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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2016-5563

2. Registrant Information.

Registrant Reference Number: Rocky Mountain Poison and Drug case 5683558

Registrant Name (Full Legal Name no abbreviations): LOVELAND Products Canada, Inc.

Address: 789 Donnybrook Drive

City: Dorchester

Prov / State: Ontario

Country: Canada

Postal Code: N0L1G5

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

Domestic Animal

4. Date registrant was first informed of the incident.


5. Location of incident.

Country: CANADA


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.


PMRA Registration No. 9382      PMRA Submission No.       EPA Registration No.

Product Name: LAGON 480 E

  • Active Ingredient(s)

7. b) Type of formulation.

Application Information

8. Product was applied?


9. Application Rate.


10. Site pesticide was applied to (select all that apply).

Site: Agricultural-Outdoor/Agricole-extérieur

Préciser le type: CHERRY

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

Neighbor was spraying and it drifted to a sweet corn crop and goats are grazing on the sweet corn. Lagon R 480E [Dimethoate 44% (organophosphate) cyclohexanone 39% (ketones)]

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?


Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Other / Autre

specify BOER GOAT

3. Breed


4. Number of animals affected


5. Sex


6. Age (provide a range if necessary )


7. Weight (provide a range if necessary )



8. Route(s) of exposure


9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>3 days <=1 wk / >3 jours <=1 sem

11. List all symptoms


  • General
    • Symptom - Death

12. How long did the symptoms last?

Persisted until death

13. Was medical treatment provided? Provide details in question 17.


14. a) Was the animal hospitalized?


14. b) How long was the animal hospitalized?

15. Outcome of the incident


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

Neighboring farmer sprayed Lagon on the evening of Sept 9, 2016. Caller immediately noticed odor of spray drift in area where his 130 goats were grazing. Dead flies were seen in area where goats were present. Goats were removed from that area for 2 days. On Sept 15, 2016 one female goat of a 130 goat herd died. Caller will inform us if any more animals show symptoms after exposure.

To be determined by Registrant

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


19. Provide supplemental information here