Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2012-0849

2. Registrant Information.

Registrant Reference Number: 772856

Registrant Name (Full Legal Name no abbreviations): Bayer CropScience Inc.

Address: 295 Henderson Drive

City: Regina

Prov / State: SK

Country: Canada

Postal Code: S4N 6C2

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

Human

4. Date registrant was first informed of the incident.

08-APR-11

5. Location of incident.

Country: CANADA

Prov / State: BRITISH COLUMBIA

6. Date incident was first observed.

08-APR-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. 23600      PMRA Submission No.       EPA Registration No.

Product Name: Ronstar 2G

• Active Ingredient(s)
  • OXADIAZON

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PMRA Registration No. 25231      PMRA Submission No.       EPA Registration No.

Product Name: Devrinol 50-DF

• Active Ingredient(s)
  • NAPROPAMIDE

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7. b) Type of formulation.

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: Nursery

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

To be determined by Registrant

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

Yes

Subform II: Human Incident Report (A separate form for each person affected)

1. Source of Report.

Other

2. Demographic information of data subject

Sex: Female

Age: >12 <=19 yrs / >12 <=19 ans

3. List all symptoms, using the selections below.

System

• Gastrointestinal System
  • Symptom - Irritated throat
  • Symptom - Nausea

• Respiratory System
  • Symptom - Respiratory irritation

4. How long did the symptoms last?

<=30 min / <=30 min

5. Was medical treatment provided? Provide details in question 13.

Unknown

6. a) Was the person hospitalized?

No

6. b) For how long?

7. Exposure scenario

Occupational

8. How did exposure occur? (Select all that apply)

Drift from the application site

9. If the exposure occured during application or re-entry, what protective clothing was worn? (select all that apply)

None

10. Route(s) of exposure.

Respiratory

11. What was the length of exposure?

<=15 min / <=15 min

12. Time between exposure and onset of symptoms.

<=30 min / <=30 min

13. Provide any additional details about the incident (eg. description of the frequency and severity of the symptoms, type of medical treatment, results from medical tests, outcome of the incident, amount of pesticide exposed to, etc.)

4/8/2011 Caller is a supervisor at a nursery calling for an employee. The employee was working downwind from someone spraying the mixed products. The employee inhaled a small amount of the products fifteen minutes ago. The employee developed mild throat irritation, respiratory irritation, and nausea a few minutes later. The employee has had some water to drink, and the throat and respiratory irritation is improving. Devrinol 50-DF is a non-Bayer product.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.