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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-0622

2. Registrant Information.

Registrant Reference Number: 90092414

Registrant Name (Full Legal Name no abbreviations): Monsanto Canada Inc.

Address: 350 Albert St., Suite 315

City: Ottawa

Prov / State: ON

Country: CANADA

Postal Code: K1R 1A4

3. Select the appropriate subform(s) for the incident.

Domestic Animal

4. Date registrant was first informed of the incident.


5. Location of incident.


Prov / State: CALIFORNIA

6. Date incident was first observed.


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.


PMRA Registration No.       PMRA Submission No.       EPA Registration No. 71995-32

Product Name: Roundup Weed And Grass Killer Ready To Use No Root No Weed No Problem

  • Active Ingredient(s)
      • Guarantee/concentration 2 %

7. b) Type of formulation.


Application Information

8. Product was applied?


9. Application Rate.


10. Site pesticide was applied to (select all that apply).

Site: Res. - Out Home / Rés - à l'

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?


Subform III: Domestic Animal Incident Report

1. Source of Report


2. Type of animal affected

Dog / Chien

3. Breed


4. Number of animals affected


5. Sex


6. Age (provide a range if necessary )


7. Weight (provide a range if necessary )



8. Route(s) of exposure



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


  • Gastrointestinal System
    • Symptom - Bloating
    • Symptom - Retching

12. How long did the symptoms last?

Persisted until death

13. Was medical treatment provided? Provide details in question 17.


14. a) Was the animal hospitalized?


14. b) How long was the animal hospitalized?

15. Outcome of the incident

Euthanised / Euthanasie

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

Roundup Weed And Grass Killer Ready To Use No Root No Weed No Problem (evidence agent id) Possible exposure occurred on Aug 14, 2009 at 08:00 PM CDT (possible ). Exposure involved 0.0 Not App (not specific) orally. The exposure was accidental, and occurred at animal owner yard. [Note : The grass was sprayed on Friday evening (08/14) and the dog may have ingested some of the grass. Last evening (08/15), the dog developed a bloated abdomen and was dry heaving. (by CD on Aug 16, 2009 at 11:37 AM)] Because the amount was poorly consistent, the patient was considered to be at low risk of developing clinical signs. If signs develop, there is low risk that those signs will be life-threatening. [Note : Ingestion of wet product can cause GI upset within a few hours of the exposure. The signs this dog is showing is more likely due to GDV. (by (name) on Aug 16, 2009 at 11:37 AM)] Note : Owner called in to update the case. Misha was taken into the Evet where she was diagnosed with bloat. The owner euthanized the animal. (by (name) on Aug 19, 2009 at 08:42 PM)]

To be determined by Registrant

18. Severity classification (if there is more than 1 possible classification


19. Provide supplemental information here

Roundup Weed And Grass Killer Ready To Use No Root No Weed No Problem Because the time course was poorly consistent, the amount was poorly consistent, and the findings were poorly consistent, this substance was considered to have not related likelihood of causing the clinical situation. Gastric Dilitation and Volvulus Because the time course was unknown consistent and the findings were generally consistent, this condition was considered to have high likelihood of causing the clinical situation.