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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2022-1009

2. Registrant Information.

Registrant Reference Number: ProPharma Group case #: 2022SCPU00038316

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.


4. Date registrant was first informed of the incident.


5. Location of incident.


Prov / State: UNKNOWN

6. Date incident was first observed.


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.


PMRA Registration No.       PMRA Submission No.       EPA Registration No. Unknown


  • Active Ingredient(s)
      • Unknown

7. b) Type of formulation.


Application Information

8. Product was applied?


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?


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

1. Source of Report.


2. Demographic information of data subject

Sex: Male

Age: >19 <=64 yrs / >19 <=64 ans

3. List all symptoms, using the selections below.


  • General
    • Symptom - Death
  • Gastrointestinal System
    • Symptom - Vomiting
    • Symptom - Stomach pain
    • Symptom - Diarrhea
  • General
    • Symptom - Other
    • Specify - Unable to tolerate food or water
  • Blood
    • Symptom - Other
    • Specify - Abnormal renal values
  • Nervous and Muscular Systems
    • Symptom - Seizure
  • Liver
    • Symptom - Elevated liver enzymes
  • General
    • Symptom - Abnormal behaviour
    • Symptom - Other
    • Specify - Obtundation
  • Nervous and Muscular Systems
    • Symptom - Other
    • Specify - Cerebral edema
    • Symptom - Other
    • Specify - Loss of brainstem reflexes
  • Renal System
    • Symptom - Low urine output
  • Nervous and Muscular Systems
    • Symptom - Agitation
    • Symptom - Other
    • Specify - Hypoxic ischemic encephalopathy

4. How long did the symptoms last?

Persisted until death

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


6. a) Was the person hospitalized?


6. b) For how long?


Day(s) / Jour(s)

7. Exposure scenario


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

Poisoning from ingestion of the pesticide

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


10. Route(s) of exposure.


11. What was the length of exposure?

Unknown / Inconnu

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.)

2022SCPU000383016 - Acute glyphosate ingestion: undoubtedly responsible Scenario/Substances: A 47 y/o male drank 1 L of glyphosate because he was feeling sad. He vomited immediately after drinking it and experienced several additional episodes of vomiting and diarrhea overnight. He was unable to tolerate food or water and reported decreased urine output. Past Medical History: Depression Physical Exam: In the ED he was alert and oriented without evidence of trauma. BP 123/84, HR 99, RR 18, O2 Sat 100% on RA, T 37C.Laboratory/Diagnostic Findings: Na 136/K 4.2/Cl 94/CO2 12/BUN 77/Cr9.19/Glu 139/AG 30, lactate 2.7 mmol/L, serum osmolality 319 mOsm/Kg,CK 16,878, AST 354, ALT 424, bilirubin 1.1, INR 0.82, WBC 24.5/Hgb 17.8/Hct 50.4/PLT 330, ABG-pH 7.0/pCO2 49/pO2 536/HCO3 10.1/BE -19.Serum APAP, ethanol, and salicylate not detected. CxR: unremarkable, CTabd/pelvis unremarkable. Clinical Course: In the ED the day after the ingestion he complained of abdominal pain. He developed seizures for which he was given lorazepam and was intubated. He was started on a bicarbonate drip, NAC, and admitted to the ICU. His conditioned worsened with progressive agitation and then obtundation despite being off of any type of sedation. Head CT was consistent with cerebral edema and hypoxic ischemicencephalopathy. He lost his brainstem reflexes and died on Day 3.Autopsy Findings: Antemortem blood: glyphosate 95,000 ng/mL(reporting limit 10 ng/mL). Cause of death: glyphosate toxicity.

To be determined by Registrant

14. Severity classification.


15. Provide supplemental information here.

The information for this report was received via an external publication and the summary provided in Section 13 is included directly as written by Gummin et al., 2021. Citation:David D. Gummin, James B. Mowry, Michael C. Beuhler, Daniel A. Spyker, Alvin C. Bronstein, Laura J. Rivers, Nathaniel P. T. Pham Julie Weber (2021) 2020 Annual Report of the American Association of Poison Control Centers National Poison Data System (NPDS): 38th Annual Report, Clinical Toxicology, 59:12, 1282-1501. The exact name of the product was not stated in the publication.