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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2013-0891
2. Registrant Information.
Registrant Reference Number: StudyID080428
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.
Scientific Study
4. Date registrant was first informed of the incident.
5. Location of incident.
6. Date incident was first observed.
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. Unknown
Product Name: none
- Active Ingredient(s)
- OXYFLUORFEN
7. b) Type of formulation.
Application Information
8. Product was applied?
Unknown
9. Application Rate.
10. Site pesticide was applied to (select all that apply).
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 VII: Scientific Study
1. Study Reference
Title ANALYSIS OF MOLECULAR, CELLULAR, AND BIOCHEMICAL CHANGES IN THE LIVERS OF MALE Crl:CD1(ICR) MICE TREATED WITH OXYFLUORFEN
Date 20-AUG-09
2. a) Is an extension needed to translate the document?
No
3. Type of incident identified in the study
New health or environmental hazard
4. Describe the incident identified in the study (e.g. study demonstrates an increased risk to non-Hodgkin's Lymphoma after exposure to pesticide X)
DAS agrees that any of these data taken alone or cumulatively do not meet the threshold for reporting under FIFRA 6(a)(2) and has not concluded that this information regards an unreasonable adverse effect on the environment or that it is reportable under FIFRA 6(a)(2). However, in an abundance of caution, DAS intends that the submission of the list of studies to the OPPs 6(a)(2) Document Processing Office completes its reporting obligations in response to its understanding of EPAs interpretation of FIFRA 6(a)(2) requirements for EDSP screening assays and 40 C.F.R. 159.158(a) (information relevant to the assessment of risks or benefits of one or more specific pesticide registrations) and 40 C.F.R. 159.195(a) (The registrant shall submit to the Administrator information other than that described in 159.165 through 159.188 if the registrant knows, or reasonably should know, that if the information should prove to be correct, EPA might regard the information alone or in conjunction with other information about the pesticide as raising concerns about the continued registration of a product or about the appropriate terms and conditions of registration of a product).
5. a) Was the study discontinued before completion?
No
5. b) Provide the reason for discontinuation
6. If the study is ongoing, what is the expected completion date?
Unknown
