Health Canada
Symbol of the Government of Canada
Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-3125

2. Registrant Information.

Registrant Reference Number: 2014-IR-03

Registrant Name (Full Legal Name no abbreviations): E.I. du Pont Canada Company

Address: 1919 Minnesota Court

City: Mississauga

Prov / State: ON

Country: Canada

Postal Code: L5M 2J4

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

Domestic Animal

4. Date registrant was first informed of the incident.

05-AUG-14

5. Location of incident.

Country: UNITED STATES

Prov / State: IDAHO

6. Date incident was first observed.

10-JUL-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.       PMRA Submission No.       EPA Registration No. 352-615

Product Name: Cimarron Max Herbicide

  • Active Ingredient(s)
    • 2,4-D (PRESENT AS AMINE SALTS : DIMETHYLAMINE SALT, DIETHANOLAMINE SALT, OR OTHER AMINE SALTS)
      • Unknown
    • METSULFURON-METHYL
      • Unknown

7. b) Type of formulation.

Dry Flowable (water dispersible granules)

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: pasture

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

Farmer applied Cimarron Max to pastures on June 3rd and let calves graze 2 days later. There were many toxic plants in the field, including water hemlock, poison hemlock.

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

5

5. Sex

Female

6. Age (provide a range if necessary )

1

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Oral

9. What was the length of exposure?

>1 wk <=1 mo / > 1 sem < = 1 mois

10. Time between exposure and onset of symptoms

>1 wk <=1 mo / > 1 sem < = 1 mois

11. List all symptoms

System

  • General
    • Symptom - Drowsiness
    • Specify - drowsy
  • Respiratory System
    • Symptom - Other
    • Specify - bradypnea
  • Cardiovascular System
    • Symptom - Bradycardia
  • General
    • Symptom - Lethargy

12. How long did the symptoms last?

Persisted until death

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

Yes

14. a) Was the animal hospitalized?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Euthanised / Euthanasie

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

Farmer sprayed the field with Cimarron Max on june 3rd and 2 days later let calves on the field. there were many toxic plants in the field, including water hemlock and poison hemlock. the vet saw them on june 4th and 4 calves were sick. another calf came down with symptoms a week later. the farmer also changed the feed recently. he talked with a vet at the university and they said the symptoms weren't caused by this product, could be caused by plants or a thiamine deficiency from the change in feed. The vet contacted the poison control centre to inquire if DuPont had seen this before with this product. there were a lot of different sorts of toxic plants in the two pastures.


To be determined by Registrant

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

Death

19. Provide supplemental information here