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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-3678

2. Registrant Information.

Registrant Reference Number: X

Registrant Name (Full Legal Name no abbreviations): X

Address: X

City: X

Prov / State: XX

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, Amitraz and antibiotics. In 2013, the following treatments were applied to the hives: Antibiotics. Information on crops located near the beeyards: Large area of corn was 200m from the beeyard, and was planted on aprox May 2 2013. Seed treatment was used on the crop. Other crops in the area include corn, beans, wheat, forages, pasture in the area. Prepping/Planting started May 2nd. All planted by May 9, 2013.Large area of winter wheat was 20m from the beeyard, and was planted in Aug/Fall 2012. Yard 8 considered very representative of all yards (9 yards affected ). 1 unaffected hive (#3) some over-winter loss, strong hives hit hardest - no health issues. Hive #1 - affected Hive. Beekeeper considers all hives to be exposed. Considers Hive 3 as least affected.

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.).

Large amount of corn was 200 m from the beeyard, and was planted on aprox May 2 2013. Large amount of winter wheat was 20 m from the beeyard, and was planted on Aug/Fall 2012. There were a total of 8 colonies in the bee yard. There were 0 to 500 dead bees per colony observed. Bees were actively foraging at the time of the incident. Dead bees had pollen on their legs. Strongest hives are most severly affected, too soon to see long term foraging effects. Some flying around but not a lot, it is a warm and sunny at this point in the day. Adult bee symptoms included Shaking/trembling/twitching, Crawling, Disoriented. Additionally, observed tongues out, stinging ground. All symptoms are neurological according to beekeeper. Brood symptoms included, dead larvae/pupae outside of colony, spotty Brood pattern, bees uncapping cells for removal of pupae and overall decline in brood production. Queen symptoms included unusual laying pattern. Additionally, in 2012 saw queen cells, too soon to have dead queens, failure to requeen.Sample of pollen taken from affected hive, affected pollen comb, hive 1, affected yard. Beekeeper felt pollen in comb was collected in 2012. Had positive detects for Clothianidin, Thiamethoxam. Sample of honey taken Affected pollen comb, hive 1, AFFECTED . Beekeeper felt pollen in comb was collected in 2012. Had positive detects for thiamethoxam. Sample of dead bees taken from in front of ALL hives from AFFECTED yard. Had positive detects for Clothianidin, Demeton-S-methyl-sulfone, Thiabendazole. Sample of live bees taken from affected hive #3. Had positive detects for Clothianidin. Sample of live bees from the affected hive had no detected active ingredients. Sample of pollen taken from affected pollen comb, affected hive 1. Had positive detects for clothianidin, propamocarb, thiopanate-methyl. Sample of honey taken from affected hive (affected pollen comb, yard hive 1), had positive detects for thiopanate-methyl. Sample of pollen taken from strong hive, unaffected pollen comb, yard 8, hive 3. (note: beekeeper considers hive as least affected). Had positive detects for Carbendazim, clothianidin,thiamethoxam. Sample of dead bees affected give. composite dead bee sample collected from affected home yard. Had positive detects for clothianidin, Thiabendazole. The weather at the time of the incident was Sunny, dry, windy, temperature (20-25C), low humdity, Other notes: Dust plumes while planting (bkeeper notes temperature inversions). Raining on May 9, 2013 as questionaire is being filled out.Prior to the incident, there were an average of 10% good - 3 boxes (40-60K bees), 90% low - 1 to 1.5 boxes approx. 20K bees frames of bees, Most: 2-14 frames, good: 16-18 frames frames of brood, and Full supers. 4-5 frames left in winter dead outs. The following pests were present in the affected bee yard in the past year,American Foulbrood (AFB), European Foulbrood (EFB), Chalkbrood, Varroa Mite. AFB hives burned (Yard 1). After the incident, it was too recent to determine a change of frames of bees, too brood, pollen and honey. It is unknown if the previously noted disease(s) or pest(s) got worse after the incident. Additional food sources provided to the bees included Sugar Syrup (Fall and Spring), 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