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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-3711

2. Registrant Information.

Registrant Reference Number: 100074728

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.

16-JUL-10

5. Location of incident.

Country: UNITED STATES

Prov / State: CALIFORNIA

6. Date incident was first observed.

30-MAY-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. 71995-25

Product Name: Roundup Weed and Grass Killer Super Concentrate

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

7. b) Type of formulation.

Other (specify)

Concentrate

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

Cat / Chat

3. Breed

Shorthair

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

10

7. Weight (provide a range if necessary )

8.55

lbs

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>1 wk <=1 mo / > 1 sem < = 1 mois

11. List all symptoms

System

  • General
    • Symptom - Abnormal behaviour
    • Specify - Behavior Change
  • Gastrointestinal System
    • Symptom - Loss of appetite
    • Symptom - Difficulty swallowing
    • Specify - Dysphagia
  • General
    • Symptom - Adipsia
    • Specify - Hypodipsia
  • Nervous and Muscular Systems
    • Symptom - Recumbent
  • Respiratory System
    • Symptom - Laboured breathing
  • General
    • Symptom - Weakness
  • Gastrointestinal System
    • Symptom - Vomiting
  • General
    • Symptom - Vocalizing
    • 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?

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

Signalment 10.0 yr neutered female weighing 8.55 lb. Was in fair health previously. Normal environment: indoors mostly. Patient Note [Note : Owner states that DVM recommended lab work but she declined. Cat's signs became worse and then she died. Body not available, it was buried on 6/12/10. Owner has feral cats all around yard that she feeds and cares for. (by (name) on Jun 16, 2010 at 11:06 AM)] Agent Exposure Roundup Weed and Grass Killer Super Concentrate (observed agent id) Possible exposure occurred on May 30, 2010 at 12:00 PM CDT (possible ). Exposure involved 0.0 Not App (unknown) by unknown route. The exposure was home use, and occurred at animal owner home. [Note : The caller said that roundup had been sprayed on May 30 in the wooded area where the cat sleeps during the day. Signs developed on the 7th of June. (by (name) on Jun 11, 2010 at 11:16 PM)] Because the amount was unknown consistent, the patient was considered to be at low risk of developing clinical signs. If signs develop, there is low risk that those signs will be life-threatening. [Note : We could see mild GI upset with exposure to the product, but signs were be within a few hours not days later. (by (name) on Jun 11, 2010 at 11:16 PM)] Inappetence {Digestive} [Note : Had to be coaxed to eat and offered special treats in order to get her to eat. (by(name) on Jun 11, 2010 at 11:16 PM)] Hypodipsia {Urinary} [Note : Has not been seen to drink water in 4 days. (by (name) on Jun 11, 2010 at 11:16 PM)] [Note : DVM said the cat was not dehydrated. (by (name) on Jun 11, 2010 at 11:16 PM)] Recumbent {General Disorders} [Note : Did not want to get up from where she was laying in the woods to come in. (by (name) on Jun 11, 2010 at 11:16 PM)] Weakness {Musculoskeletal} [Note : much weaker (by VS on Jun 11, 2010 at 11:16 PM)] Vomiting {Digestive} [Note : Vomited dark green liquid. (by (name) on Jun 11, 2010 at 11:16 PM)] Vocalization {General Disorders} [Note : Purring a lot. (by (name) on Jun 11, 2010 at 11:16 PM)] Potential Cause Roundup Weed and Grass Killer Super Concentrate Because the time course was not consistent, the amount was unknown consistent, and the findings were not consistent, this substance was considered to have not related likelihood of causing the clinical situation. Unplanned Care Take Animal to Veterinarian Details: Performed Jun 11, 2010 11:30 AM , Effectiveness: Not Applicable Fluid Therapy Details:SQ fluids given. Performed Jun 11, 2010 11:30 AM , Effectiveness: Unknown Vitamin B12 - Cat Details: Performed Jun 11, 2010 11:30 AM , Effectiveness: Unknown Mirtazapine Details:Appetite stimulant Performed Jun 11, 2010 11:30 AM


To be determined by Registrant

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

Death

19. Provide supplemental information here