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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2018-4718

2. Registrant Information.

Registrant Reference Number: 2018CP227

Registrant Name (Full Legal Name no abbreviations): Bayer inc

Address: 2920 Matheson Blvd

City: Mississaugua

Prov / State: ON

Country: Canada

Postal Code: L4W 5R6

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

Environment

4. Date registrant was first informed of the incident.

09-AUG-18

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

25-JUN-18

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. 29779      PMRA Submission No.       EPA Registration No.

Product Name: K9advantixII extra large dog

  • Active Ingredient(s)
    • IMIDACLOPRID
    • PERMETHRIN
    • PYRIPROXYFEN

7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

4

Units: mL

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

Site: Animal / Usage sur un animal domestique

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

one tube was applied to a 49.5 kg, 4 year old female german shepherd dog on May 16 and June 16 2018; the dog was also applied one tube advantage multi 100 on May 28 2018; advantage multi 100 is a VDD registered product that contains 400mg imidacloprid and 100 mg moxidectin

To be determined by Registrant

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

Unknown

Subform IV: Environment (includes plants insects and wildlife)

1. Type of organism affected

Terr. Invrtbrt-Honey Bee/Inv.Ter-Abeille

2. Common name(s)

queen bee ( honey bee)

3. Scientific name(s)

Apis mellifera

4. Number of organisms affected

Unknown

5. Description of site where incident was observed

Fresh water

Terrestrial

Residential

Salt Water

6. Check all symptoms that apply

Death

7. Describe symptoms and outcome (died, recovered, etc.).

the pet owner patted her dog and then manipulated some queen bees with her bare hands, (without using gloves), without washing her hands previously, on June 10, June 15, June 22 and June 25 2018 as the bees were packaged and shipped to some purchasers. The purchasers reported a higher than usual death rates in the bees upon receiving the June 25 shipment. Some dead bees were sent for analysis at MAPAQ on June 26. The bees had a level of 0.004 micrograms of imidacloprid .The bees had a level of .0072 micrograms of permethrin-cis and a level of .0067 micrograms permethrin -trans

8. a) Was the incident a result of (select all that apply)

N/A

Unknown

8. b) i) How many times has the product been applied this year?

8. b) ii) What was the date of the last application?

9. Did it rain

9. a) During application?

No

9. b) Up to 3 days after application?

No

10. a) Was there a buffer zone?

No

10. b) What type?

10. c) What was the size of the buffer zone?

11. a) Were environmental samples collected and analysed?

No

To be determined by Registrant

12. Severity classification (if there is more than one possible classification, select the most severe)

Minor

13. Please provide supplemental information here

No cases of bees being affected by a dog that was treated with K9advantixII or advantageII have been reported in North America or globally.