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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2012-3399

2. Registrant Information.

Registrant Reference Number: A120060775

Registrant Name (Full Legal Name no abbreviations): Dow AgroSciences Canada Inc.

Address: Suite 2100, 450 - 1st Street S.W.

City: Calgary

Prov / State: Alberta

Country: Canada

Postal Code: T2P 5H1

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

Domestic Animal

4. Date registrant was first informed of the incident.

10-MAY-12

5. Location of incident.

Country: UNITED STATES

Prov / State: OREGON

6. Date incident was first observed.

07-MAY-12

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. 62719-260

Product Name: Crossbow Weed and Brush Killer

  • Active Ingredient(s)
    • 2,4-D (PRESENT AS LOW VOLATILE ESTERS)
      • Guarantee/concentration 34.4 %
    • TRICLOPYR
      • Guarantee/concentration 16.5 %

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 524-308

Product Name: Roundup Herbicide

  • Active Ingredient(s)
    • GLYPHOSATE (PRESENT AS ISOPROPYLAMINE SALT OR ETHANOLAMINE SALT)
      • Guarantee/concentration 41 %

PMRA Registration No.       PMRA Submission No.       EPA Registration No. Unknown

Product Name: 2,4-D

  • Active Ingredient(s)
    • 2,4-D (PRESENT AS ACID)
      • Unknown

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 71995-8-239

Product Name: Ortho Total Kill Weed and Grass Killer Ready to Use

  • Active Ingredient(s)
    • GLYPHOSATE (PRESENT AS ISOPROPYLAMINE SALT OR ETHANOLAMINE SALT)
      • Guarantee/concentration .96 %

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).

On Monday, May 7, 2012 in the late afternoon, the neighbor had sprayed Crossbow, Roundup, 24D, and Total Kill weed killer. The owner does not know the exact products.

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

Miniature Schnauzer (named Jenny)

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

5

7. Weight (provide a range if necessary )

20

lbs

8. Route(s) of exposure

Unknown

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

  • Gastrointestinal System
    • Symptom - Vomiting
    • Symptom - Bloody diarrhea
  • General
    • Symptom - Death

12. How long did the symptoms last?

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

13. Was medical treatment provided? Provide details in question 17.

Yes

14. a) Was the animal hospitalized?

Unknown

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

On Monday, May 7th in the late afternoon, the neighbor had sprayed Crossbow, Roundup, 24D, and Total Kill weed killer. The owner did not know the exact products. The 4 dogs (Jenny, Reggie, Dakota and Jack) were exposed to the yard where the neighbor sprayed. On Tuesday, May 8th, all of the dogs started vomiting continually. There was only phlegm and food in the vomit. The next day, they all had bloody diarrhea. At 3AM (5:00 CT) on May 9th, the owner took the dogs to the Veterinarian and they were placed on fluids and care was administered. Jenny died on May 9th. Reggie and Dakota were getting worse, and Jack was about the same.


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

Dog / Chien

3. Breed

Miniature Schnauzer (named Jack)

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

6

7. Weight (provide a range if necessary )

19

lbs

8. Route(s) of exposure

Unknown

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

  • Gastrointestinal System
    • Symptom - Vomiting
    • Symptom - Bloody diarrhea

12. How long did the symptoms last?

Unknown / Inconnu

13. Was medical treatment provided? Provide details in question 17.

Yes

14. a) Was the animal hospitalized?

Unknown

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

On Monday, May 7th in the late afternoon, the neighbor had sprayed Crossbow, Roundup, 24D, and Total Kill weed killer. The owner did not know the exact products. The 4 dogs (Jenny, Reggie, Dakota and Jack) were exposed to the yard where the neighbor sprayed. On Tuesday, May 8th, all of the dogs started vomiting continually. There was only phlegm and food in the vomit. The next day, they all had bloody diarrhea. At 3AM (5:00 CT) on May 9th, the owner took the dogs to the Veterinarian and they were placed on fluids and care was administered. Jenny died on May 9th. Reggie and Dakota were getting worse, and Jack was about the same.


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

Dog / Chien

3. Breed

Golden Retriever (named Reggie)

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

4

7. Weight (provide a range if necessary )

80

lbs

8. Route(s) of exposure

Unknown

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

  • Gastrointestinal System
    • Symptom - Bloody diarrhea
    • Symptom - Vomiting

12. How long did the symptoms last?

Unknown / Inconnu

13. Was medical treatment provided? Provide details in question 17.

Yes

14. a) Was the animal hospitalized?

Unknown

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

On Monday, May 7th in the late afternoon, the neighbor had sprayed Crossbow, Roundup, 24D, and Total Kill weed killer. The owner did not know the exact products. The 4 dogs (Jenny, Reggie, Dakota and Jack) were exposed to the yard where the neighbor sprayed. On Tuesday, May 8th, all of the dogs started vomiting continually. There was only phlegm and food in the vomit. The next day, they all had bloody diarrhea. At 3AM (5:00 CT) on May 9th, the owner took the dogs to the Veterinarian and they were placed on fluids and care was administered. Jenny died on May 9th. Reggie and Dakota were getting worse, and Jack was about the same.


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

Dog / Chien

3. Breed

Siberian Husky (named Dakota)

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

5

7. Weight (provide a range if necessary )

75

lbs

8. Route(s) of exposure

Unknown

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

  • Gastrointestinal System
    • Symptom - Bloody diarrhea
    • Symptom - Vomiting

12. How long did the symptoms last?

Unknown / Inconnu

13. Was medical treatment provided? Provide details in question 17.

Yes

14. a) Was the animal hospitalized?

Unknown

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

On Monday, May 7th in the late afternoon, the neighbor had sprayed Crossbow, Roundup, 24D, and Total Kill weed killer. The owner did not know the exact products. The 4 dogs (Jenny, Reggie, Dakota and Jack) were exposed to the yard where the neighbor sprayed. On Tuesday, May 8th, all of the dogs started vomiting continually. There was only phlegm and food in the vomit. The next day, they all had bloody diarrhea. At 3AM (5:00 CT) on May 9th, the owner took the dogs to the Veterinarian and they were placed on fluids and care was administered. Jenny died on May 9th. Reggie and Dakota were getting worse, and Jack was about the same.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here