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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2020-3115

2. Registrant Information.

Registrant Reference Number: ProPharma Group case #: 1-61663854

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.

14-JUL-20

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

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. 26271      PMRA Submission No.       EPA Registration No. Unknown

Product Name: REWARD AQUATIC HERBICIDE

  • Active Ingredient(s)
    • DIQUAT

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).

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

Chihuahua

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

3.5

lbs

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
    • Symptom - Diarrhea
  • Liver
    • Symptom - Elevated liver enzymes
  • General
    • Symptom - Dehydration

12. How long did the symptoms last?

Unknown / Inconnu

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

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

1-61663854 - The reporter, a veterinarian, indicates an exposure to a herbicide containing the active ingredient diquat. Two days before the day of initial contact with the registrant, the reporter indicated a 3.5-pound, female Chihuahua dog of unknown age ingested part of a trout which may have been killed by exposure to the herbicide an unknown amount of time earlier. The reporter indicated the dog had developed vomiting and diarrhea since the time of ingestion, was dehydrated, and had an elevated liver enzyme. The reporter was advised to provide supportive care to the dog and monitor any progression of the liver enzyme, but the described exposure to the diluted pesticide would not be expected to cause a toxicity. The reporter was not available on follow-up call three days later. On a follow-up call six days later, the reporter indicated the elevated liver enzyme had decreased and the other symptoms had resolved. No additional information is available.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here