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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-1157

2. Registrant Information.

Registrant Reference Number: PROSAR case #: 1-39859316

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.

05-MAR-15

5. Location of incident.

Country: UNITED STATES

Prov / State: FLORIDA

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: Abound Fungicide

  • Active Ingredient(s)
    • AZOXYSTROBIN
      • Guarantee/concentration 22.9 %

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: Unknown

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

Sheep / Mouton

3. Breed

Unknown

4. Number of animals affected

2

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

  • 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?

Spray drift / Dérive de pulvérisation

17. Provide any additional details about the incident

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

1-39859316 - The reporter, a farmer, indicated that her herd of sheep and her horses may have been exposed to a fungicide containing the active ingredient azoxystrobin. The reporter did not have product packaging and could not provide the registration number for the product but provided the partial name of Abound. The reporter indicated that for some unspecified length of time her neighbors had been spraying the grove with the fungicide and the reporter was concerned that drift was entering her pastures where her horses and sheep were grazing. The reporter indicated that after her neighbors started spraying, about one month prior to her initial call, two of the callers lambs died. The reporter did not indicate if these lambs exhibited any symptoms prior to death or if medical care was provided. Neither lamb underwent a necropsy. None of the reporters other animals exhibited symptoms. The reporter was advised that ingestion of overspray may result in transient gastrointestinal irritation but sudden death is not consistent with exposure to the applied 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