Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-4695

2. Registrant Information.

Registrant Reference Number: Prosar 1-19893006

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.

10-SEP-09

5. Location of incident.

Country: UNITED STATES

Prov / State: IOWA

6. Date incident was first observed.

09-SEP-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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No.

Product Name: Non-specific Flea/Tick Powder for Cats (Tetrachlorvinphos)

• Active Ingredient(s)
  • TETRACHLORVINPHOS
    • Unknown

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7. b) Type of formulation.

Dust

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 3 cats on 09/09/2009.

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

Cat / Chat

3. Breed

Domestic Longhair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

1.5

7. Weight (provide a range if necessary )

16

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

• General
  • Symptom - Lethargy

• Nervous and Muscular Systems
  • Symptom - Abnormal gait

• Gastrointestinal System
  • Symptom - Anorexia

• General
  • Symptom - Adipsia

• Respiratory System
  • Symptom - Difficulty Breathing

• Nervous and Muscular Systems
  • Symptom - Other
  • Specify - "Limp/cannot move"

• General
  • Symptom - Death

• Nervous and Muscular Systems
  • Symptom - Abasia
  • Specify - "Limp/cannot walk

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?

No

14. b) How long was the animal hospitalized?

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

1-19893006: A reporter (cat owner) called on 09/10/2009 to report the exposure of her 3 cats to a flea and tick powder containing the active ingredient Tetrachlorvinphos. According to the reporter, the product was applied to her 3 cats on 09/09/2009. Cat #1 (1st Subform III) developed lethargy, an abnormal gait, anorexia, and stopped drinking later on the day of product application. All 3 cats were bathed with a non-medicated shampoo on 09/10/2009. The other cats remained asymptomatic. Cat #1 was taken to a veterinarian and received a steroid injection and fluid therapy. The reporter was advised that the product contains a cholinesterase inhibitor. Adverse reactions to the product or overdoses may result in signs such as CNS depression, ataxia, increased salivation, tearing of the eyes, excessive urination, vomiting, and diarrhea. A recommendation was made to have the veterinarian conduct cholinesterase testing to determine whether the signs are product-related. The initial reporter's significant other called later on 09/10/2009 to report that Cat #1 was brought home from the clinic and is limp/not able to move and struggling to breathe. The reporter was advised of the active ingredient, and potential signs of overdose/reaction were discussed. The reporter was also advised that treatment includes symptomatic and supportive care and possibly atropine or 2-PAM (the reversal agent). A recommendation was made to have Cat #1 evaluated by an emergency clinic veterinarian for appropriate overnight care. Cholinesterase testing was also discussed. The reporter called back on 09/10/2009 and stated that Cat #1 had died. Necropsy was recommended to try and determine the cause of death. No further information was obtained.

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To be determined by Registrant

18. Severity classification (if there is more than 1 possible classification

Death

19. Provide supplemental information here