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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2023-6082

2. Registrant Information.

Registrant Reference Number: FMC58939

Registrant Name (Full Legal Name no abbreviations): FMC of Canada Limited

Address: 6755 Mississauga Road, Suite 204

City: Mississauga

Prov / State: Ontario

Country: Canada

Postal Code: L5N 7Y2

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

Scientific Study

4. Date registrant was first informed of the incident.

5. Location of incident.

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. 20213      PMRA Submission No.       EPA Registration No. 279-9579

Product Name: Metsulfuron Methyl Technical

  • Active Ingredient(s)

PMRA Registration No. 22330      PMRA Submission No.       EPA Registration No. 279-9580

Product Name: DPX L5300 Technical

  • Active Ingredient(s)

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 VII: Scientific Study

1. Study Reference

Title Metsulfuron Methyl 20SG/Tribenuron Methyl 50SG(LDY15)(1:1), A Blend of Paste Extruded Granules (14.3% + 14.3% Active) Plus KG691 Surfactant: A 22-Day Chronic Larval Toxicity Test with Repeated Exposure Honey Bee (Apis mellifera L.) in the Laboratory

Date 06-JUL-23

2. a) Is an extension needed to translate the document?


3. Type of incident identified in the study

New health or environmental hazard

4. Describe the incident identified in the study (e.g. study demonstrates an increased risk to non-Hodgkin's Lymphoma after exposure to pesticide X)

FMC Corp. has sponsored thirteen (13) ecotoxicity studies conducted with formulated blendscontaining metsulfuron methyl (CAS No. 74223-64-6) and tribenuron methyl (CAS No. 101200-48-0).These blends also included the surfactant KG691. FMC believes endpoints reached in these studiesare reportable.

5. a) Was the study discontinued before completion?


5. b) Provide the reason for discontinuation

6. If the study is ongoing, what is the expected completion date?

For Registrant use only

7. Provide supplemental information here