Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2019-6043

2. Registrant Information.

Registrant Reference Number: 190171281

Registrant Name (Full Legal Name no abbreviations): Wellmark International

Address: 100 Stone Road West, Suite 111

City: Guelph

Prov / State: Ontario

Country: Canada

Postal Code: N1G5L3

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

Domestic Animal

4. Date registrant was first informed of the incident.

28-SEP-19

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

28-SEP-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. 15176      PMRA Submission No.       EPA Registration No.

Product Name: Agricultural Starbar Premium Fly Bait With Muscamone

• Active Ingredient(s)
  • (Z)-9-TRICOSENE
  • METHOMYL

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7. b) Type of formulation.

Application Information

8. Product was applied?

Unknown

9. Application Rate.

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

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

To be determined by Registrant

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

Unknown

Subform III: Domestic Animal Incident Report

1. Source of Report

Medical Professional

2. Type of animal affected

Dog / Chien

3. Breed

Domestic Unspecified

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

2.0

7. Weight (provide a range if necessary )

31.0

kg

8. Route(s) of exposure

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

• Gastrointestinal System
  • Symptom - Vomiting

12. How long did the symptoms last?

Unknown / Inconnu

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?

15. Outcome of the incident

Unknown/Inconnu

16. How was the animal exposed?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

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

On September 28, 2019, the dog ingested some granules of this bait. The dog then vomited a few times. Soon after, the regular veterinarian contacted the Animal Product Safety Service (APSS). The regular veterinarian stated that the dog's heart rate was normal with a value of 136.0 beats per minute (bpm). The APSS veterinarian stated that methomyl is a carbamate that is rapidly absorbed after ingestion, but does not accumulate in the tissues and that it does not "age" on the receptors like organophosphates (OPs) do, so signs are often short-lived. The APSS veterinarian also stated that signs occur within minutes after ingestion. Finally, the APSS veterinarian stated that if not a lethal exposure, signs are expected to resolve spontaneously due to the reversible nature of carbamate toxicity. The APSS veterinarian recommended the regular veterinarian monitor at a veterinary facility (for another 30-60 minutes (min)), monitor for gastrointestinal (GI) signs, monitor for central nervous system (CNS) signs, monitor cardiovascular function, provide atropine cholinergic toxicity (as needed for bronchial secretions, bradycardia), give diazepam, manage seizures, and to call back with questions.

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To be determined by Registrant

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

Minor

19. Provide supplemental information here

Signs were expected to be mild and self-limiting. After one hour the dog was acting normal, self decontaminated was suspected. This was off label use, the bait should not be anywhere pets may have access to.