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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-3156

2. Registrant Information.

Registrant Reference Number: PROSAR case: 1-37220808

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.

26-MAY-14

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

24-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. 27428      PMRA Submission No.       EPA Registration No.

Product Name: Demand CS

  • Active Ingredient(s)
    • LAMBDA-CYHALOTHRIN

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

Product Name: Tempo

  • Active Ingredient(s)
    • CYFLUTHRIN

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. - In Home / Rés. - à l'int. 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

Unknown

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

10.5

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Respiratory

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 - Head tilt

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?

Unknown

14. b) How long was the animal hospitalized?

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

1-37220808- The reporter, a pet owner, indicates that her cat was exposed to an insecticide containing the active ingredient Lambda-cyhalothrin and to a non-registrant product called Tempo with unknown active ingredients. The reporter states that two days prior to initial contact with the registrant the reporters home was treated for carpenter ants and these insecticides were drilled into wood planks in the reporters home. Caller states that later that same day her 10.5-year-old, male cat developed a head tilt and was brought to the veterinarian. Per the reporter it would have been impossible for the cat to directly access the product so ingestion was impossible but the cat may have inhaled mild fumes that were noted in the home. The reporter indicates that her veterinarian thought the cat might have a brain tumor or it may have had a stroke but the caller was wondering if symptoms might be from inhalation of the products. The reporter was advised that the described symptoms are not consistent with the described exposure to the product and it was recommended that she continue working with her veterinarian to find an underlying cause and appropriate treatment. 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

Label directions were not followed.