Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-3246

2. Registrant Information.

Registrant Reference Number: 2014-27

Registrant Name (Full Legal Name no abbreviations): BASF Canada

Address: 100 Milverton

City: Mississauga

Prov / State: ON

Country: Canada

Postal Code: L5R4H1

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

Domestic Animal

4. Date registrant was first informed of the incident.

29-JUL-14

5. Location of incident.

Country: CANADA

Prov / State: SASKATCHEWAN

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. 29368      PMRA Submission No.       EPA Registration No.

Product Name: Heat

• Active Ingredient(s)
  • SAFLUFENACIL

---

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: Agricultural-Outdoor/Agricole-extérieur

Préciser le type: alfalfa

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

Product reportedly applied at full rate, 240 A case, no glyphosate to full standing alfalfa as a harvest aid, cut and baled 2days later.

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

Horse / Cheval

3. Breed

unknown

4. Number of animals affected

10

5. Sex

Unknown

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?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

• General
  • Symptom - Death

• Skin
  • Symptom - Hair loss

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?

Other / Autre

specify animals fed hay treated in December 2012; hay sat for 2 seasons before feeding

17. Provide any additional details about the incident

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

Over 500 animals affected, cattle and horses. Horses: 1 horse, 9 yearlings died. Other symptoms reported as hair loss, blindness, open sores-unclear if all symptoms seen in both cattle and horses, horses definite hair loss.

---

To be determined by Registrant

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

Death

19. Provide supplemental information here

Unclear if product related, not a label use, and 2 seasons after treatment.

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cow / Vache

3. Breed

unknown

4. Number of animals affected

43

5. Sex

Unknown

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

• General
  • Symptom - Death

• Skin
  • Symptom - Hair loss
  • Symptom - Bleeding

• Eye
  • Symptom - Blindness (temporary)
  • Specify - unknown if temporary

• Skin
  • Symptom - Other
  • Specify - open sores

• Reproductive System
  • Symptom - Other
  • Specify - abortions

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?

Other / Autre

specify Cattle fed alfalfa treated with Heat, 2 seasons storage before feeding

17. Provide any additional details about the incident

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

Blindness, open sores abortions; cattle:2 bull, 11 cow, 30 calves. Abortions added here, because reproductive entry field did not work

---

To be determined by Registrant

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

Major

19. Provide supplemental information here

Feed stored for 2 seasons before being fed to animals