Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-2547

2. Registrant Information.

Registrant Reference Number: 100038664

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.

29-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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 71995-25

Product Name: Roundup Weed and Grass Killer Super Concentrate

• Active Ingredient(s)
  • GLYPHOSATE (PRESENT AS ISOPROPYLAMINE SALT OR ETHANOLAMINE SALT)
    • Guarantee/concentration 50 %

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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

Bulldog

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

0.25

7. Weight (provide a range if necessary )

15

lbs

8. Route(s) of exposure

Oral

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

• Gastrointestinal System
  • Symptom - Vomiting
  • Symptom - Diarrhea
  • Symptom - Anorexia
  • Symptom - Bloody vomit

• 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?

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 Weed and Grass Killer Super Concentrate (evidence agent id) Evidence exposure occurred on Mar 29, 2010 at 10:00 AM CDT (evidence ). Exposure involved 0.0 Not App (not specific) orally. The exposure was accidental, and occurred at yard. [Note : Owner is calling about her puppies who ingested some weeds that were sprayed with Roundup two days ago. Owner stated starting yesterday both puppies have been vomiting and are having diarrhea. Owner has tried to feed them boiled chicken and force water down them to keep them hydrated. The Roundup was diluted as labeled. (by (name) on Mar 31, 2010 at 05:35 PM; amended by (name) on Mar 31, 2010 at 05:49 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 : Product is safe when used per label instructions; casual ingestion of freshly-treated vegetation by a puppy may result in transient digestive upset, at most. These pups should respond to supportive care over 24 to 48 hrs. Note: pups were last vaccinated several weeks ago, by the client (by (name) on Mar 31, 2010 at 05:49 PM)] Potential Cause Roundup Weed and Grass Killer Super Concentrate Because the time course was generally 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. Mar 31, 2010 at 05:35 PM CDT (toxicologist) interacted with Ms. (owner) for reason: obtain help. [Note : spoke with client about nursing care at home (single mom, cannot afford a vet): liquid diet (chicken broth, yogurt; water) next two days; graduate to hamburger-rice mixture (by (name) on Mar 31, 2010 at 05:49 PM)]

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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

Two Dogs were involved in this incident, however only one dog died. Therefore the one that died was the only one entered into this incident report.