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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-3628

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).

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


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

There were a total of 3 colonies in the bee yard. There were 3 affected colonies. There were > 2000 dead bees per colony observed outside the hive. The bees were actively foraging at the time of the incident. Adult bee symptoms included aggressive, shaking/trembling/twitching, disoriented. There are no brood symptoms as they were so far normal. No queen symptoms observed, as they were normal so far.Sample of pollen taken from affected hive, the comb sample collected from home yard, had positive detects for clothianidin and thiamethoxam. Sample of dead bees taken from affected hive, from home yard (died overnight), had positive detects for clothianidin. Sample of live bees taken from affected hive, collected from home yard (affected), had positive detects for clothianidin. Sample of dead bees taken from affected hive, collected from home yard (died overnight), had positive detects for carbendazim and clothianidin. The weather at the time of the incident was sunny and dry, temp 22C. Prior to the incident, there were an average of 20 frames of solid bees, the average number of Frames of Brood was between 10 to 12, and the average number of frames of pollen and honey between 8 to 10. After the incident, it was too soon to tell what the general health of affected beeyard after the case. There were no additional food sources provided to the bees. In 2012, the following treatments were applied to the hives: formic acid. In 2013, the following treatments were applied to the hives: Fluvalinate-tau and anti-biotics. Information on crops located near the beeyards: Corn was located 1km from the beeyard and was planted on 2013-05-15. The planting method was air seeded. Other crops in the area included corn fields which were 1 km away from the bee yard. The one closest to the yard (less than 1 km) was planted the day of the inspection (may 16). Beekeeper indicates kills are still happening, not quite as bad. He swept probably a couple of thousand bees. Bees were actively foraging at the time of the case. They had no pollen on their legs. Effects in adult bees include aggression, shaking/twitching, disorientation. Brood and queen were normal so far. Samples were taken. The general health of the affected bee yard before and the after the honey bee case was too soon to tell. No pest/disease was noted on the bees.No additonal food source was given to bees. Treament for pest/disease was given in both the Fall and Spring. Corn fields were close to the bee yard. Initial call (May 14): corn planted yesterday with air seeder. 3 hives.

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