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.