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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-3627

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: Amitraz. In 2013, the following treatments were applied to the hives: formic acid and antibiotics. Information on crops located near the beeyards: 1 ac of corn was 1 km from the beeyard, and was planted on 2013-05-14; 3 ac of soybean, unknoen distance from beeyard; grass pasture was next to bee yard. Bee keeper first noticed a decline in the number of bees in September 2012. This is not an acute poisoning but rather accumulated effects of suspected pesticide poisoning. In late September, the number of hives dropped from 39 to 34. Most were failing to take feed down. In spring, there were 3 dead hives. By late April he ws down to 22 hives and on May 15 2 more died and 13 were on the verge so he took the queens and split to make up new nucs and moved them to a different yard. Bee keeper feels bee deaths are due to goldenrod pollen from goldenrod which fills in the wet spots in the fields around bee yard. He questions whether exposed soybean seed could be impacting bee kills. Exposed soybean seed was wide spread throught nearby field. On June 27, 2013, the bee keeper reported a second incident at the same yard. He reported that there has been continual die off at the yard. Bee and water samples were collected on May 17, 2013 for analysis. Initial call: field of exposed treated seed - soy potentially (neon blue).

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 39 colonies in the bee yard. There were 37 affected colonies. There were 0 - 500 dead bees per colony observed inside and outside.Bees were actively foraging at the time of the incident. After the adverse effects there was a noticeable decline in foraging. Bees hanging around the entrance not doing anything. Adult bee symptoms included Shaking/trembling/twitching, vomiting, regurgitation, crawling, sisoritentation. Additionally, loss of muscle control, long slow decline in strength of bee. Brood symptoms included dead larvae/pupae on bottom board, dead larvae/pupae outside of colony, spotty brood pattern, Bees uncapping cells for removal of pupae, Overall decline in brood production. Additionally, too weak, no more than a two inch circle of brood. Not enough population to cover cup brood. No queen symptoms observed. Additionally, there was premature queen failure. Samples of Water run off from field had no detected active ingredients. Sample of composite dead bees taken from affected hive had positive detects for Thiabendazole. Sample of dead bees on comb taken from affected hive had positive detects for Pyrimethanil. The weather at the time of the incident was unknown. The following pests were present in the affected bee yard in the past year; varroa mite.

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