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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2012-2818
2. Registrant Information.
Registrant Reference Number: PROSAR Case #: 1-30606571
Registrant Name (Full Legal Name no abbreviations): Syngenta 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.
23-JUN-125. Location of incident.
Country: CANADA
Prov / State: ONTARIO
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. 28072 PMRA Submission No. EPA Registration No.
Product Name: Touchdown Total Herbicide
- Active Ingredient(s)
- GLYPHOSATE (PRESENT AS POTASSIUM SALT)
PMRA Registration No. 18450 PMRA Submission No. EPA Registration No.
Product Name: AAtrex Liquid 480 Agricultural Herbicide
- Active Ingredient(s)
- ATRAZINE (PLUS RELATED ACTIVE TRIAZINES)
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: corn
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
Sheep / Mouton
3. Breed
unknown
4. Number of animals affected
3
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
>2 hrs <=8 hrs / > 2 h < = 8 h
11. List all symptoms
System
- Respiratory System
- Symptom - Difficulty Breathing
- 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?
Spray drift / Dérive de pulvérisation
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
1-30606571- The reporter indicated possible exposure of domestic animals to two herbicidal products. The first product contained the active ingredient glyphosate; the second contained the active ingredient atrazine. The reporter identified himself as an employee of the company contracted for the custom application of the products. The reporter indicted the product was applied to corn crops in accordance with the label one day prior to his initial report. The application site was described to be adjacent to a livestock containment area holding and estimated 50 head of sheep. The reporter stated the animals were typically seen along the fence line during work (attracted by activity) but were unseen the day of the application. He also added that a pond of unknown dimensions lies between the fence line and the application site. He, lastly, added that the conditions were not windy the day of application and that drift was unlikely. No discreet exposure incident was described. The reporter stated the owner of the land and sheep adjacent to the application site had observed three animals (Subform III, #1) breathing hard that they had died within one day of application. The reporter stated he had visited the farm the day of his report (one day following application) and observed five additional animals (Subform III, #2) that could not stand or had difficulty walking. The reporter stated he anticipated those animals would likely die due to their poor condition. He indicated the animals had no veterinary care but one of the animals remains had been submitted to a local veterinarian for necropsy. No results of the necropsy were provided. The reporter indicated he believed the animals were poorly managed and he believed poor husbandry was likely responsible for the animals death. The reporter spontaneously called back three days later to report one additional animal (Subform III, #3) had died and the remains would be submitted for necropsy with a Veterinary Diagnostic Laboratory. The reporter was unsure if the results would be shared with him. The described incident would not be expected to yield either the signs seen or the outcome seen. It is inconsistent with the profile of the active ingredient or the finished products. 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
Sheep / Mouton
3. Breed
unknown
4. Number of animals affected
4
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
Unknown / Inconnu
11. List all symptoms
System
- Nervous and Muscular Systems
- Symptom - Difficulty getting up
- Symptom - Difficulty walking
- Respiratory System
- Symptom - Laboured breathing
- Nervous and Muscular Systems
- Symptom - Muscle tremors
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?
Spray drift / Dérive de pulvérisation
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
1-30606571- The reporter indicated possible exposure of domestic animals to two herbicidal products. The first product contained the active ingredient glyphosate; the second contained the active ingredient atrazine. The reporter identified himself as an employee of the company contracted for the custom application of the products. The reporter indicted the product was applied to corn crops in accordance with the label one day prior to his initial report. The application site was described to be adjacent to a livestock containment area holding and estimated 50 head of sheep. The reporter stated the animals were typically seen along the fence line during work (attracted by activity) but were unseen the day of the application. He also added that a pond of unknown dimensions lies between the fence line and the application site. He, lastly, added that the conditions were not windy the day of application and that drift was unlikely. No discreet exposure incident was described. The reporter stated the owner of the land and sheep adjacent to the application site had observed three animals (Subform III, #1) breathing hard that they had died within one day of application. The reporter stated he had visited the farm the day of his report (one day following application) and observed five additional animals (Subform III, #2) that could not stand or had difficulty walking. The reporter stated he anticipated those animals would likely die due to their poor condition. He indicated the animals had no veterinary care but one of the animals remains had been submitted to a local veterinarian for necropsy. No results of the necropsy were provided. The reporter indicated he believed the animals were poorly managed and he believed poor husbandry was likely responsible for the animals death. The reporter spontaneously called back three days later to report one additional animal (Subform III, #3) had died and the remains would be submitted for necropsy with a Veterinary Diagnostic Laboratory. The reporter was unsure if the results would be shared with him. The described incident would not be expected to yield either the signs seen or the outcome seen. It is inconsistent with the profile of the active ingredient or the finished products. No further information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Moderate
19. Provide supplemental information here
Subform III: Domestic Animal Incident Report
1. Source of Report
Other
2. Type of animal affected
Sheep / Mouton
3. Breed
unknown
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
Unknown / Inconnu
11. List all symptoms
System
- Respiratory System
- Symptom - Difficulty Breathing
- Nervous and Muscular Systems
- Symptom - Difficulty getting up
- Symptom - Difficulty walking
- Symptom - Muscle tremors
- 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?
Spray drift / Dérive de pulvérisation
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
1-30606571- The reporter indicated possible exposure of domestic animals to two herbicidal products. The first product contained the active ingredient glyphosate; the second contained the active ingredient atrazine. The reporter identified himself as an employee of the company contracted for the custom application of the products. The reporter indicted the product was applied to corn crops in accordance with the label one day prior to his initial report. The application site was described to be adjacent to a livestock containment area holding and estimated 50 head of sheep. The reporter stated the animals were typically seen along the fence line during work (attracted by activity) but were unseen the day of the application. He also added that a pond of unknown dimensions lies between the fence line and the application site. He, lastly, added that the conditions were not windy the day of application and that drift was unlikely. No discreet exposure incident was described. The reporter stated the owner of the land and sheep adjacent to the application site had observed three animals (Subform III, #1) breathing hard that they had died within one day of application. The reporter stated he had visited the farm the day of his report (one day following application) and observed five additional animals (Subform III, #2) that could not stand or had difficulty walking. The reporter stated he anticipated those animals would likely die due to their poor condition. He indicated the animals had no veterinary care but one of the animals remains had been submitted to a local veterinarian for necropsy. No results of the necropsy were provided. The reporter indicated he believed the animals were poorly managed and he believed poor husbandry was likely responsible for the animals death. The reporter spontaneously called back three days later to report one additional animal (Subform III, #3) had died and the remains would be submitted for necropsy with a Veterinary Diagnostic Laboratory. The reporter was unsure if the results would be shared with him. The described incident would not be expected to yield either the signs seen or the outcome seen. It is inconsistent with the profile of the active ingredient or the finished products. No further information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
