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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-1093

2. Registrant Information.

Registrant Reference Number: 806443

Registrant Name (Full Legal Name no abbreviations): Bayer CropScience Inc.

Address: 295 Henderson Drive

City: Regina

Prov / State: SK

Country: Canada

Postal Code: S4N 6C2

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

Domestic Animal

4. Date registrant was first informed of the incident.

20-JUN-11

5. Location of incident.

Country: UNITED STATES

Prov / State: NORTH CAROLINA

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.       PMRA Submission No.       EPA Registration No. Unknown

Product Name: SEVIN Brand (Non-specific)

  • Active Ingredient(s)
    • CARBARYL
      • Unknown

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

Product Name: Malathion

  • Active Ingredient(s)
    • MALATHION
      • Unknown

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: Animal / Usage sur un animal domestique

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

No

Subform III: Domestic Animal Incident Report

1. Source of Report

Medical Professional

2. Type of animal affected

Dog / Chien

3. Breed

Beagle

4. Number of animals affected

4

5. Sex

Unknown

6. Age (provide a range if necessary )

0.29

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

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
  • Nervous and Muscular Systems
    • Symptom - Muscle tremors

12. How long did the symptoms last?

Persisted until death

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

Unknown

14. a) Was the animal hospitalized?

Yes

14. b) How long was the animal hospitalized?

Unknown

15. Outcome of the incident

Died

16. How was the animal exposed?

Treatment / Traitement

17. Provide any additional details about the incident

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

6/20/2011 Caller works in a veterinary clinic with a client that has been applying a product containing unspecified Sevin Brand insecticide on six puppies and in their pen for flea control. Over the past few days, several of the puppies have died. The clinic believes the puppies have parvovirus. The only clinical symptom that the caller is able to give is that one of the puppies is having tremors at this time. 6/21/2011 Callback to the original caller for follow up information. Four of the six puppies have died, and the other two puppies are still not doing very well. The owner now states he mixed an unspecified Malathion containing product with the Sevin containing product before applying it to the puppies for flea control. The clinic sent deceased puppy to have a necropsy performed. The puppy was found to have a bacterial lung infection. All of the puppies experienced tremors. 6/30/2011 Callback to the original caller for follow up information. The clinic has not heard from the owner, and is not sure how the remaining two puppies are doing. There is no information regarding the results of a necropsy


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

Medical Professional

2. Type of animal affected

Dog / Chien

3. Breed

Beagle

4. Number of animals affected

2

5. Sex

Unknown

6. Age (provide a range if necessary )

0.29

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

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 - Muscle tremors

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

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?

Treatment / Traitement

17. Provide any additional details about the incident

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

6/20/2011 Caller works in a veterinary clinic with a client that has been applying a product containing unspecified Sevin Brand insecticide on six puppies and in their pen for flea control. Over the past few days, several of the puppies have died. The clinic believes the puppies have parvovirus. The only clinical symptom that the caller is able to give is that one of the puppies is having tremors at this time. 6/21/2011 Callback to the original caller for follow up information. Four of the six puppies have died, and the other two puppies are still not doing very well. The owner now states he mixed an unspecified Malathion containing product with the Sevin containing product before applying it to the puppies for flea control. The clinic sent deceased puppy to have a necropsy performed. The puppy was found to have a bacterial lung infection. All of the puppies experienced tremors. 6/30/2011 Callback to the original caller for follow up information. The clinic has not heard from the owner, and is not sure how the remaining two puppies are doing. There is no information regarding the results of a necropsy


To be determined by Registrant

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

Moderate

19. Provide supplemental information here