Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2023-5452

2. Registrant Information.

Registrant Reference Number: 2023GOWN00071525

Registrant Name (Full Legal Name no abbreviations): Gowan Company, L.L.C.

Address: P.O. Box 5569

City: Yuma

Prov / State: AZ

Country: USA

Postal Code: 853665569

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

Human

4. Date registrant was first informed of the incident.

07-AUG-23

5. Location of incident.

Country: UNITED STATES

Prov / State: VERMONT

6. Date incident was first observed.

05-AUG-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. 29064      PMRA Submission No.       EPA Registration No. 10163-169

Product Name: IMIDAN WP INSECTICIDE (IMIDAN 70-W)

• Active Ingredient(s)
  • PHOSMET
    • Guarantee/concentration 70 %

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 70506-445

Product Name: Captan 80 WDG

• Active Ingredient(s)
  • CAPTAN
    • Guarantee/concentration 77.8 %

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7. b) Type of formulation.

Granular

Wettable or soluble powder

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

10. Site pesticide was applied to (select all that apply).

Site: Pub. Area - Outdoor/Zone publique - ext

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: Female

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

3. List all symptoms, using the selections below.

System

• Skin
  • Symptom - Hives
  • Specify - Allergic urticaria (lips)

• Gastrointestinal System
  • Symptom - Irritated throat

• General
  • Symptom - Swelling

4. How long did the symptoms last?

>3 days <=1 wk / >3 jours <=1 sem

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

Yes

6. a) Was the person hospitalized?

No

6. b) For how long?

7. Exposure scenario

Non-occupational

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)

None

10. Route(s) of exposure.

Oral

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.)

Caller was walking on the grounds of a college with an orchard on it on Saturday 05-AUG-2023. She started to eat an apple from the orchard, but then spit it out. She got a severe allergic reaction on the way back to her car and her lips swelled up very large. She went immediately to the ER and they commented that they thought the apple had been sprayed with something, or maybe she is just allergic to apples now. Since they did not know what caused the allergic urticaria, they gave her a steroid treatment to take for 4 days and Loratidine. This morning, she contacted the college with an incident report to find out what was sprayed and they were able to provide the product info. The swelling has gone down now, but the inside of her mouth feels raw.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.

The caller potentially was exposed to both Imidan 70 W and Captan 80 WDG. Gowan Company has no information on the alleged application incident, apart from that included in the Propharma report. It is Gowan Company's opinion that it is unlikely that the reported reaction was caused by exposure to Imidan 70 W. The US EPA previously has concluded that phosmet is not an eye or dermal irritant or a skin sensitizer. On the other hand, the US EPA has classified the active ingredient captan as severely irritating to the eyes and a moderate skin sensitizer.