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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-6100

2. Registrant Information.

Registrant Reference Number: PROSAR Case #: 1-28115346

Registrant Name (Full Legal Name no abbreviations): Syngenta Crop Protection Canada, Inc.

Address: 140 Research Lane, Research Park

City: Guelph

Prov / State: Ontario

Country: Canada

Postal Code: N1G4Z3

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

Domestic Animal

4. Date registrant was first informed of the incident.

17-NOV-11

5. Location of incident.

Country: UNITED STATES

Prov / State: FLORIDA

6. Date incident was first observed.

Unknown

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. 100-997

Product Name: Prelude

  • Active Ingredient(s)
    • PERMETHRIN
      • Guarantee/concentration 25.6 %

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. - In Home / Rés. - à l'int. 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

Cat / Chat

3. Breed

Persian cat

4. Number of animals affected

1

5. Sex

Unknown

6. Age (provide a range if necessary )

2

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

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

1-28115346- The reporter, a commercial pest control operator, indicates possible exposure of a clients pets to an insecticide containing the active ingredient permethrin. The reporter indicated he applied the product diluted according to the label to a pet owners apartment 11/14/11. The pet owner had kept his two cats in the bathroom while the apartment was being treated. The product was applied to the carpet of the home only. The reporter was unsure how long the animals were kept in the bathroom of the home before they were allowed into the application area. He was unable to describe a discreet exposure incident and was unsure if the animals were actually exposed to the product in any way. The pet owner had contacted him to report one animal had died the day after application and another the second day after application. The pet owner indicated the fist cat, a two year old Persian (Subform III, #1), demonstrated no signs but was simply found dead the day after application. The second animal, also a two year Persian cat (Subform III, #2), had acted dizzy and confused prior to its death two days after application. The caller was unable comment on whether the pets had been taken to the veterinarian or if any necropsy was planned. His primary motive for calling was to determine if the animals signs or the outcome would be expected following product use. The reporter was advised use of the product as labeled followed by an appropriate re-entry interval would not be expected to elicit any signs. In this circumstance no exposure was observed. The caller was advised cats, as a species, are uniquely sensitive to the active ingredient. However, sudden death would not be expected and the signs seen are inconsistent with the signs expected in known toxicity instances. It is unlikely the animals illness was related to the use of this product. No further information is available.


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

Cat / Chat

3. Breed

Persian

4. Number of animals affected

1

5. Sex

Unknown

6. Age (provide a range if necessary )

2

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

  • Nervous and Muscular Systems
    • Symptom - Dizziness
    • Symptom - Confusion
  • General
    • Symptom - Death

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

1-28115346- The reporter, a commercial pest control operator, indicates possible exposure of a clients pets to an insecticide containing the active ingredient permethrin. The reporter indicated he applied the product diluted according to the label to a pet owners apartment 11/14/11. The pet owner had kept his two cats in the bathroom while the apartment was being treated. The product was applied to the carpet of the home only. The reporter was unsure how long the animals were kept in the bathroom of the home before they were allowed into the application area. He was unable to describe a discreet exposure incident and was unsure if the animals were actually exposed to the product in any way. The pet owner had contacted him to report one animal had died the day after application and another the second day after application. The pet owner indicated the fist cat, a two year old Persian (Subform III, #1), demonstrated no signs but was simply found dead the day after application. The second animal, also a two year Persian cat (Subform III, #2), had acted dizzy and confused prior to its death two days after application. The caller was unable comment on whether the pets had been taken to the veterinarian or if any necropsy was planned. His primary motive for calling was to determine if the animal¿s signs or the outcome would be expected following product use. The reporter was advised use of the product as labeled followed by an appropriate re-entry interval would not be expected to elicit any signs. In this circumstance no exposure was observed. The caller was advised cats, as a species, are uniquely sensitive to the active ingredient. However, sudden death would not be expected and the signs seen are inconsistent with the signs expected in known toxicity instances. It is unlikely the animals illness was related to the use of this product. No further information is available.


To be determined by Registrant

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

Death

19. Provide supplemental information here