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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2007-7285
2. Registrant Information.
Registrant Reference Number: CA200701583
Registrant Name (Full Legal Name no abbreviations): Novartis Animal Health Canada Inc.
Address: Suite 400, Plaza 3, 2000 Argentia Road
City: Mississauga
Prov / State: ON
Country: Canada
Postal Code: L5N 1V9
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
09-AUG-075. Location of incident.
Country: CANADA
Prov / State: MANITOBA
6. Date incident was first observed.
09-AUG-07Product 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.
Active(s)PMRA Registration No. 25808 PMRA Submission No. EPA Registration No.
Product Name: Snip Fly Bait
- Active Ingredient(s)
- (Z)-9-TRICOSENE
- AZAMETHIPHOS
7. b) Type of formulation.
Application Information
8. Product was applied?
No
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).
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
Unknown
Subform III: Domestic Animal Incident Report
1. Source of Report
Animal's Owner
2. Type of animal affected
Dog / Chien
3. Breed
Cocker Spaniel
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
2.5
7. Weight (provide a range if necessary )
12.7
kg
8. Route(s) of exposure
Oral
9. What was the length of exposure?
<=15 min / <=15 min
10. Time between exposure and onset of symptoms
>8 hrs <=24 hrs / > 8 h < = 24 h
11. List all symptoms
System
- Gastrointestinal System
- Symptom - Diarrhea
- Symptom - Vomiting
12. How long did the symptoms last?
>24 hrs <=3 days / >24 h <=3 jours
13. Was medical treatment provided? Provide details in question 17.
No
14. a) Was the animal hospitalized?
No
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Unknown/Inconnu
16. How was the animal exposed?
Accidental ingestion/Ingestion accident.
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
On Aug. 9, 2007, the product safety call centre was contacted by the pet owner regarding the inadvertent ingestion of a small quantity of fly bait by a 2.5 year old Cocker Spaniel dog. On Aug. 10, 2007, (company name), spoke with the pet owner. The dog was a female that has just weaned a litter after whelping on June 3, 2007. Ingestion of a small but unknown amount of azamethiphos, z-9-tricosene had occurred around 10 PM on Aug. 9, 2007. The dog had no change in activity or appetite. The owner commented that the stool was soft about 12 hours after ingestion. Diarrhea resolved without treatment over 2 days. Follow-up information obtained on Aug. 23, 2007 indicated that the owner felt that the dog's stomach was more sensitive since the exposure. Two separate episodes of vomiting have occurred since. On Aug. 17, 2007, the dog vomited a meal within a few hours of eating. On Aug. 20, 2007, the dog ate raw apples and vomited 4 times over the day. The dog's appetite is still good however she tends to spread out the eating of her food over the day more than she used to. The dog's diet is commercial dog food and raw meat and bones (venison, goose and moose heart and liver especially) and raw vegetables and fruit. The dog apparently gets into the garden to eat things quite often. Veterinary examination or consultation for the clinical signs has not been sought.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
