female cow had signs of drooling, foaming, respiratory distress, tremors, paresis. Other cows were not affected. Dr. (name) called to discuss the case. He said since the field was sprayed on 8/18, and the signs started on the 22nd, plus other cows were not affected, signs are more likely due to primary respiratory disease. Patient was brought to the clinic and treated with Micotil. Lab results were pending. Aug 29/08, the cow's breathing improved by 70% as per owner Tuesday 8-19.

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To be determined by Registrant

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

Moderate

19. Provide supplemental information here