Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-1557

2. Registrant Information.

Registrant Reference Number: Prosar 1-18195498

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.

21-APR-09

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

21-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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No.

Product Name: Helix Treated Canola Seed (non specific)

• Active Ingredient(s)
  • DIFENOCONAZOLE
  • FLUDIOXONIL
  • METALAXYL-M (MEFENOXAM)
  • THIAMETHOXAM

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7. b) Type of formulation.

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

Horse / Cheval

3. Breed

Morgan

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

20

7. Weight (provide a range if necessary )

1400

lbs

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

• 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?

Other / Autre

specify Unknown if exposure occurred

17. Provide any additional details about the incident

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

1-18195498: A reporter called on 04/21/2009 to report the possible exposure of his horse to a treated seed containing the active ingredients Thiamethoxam, Difenoconazole, Metalaxyl-M, and Fludioxonil. According to the reporter, the horse was found dead in 12/2008. There were no signs of struggle as if the horse had colicked and the cause of death was unknown. Just prior to the report, the reporter found the product in the field where the horse would have had access to it. The reporter thought the horse may have ingested 1-2 pounds of seed at some point and wanted to know whether that could have been the cause of death. The reporter was advised that if the horse had ingested a small amount of seed, he may have had signs of colic. Toxicity from the product would not be expected from the possible ingestion of 1-2 pounds of seed. No further information was obtained.

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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

No product exposure was witnessed. Death would not be expected from the ingestion of 1-2 pounds of seed.