Health Canada
Symbol of the Government of Canada
Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2016-2907

2. Registrant Information.

Registrant Reference Number: A160039424

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

Address: 2400, 215-2nd Street SW

City: Alberta

Prov / State: Calgary

Country: Canada

Postal Code: T2P 1M4

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

Domestic Animal

4. Date registrant was first informed of the incident.

22-MAR-16

5. Location of incident.

Country: UNITED STATES

Prov / State: MARYLAND

6. Date incident was first observed.

08-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. 62719-37

Product Name: Garlon 3A

  • Active Ingredient(s)
    • TRICLOPYR TRIETHYLAMINE SALT
      • Guarantee/concentration 44.4 %

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 62719-537

Product Name: Milestone VM Herbicide

  • Active Ingredient(s)
    • AMINOPYRALID
      • Guarantee/concentration 40.6 %

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 62719-17

Product Name: Forestry Tordon K Herbicide

  • Active Ingredient(s)
    • PICLORAM (PRESENT AS POTASSIUM SALT)

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

Medical Professional

2. Type of animal affected

Cow / Vache

3. Breed

Angus

4. Number of animals affected

3

5. Sex

Unknown

6. Age (provide a range if necessary )

0

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

Oral

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>6 mos / > 6 mois

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.

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?

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 product was applied in August, 2015 (exact date unknown). The caller was out of town when the product was applied. On March 22, 2016, approximately 7 months after the product was applied, the caller is reporting that 3 calves died a few days after being born. The owner does have one calf that is 2 days old and healthy.


To be determined by Registrant

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

Death

19. Provide supplemental information here

Because the amount was unknown consistent, the calves were considered to be at low risk of developing clinical signs. If signs develop, there is low risk that those signs will be life-threatening. [Note : These products would not be a risk to the cattle or to the embryos in pregnant cattle. Would not expect the deaths of the calves to be related to this exposure.]