Health Canada
Symbol of the Government of Canada
Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-7062

2. Registrant Information.

Registrant Reference Number: 1-35458560

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.

08-NOV-13

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

30-OCT-13

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. 27428      PMRA Submission No.       EPA Registration No.

Product Name: Demand CS Insecticide

  • Active Ingredient(s)
    • LAMBDA-CYHALOTHRIN

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: 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

Animal's Owner

2. Type of animal affected

Bird / Oiseau

3. Breed

Cockatiel

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

12

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

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

11. List all symptoms

System

  • General
    • Symptom - Listless
    • Symptom - Death
    • Symptom - Adipsia
    • Symptom - Weakness
  • Nervous and Muscular Systems
    • Symptom - Ataxia
  • Gastrointestinal System
    • Symptom - Other
    • Specify - Clumps of stool sticking to cloacae
    • Symptom - Anorexia
  • Nervous and Muscular Systems
    • Symptom - Loss of coordination
    • Specify - Unable to fly well - wobbly while flying

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?

Other / Autre

specify No specific witnessed exposure; the bird was brought back into the treated area about 36 hours after treatment

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

1-35458560 - The reporter, a pet owner, indicated that her Cockatiel lives in an apartment that was treated with an insecticide containing the active ingredient lambda-cyhalothrin. Four weeks prior to initial contact, the apartment had been treated with this insecticide without issue. On the day that her apartment was treated for the second time (morning of 10/28/13) the bird was stored in a separate apartment unit to prevent exposure. The bird was reintroduced to her cage in the treated apartment about 36 hours after treatment (evening of 10/29/23). The next morning (10/30/13) the bird was listless. Over the next 9 days, the bird became anorectic, adipsic, weak, ataxic, and had lumps of stool clinging to her cloacae. The bird was wobbly while trying to fly. The reporter contacted the registrant on 11/08/13 to ask if the insecticide was caustic. The reporter was informed that the product is not caustic, but was urged to seek immediate veterinary care for the bird and clean the treated area to remove any residue of the insecticide. The reporter contacted the registrant the following day to relate that the bird had died. 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