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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-2274

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: MANITOBA

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: about 5ha of soybeans were 100m W from the beeyard, and was planted around 10/05/2013. Apron Maxx RTA was used on the crop. Round up is also used on weeds around yard when needed (2013-14) used at label rate.

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 407 colonies in the bee yard including 293 nucs. There were 80 affected colonies and 150 dead colonies. There were an average of 6 frames of bees, 3 frames of brood, and 3 frames of pollen and honey. The following pests were present in the affected bee yard in the past year; varroa mite, wax moth, dyintry (unknown if related to nosema). In the spring 2013, apistan was applied at 2 strips per single to the hives to treat mite. Apivar was used in the fall 2013 to treat mites. In the spring 2013, the antibotic oxtetracycline was applied to the hives 3 does in one month. the rodenticides hombre mini blocks (pcp 26685) and ratoxin (pcp 23253) were used around the over winter shed for mice when needed (fall and winter 2013-14). Bees were actively foraging at time or incidet and when questionnaire was being filled out. Dead bees had pollen on there legs. there were 1501-2000 dead bees observed inside each hive. Adult bee symptoms included; trembling, crawlig, disoriented and confused. Brood symptoms included spotty brood production, bees uncapping cells for removal of pupae and overall decline in brood production. Additionally going to be no bees to produce. no queen symptoms observed but hard to tell short term-event happened in just a couple of days boxes checked still had queens so not sure effects yet. The weather at the time of the incident was sunny and 16C. beekeeper was really unsure what caused the incident. Has contacted neighbours for use of pesticides, no is using yet. The beekeeper had minial loss over the winer (15%), this was the only yard affected with losses after being pulled out of winter storage. The single hives and nucs were dwindling each day. Bees are found dead at the bottom board and are shaken out by bee keeper periodically. Beekeeper checked bees Saturday. April 19th and by tuesday April 22, 2014 most bees were dead. bees remaining showed signs of intoxication in hives. there was only one strong hive in the yard which appeared to be a drone hive. Bee keeper indicated that drones generally don't fly as far as worker bees, so maybe didn't get exposed to what the other bees were. Beekeeper indicated he had contacted many of the neighbours about products used. because it was so early, no one has used anything. He contacted a few of the growers. [name] research center (1-2 miles away), [name] tree nursary (across the road and down the road (few locations)). Samples of dead bees and uncapped nector taken had positive detects for thiamethoxan and clothiandin. Samples of live bees take from unaffected hive had no detected active ingredients.

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