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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-0233

2. Registrant Information.

Registrant Reference Number: PROSAR case #: 1-35832681

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.

24-DEC-13

5. Location of incident.

Country: UNITED STATES

Prov / State: MISSISSIPPI

6. Date incident was first observed.

24-DEC-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.       PMRA Submission No.       EPA Registration No. 100-1247

Product Name: Cruiser Maxx

  • Active Ingredient(s)
    • FLUDIOXONIL
      • Guarantee/concentration 1.12 %
    • METALAXYL-M (MEFENOXAM)
      • Guarantee/concentration 1.7 %
    • THIAMETHOXAM
      • Guarantee/concentration 22.61 %

7. b) Type of formulation.

Other (specify)

Treatment on soybeans

Application Information

8. Product was applied?

No

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 III: Domestic Animal Incident Report

1. Source of Report

Medical Professional

2. Type of animal affected

Cow / Vache

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

  • 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?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

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

1-35832681 - The reporter, a veterinarian, indicated that unknown number of cows had been exposed to soybean seeds which were treated with the active ingredients thiamethoxam, fludioxonil and metalaxyl-m. On the day of initial contact, the reporter indicated that he just received a call from a farmer who stated that his cows ingested soybean seeds that had been treated with this product. The reporter had not yet seen the cows but the farmer indicated that one cow was dead (Subform III #1), one cow was down and 3-4 cows had discoloration on their muzzle which matched the dye in this product. The reporter was advised that there is a very small amount of active ingredient on the treated seeds and it was recommended that the reporter consider other possible causes for the described symptoms. On follow-up call, two days later, the reporter indicated that he had not heard back from the farmer but the reporter thought that the cows death and the other cows inability to rise was secondary to grain overload and not related to the active ingredients on the treated soybeans. 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