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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-2247

2. Registrant Information.

Registrant Reference Number: PROSAR case: 1-37275782

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.

30-MAY-14

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

30-MAY-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)

PMRA Registration No. 28072      PMRA Submission No.       EPA Registration No.

Product Name: Touchdown Total Herbicide

  • Active Ingredient(s)
    • GLYPHOSATE (PRESENT AS POTASSIUM SALT)

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. - Out Home / Rés - à l'ext.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

Cat / Chat

3. Breed

Domestic Shorthair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

1.5

7. Weight (provide a range if necessary )

10

lbs

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>30 min <=2 hrs / >30 min <=2 h

11. List all symptoms

System

  • General
    • Symptom - Fever
  • Gastrointestinal System
    • Symptom - Stomach pain
  • General
    • Symptom - Dehydration

12. How long did the symptoms last?

Unknown / Inconnu

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

Yes

14. a) Was the animal hospitalized?

Yes

14. b) How long was the animal hospitalized?

1

Day(s) / Jour(s)

15. Outcome of the incident

Unknown/Inconnu

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

1-37275782 - The reporter, a pet owner, indicated that her cat was exposed to an herbicide containing the active ingredient glyphosate. The product was applied to the reporters lawn as a spot treatment one day prior to initial contact with the registrant. Although no specific exposure to the product was noted the reporter indicated that her 18-month-old, 10 pound, indoor and outdoor male cat could have entered the application site within the hour that it was applied. One hour after the product was applied the cat was noted to have a fever and abdominal pain. The following morning the cat was brought to the veterinarian and at the time of the initial call the cat was still at the veterinary clinic where it was being treated for dehydration. The reporter did not indicate if any diagnostic tests had been run. The reporter was advised that the described symptoms are not consistent with 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

Moderate

19. Provide supplemental information here