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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-3469

2. Registrant Information.

Registrant Reference Number: PROSAR Case #: 1-23216171

Registrant Name (Full Legal Name no abbreviations): Syngenta Crop Protection Canada, Inc.

Address: 140 Research Lane, Research Park

City: Guelph

Prov / State: Ontario

Country: Canada

Postal Code: N1G4Z3

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

Domestic Animal

4. Date registrant was first informed of the incident.

26-JUN-10

5. Location of incident.

Country: UNITED STATES

Prov / State: ALABAMA

6. Date incident was first observed.

26-JUN-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. Unknown

Product Name: Talon G

  • Active Ingredient(s)
    • BRODIFACOUM
      • Guarantee/concentration .005 %

7. b) Type of formulation.

Other (specify)

pellets

Application Information

8. Product was applied?

Unknown

9. Application Rate.

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

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

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Dachshund

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.58

7. Weight (provide a range if necessary )

25

lbs

8. Route(s) of exposure

Oral

9. What was the length of exposure?

>1 mo <= 6 mos / > 1 mois < = 6 mois

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • Respiratory System
    • Symptom - Rapid breathing
  • General
    • Symptom - Lethargy
    • 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?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

1-23216171- The reporter, a pet owner, indicates his animal may have been exposed to a rodenticide containing the active ingredient Brodifacoum. The caller reported his seven month male 25 pound dachshund had access to the product for over one month. The caller did not specify that the product had been applied. He did not indicate that he had observed the animal ingest any of the product. The caller reported on the morning of the initial contact with the registrant that his animal was lethargic and breathing rapidly in "quick short breaths". The caller was advised to seek prompt veterinary care. He was advised of the mechanism of action of the active ingredient and of signs that might be seen in cases of exposure. On routine call back the pet owner indicated the animal had died. They had sought prompt veterinary care at which time the veterinarian had given an injection of Vitamin K1, the antidote given in cases of ingestion exposures. The veterinarian had advised the owner to bring the dog to an emergency and critical care veterinarian for additional treatments. The veterinarian had expressed the opinion that the animal¿¿¿s signs were consistent with exposure, but had not done any diagnostics to validate this opinion. The pet owner brought the animal home and did not seek any further veterinary care. The animal died within 30 minutes of bringing it home. The pet owner commented that there was no evidence of hemorrhage when asked. No necropsy was performed. No further information is available.


To be determined by Registrant

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

Death

19. Provide supplemental information here