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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2020-0689
2. Registrant Information.
Registrant Reference Number: ProPharma Group case #: 1-59711095
Registrant Name (Full Legal Name no abbreviations): Syngenta Canada Inc.
Address: 140 Research Lane, Research Park
City: Guelph
Prov / State: Ontario
Country: Canada
Postal Code: N1G4Z3
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
09-JAN-205. Location of incident.
Country: UNITED STATES
Prov / State: IOWA
6. Date incident was first observed.
Unknown
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. PMRA Submission No. EPA Registration No. 100-1383
Product Name: CRUISERMAXX VIBRANCE CEREALS
- Active Ingredient(s)
- DIFENOCONAZOLE
- Guarantee/concentration 3.34 %
- METALAXYL-M (MEFENOXAM)
- Guarantee/concentration .86 %
- SEDAXANE
- Guarantee/concentration .72 %
- THIAMETHOXAM
- Guarantee/concentration 2.78 %
- DIFENOCONAZOLE
7. b) Type of formulation.
Other (specify)
coated seed cornApplication Information
8. Product was applied?
No
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
Other
2. Type of animal affected
Cow / Vache
3. Breed
unknown
4. Number of animals affected
8
5. Sex
Unknown
6. Age (provide a range if necessary )
Unknown
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
- Nervous and Muscular Systems
- Symptom - Ataxia
12. How long did the symptoms last?
Persisted until death
13. Was medical treatment provided? Provide details in question 17.
Yes
14. a) Was the animal hospitalized?
Unknown
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Died
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
1-59711095 - The reporter, a salesperson , indicates an exposure to a pesticide product containing the active ingredients thiamethoxam, metalaxyl-m (mefenoxam), difenoconazole and sedaxane. On the day of initial contact with the registrant, the reporter indicated a cattle producer had informed him that eight of his cows of unknown age, weight, breed and gender had ingested approximately 100 pounds of the treated seed corn between them approximately 24-36 hours previous. The producer indicated the cattle subsequently developed ataxia then died an unknown amount of time later. The producer stated he had his veterinarian out to treat the animals, but there was little the veterinarian could do. The producer stated the seed corn had been coated with a polymer manufactured by another company and the cattle also ingested an unknown amount of treated soybean seed manufactured by another company. The reporter was advised it would be highly unusual for the registrant's product to be the cause of the death due to the small amount ingested and the low toxicity of the active ingredients. No additional information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
