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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-1964

2. Registrant Information.

Registrant Reference Number: PROSAR case: 1-37076776

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.

28-APR-14

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: Gramaxone

  • Active Ingredient(s)
    • PARAQUAT
      • Unknown

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

Product Name: Atrazine

  • Active Ingredient(s)
    • ATRAZINE (PLUS RELATED ACTIVE TRIAZINES)
      • Unknown

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: Agricultural-Outdoor/Agricole-extérieur

Préciser le type: Corn

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

Other

2. Type of animal affected

Horse / Cheval

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

  • Nervous and Muscular Systems
    • Symptom - Bizarre behaviour
    • Specify - Erratic behavior
  • General
    • Symptom - Death

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?

Unknown

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

16. How was the animal exposed?

Contact treat.area/Contact surf. traitée

17. Provide any additional details about the incident

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

1-37076776 - The reporter, a farmer, indicated that a neighbors horses may have been exposed to two different herbicides one herbicide containing the active ingredient Paraquat and the other containing the active ingredient atrazine. The reporter did not provide any additional product information and it is unknown if the atrazine is a registrant product. The reporter stated that he applied the products to his corn field about four days prior to speaking with the registrant. The reporter indicated that during application he did not see his neighbors horses anywhere in the area. The reporter also indicated that it was not windy and any wind that did blow was blowing away from his neighbors pasture. A day or two later the horse owner called the reporter very irate, stating that his horses were behaving erratically and the horse owner was convinced that the reporter had poisoned his horses. One follow-up, one day later, the reporter indicated that one of the horses had died. The reporter had contacted a lawyer and a necropsy was planned to help determine a cause for the horses symptoms. The described symptoms are not consistent with the described exposure to the product. 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