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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-3954

2. Registrant Information.

Registrant Reference Number: PROSAR Case #: 1-23237083

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.

27-JUN-10

5. Location of incident.

Country: UNITED STATES

Prov / State: GEORGIA

6. Date incident was first observed.

27-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. 100-1000

Product Name: Demon WP in Water-Soluble Packets

  • Active Ingredient(s)
    • CYPERMETHRIN
      • Guarantee/concentration 40 %

7. b) Type of formulation.

Wettable or soluble powder

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

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

Site: Res. - In Home / Rés. - à l'int. 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

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Weimaraner

4. Number of animals affected

3

5. Sex

Unknown

6. Age (provide a range if necessary )

0.17

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Oral

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • Gastrointestinal System
    • Symptom - Anorexia
  • General
    • Symptom - Malaise
  • Respiratory System
    • Symptom - Panting
  • Nervous and Muscular Systems
    • Symptom - Seizure
  • Gastrointestinal System
    • Symptom - Rectal hemorrhage
  • 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

1-23237083- The reporter, a pet owner, indicates his animals may have been exposed to an insecticide containing the active ingredient Cypermethrin. The caller reports his son applied the product to his dog kennel a "few days" prior to the initial contact with the registrant, unknown dilution factor/application rate. The caller indicates seven 9 week Weimaraner dogs have had exposure to the application area. The caller does not specify if the animals were in the kennel at the time of the application or the re-entry interval observed. The caller speculates his son may have sprayed food/water dishes. No discreet exposure is described. The caller specifies the animals had demonstrated general malaise the day of the contact with the registrant. The caller indicates he had discussed the animal's signs with a veterinarian and had been told they may be due to a parvovirus infection. The caller was advised the signs seen would not be expected following use of the product as labeled. The animals were likely suffering from some unrelated illness. The caller was told direct exposure to wetted dilute product may result in mild self-limiting irritation to the body surfaces exposed. The caller was advised to seek veterinary assistance. On routine call back the pet owner indicated three of the animals had died ( Sub-form III, #1). They had developed rapid breathing, seizuring, rectal bleeding, and anorexia. The animals had died one day following the initial contact with the registrant. The pet owner had not brought any of the animals to the veterinarian. The remaining animals (Sub-form III, #2) were described as improved. The caller was advised the signs seen and outcome was inconsistent with exposure to the product. It was reiterated the animals should be brought to the veterinarian. The caller did not return further call back attempts. 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

It is highly unlikely that cypermethrin was involved in this case based on the symptoms described. the treating veterinarian indicated a parvo virus may be the cause.

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Wiemaraner

4. Number of animals affected

4

5. Sex

Unknown

6. Age (provide a range if necessary )

0.17

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • General
    • Symptom - Malaise

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown/Inconnu

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

1-23237083- The reporter, a pet owner, indicates his animals may have been exposed to an insecticide containing the active ingredient Cypermethrin. The caller reports his son applied the product to his dog kennel a "few days" prior to the initial contact with the registrant, unknown dilution factor/application rate. The caller indicates seven 9 week Weimaraner dogs have had exposure to the application area. The caller does not specify if the animals were in the kennel at the time of the application or the re-entry interval observed. The caller speculates his son may have sprayed food/water dishes. No discreet exposure is described. The caller specifies the animals had demonstrated general malaise the day of the contact with the registrant. The caller indicates he had discussed the animal's signs with a veterinarian and had been told they may be due to a parvovirus infection. The caller was advised the signs seen would not be expected following use of the product as labeled. The animals were likely suffering from some unrelated illness. The caller was told direct exposure to wetted dilute product may result in mild self-limiting irritation to the body surfaces exposed. The caller was advised to seek veterinary assistance. On routine call back the pet owner indicated three of the animals had died ( Sub-form III, #1). They had developed rapid breathing, seizuring, rectal bleeding, and anorexia. The animals had died one day following the initial contact with the registrant. The pet owner had not brought any of the animals to the veterinarian. The remaining animals (Sub-form III, #2) were described as improved. The caller was advised the signs seen and outcome was inconsistent with exposure to the product. It was reiterated the animals should be brought to the veterinarian. The caller did not return further call back attempts. No further information is available.


To be determined by Registrant

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

Minor

19. Provide supplemental information here