Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-1782

2. Registrant Information.

Registrant Reference Number: 140026226

Registrant Name (Full Legal Name no abbreviations): Wellmark International

Address: 100 Stone Road West, Suite 111

City: Guelph

Prov / State: Ontario

Country: Canada

Postal Code: N1G5L3

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

Domestic Animal

4. Date registrant was first informed of the incident.

04-MAR-14

5. Location of incident.

Country: UNITED STATES

Prov / State: OHIO

6. Date incident was first observed.

03-MAR-14

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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2724-262

Product Name: Starbar Prolate Lintox HD Insecticidal Spray and Backrubber

• Active Ingredient(s)
  • PHOSMET
    • Guarantee/concentration 11.75 %

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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: 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).

On March 2, 2014 the owner inappropriately applied the undiluted product to the steer.

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

Animal's Owner

2. Type of animal affected

Cow / Vache

3. Breed

Unspecified

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.71

7. Weight (provide a range if necessary )

650.0

lbs

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

• Gastrointestinal System
  • Symptom - Loss of appetite

• Nervous and Muscular Systems
  • Symptom - Shaking
  • Symptom - Recumbent

• Gastrointestinal System
  • Symptom - Drooling
  • Symptom - Diarrhea

• General
  • Symptom - Death

• Gastrointestinal System
  • Symptom - Salivating excessively

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?

Treatment / Traitement

17. Provide any additional details about the incident

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

On March 3, 2014 the owner noticed the steer was inappetant and shaking. On March 4, 2014, the owner noticed the steer was recumbent, hypersalivating, and had diarrhea and the owner called the Animal Product Safety Service (APSS) to obtain help. The APSS veterinarian stated this is an organophosphate product that is supposed to be diluted prior to use. The APSS veterinarian also stated risks are for salivation, lacrimation, urination, defecation, dyspnea, emesis (SLUDDE) signs - hypersalivation, diarrhea, tearing, abdominal cramping, and dyspnea. She also stated nicotinic effects can include ataxia, tremors, weakness, recumbency, and possibly seizures and bradycardia can also develop. The APSS veterinarian recommended the owner call his livestock veterinarian, bathe the steer with dish soap multiple times, prevent human exposure by wearing gloves, allow access to water and food, prevent decubital ulcers by padding the pen, and calling back with questions.

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To be determined by Registrant

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

Death

19. Provide supplemental information here

On March 5, 2014 the owner called the APSS and reported to the APSS assistant that they bathed the calf with liquid dish washing detergent (LDWD) and he had been eating some food and water, but was still periodically recumbent. They found the steer had died on the afternoon of March 5, 2014. A necropsy is not available. Extra label use as product was applied undiluted.