Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2023-6197

2. Registrant Information.

Registrant Reference Number: 2023-21

Registrant Name (Full Legal Name no abbreviations): BASF Canada Inc.

Address: 5025 Creekbank Road, Building A, 2nd Floor

City: Mississauga

Prov / State: Ontario

Country: Canada

Postal Code: L4W 0B6

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

Domestic Animal

4. Date registrant was first informed of the incident.

20-JUL-23

5. Location of incident.

Country: UNITED STATES

Prov / State: FLORIDA

6. Date incident was first observed.

19-JUL-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.       PMRA Submission No. 2023-0864      EPA Registration No. 7969-382

Product Name: Selontra Rodent Bait

• Active Ingredient(s)
  • CHOLECALCIFEROL
    • Guarantee/concentration .075 %

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7. b) Type of formulation.

Bait

Application Information

8. Product was applied?

Unknown

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 III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Domestic Shorthair

4. Number of animals affected

2

5. Sex

Male

6. Age (provide a range if necessary )

.16

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

• General
  • Symptom - Death
  • Symptom - Lethargy

12. How long did the symptoms last?

Persisted until death

13. Was medical treatment provided? Provide details in question 17.

No

14. a) Was the animal hospitalized?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

16. How was the animal exposed?

Other / Autre

specify The kittens were outside and had access to the Selontra Rodent Bait. It's unknown who ingested what, if any.

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

On July 19, 2023, the caller found a block of Selontra Rodent Bait was chewed on/missing parts and found one kitten deceased outside. Another kitten was found outside and reported to be sluggish. This kitten was given some water via eye dropper and later died as well.

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To be determined by Registrant

18. Severity classification (if there is more than 1 possible classification

Death

19. Provide supplemental information here