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Consumer Product Safety
Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2016-1825
2. Registrant Information.
Registrant Reference Number: 20160315
Registrant Name (Full Legal Name no abbreviations): Sumitomo Chemical Company, Ltd.
Address: 27-1, Shinkawa 2-chome, Chuo-ku
City: Tokyo
Country: Japan
Postal Code: 104-8260
3. Select the appropriate subform(s) for the incident.
Scientific Study
4. Date registrant was first informed of the incident.
5. Location of incident.
6. Date incident was first observed.
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. 27387 PMRA Submission No. 2016-1583 EPA Registration No. 10308-12
Product Name: ETOC Technical Grade
- Active Ingredient(s)
- PRALLETHRIN
7. b) Type of formulation.
Application Information
8. Product was applied?
Unknown
9. Application Rate.
10. Site pesticide was applied to (select all that apply).
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 VII: Scientific Study
1. Study Reference
Title Study Director
Date 26-FEB-16
2. a) Is an extension needed to translate the document?
No
3. Type of incident identified in the study
Increased health or environmental risk
4. Describe the incident identified in the study (e.g. study demonstrates an increased risk to non-Hodgkin's Lymphoma after exposure to pesticide X)
Neurotoxicity was observed and the NOAEL was lower than 200mg/kg/day during a dosing period of less than four weeks.
5. a) Was the study discontinued before completion?
No
