Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2017-7512

2. Registrant Information.

Registrant Reference Number: 2115782

Registrant Name (Full Legal Name no abbreviations): Bayer CropScience Inc.

Address: 160 QUARRY PARK BLVD. SE Suite 200

City: CALGARY

Prov / State: AB

Country: Canada

Postal Code: T2C 3G3

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

Domestic Animal

4. Date registrant was first informed of the incident.

25-SEP-17

5. Location of incident.

Country: UNITED STATES

Prov / State: WISCONSIN

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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 432-1516

Product Name: Esplanade 200 SC

• Active Ingredient(s)
  • INDAZIFLAM

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 432-1565

Product Name: Method 240SL Herbicide

• Active Ingredient(s)
  • AMINOCYCLOPYRACHLOR POTASSIUM SALT

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7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

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

Site: Other / Autre

Préciser le type: Vegetation near railroad

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

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

To be determined by Registrant

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

Yes

Subform III: Domestic Animal Incident Report

1. Source of Report

Other

2. Type of animal affected

Cow / Vache

3. Breed

Unknown

4. Number of animals affected

3

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?

Unknown

15. Outcome of the incident

Died

16. How was the animal exposed?

Other / Autre

specify Defined point of exposure not evident or witnessed. Exposure based on speculation.

17. Provide any additional details about the incident

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

9/25/2017 Caller's employer controls vegetation for railroads. The products were applied on 6/22/2017, and the application is suspected to have killed three cows. Caller did not have further information regarding the exposure or the cows. Caller states that the Esplanade was applied 3.5 ounces per 20 gallons of water, the Method 240 SL was applied 6 ounces per gallon of water, and the Oust XP was 3 ounces per gallon of water. Razor was applied 2 pints per 20 gallons of water, as were a couple of adjuvant products. Droxyl NES 100 was 1 pint per 20 gallons of water, and Exacto Drift control amount depends on the wind conditions present at the time.

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To be determined by Registrant

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

Death

19. Provide supplemental information here