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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-3663

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


Reproductive impairment

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

There were a total of 50 colonies in the bee yard. There were 50 affected colonies. There were 0-500 (30-40 in front of each hive) dead bees per colony observed outside of hive in front. After the adverse effects there was a noticeable decline in foraging. Only 10-20% foraging, dandelions out/good weather. Stronger hives hit worse. Adult bee symptoms included shaking/trembling/twitching. Additionally, more docile less foraging, crawling away from hive, not flying. Brood symptoms included overall decline in brood production, no actual brood symptoms. It is now slightly normal. No queen symptoms yet. Sample of dead bees taken from affected hive and composite sample of dead bees collected by the bee keeper from Yard had positive detects for clothianidin. The weather at the time of the incident was Sunny, dry (week of 14 may), raining (may 13), quiet windy, warm. Prior to the incident, there were an average of weaker than normal over-winter, higher than avg. mortality frames of bees, slightly behind (less bees) frames of brood, and saw too early to assess and then after frames of pollen and honey. The following pests were present in the affected bee yard in the past year; varroa mite. After the incident, the average frames of bees of 80% decline in foragers (no old bees in hive) only young left, slight decline, now bounced back frames of brood slightly declined, then bounced back, and frames of pollen and honey starting to recover, forage correctly. The previously noted disease(s) or pest(s) got worse after the incident slight increase in chalkbrood. Additional food sources provided to the bees included sugar syrup (fall 2012, spring 2013) and pollen supplement (spring 2013, 15% natural pollen). In 2012, the following treatments were applied to the hives: formic acid and antibiotics. In 2013, the following treatments were applied to the hives: amitraz and antibiotics. It is unknown when the following treatments were applied to the hives. Information on crops located near the beeyards: Corn was planted on coming up on May 13th.Yard not visited. Bees inspected at holding yard. Yard 1: 37 total yards. 24 have colonies (some just for over-wintering). Observations from beekeeper - some dead bees in front - not many. No foraging bees in the air. 80% of foragers affected. Same effect at beekeepers other. same thing seen across all yard. Yard2 - no foraging bees in the colony. moved to holding yard at house 1 week later bees still dying, starting to bounce back. Initial Call: yard affected, 30-40 bees in front of each colony. Corn right beside, planted a couple of days ago. Other yard, no bees flying.

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