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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-5679

2. Registrant Information.

Registrant Reference Number: 100131856

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.


5. Location of incident.


Prov / State: MISSOURI

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. 71995-33

Product Name: Roundup Weed And Grass Killer Ready To Use Plus Pump N Go Sprayer

  • Active Ingredient(s)
      • Guarantee/concentration 2 %

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).

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


2. Type of animal affected

Dog / Chien

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

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

11. List all symptoms


  • Gastrointestinal System
    • Symptom - Vomiting
    • Symptom - Anorexia
  • General
    • Symptom - Lethargy
    • Symptom - Death

12. How long did the symptoms last?

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

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

Signalment Age unknown intact female weighing unknown amount. Normal environment: roaming. Agent Exposure Roundup Weed And Grass Killer Ready To Use Plus Pump N Go Sprayer (observed agent id) Observed exposure occurred on Sep 26, 2010 at 12:00 PM CDT (not specific ). Exposure involved unknown amount dermally and orally. The exposure was yard use, and occurred at animal owner yard. The use was appropriate. [Note : The owner has used the product periodically all summer. Last use was on 9-26. Dogs are kept off yard during application and until dry. Dogs do roam neighborhood. Both dogs became ill on either 10-4 or 10-5, vomiting, anorexia, lethargy. Dog 2 died on 10-8. Dog 1 is worsening, and is starting to lose weight. Dogs have not been seen by a DVM, and owner is not going to seek DVM care. (by CM on Oct 10, 2010 at 07:36 AM)] Because the amount was unknown consistent, the patient was considered to be at unknown risk of developing clinical signs. If signs develop, there is low risk that those signs will be life-threatening. [Note : Glyphosate is an amino acid inhibitor that affects the shikimic pathway in plants. Mammals do not have this pathway. Glyphosate is considered practically non-toxic via dermal and oral routes. However, the formulation frequently includes surfactants that can be irritating. Most yard use products will cause no more than mild self-limiting GI upset. (by CM on Oct 10, 2010 at 07:36 AM)] Potential Cause Roundup Weed And Grass Killer Ready To Use Plus Pump N Go Sprayer Because the time course was poorly consistent, the amount was unknown consistent, and the findings were poorly consistent, this substance was considered to have not related likelihood of causing the clinical situation

To be determined by Registrant

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


19. Provide supplemental information here

There were 2 dogs involved in this incident. The outcome of one of the dogs was unknown, therefore only the one dog that died was entered into this report.