Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2023-7172

2. Registrant Information.

Registrant Reference Number: CTVA230605

Registrant Name (Full Legal Name no abbreviations): Corteva Agriscience Canada Company

Address: 240, 115 Quarry Park Road SE

City: Calgary

Prov / State: Alberta

Country: Canada

Postal Code: T2C 5G9

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

Domestic Animal

4. Date registrant was first informed of the incident.

21-AUG-23

5. Location of incident.

Country: UNITED STATES

Prov / State: UNKNOWN

6. Date incident was first observed.

01-JUN-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.       EPA Registration No. 62719-739

Product Name: Duracor

• Active Ingredient(s)
  • AMINOPYRALID (PRESENT AS POTASSIUM SALT)
  • FLORPYRAUXIFEN (PRESENT AS BENZYL ESTER)

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7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

16

Units: oz (fl) / oz (liquide)

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

Site: Unknown / Inconnu

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

Horse / Cheval

3. Breed

Unknown

4. Number of animals affected

4

5. Sex

Unknown

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

250

lbs

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 - Other
  • Specify - Unknown symptoms
  • Symptom - Death

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

14. a) Was the animal hospitalized?

Unknown

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

16. How was the animal exposed?

Other / Autre

specify UNKNOWN

17. Provide any additional details about the incident

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

Caller applied Duracor at proper rate, claims he lost 4 calves after consuming yuuca plants after the application of Duracor

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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

Caller says he has lost 4, 250lb calves after Duracor application when the calves consumer flowers from yucca plants after the application