Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2009-3973
2. Registrant Information.
Registrant Reference Number: Prosar 1-19374243
Registrant Name (Full Legal Name no abbreviations): The Hartz Mountain Corporation
Address: 400 Plaza Drive
City: Secaucus
Prov / State: New Jersey
Country: USA
Postal Code: 07094-3688
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
01-AUG-09
5. Location of incident.
Country: CANADA
Prov / State: NEWFOUNDLAND
6. Date incident was first observed.
31-JUL-09
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.
Active(s)
PMRA Registration No. 25655
PMRA Submission No.
EPA Registration No.
Product Name: Control Pet Care System Flea/Tick Guard for Cats (Canada)
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
Unknown
10. Site pesticide was applied to (select all that apply).
Site: Animal / Usage sur un animal domestique
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
The product was applied to the 8 week old kitten on 07/31/2009. NOTE: The product is not labelled for use on cats younger than 12 weeks of age.
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
No
Subform III: Domestic Animal Incident Report
1. Source of Report
Medical Professional
2. Type of animal affected
Cat / Chat
3. Breed
Domestic Shorthair
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
0.15
7. Weight (provide a range if necessary )
Unknown
8. Route(s) of exposure
Skin
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
>2 hrs <=8 hrs / > 2 h < = 8 h
11. List all symptoms
System
- Cardiovascular System
- Symptom - Abnormally fast heart rate
12. How long did the symptoms last?
Persisted until death
13. Was medical treatment provided? Provide details in question 17.
Yes
14. a) Was the animal hospitalized?
Yes
14. b) How long was the animal hospitalized?
1
Day(s) / Jour(s)
15. Outcome of the incident
Died
16. How was the animal exposed?
Treatment / Traitement
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
1-19374243: A reporter (veterinarian) called on 08/01/2009 to report the exposure of an 8 week old cat to a flea and tick spray containing the active ingredient Tetrachlorvinphos. According to the reporter, the cat was sprayed with the product on 07/31/2009. Within 2-3 hours of product application, the cat developed mydriasis, vocalization, increased heart rate, hypothermia, and anemia (PCV 24%). The cat was evaluated at an emergency veterinary clinic where the cat was warmed and received IV fluids. Further treatment was not provided due to financial constraints. The cat died during the night. The reporter was advised to consider necropsy to determine the cause of death. No further information was obtained. NOTE: This product is not labelled for use in cats younger than 12 weeks of age.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here