Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-2540

2. Registrant Information.

Registrant Reference Number: 100024814

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

Address: 180 Kent Street, Suite 810

City: Ottawa

Prov / State: ON

Country: Canada

Postal Code: K1P 0B6

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

Domestic Animal

4. Date registrant was first informed of the incident.

12-APR-10

5. Location of incident.

Country: UNITED STATES

Prov / State: ARIZONA

6. Date incident was first observed.

26-FEB-10

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.       PMRA Submission No.       EPA Registration No. 239-2653

Product Name: Roundup Concentrate Weed And Grass Killer 1 (Discontinued)

• Active Ingredient(s)
  • GLYPHOSATE (PRESENT AS ISOPROPYLAMINE SALT OR ETHANOLAMINE SALT)
    • Guarantee/concentration 18 %

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7. b) Type of formulation.

Liquid

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).

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

Other

2. Type of animal affected

Dog / Chien

3. Breed

Wirehaired Fox Terrier

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

1

7. Weight (provide a range if necessary )

20

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

• Gastrointestinal System
  • Symptom - Vomiting

• General
  • Symptom - Lethargy

• Gastrointestinal System
  • Symptom - Loss of appetite

• General
  • Symptom - Death

12. How long did the symptoms last?

Persisted until death

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

Unknown

14. a) Was the animal hospitalized?

Unknown

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

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 Concentrate Weed And Grass Killer 1 (Discontinued) (observed agent id) Evidence exposure occurred on Feb 26, 2010 at 12:00 PM CST (not specific ). Exposure involved 0.0 Not App (not specific) orally. The exposure was accidental, and occurred at animal owner yard. The agent was obtained from Other Retailer. The lot number was na. The expiration date was null. [Note : Exposure happened sometime on 2/26/10. The product was used and the dog was following the owner. Sometime after the exposure, the dog began to vomit, was lethargic and has been inappetent. The dog was seen at the e-clinic over the weekend and is being transferred to day practice. (by FD on Mar 01, 2010 at 12:12 PM)] Because the amount was unknown consistent, the patient was considered to be at unknown risk of developing clinical signs. If signs develop, there is low risk that those signs will be life-threatening. [Note : Glyphosate is an amino acid inhibitor that affects the shikimic pathway in plants. Mammals do not have this pathway. Glyphosate is considered practically non-toxic via dermal and oral routes. However, the formulation frequently includes surfactants that can be irritating. Most yard use products will cause no more than mild self-limiting GI upset. Dilute with water, NPO if vomiting. If significant dermal exposure, bathe with LDWS. (by (name) on Mar 01, 2010 at 01:02 PM)] Because the time course was poorly consistent, the amount was unknown consistent, and the findings were poorly consistent, this substance was considered to have doubtful likelihood of causing the clinical situation. [Note : Per clinic update, pet died. Clinic stated it was not related to the exposure. When asked what it was related to the clinic stated, "It's an extremely complicated case and I couldn't even begin to explain." Did mention that the pet had needed to have its gallbladder removed. (by (name) on Mar 04, 2010 at 09:36 AM)]

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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