Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2024-1968
2. Registrant Information.
Registrant Reference Number: ProPharma Group case #: 2024SCPU00078139
Registrant Name (Full Legal Name no abbreviations): Syngenta Canada Inc.
Address: 140 Research Lane, Research Park
City: Guelph
Prov / State: Ontario
Country: Canada
Postal Code: N1G4Z3
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
28-MAR-24
5. Location of incident.
Country: UNITED STATES
Prov / State: MINNESOTA
6. Date incident was first observed.
27-MAR-24
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.
PMRA Submission No.
EPA Registration No. 100-1055
Product Name: TALON WEATHERBLOK XT
- Active Ingredient(s)
- BRODIFACOUM
- Guarantee/concentration .005 %
7. b) Type of formulation.
Bait
Application Information
8. Product was applied?
Yes
9. Application Rate.
Unknown
10. Site pesticide was applied to (select all that apply).
Site: Res. - Out Home / Rés - à l'ext.maison
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
Other
2. Type of animal affected
Dog / Chien
3. Breed
Unknown
4. Number of animals affected
1
5. Sex
Unknown
6. Age (provide a range if necessary )
Unknown
7. Weight (provide a range if necessary )
40
lbs
8. Route(s) of exposure
Oral
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
Unknown / Inconnu
11. List all symptoms
System
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 Possible accidental secondary exposure to pesticide via ingestion of a rodent that may have been exposed to this product
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
2024SCPU00078139 - The reporter, a pest control operator, suspects a possible exposure to a pesticide containing the active ingredient brodifacoum. The reporter indicated that an unknown amount of time before the day of initial contact with the registrant, an approximately 40 pound dog of unknown sex, age and breed may have ingested an unknown amount of the pesticide via possible ingestion of a rodent that may have been exposed to this product. One day before the day of initial contact the dog died suddenly before the owner could seek medical attention. No additional information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here
The reporter indicates the product has been used in bait stations and there is no evidence that the dog was able to get to the bait in the bait stations directly.