Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2023-4994

2. Registrant Information.

Registrant Reference Number: 3666896

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

Packaging Failure

4. Date registrant was first informed of the incident.

02-JUN-23

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

26-MAY-23

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. 31240      PMRA Submission No.       EPA Registration No. Unknown

Product Name: Roundup Advanced Ready-to-Use Grass and Weed Control

• Active Ingredient(s)
  • ACETIC ACID

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7. b) Type of formulation.

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

1. Source of Report.

Data Subject

2. Demographic information of data subject

Sex: Unknown

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Skin
  • Symptom - Irritated skin
  • Symptom - Other
  • Specify - Burning sensation

4. How long did the symptoms last?

Unknown / Inconnu

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

No

6. a) Was the person hospitalized?

Unknown

6. b) For how long?

7. Exposure scenario

Non-occupational

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

What was the activity? Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding the activity

Pesticide Spill

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

None

10. Route(s) of exposure.

Skin

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.)

5/26/2023 Caller reported to the company via email a product packaging leak, resulting in exposure and burning sensation to his hands. The Consumer Services Department received the following incident report: I purchased Roundup at [Store] in [City], Ontario yesterday. Today I went back to return it after learning of it's toxicity and one of the bottles leaked all over my hands! I washed my hands for approximately 10 minutes at the [Store] store and still have burning sensation on my hands. I am currently on hold with the Poison Control Center. I am completely shocked that such a toxic product would not have any safety measures to prevent the product from spilling out of the bottle onto my hands. On 6/5/2023 Call back was attempted. Call went to the consumer's voicemail.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.

The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified in the telephone interviews.

Subform VI: Packaging Failure

1. What is the type of packaging that failed?

Bottle-plastic / Bouteille-plastique

2. Did packaging failure occur during?

Other

specify The consumer was returning the product to the store when it leaked on their hands.

3. Did packaging failure result in?

potential injury

potential exposure

4. Describe how the packaging failed and the surrounding circumstances, including a description of the potential injury or exposure.

5/26/2023 Caller reported to the company via email a product packaging leak, resulting in exposure and burning sensation to his hands. The Consumer Services Department received the following incident report: I purchased Roundup at Home Depot in Collingwood, Ontario yesterday. Today I went back to return it after learning of it's toxicity and one of the bottles leaked all over my hands! I washed my hands for approximately 10 minutes at the Home Depot store and still have burning sensation on my hands. I am currently on hold with the Poison Control Center. I am completely shocked that such a toxic product would not have any safety measures to prevent the product from spilling out of the bottle onto my hands. On 6/5/2023 Call back was attempted. Call went to the consumer's voicemail.

For Registrant use only

5. Provide supplemental information here.

The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified in the telephone interviews.