Health Canada
Symbol of the Government of Canada
Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-2236

2. Registrant Information.

Registrant Reference Number: x

Registrant Name (Full Legal Name no abbreviations): x

Address: x

City: x

Country: 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: x

  • 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).

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

Information on crops located near the beeyards: 30ha of corn and 41.9ha of soy were an unknown distance from the bee yard, and were planted approximately within the last week. The yard is completely surrounded by 2 large fields, one planted to corn and one planted to soybean. Both fields have been recently planted (estimated to be within the last week)

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)


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 28 colonies in the bee yard. There were 5 affected colonies and 0 dead colonies. Actively foraging when questionnaire being filled out;at time of inspection, some live bees with pollen on their legs, but not on the dead/affected bees. Prior to the incident, there were an average of 7-8, sometimes 9 frames of bees, 6-7 frames of brood, and 2 frames of pollen and honey.The following pests were present in the affected bee yard in the past year; Chalkbrood, Varroa mite and Nosema (assumed). Additional food sources provided to the bees included Sugar syrup (Fall 2013) and pollen supplement (April 7th, 2014). Oxalic Acid in spring and fall 2013, and Apivar in spring 2014 were applied at label rate to the hives to treat varroa mites. In Spring and fall of 2013 and spring of 2014 the antibotic Oxytetracycline were applied to the hives to treat american and european foul brood. A 'minor' bee mortality event was reported by Bker for this yard. Bker believes that this incident is a result of minor exposure to neonic. Sample of Dead bees taken had positive detects for clothianidin. Sample of pollen comb taken had positive detects for clothianidin, imidacloprid and thiamethoxam.Sample of water taken from the ditch was discarded. There were 0-500 dead bees observed outside of hive in grass and vegetation. Adult bee symptoms included aggressive, shaking/trembling/twitching, crawling. Additionally, tongues out for some bees. Nothing significant observed with respect to the brood for the 3 colonies that were opened up by OMAF. Some frames had some spotty brood.

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