Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2019-3684

2. Registrant Information.

Registrant Reference Number: 2463774

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.

Human

4. Date registrant was first informed of the incident.

18-JUN-19

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

05-JUN-19

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. 29615      PMRA Submission No.       EPA Registration No.

Product Name: PUMA ADVANCE HERBICIDE (CANADA)

• Active Ingredient(s)
  • FENOXAPROP-P-ETHYL (ISOMER)

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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: Res. - Out Home / Rés - à l'ext.maison

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?

No

Subform II: Human Incident Report (A separate form for each person affected)

1. Source of Report.

Other

2. Demographic information of data subject

Sex: Male

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Respiratory System
  • Symptom - Respiratory irritation
  • Symptom - Shortness of breath
  • Symptom - Other
  • Specify - Stain of lungs

4. How long did the symptoms last?

Unknown / Inconnu

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

Yes

6. a) Was the person hospitalized?

Unknown

6. b) For how long?

Unknown

7. Exposure scenario

Non-occupational

8. How did exposure occur? (Select all that apply)

What was the activity? Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding the activity

Other

9. If the exposure occured during application or re-entry, what protective clothing was worn? (select all that apply)

None

10. Route(s) of exposure.

Unknown

11. What was the length of exposure?

<=15 min / <=15 min

12. Time between exposure and onset of symptoms.

Unknown / Inconnu

13. Provide any additional details about the incident (eg. description of the frequency and severity of the symptoms, type of medical treatment, results from medical tests, outcome of the incident, amount of pesticide exposed to, etc.)

6/18/2019 Caller is an employee of the city where the patient lives. On 6/5/2019 the product was sprayed in the garden of a private property. Caller is unsure who applied the product. The man who lives there was outside at the time. Since then, he has had respiratory difficulty and discomfort. He has had an x-ray, which showed stains on his lungs. Further tests results are pending.

To be determined by Registrant

14. Severity classification.

Moderate

15. Provide supplemental information here.

There does not appear to be any direct evidence of a defined exposure taking place. The reporter's description of exposure is speculative. Residual odors that remain after application do not carry significant airborne quantities of the active ingredients that would pose a legitimate health risk to individuals who detect the odor. Even had incidental contact the diluted herbicide occurred, the delayed onset of the symptoms described is not consistent with the toxicological profile of this product. Finally, this product is for commercial use only in wheat and barley and has no place in residential gardens.