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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-3127

2. Registrant Information.

Registrant Reference Number: DAS110629

Registrant Name (Full Legal Name no abbreviations): Dow AgroSciences Canada Inc.

Address: Suite 2100, 450 - 1st Street S.W.

City: Calgary

Prov / State: Alberta

Country: Canada

Postal Code: T2P 5H1

3. Select the appropriate subform(s) for the incident.

Domestic Animal

4. Date registrant was first informed of the incident.

29-JUN-11

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

28-JUN-11

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. 27634      PMRA Submission No.       EPA Registration No.

Product Name: Grazon Herbicide

  • Active Ingredient(s)
    • 2,4-D (PRESENT AS AMINE SALTS : DIMETHYLAMINE SALT, DIETHANOLAMINE SALT, OR OTHER AMINE SALTS)
    • PICLORAM (PRESENT AS AMINE SALTS)

7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

2

Units: L

Other Units: per 50 acre

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).

The application was made by a custom applicator spot spraying along the fence line of a pasture at a rate of 2 L of Grazon per 50 acre.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

Yes

Subform III: Domestic Animal Incident Report

1. Source of Report

Other

2. Type of animal affected

Horse / Cheval

3. Breed

Foal

4. Number of animals affected

1

5. Sex

Unknown

6. Age (provide a range if necessary )

Unknown

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

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

11. List all symptoms

System

  • General
    • Symptom - Death
    • Specify - foal died
  • Respiratory System
    • Symptom - Respiratory failure
    • Specify - asphyxiation

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

Died

16. How was the animal exposed?

Other / Autre

specify Refer to details of incident.

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

The product was spot sprayed and a foal died the next day on June 28th. The owner believed that the foal died due to the application of Grazon. A veterinarian from Ponoka (Central Vet Clinic 403-783-5200) administered an autopsy on June 29th. The stomach, liver and a few other organs had been eaten by coyotes and other scavengers. The vet indicated that it looked like the cause was asphyxiation as there was substantial foam in the esophagus and lungs. The vet suggested that the foal was likely kicked in the chest or neck. Toxin ingestion would show up in the digestive system and would not cause asphyxiation symptoms.


To be determined by Registrant

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

Death

19. Provide supplemental information here