Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-3132

2. Registrant Information.

Registrant Reference Number: 110077314

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.

13-JUL-11

5. Location of incident.

Country: UNITED STATES

Prov / State: OHIO

6. Date incident was first observed.

16-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)

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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)
  • GLYPHOSATE (PRESENT AS ISOPROPYLAMINE SALT OR ETHANOLAMINE SALT)
    • Guarantee/concentration 2 %

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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

Other / Autre

specify goat

3. Breed

unknown

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.25

7. Weight (provide a range if necessary )

20

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

• Nervous and Muscular Systems
  • Symptom - Ataxia

• Respiratory System
  • Symptom - Runny nose
  • Specify - Nasal discharge

• General
  • Symptom - Death

12. How long did the symptoms last?

<=30 min / <=30 min

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?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

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

Caprine Unspecified Mix (Caprine) Signalment 3.0 mo intact male weighing 20.0 lb. Was in good health previously. Agent Exposure Roundup Weed And Grass Killer Ready To Use Plus Pump N Go Sprayer (observed agent id) Possible exposure occurred on Jun 16, 2011 at 08:31 PM CDT¿12 hr (observed ). Exposure involved 0.0 Not App (unknown) orally. The exposure was accidental, and occurred at animal owner field/pasture. [Note : On Wednesday and Thursday, the owner's husband saw the two goats follow behind him and eat the plants that had been sprayed with the product. (by [initals] on Jun 20, 2011 at 08:24 PM)] 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 : Roundup has a fairly good margin of safety in grazing ruminants; ingestion of toxic plants recently treated with herbicides in general can cause problems in ruminants eating the treated plants (by [initials] on Jun 20, 2011 at 08:53 PM)] Clinical Status Ataxia {Nervous} [Note : The owner stated that the kids came inside to say that the goats were acting drunk. the owner went out to see the first patient dead and the second patient staggering in the pen. (by [initials] on Jun 20, 2011 at 08:24 PM)] Time Observed: Jun 17, 2011 at 02:00 PM CDT Status: Unknown Death {General Disorders} Time Observed: Jun 17, 2011 at 02:30 PM CDT Status: Death Nasal Discharge {Sensory Disorders} [Note : The owner described a green pus like discharge coming out of the noses of both goats. (by [initials] on Jun 20, 2011 at 08:24 PM)] Time Observed: Jun 17, 2011 at 02:30 PM CDT Status: Unknown Potential Cause Roundup Weed And Grass Killer Ready To Use Plus Pump N Go Sprayer Because the time course was somewhat consistent, the amount was unknown consistent, and the findings were unknown consistent, this substance was considered to have unknown likelihood of causing the clinical situation. Patient Care Planned/Recommended Care No Follow Up - No Add'n Info Expected Purpose: Information Who: Not asked ; Willingness: Not asked Recommended Details: O elected to do no necropsy or diagnostics Outcome Died , EPA max illness designation: D-A

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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

Subform III: Domestic Animal Incident Report

1. Source of Report

Other

2. Type of animal affected

Other / Autre

specify goat

3. Breed

unknown

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.25

7. Weight (provide a range if necessary )

20

lbs

8. Route(s) of exposure

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>8 hrs <=24 hrs / > 8 h < = 24 h

11. List all symptoms

System

• Nervous and Muscular Systems
  • Symptom - Ataxia

• Gastrointestinal System
  • Symptom - Bloating

• Respiratory System
  • Symptom - Runny nose
  • Specify - Nasal discharge

• General
  • Symptom - Death

• Respiratory System
  • Symptom - Shortness of breath
  • Specify - shallow breathing

12. How long did the symptoms last?

<=30 min / <=30 min

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

Caprine Unspecified (Caprine) Signalment 3.0 mo immature male weighing 20.0 lb. Was in good health previously. Agent Exposure Roundup Weed And Grass Killer Ready To Use Plus Pump N Go Sprayer (observed agent id) Not Specific exposure occurred on Jun 16, 2011 at 08:31 PM CDT¿12 hr (observed ). Exposure involved 0.0 Not App (observed) orally. The exposure was accidental, and occurred at animal owner field/pasture. [Note : On Wednesday and Thursday, the owner's husband saw the two goats follow behind him and eat the plants that had been sprayed with the product. (by [initals] on Jun 20, 2011 at 08:24 PM)] 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 : Roundup has a fairly good margin of safety in grazing ruminants; ingestion of toxic plants recently treated with herbicides in general can cause problems in ruminants eating the treated plants (by [initials] on Jun 20, 2011 at 08:53 PM)] Clinical Status Ataxia {Nervous} Time Observed: Jun 17, 2011 at 02:30 PM CDT Status: Moderate Bloat {Digestive} [Note : The owner stated that the second patient dropped to the ground and looked very bloated in the rumen area, before it died. (by [initials] on Jun 20, 2011 at 08:24 PM)] Time Observed: Jun 17, 2011 at 02:30 PM CDT Status: Severe Death {General Disorders} Time Observed: Jun 17, 2011 at 02:45 PM CDT Status: Death Nasal Discharge {Sensory Disorders} Time Observed: Jun 17, 2011 at 02:30 PM CDT Status: Unknown Potential Cause Roundup Weed And Grass Killer Ready To Use Plus Pump N Go Sprayer Because the time course was somewhat consistent, the amount was unknown consistent, and the findings were unknown consistent, this substance was considered to have unknown likelihood of causing the clinical situation. Patient Care Planned/Recommended Care No Follow Up - No Add'n Info Expected Purpose: Information Who: Not asked ; Willingness: Not asked Recommended Details: O elected to do no necropsy or diagnostics Outcome Died , EPA max illness designation: D-A List of Contacts Jun 20, 2011 at 08:24 PM CDT [name] (assistant) interacted with [name] (owner) for reason: obtain help. Jun 20, 2011 at 08:53 PM CDT [name] (toxicologist) interacted with [name] (owner) for reason: obtain help. [Note : spoke with O at 2053cst: baby goats, but had been off the bottle died Friday morning; were 'goofy' 'acting drunk' initially larger goat died at 2 pm local time littermate was on his side, shallow breathing; green mucus out the mouth and nose O saw the goats eating the treated plants (unknown plant, but has a rhubarb-look to it) (by [initials] on Jun 20, 2011 at 09:13 PM)]

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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