Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2009-2026
2. Registrant Information.
Registrant Reference Number: 2009-4
Registrant Name (Full Legal Name no abbreviations): BASF Canada
Address: 100 Milverton, 5th fl
City: Mississauga
Prov / State: ON
Country: Canada
Postal Code: L5R4H1
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
12-JUN-09
5. Location of incident.
Country: CANADA
Prov / State: QUEBEC
6. Date incident was first observed.
12-JUN-09
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:
- Active Ingredient(s)
- DICAMBA (PRESENT AS ACID, AMINE SALT, ESTER, OR SODIUM SALT)
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: corn field
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
Farmer applied herbicide in the morning to corn field adjacent to horse paddock
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
not specified
4. Number of animals affected
7
5. Sex
Male
Female
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
- Eye
- Symptom - Blindness (temporary)
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?
Yes
14. b) How long was the animal hospitalized?
24
Hour(s) / Heure(s)
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
Farmer applied herbicide Marksman while animals were in paddock and did not provide warning so they could be removed. He applied in the morning, they noticed the horses were suffering symptoms, initially they thought the paddock had been sprayed by a skunk, as they noticed a strong smell, those that were affected continued to smell even after being washed.Approx 4 hour between exposure and symptom onset-blindness in one female, milky coating on rest but not blind, one horse had a red nose. treated with antibiotics and painkillers.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Major
19. Provide supplemental information here
Unclear if blindness is temporary, if it was, would be moderate.