Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-4904

2. Registrant Information.

Registrant Reference Number: 100110123

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.

15-SEP-10

5. Location of incident.

Country: UNITED STATES

Prov / State: CALIFORNIA

6. Date incident was first observed.

18-AUG-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. 524-308

Product Name: Honcho Plus Herbicide

• Active Ingredient(s)
  • GLYPHOSATE (PRESENT AS ISOPROPYLAMINE SALT OR ETHANOLAMINE SALT)
    • Guarantee/concentration 41 %

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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

Bird - Poultry / Oiseau - Volaille

3. Breed

Chicken

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 )

Unknown

8. Route(s) of exposure

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>3 days <=1 wk / >3 jours <=1 sem

11. List all symptoms

System

• Gastrointestinal System
  • Symptom - Anorexia

• General
  • 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?

Unknown

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 3.0 mo intact female weighing unknown amount. Was in good health previously. Normal environment: indoors only. Agent Exposure Honcho Plus Herbicide (observed agent id) Evidence exposure occurred on Aug 18, 2010 at 04:00 PM CDT (not specific ). Exposure involved 0.0 Not App (not specific) orally. The exposure was non-medical use, and occurred at animal owner enclosure. The use was not labeled. [Note : Agent was sprayed on Monday by the husband. On Wednesday, the wife pulled some sprayed weeds (not realizing they had been sprayed) and fed them to her chickens. The dead chicken and the ill chicken were the first to arrive and ate more than the others. Friday morning one chicken seemed disoriented (possibly blind?). Saturday morning the chicken was droopy and lethargic. The owner took the chicken to her RDVM who gave the bird fluids and antibiotics. The owner declined offerred diagnostics. That chicken is still blind and listless. The second chicken ignored food Saturday night and died Sunday morning. The owner has 6 hens, a rooster, several babies which are all fine. (by PG on Aug 22, 2010 at 02:04 PM)] Because the amount was poorly 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 : Ingestion of small amounts of this agent is not expected to cause significant clinical signs. If the agent is still wet when licked up, dogs may experience a taste reaction or mild GI upset, most typically from the surfactants and other inactive ingredients. The glyphosate itself has a very wide margin of safety in mammals and is typically not a concern. The LD 50 in birds is 2500 mg/kg. It is considered virtually non-toxic in birds. (by PG on Aug 22, 2010 at 02:04 PM)] Potential Cause Honcho Plus Herbicide Because the time course was not consistent, the amount was poorly consistent, and the findings were not consistent, this substance was considered to have not related likelihood of causing the clinical situation.

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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

There were 14 plus or minus 2 animals involved in this case, however only one was reported to have died. Therefore only 1 animal is reported on in this incident report.