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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-3615

2. Registrant Information.

Registrant Reference Number: x

Registrant Name (Full Legal Name no abbreviations): x

Address: x

City: x

Prov / State: x

Country: x

Postal Code: X

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


4. Date registrant was first informed of the incident.

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

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.


PMRA Registration No.       PMRA Submission No.       EPA Registration No.

Product Name: unknown

  • Active Ingredient(s)

7. b) Type of formulation.

Application Information

8. Product was applied?


9. Application Rate.


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).

In 2012, the following treatments were applied to the hives: formic acid and antibiotics. In 2013, the following treatments were applied to the hives: formic acid and antibiotics.Information on crops located near the beeyards: corn was 200 m from the beeyard, and was planted on 2013-05-04. Seed treatment was used on the crop; 10 ac of apple orchard was 5 m from the beeyard. Pesticide was used on the crop before bees were present. Beekeeper feels this yard was hit slightly before other yard because bees were already dead May11 when he checked. Yard is slightly less impacted than other yard. Bees are foraging but no pollen on legs of dead bees. Beekeeper notes that his colonies that are in cherry pollination are doing really well and no corn nearby. Initial call (May 11): 2 yards affected. 1/2 cup bees affected in every hive affected. Planted corn in the area recently.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?


Subform IV: Environment (includes plants insects and wildlife)

1. Type of organism affected

Terr. Invrtbrt-Honey Bee/Inv.Ter-Abeille

2. Common name(s)

honey bee

3. Scientific name(s)


4. Number of organisms affected


5. Description of site where incident was observed

Fresh water



Salt Water

6. Check all symptoms that apply

Abnormal behavioural effects


Reproductive impairment

7. Describe symptoms and outcome (died, recovered, etc.).

There were a total of 16 colonies in the bee yard. There were 12 affected colonies. There were between 0 and 500 dead bees per colony observed outside hive and the bottom board, dragging out.Bees were actively foraging at the time of the incident. Adult bee symptoms included shaking/trembling/twitching, crawling and disorientation. Additionally, bees were rolling on back, tongues out, lethargic, stronger hives more impacted. Brood symptoms included Dead larvae/pupae outside of colony. No queen symptoms observed.Sample of pollen taken from affected hive c had positive detects for clothianidin, napropamide, oxamyl oxine, propamocarb and thiamethoxam. Sample of honey taken from, pollen comb of affected hive c had positive detects for clothianidin and propamocarb. Sample of dead and dying bees taken from affected hive, dead and dying bees had positive detects for clothianidin,Pyrimethanil and Thiabendazole. The weather at the time of the incident was cool. Prior to the incident, the bee frames were doing well. The following pests were present in the affected bee yard in the past year: european foulbrood, sacbrood, varro a mite and lots of chalkbrood.After the incident, the average number of frames of brood was the same as before. It was too soon to know if the previously noted disease(s) or pest(s) got worse.Additional food sources provided to the bees included sugar syrup (fall granular + water), pollen supplement.

8. a) Was the incident a result of (select all that apply)


8. b) i) How many times has the product been applied this year?


8. b) ii) What was the date of the last application?


9. Did it rain

9. a) During application?


9. b) Up to 3 days after application?


10. a) Was there a buffer zone?


10. b) What type?

10. c) What was the size of the buffer zone?

11. a) Were environmental samples collected and analysed?


To be determined by Registrant

12. Severity classification (if there is more than one possible classification, select the most severe)

13. Please provide supplemental information here