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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-2543

2. Registrant Information.

Registrant Reference Number: 100029259

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: TEXAS

6. Date incident was first observed.

10-MAR-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)

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 71995-17

Product Name: Roundup Concentrate Weed And Grass Killer 1

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

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

Unknown

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

4

7. Weight (provide a range if necessary )

40

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>8 hrs <=24 hrs / > 8 h < = 24 h

11. List all symptoms

System

  • General
    • Symptom - Lethargy
  • Eye
    • Symptom - Pupil dilation
    • Specify - Mydriasis
  • General
    • Symptom - Death
  • Nervous and Muscular Systems
    • Symptom -
    • Specify - nearly comatose

12. How long did the symptoms last?

Persisted until death

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

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

Agent Exposure Roundup Concentrate Weed And Grass Killer 1 (possible agent id) Evidence exposure occurred on Mar 10, 2010 at 03:30 PM CST (evidence ). Exposure involved unknown amount dermally. The exposure was accidental, and occurred at animal owner home. [Note : The dog had gone into the field where the owner was spraying a Roundup concentrate (presumably diluted) yesterday afternoon. She presented nearly comatose to the DVM this am. (by DM on Mar 11, 2010 at 10:53 AM)] Because the amount was unknown consistent, the patient was considered to be at medium risk of developing clinical signs. If signs develop, there is low risk that those signs will be life-threatening. [Note : Risk of mild vomiting and hypersalivation with oral exposure to diluted Roundup products. Dermal exposure can result in hypersensitivity reactions. The concentrates can cause oral or more distal ulceration. These signs are not consistent with the available exposure information. (by (name) on Mar 11, 2010 at 10:53 AM)] Potential Causes Roundup Concentrate Weed And Grass Killer 1 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. Botulism Because the time course was unknown consistent, the amount was unknown consistent, and the findings were somewhat consistent, this substance was considered to have low likelihood of causing the clinical situation. [Note : Botulism is a potent neurotoxin that results in death due to respiratory paralysis. Affected animals are mentally aware which is inconsistent with the reported clinical picture. (by (name) on Mar 14, 2010 at 09:35 AM)] Patient Care Planned/Recommended Care Necropsy Purpose: Diagnostic; Importance: Potential Who: Regular Veterinarian ; Willingness: Willing Refused Obtain Additional Information Purpose: Information; Importance: Potential Who: Regular Veterinarian ; Willingness: Willing Recommended Details: EPA reg of product Unplanned Care Take Animal to Veterinarian Details: Performed Mar 11, 2010 10:10 AM Atropine - Dog Details:1/4 ml of LA atropine SC (0.2 mg/kg if it were 15 mg/ml) Performed Mar 11, 2010 10:15 AM Fluid Therapy Details: Performed Mar 11, 2010 10:15 AM Dextrose - Dog Details: Performed Mar 11, 2010 10:15 AM Vitamin B - Dog Details: Performed Mar 11, 2010 10:15 AM Mar 11, 2010 at 10:53 AM CST (name) (toxicologist) interacted with Dr. (name) (regular veterinarian) for reason: obtain help. [Note : Dr. (name)called in about this case. The dog presented this am nearly comatose and did not respond to bolus fluids, dextrose, vitamin B, and atropine. He does not have the Roundup product details (got the APSS # from a bottle of Roundup that he had). I let him know that the signs are not consistent with the reported Roundup exposure and asked if he or the owners might be able to provide the EPA reg # of the product as well as any other potential toxic agents to which the dog could have been exposed. (by (name) on Mar 11, 2010 at 11:34 AM)] Mar 11, 2010 at 12:06 PM CST (name) (technician) interacted with Dr. (name) (regular veterinarian) for reason: monitor case-out. [Note : Contacted the clinic to see if we can get either the owner's phone number or specifics on the product involved in the exposure. The phone rang without an answering service picking up and ultimately disconnected on me. (by (name) on Mar 11, 2010 at 12:09 PM)] Mar 14, 2010 at 07:31 AM CDT (name) (technician) interacted with Dr. (name) (regular veterinarian) for reason: monitor case-out. [Note : Contacted the clinic and spoke with (name). Per Dr. (name) he diagnosed the animal with botchalism after the owners stated they found a dead deer on their property. Unknown if the animal ingested any of the deer meat though. (by (name) on Mar 14, 2010 at 07:46 AM)]


To be determined by Registrant

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

Death

19. Provide supplemental information here