Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2022-3967

2. Registrant Information.

Registrant Reference Number: 3239456

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

Address: 160 Quarry Park Boulevard SE Suite 130

City: CALGARY

Prov / State: AB

Country: Canada

Postal Code: T2C 3G3

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

Human

4. Date registrant was first informed of the incident.

08-APR-22

5. Location of incident.

Country: CANADA

Prov / State: BRITISH COLUMBIA

6. Date incident was first observed.

23-FEB-22

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. 32524      PMRA Submission No.       EPA Registration No.

Product Name: TEMPRID SC

• Active Ingredient(s)
  • BETA-CYFLUTHRIN
  • IMIDACLOPRID

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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. - In Home / Rés. - à l'int. maison

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

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

To be determined by Registrant

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

Yes

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

1. Source of Report.

Data Subject

2. Demographic information of data subject

Sex: Male

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

3. List all symptoms, using the selections below.

System

• Gastrointestinal System
  • Symptom - Irritated throat

• Respiratory System
  • Symptom - Coughing
  • Symptom - Respiratory irritation
  • Symptom - Sore throat

4. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

6. a) Was the person hospitalized?

No

6. b) For how long?

Unknown

7. Exposure scenario

Non-occupational

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

Contact with treated area

Amount of time between application and contact 1

Day(s) / Jour(s)

What was the activity? Wiping treated baseboards and walls.

Other

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

Unknown

10. Route(s) of exposure.

Unknown

11. What was the length of exposure?

<=15 min / <=15 min

12. Time between exposure and onset of symptoms.

<=30 min / <=30 min

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.)

4/8/2022 Caller is the owner of a rental property. In early February 2022 caller had a professional company spray the property for bed bugs. Product was applied along the baseboards and walls. On 2/23/2022 caller used a wet cloth and hot water to wipe the treated baseboards and walls. Later that day he developed a cough, sore throat, and irritation in his lungs. He spoke to his doctor over the phone, and his physician believed he had a viral infection that should resolve in about 4 weeks. Caller is still having issues. 4/15/2022 Call back to the original caller. There has been no change in symptoms. He was seen in person by his doctor and is waiting on the results of blood work. 4/29/2022 Attempted call back to the original caller. A message was left requesting follow up information. 5/2/2022 Attempted call back to the original caller. A message was left requesting follow up information.

To be determined by Registrant

14. Severity classification.

Moderate

15. Provide supplemental information here.

The product was applied and dried for several weeks prior to the caller washing it off with water. I would not expect to see cough, sore throat and respiratory irritation with the described exposure. The physician felt the cause of his symptoms was a viral infection and removal from the exposure/product has not resolved his symptoms. No re-challenge has occurred.