Health Canada
www.hc-sc.gc.ca
Common menu bar links
Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2024-1624
2. Registrant Information.
Registrant Reference Number: ProPharma Group case #: 2024GOWN00077758
Registrant Name (Full Legal Name no abbreviations): Gowan Company, L.L.C.
Address: P.O. Box 5569
City: Yuma
Prov / State: Arizona
Country: USA
Postal Code: 85366-5569
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
15-MAR-245. Location of incident.
Country: CANADA
Prov / State: ALBERTA
6. Date incident was first observed.
Unknown
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. 25112 PMRA Submission No. EPA Registration No.
Product Name: AVADEX MICROACTIV HERBICIDE
- Active Ingredient(s)
- TRIALLATE
7. b) Type of formulation.
Application Information
8. Product was applied?
No
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
Cow / Vache
3. Breed
Unknown
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
1.7
7. Weight (provide a range if necessary )
Unknown
8. Route(s) of exposure
Oral
9. What was the length of exposure?
>3 days <=1 wk / >3 jours <=1 sem
10. Time between exposure and onset of symptoms
Unknown / Inconnu
11. List all symptoms
System
- Gastrointestinal System
- Symptom - Diarrhea
- General
- Symptom - Weakness
- Symptom - Loss of balance
- Nervous and Muscular Systems
- Symptom - Collapse
12. How long did the symptoms last?
Unknown / Inconnu
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
Unknown/Inconnu
16. How was the animal exposed?
Accidental ingestion/Ingestion accident.
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
2024GOWN00077758- The reporter, an animal owner, indicates an exposure to a pesticide containing the active ingredient triallate. During the three to five days preceding the day of initial contact with the registrant, a twenty month old, female cow of unknown weight and breed ingested an unknown amount of the pesticide via ingestion of barley that had been stored in a bag that may have contained product residue. Two days before the day of initial contact the cow began experiencing diarrhea and weakness and was falling down. The reporter was advised that the symptoms were not consistent with exposure to this pesticide as described but the patient should receive symptomatic and supportive medical attention. No additional information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
