Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-4644

2. Registrant Information.

Registrant Reference Number: Prosar 1-20500584

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.

22-OCT-09

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

09-JUL-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. 29138      PMRA Submission No.       EPA Registration No.

Product Name: Broadband Herbicide

• Active Ingredient(s)
  • FLORASULAM
  • PINOXADEN

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

Product Name: Non-specific Axial (Pinoxaden-based product)

• Active Ingredient(s)
  • PINOXADEN

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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: Unknown

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

A neighboring field was sprayed with the 2 company products and a non-company product (MCPA Ester 600) on 07/06/2009.

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

Horse / Cheval

3. Breed

Quarter Horse

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

9

7. Weight (provide a range if necessary )

1100

lbs

8. Route(s) of exposure

Skin

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

• Skin
  • Symptom - Burns (2nd or 3rd degree)
  • Specify - Bumps on skin that filled with pus and looked like chemical burns

• Liver
  • Symptom - Other
  • Specify - "Blood work showed liver was stressed"

• Skin
  • Symptom - Other
  • Specify - "Allergic reaction"

12. How long did the symptoms last?

>1 wk <=1 mo / > 1 sem < = 1 mois

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

Fully Recovered / Complètement rétabli

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

1-20500584: A reporter (horse owner) called on 10/22/2009 to report the exposure of her horse to an herbicide containing the active ingredient Pinoxaden and an herbicide containing the active ingredients Pinoxaden and Florasulam. According to the reporter her horse was in a pasture on 07/06/2009 and someone in a neighboring field was spraying the 2 company products and a non-company product (MCPA Ester 600). It was very windy during product application and the reporter could see the spray lift into the air and settle on the horse. The person spraying the products refused to stop product application, so the reporter moved her horse to a different area. By 07/09/2009, the horse developed pus-filled bumps all over his skin that looked like chemical burns. On 07/12/2009, the areas had become larger and there were 34-38 areas all over the horse's body. The horse was bathed several times and taken to the veterinarian. A biopsy revealed that the horse had sustained an allergic reaction to something and blood work indicated that his liver was stressed. The reporter indicated that the horse had fully recovered within 1 month. 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

Both company products can result in skin irritation, however, the extent of the signs described is not expected. It is unknown what effect the non-company product may have contributed to the incident.