Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-2124

2. Registrant Information.

Registrant Reference Number: Prosar 1-18736985

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.

06-JUN-09

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

04-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)

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PMRA Registration No. 27428      PMRA Submission No.       EPA Registration No. 100-1066

Product Name: Demand CS

• Active Ingredient(s)
  • LAMBDA-CYHALOTHRIN

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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: Res. - Out Home / Rés - à l'ext.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 to the lawn on 06/04/2009.

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

Maltese

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

5

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

• Nervous and Muscular Systems
  • Symptom - Shaking

• General
  • Symptom - Lethargy
  • Symptom - Fever

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?

Unknown

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Unknown/Inconnu

16. How was the animal exposed?

Contact treat.area/Contact surf. traitée

17. Provide any additional details about the incident

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

1-18736985: A reporter (dog owner) called on 06/06/2009 to report the possible exposure of her dogs to an insecticide containing the active ingredient Lambda-cyhalothrin. According to the reporter, the lawn was treated with the product on 06/04/2009. The reporter's 2 dogs were not allowed on the treated lawn until the product was dry. At an unknown time, one of the reporter's dogs (1st Subform III) became lethargic and started shaking. The route of product exposure was unknown. The reporter's other dog was asymptomatic. The reporter was advised that it is unlikely that the dog's signs are related to product exposure given that the product was dry before the dogs had access to the treated area. The reporter was advised of the signs of a mild over-exposure including hypersalivation, vomiting, mild tremors, and hyperexcitability or depression. A recommendation was made to bathe the dog in the event of a dermal exposure to wet product and have the dog evaluated by a veterinarian. The reporter was advised that treatment of product over-exposure is aimed at managing symptoms. On follow up, the reporter stated that the symptomatic dog was evaluated by a veterinarian and treated with IV fluids, antibiotics, and pain medications. The results of blood work were pending. The dog was still lethargic, shaking on and off, and had a fever at the time of the follow up. The other dog remained asymptomatic. The reporter was advised to have the veterinarian call with any questions about the product. 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

Moderate

19. Provide supplemental information here

Exposure was not clearly established since reporter indicated the product had dried on the lawn before the dog was allowed back on the lawn. Additionally, only one dog evinced any symptoms. The symptoms described are not entirely consistent with exposure to Lambda-Cyhalothrin.