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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2011-3499
2. Registrant Information.
Registrant Reference Number: 110085240
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.
11-AUG-115. Location of incident.
Country: UNITED STATES
Prov / State: TENNESSEE
6. Date incident was first observed.
22-JUN-11Product 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. 71995-33
Product Name: Roundup Weed and Grass Killer Ready To Use Plus
- Active Ingredient(s)
- GLYPHOSATE (PRESENT AS ISOPROPYLAMINE SALT OR ETHANOLAMINE SALT)
- Guarantee/concentration 2 %
- GLYPHOSATE (PRESENT AS ISOPROPYLAMINE SALT OR ETHANOLAMINE SALT)
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
Dog / Chien
3. Breed
Chihuahua
4. Number of animals affected
2
5. Sex
Male
6. Age (provide a range if necessary )
0.17
7. Weight (provide a range if necessary )
2
lbs
8. Route(s) of exposure
Skin
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 - Lethargy
- Gastrointestinal System
- Symptom - Anorexia
- General
- Symptom - Death
- Symptom - Adipsia
12. How long did the symptoms last?
Persisted until death
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
Signalment 8.0 wk immature male weighing 2.0 lb. Was in good health previously. Normal environment: indoors mostly. Agent Exposures Roundup Weed and Grass Killer Ready To Use Plus (evidence agent id) Suspected exposure occurred on Jun 22, 2011 at 12:00 PM CDT (evidence ). Exposure involved 0.0 Not App (not specific) dermally and orally. The exposure was accidental, and occurred at animal owner yard. [Note : Owner states he had a litter of chihuahuas that he was raising to sell. Around 6/22 he had sprayed around a fence in his yard with the roundup product. After 30-45 minutes he let the dogs outside into the yard and treated area. Roughly 2 days later, on 6/24, he saw one of the puppies become lethargic and did not want to eat and drink. He started giving pepto bismol twice daily and estimates that the doses were 1 oz but is not certain. The next day, a second puppy starting showing signs as well and the following day, 6/26, the first puppy had died. The second puppy did not improve at all and just died yesterday. As of today the last puppy is now starting to show the same signs. The owner suspects that this is all from exposure to the roundup. (by JG on Jul 06, 2011 at 10:04 AM)] 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 : Exposure to a wet product can cause mild transient gi upset. Serious toxicity or death are not expected. (by IM on Jul 08, 2011 at 10:02 AM)] Clinical Status Lethargy {Nervous} Time Observed: Jul 06, 2011 at 08:00 AM CDT¿6 hr Status: Moderate Anorexia {General Disorders} Time Observed: Jul 06, 2011 at 08:00 AM CDT¿6 hr Status: Mild Potential Causes Roundup Weed and Grass Killer Ready To Use Plus Because the time course was somewhat consistent, the amount was poorly consistent, and the findings were poorly consistent, this substance was considered to have doubtful likelihood of causing the clinical situation. Pepto Bismol Original Liquid Bismuth Subsalicylate 262 mg Per 15 mL Because the time course was somewhat consistent, the amount was generally consistent, and the findings were somewhat consistent, this substance was considered to have low likelihood of causing the clinical situation.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here
There were 3 dogs involved in this incident, however only 2 of them died. Therefore only 2 dogs were entered into this incident report.
Subform III: Domestic Animal Incident Report
1. Source of Report
Other
2. Type of animal affected
Dog / Chien
3. Breed
Chihuahua
4. Number of animals affected
1
5. Sex
6. Age (provide a range if necessary )
0.17
7. Weight (provide a range if necessary )
2
lbs
8. Route(s) of exposure
Skin
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 - Lethargy
- Gastrointestinal System
- Symptom - Anorexia
- General
- Symptom - Adipsia
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
Unknown/Inconnu
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 8.0 wk immature male weighing 2.0 lb. Was in good health previously. Normal environment: indoors mostly. Agent Exposures Roundup Weed and Grass Killer Ready To Use Plus (evidence agent id) Suspected exposure occurred on Jun 22, 2011 at 12:00 PM CDT (evidence ). Exposure involved 0.0 Not App (not specific) dermally and orally. The exposure was accidental, and occurred at animal owner yard. [Note : Owner states he had a litter of chihuahuas that he was raising to sell. Around 6/22 he had sprayed around a fence in his yard with the roundup product. After 30-45 minutes he let the dogs outside into the yard and treated area. Roughly 2 days later, on 6/24, he saw one of the puppies become lethargic and did not want to eat and drink. He started giving pepto bismol twice daily and estimates that the doses were 1 oz but is not certain. The next day, a second puppy starting showing signs as well and the following day, 6/26, the first puppy had died. The second puppy did not improve at all and just died yesterday. As of today the last puppy is now starting to show the same signs. The owner suspects that this is all from exposure to the roundup. (by JG on Jul 06, 2011 at 10:04 AM)] 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 : Exposure to a wet product can cause mild transient gi upset. Serious toxicity or death are not expected. (by IM on Jul 08, 2011 at 10:02 AM)] Clinical Status Lethargy {Nervous} Time Observed: Jul 06, 2011 at 08:00 AM CDT¿6 hr Status: Moderate Anorexia {General Disorders} Time Observed: Jul 06, 2011 at 08:00 AM CDT¿6 hr Status: Mild Potential Causes Roundup Weed and Grass Killer Ready To Use Plus Because the time course was somewhat consistent, the amount was poorly consistent, and the findings were poorly consistent, this substance was considered to have doubtful likelihood of causing the clinical situation. Pepto Bismol Original Liquid Bismuth Subsalicylate 262 mg Per 15 mL Because the time course was somewhat consistent, the amount was generally consistent, and the findings were somewhat consistent, this substance was considered to have low likelihood of causing the clinical situation.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
