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Sécurité des produits de consommation

Déclaration d'incident

Sous-formulaire I: Renseignements généraux

1.Type de rapport.

Nouvelle déclaration d'incident

No de la demande: 2017-4823

2. Renseignements concernant le titulaire.

Numéro de référence du titulaire d'homologation: 2035915

Nom du titulaire (nom légal complet, aucune abbréviation): Bayer CropScience Inc.

Adresse: 160 QUARRY PARK BLVD. SE Suite 200

Ville: CALGARY

État: AB

Pays: Canada

Code postal /Zip: T2C 3G3

3.Choisir le (les) sous-formulaire(s) correspondant à l'incident.

Incident chez un animal domestique

4. Date à laquelle le titulaire d'homologation a été informé pour la première fois de l'incident.

09-MAY-17

5. Lieu de l'incident.

Pays: UNITED STATES

État: CALIFORNIA

6. Date de la première observation de l'incident.

09-APR-17

Description du produit

7. a) Donner le nom de la matière active et, si disponibles, le numéro d'homologation et le nom du produit (incluant tous les mélanges). Si le produit n'est pas homologué, donner le numéro de la demande d'homologation.

Matière(s) active(s)

ARLA No d'homologation       ARLA No de la demande d'homologation       EPA No d'homologation. 432-763

Nom du produit: Suspend SC

  • Matière active
    • DELTAMETHRIN
      • Garantie/concentration 4.75 %

7. b) Type de formulation.

Renseignments sur l'application

8. Est-ce que le produit a été appliqué?

Oui

9. Dose d'application.

Inconnu

10. Site d'application (choisir tout ce qui s'applique).

Site: Res. - Out Home / Rés - à l'ext.maison

11. Donner tout renseignement additionnel concernant l'application (comment le produit a été appliqué, la quantité utilisée, la superficie de la zone traitée, etc.)

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

À être déterminé par le titulaire

12. Selon vous, le produit a-t-il été utilisé en conformité avec le mode d'emploi de L'étiquette?

Oui

Sous-formulaire III : Animal domestique

1. Source de la déclaration

Autre

2.Type d'animal touché

Cat / Chat

3. Race

Unknown

4. Nombre d'animaux touchés

1

5. Sexe:

Femme

6. Âge (fournir un ordre de grandeur si nécessaire)

Inconnu

7. Poids (fournir un ordre de grandeur si nécessaire)

Inconnu

8. Voie(s) d'exposition:

Inconnu

9. Durée de l'exposition?

<=15 min / <=15 min

10. Temps écoulé entre l'exposition et l'apparition des symptômes

Unknown / Inconnu

11. Énumérer tous les symptômes

Système

  • General
    • Symptôme - Mort
  • Systèmes nerveux et musculaire
    • Symptôme - Faiblesse musculaire
    • Symptôme - Crise
  • Système rénal
    • Symptôme - Autre
    • Specify - Grey Spots on Kidneys Discovered on Necropsy
    • Symptôme - Incontinence urinaire

12. Quelle a été la durée des symptômes?

Persisted until death

13. Des soins médicaux ont-ils été prodigués? Donner les détails à la question 17.

Oui

14. a) Est-ce que l'animal a-t-il été hospitalisé?

Non

14. b) Combien de temps l'animal était-il hospitalisé?

Inconnu

15. Issue de l'incident

Mort

16. De quelle manière l'animal a-t-il été exposé?

Contact treat.area/Contact surf. traitée

17. Donnez tout détail additionnel au sujet de l'incident

(p.ex. description des symptômes tels que la fréquence et la gravité

5/9/2017 Caller is company representative who was notified of an animal death from a pest control company that had recently applied product to an apartment complex in April 2017. There was also mention of a dog owned by a neighbor that became ill as well. According to the pest control company, their records indicate that the product was diluted at 0.5 ounce to 1 gallon of water. 5/12/2017 Conference call with pest control operator and the cat owner. According to the pest control company, the product was diluted according to directions. The same product was applied at the apartment complex outdoors in cracks and crevices. Foliage and plant matter was not sprayed. Applications of approximately 1 gallon of the diluted product have been applied several times to the apartment complex. Applications at the same concentrations occurred in November 2016, January 2017, and February 2017. There were no reported adverse events following these applications. An application was also made most recently on April 19, 2017. Following the application on April 19, 2017, three of the six pets in the apartment complex developed symptoms. It is unclear the exact time frame from application to symptoms onset, but this was at least 2 days after product application. According to the cat owner, all of the animals involved experienced loss of muscle control and vomiting. Cat owner noted a seizure like event in his cat and inappropriate urination. One of the two dogs owned by a neighbor also had blood in vomit. Cat owner gave an activated charcoal tablet at home and bathed the cat with baby shampoo. The cat was seen by the emergency veterinarian where several unspecified lab tests were performed in addition to x-ray and ultrasound. Nothing unusual or out of normal limits was seen with these tests. The cat reportedly recovered within 2 to 3 days. The cause of the cats reported symptoms was not known. Upon returning home, the cat was let out on the patio again and seen laying down. The previously reported symptoms recurred, and was the cat was taken back to the veterinarian for further care, though did not survive. It is not known what tests or treatments the cat received with this second visit. A necropsy was performed by the veterinarian, and grey spots were found on the kidneys. It is not clear as to the significance of these pathological findings, and the owner did not know what the reported cause of death was following the necropsy. The owner did report though that veterinarian attributed the urination to this kidney abnormality that was subsequently found. Cat owner also has a second cat that never developed any symptoms. Two dogs owned by neighbors of the cat owner were reportedly seen by a veterinarian, and following unknown treatments fully recovered in a day or two.


À être déterminé par le titulaire

Classification selon la gravité (s'il y a plus d'une catégorie possible, veuillez choisir la plus grave)

Mort

19. Donner des renseignements additionnels ici

Sous-formulaire III : Animal domestique

1. Source de la déclaration

Autre

2.Type d'animal touché

Dog / Chien

3. Race

Unknown

4. Nombre d'animaux touchés

2

5. Sexe:

Inconnu

6. Âge (fournir un ordre de grandeur si nécessaire)

Inconnu

7. Poids (fournir un ordre de grandeur si nécessaire)

Inconnu

8. Voie(s) d'exposition:

Inconnu

9. Durée de l'exposition?

Unknown / Inconnu

10. Temps écoulé entre l'exposition et l'apparition des symptômes

Unknown / Inconnu

11. Énumérer tous les symptômes

Système

  • Système gastro-intestinal
    • Symptôme - Vomissement sanguinolent
  • Systèmes nerveux et musculaire
    • Symptôme - Faiblesse musculaire

12. Quelle a été la durée des symptômes?

>24 hrs <=3 days / >24 h <=3 jours

13. Des soins médicaux ont-ils été prodigués? Donner les détails à la question 17.

Oui

14. a) Est-ce que l'animal a-t-il été hospitalisé?

Non

14. b) Combien de temps l'animal était-il hospitalisé?

Inconnu

15. Issue de l'incident

Fully Recovered / Complètement rétabli

16. De quelle manière l'animal a-t-il été exposé?

Contact treat.area/Contact surf. traitée

17. Donnez tout détail additionnel au sujet de l'incident

(p.ex. description des symptômes tels que la fréquence et la gravité

5/9/2017 Caller is company representative who was notified of an animal death from a pest control company that had recently applied product to an apartment complex in April 2017. There was also mention of a dog owned by a neighbor that became ill as well. According to the pest control company, their records indicate that the product was diluted at 0.5 ounce to 1 gallon of water. 5/12/2017 Conference call with pest control operator and the cat owner. According to the pest control company, the product was diluted according to directions. The same product was applied at the apartment complex outdoors in cracks and crevices. Foliage and plant matter was not sprayed. Applications of approximately 1 gallon of the diluted product have been applied several times to the apartment complex. Applications at the same concentrations occurred in November 2016, January 2017, and February 2017. There were no reported adverse events following these applications. An application was also made most recently on April 19, 2017. Following the application on April 19, 2017, three of the six pets in the apartment complex developed symptoms. It is unclear the exact time frame from application to symptoms onset, but this was at least 2 days after product application. According to the cat owner, all of the animals involved experienced loss of muscle control and vomiting. Cat owner noted a seizure like event in his cat and inappropriate urination. One of the two dogs owned by a neighbor also had blood in vomit. Cat owner gave an activated charcoal tablet at home and bathed the cat with baby shampoo. The cat was seen by the emergency veterinarian where several unspecified lab tests were performed in addition to x-ray and ultrasound. Nothing unusual or out of normal limits was seen with these tests. The cat reportedly recovered within 2 to 3 days. The cause of the cats reported symptoms was not known. Upon returning home, the cat was let out on the patio again and seen laying down. The previously reported symptoms recurred, and was the cat was taken back to the veterinarian for further care, though did not survive. It is not known what tests or treatments the cat received with this second visit. A necropsy was performed by the veterinarian, and grey spots were found on the kidneys. It is not clear as to the significance of these pathological findings, and the owner did not know what the reported cause of death was following the necropsy. The owner did report though that veterinarian attributed the urination to this kidney abnormality that was subsequently found. Cat owner also has a second cat that never developed any symptoms. Two dogs owned by neighbors of the cat owner were reportedly seen by a veterinarian, and following unknown treatments fully recovered in a day or two.


À être déterminé par le titulaire

Classification selon la gravité (s'il y a plus d'une catégorie possible, veuillez choisir la plus grave)

Modérée

19. Donner des renseignements additionnels ici