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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-0916

2. Registrant Information.

Registrant Reference Number: 100160004

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.

07-JAN-11

5. Location of incident.

Country: UNITED STATES

Prov / State: UNKNOWN

6. Date incident was first observed.

12-DEC-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. 524-445

Product Name: Honcho Herbicide

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

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: Agricultural-Outdoor/Agricole-extérieur

Préciser le type: pasture

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

Horse / Cheval

3. Breed

Quarter Horse

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

16

7. Weight (provide a range if necessary )

1200

lbs

8. Route(s) of exposure

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>24 hrs <=3 days / >24 h <=3 jours

11. List all symptoms

System

  • General
    • Symptom - Weakness
    • Symptom - Diaphoresis
  • Nervous and Muscular Systems
    • Symptom - Trembling
  • General
    • Symptom - Death

12. How long did the symptoms last?

>2 hrs <=8 hrs / > 2 h < = 8 h

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

Quarter Horse named Thunder (Equine) Signalment 16.0 yr intact female weighing 1200.0 lb. Was in good health previously. Agent Exposure Honcho Herbicide (not specific agent id) Suspected exposure occurred on Dec 12, 2010 at 12:00 PM CST¿1 day (not specific ). Exposure involved 0.0 Not App (not specific) orally. The exposure was accidental, and occurred at field/pasture. [Note : Owner's neighbor's nephew sprayed product on neighbors pasture a few days ago. Owner found evidence that her horses were sticking their head through fence and ingested small area (about 100 feet) of treated pasture. Thunder became acutely ill the afternoon and passed within three hours of becoming ill. This AM both the ponies developed diarrhea. The mare is anorexic and letharic. (by KW on Dec 13, 2010 at 10:22 PM)] Because the amount was somewhat consistent, the patient was considered to be at medium risk of developing clinical signs. If signs develop, there is low risk that those signs will be life-threatening. [Note : If exposed to wet product, that is properly diluted, mild colic may be noted. More significant irritation/colic may be noted if exposed to concentrate. Previously unpalatable plants may be palatable after being treated with product. (by KW on Dec 13, 2010 at 10:22 PM)] Clinical Status Weakness {Musculoskeletal} Begin: Dec 13, 2010 at 02:00 PM CST Status: Severe End: Dec 13, 2010 at 05:00 PM CST Status: Death Diaphoresis {Integumentary} Begin: Dec 13, 2010 at 02:00 PM CST Status: Unknown End: Dec 13, 2010 at 05:00 PM CST Status: Death Trembling {General Disorders} Begin: Dec 13, 2010 at 02:00 PM CST Status: Unknown End: Dec 13, 2010 at 05:00 PM CST Status: Death Death {General Disorders} Permanent: Dec 13, 2010 at 05:00 PM CST Status: Death Potential Cause Honcho Herbicide Because the time course was somewhat consistent, the amount was somewhat consistent, and the findings were poorly consistent, this substance was considered to have doubtful likelihood of causing the clinical situation. Patient Care Planned/Recommended Care Necropsy Purpose: Diagnostic; Importance: Potential Who: Owner ; Willingness: Not asked Recommended Outcome Died , EPA max illness designation: D-A


To be determined by Registrant

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

Death

19. Provide supplemental information here

There were two other ponies involved in this incident, however their outcome is unknown. Therefore they were not included in this incident report. Only the horse that died was included in this report.