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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-4405

2. Registrant Information.

Registrant Reference Number: A150057961

Registrant Name (Full Legal Name no abbreviations): Dow AgroSciences Canada Inc.

Address: Suite 2100, 450-1st Street S.W.

City: Alberta

Prov / State: Calgary

Country: Canada

Postal Code: T2P 5H1

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

Domestic Animal

4. Date registrant was first informed of the incident.

04-MAY-15

5. Location of incident.

Country: UNITED STATES

Prov / State: TENNESSEE

6. Date incident was first observed.

01-MAR-15

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. 62719-175

Product Name: Snapshot 2.5 TG Herbicide

  • Active Ingredient(s)
    • ISOXABEN
      • Guarantee/concentration .5
    • TRIFLURALIN
      • Guarantee/concentration 2

7. b) Type of formulation.

Granular

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).

Owner stated the product had been used around the flower beds. They ran out of mulch so only half was covered.

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

Other

2. Type of animal affected

Dog / Chien

3. Breed

Rottweiler Dog (Canine Domestic)

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

2

7. Weight (provide a range if necessary )

110

lbs

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

>1 mo <= 6 mos / > 1 mois < = 6 mois

10. Time between exposure and onset of symptoms

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

11. List all symptoms

System

  • General
    • Symptom - Death
  • Skin
    • Symptom - Peeling skin
    • Symptom - Irritated skin
    • Symptom - Lesion
    • Specify - sore on the pad of one foot
    • Symptom - Lesion
    • Specify - foot appears to have an ulcer
  • Gastrointestinal System
    • Symptom - Vomiting
    • Symptom - Loss of appetite
    • Specify - lack of appetite
  • Renal System
    • Symptom - Renal failure

12. How long did the symptoms last?

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

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?

4

Day(s) / Jour(s)

15. Outcome of the incident

Died

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

The owner noticed the dog had developed a sore on the pad of one foot. Dog was taken to veterinarian and treated with antibiotics and topical medication. That cleared up, but now another foot appears to have an ulcer. Around April 22nd, the dog started vomiting and wasn't eating. They brought the dog back to the veterinarian and the cause was undetermined. They switched pain medication. Two days later she was brought back and they ran some blood work and took radiographs. She was found at that time to be in renal failure and then the dog was hospitalized. The dog was kept on fluids for several days and discharged on a Friday afternoon. The condition worsened within 12 hours and the dog died on the morning of May 14.


To be determined by Registrant

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

Death

19. Provide supplemental information here

The veterinarian indicated that if the dog came into contact with the product while it was still wet, he could see mild GI upset, mild dermal irritation. Signs are far more significant than would be expected from this. Because the time course was not consistent, the amount was unknown consistent, and the findings were not consistent, this substance was considered to have not related likelihood of causing the clinical situation.