Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2023-7079
2. Registrant Information.
Registrant Reference Number: FMC-69157
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: L5N7Y2
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.
Active(s)
PMRA Registration No. 33465
PMRA Submission No.
EPA Registration No. 279-3629
Product Name: Pethoxamid Technical
PMRA Registration No.
PMRA Submission No.
EPA Registration No. Unknown
Product Name: MESOTRIONE (UNSPECIFIED FORMULATION)
7. b) Type of formulation.
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 VII: Scientific Study
1. Study Reference
Title XWH14: Effects (Acute Contact) on Solitary Bees (Osmia bicornis) in the Laboratory
Date 25-JUL-23
2. a) Is an extension needed to translate the document?
No
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. have recently sponsored an acute contact study on the Solitary Bee (Osmia bicornis) conducted with a blended product containing pethoxamid (Pethoxamid Technical, EPA Reg. No. 279-3629).
5. a) Was the study discontinued before completion?
No
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