Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2019-6490

2. Registrant Information.

Registrant Reference Number: 31387

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

Address: 2920 matheson BLVD

City: Mississaugua

Prov / State: Ont

Country: Canada

Postal Code: L4W 5R6

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

Domestic Animal

4. Date registrant was first informed of the incident.

24-OCT-19

5. Location of incident.

Country: CANADA

Prov / State: UNKNOWN

6. Date incident was first observed.

09-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. 33014      PMRA Submission No.       EPA Registration No.

Product Name: Credo SC

• Active Ingredient(s)
  • IMIDACLOPRID

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7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

526

Units: g/L

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

Site: Agricultural-Indoor / Agricole-intérieur

Préciser le type: walls of a poultry barn

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

On 8-Sep-2019, Credo, was sprayed onto the walls of a poultry barn by a license pesticide application professional. The product was not used according to label. The product was not mixed properly with water and when it was applied to the walls with the sprayer, pure Credo was coming out of the sprayer. A film of white powder remained on the walls of the poultry barn when the chicks were housed.

To be determined by Registrant

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

No

Subform III: Domestic Animal Incident Report

1. Source of Report

Other

2. Type of animal affected

Bird - Poultry / Oiseau - Volaille

3. Breed

Unknown

4. Number of animals affected

5. Sex

Unknown

6. Age (provide a range if necessary )

0.019

7. Weight (provide a range if necessary )

Unknown

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

• General
  • Symptom - Death

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?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

16. How was the animal exposed?

Contact treat.area/Contact surf. traitée

17. Provide any additional details about the incident

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

On 9-Sep-2019, 1 day old male and female chicks were eating the Credo powder from the walls which resulted in increased mortality. (exact number of birds affected unknown) (Percentage of mortality increase is unknown).The outcome is death. A necropsy was performed which showed high levels of credo in the liver of the chicks.

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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