Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-4899

2. Registrant Information.

Registrant Reference Number: 2009-30

Registrant Name (Full Legal Name no abbreviations): BASF Canada

Address: 100 Milverton

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.

19-NOV-09

5. Location of incident.

Country: CANADA

Prov / State: SASKATCHEWAN

6. Date incident was first observed.

11-NOV-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. 27603      PMRA Submission No.       EPA Registration No.

Product Name: EQUINOX

• Active Ingredient(s)
  • TEPRALOXYDIM

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7. b) Type of formulation.

Application Information

8. Product was applied?

No

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

Cat / Chat

3. Breed

undescribed, "indoor" and "outdoor" cats

4. Number of animals affected

4

5. Sex

Unknown

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Oral

9. What was the length of exposure?

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

10. Time between exposure and onset of symptoms

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

11. List all symptoms

System

• Gastrointestinal System
  • Symptom - Bloody diarrhea

• 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?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

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

Grower kept plastic wrapped organ meat (liver kidneys) in an empty Equinox box in his freezer It was kept frozen for 4 months he fed the liver to his outdoor cats they developed diarrhea and bloody stool. within a few days 2 outdoor cats died. The grower assumed they had eaten something poisonous outside (rat poison etc).The next week he fed the kidneys to his indoor cats and over next few days they had same symptoms. Two of his indoor cats died as well, he wonders whether the meat became contaminated from the Equinox box.

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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 evidence of exposure to Equinox