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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-3094

2. Registrant Information.

Registrant Reference Number: 10050701

Registrant Name (Full Legal Name no abbreviations): Nufarm Agriculture Inc

Address: 5507 1st St SE

City: Calgary

Prov / State: Alberta

Country: Canada

Postal Code: T2H 1H9

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: KENTUCKY

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. 228-367-8959

Product Name: ShoreKlear Plus Aquatic Treatment

  • Active Ingredient(s)
      • Unknown

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).

History of product used in a pond where cat frequently drinks. Pond treated 4 days ago. Further questioning revealed copper algaecide product sprayed right around the edges of the pond 2 weeks prior.

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

Medical Professional

2. Type of animal affected

Cat / Chat

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

Unknown / Inconnu

11. List all symptoms


  • Gastrointestinal System
    • Symptom - Diarrhea
  • General
    • Symptom - Hyperthermia
    • Symptom - Hypothermia
    • Symptom - Lethargy
  • Nervous and Muscular Systems
    • Symptom - Coma
  • General
    • Symptom - Death

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


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

Described is a cat with a 95.2 degre temp, almost comatose; severe diarrhea. Name and other details were not known to Dr. Circumstances involve a history of product use in a pond on the cat owner's premises from which the cat always drinks. Listed product was instilled in the pond 4 days ago.

To be determined by Registrant

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


19. Provide supplemental information here

Called back, cat had passed. Was a male outdoor cat, initially presented on 5/4/10 with lethargy and hyperthermia of 105F. At 1'st DVM thought is was Rocky Mountain Spotted Tick Fever as the owner's dog was positive for it in March and was treated then. Serum was drawn and sent to the lab; cat was placed on Doxycycline pending the test results. When cat same in on 5/7, he was placed on a heating pad and under a heat lamp. The DVM was not in the clinic and by the time he came in 1 hr later the cat's temp was 94.2. They gave SQ fluids and it continued to decline until it dies at 2:40pm (temp 91.5F at 1pm). In talking in more detail with the owner he indicated he had sprayed 2 ponds including one pond 2 weeks prior with a copper algaecide product. The owner had sprayed right around the edges of the pond as well as in the pond. When the cat re-presented on 5/7, the DVM called the lab and they had some serum left so copper levels were requested. The copper levels came back high.