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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-3915

2. Registrant Information.

Registrant Reference Number: PROSAR Case # 1-26708583

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.

02-JUL-11

5. Location of incident.

Country: UNITED STATES

Prov / State: WASHINGTON

6. Date incident was first observed.

30-JUN-11

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.       PMRA Submission No.       EPA Registration No. 2596-126

Product Name: UltraGuard Flea Tick Cat Spray

  • Active Ingredient(s)
    • TETRACHLORVINPHOS
      • Guarantee/concentration 1.08 %

7. b) Type of formulation.

Liquid

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).

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

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

mixed

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

0.083

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>8 hrs <=24 hrs / > 8 h < = 24 h

11. List all symptoms

System

  • General
    • Symptom - Lethargy
  • Gastrointestinal System
    • Symptom - Anorexia
    • Symptom - Vomiting
  • Nervous and Muscular Systems
    • Symptom - Muscle tremors
  • General
    • Symptom - Death
  • Nervous and Muscular Systems
    • Symptom - Ataxia

12. How long did the symptoms last?

Persisted until death

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

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

1-26708583- the reporter, a pet owner, indicates her animal had been exposed to an insecticide containing the active ingredient tetrachlorvinphos. The pet owner indicated a party in her household had applied the product to two four week female cats two days prior to the initial contact with the registrant. The pet owner indicated one animal (Subform III, #1) developed signs of lethargy, anorexia, tremors, vomiting, and ataxia within one day of application. The animal had died the day prior to her initial contact with the registrant. The second animal (Subform III, #2) developed ataxia, dehydration, anorexia, and a low body temperature within one day of application. The animal was brought to the veterinarian where the veterinarian had recommended euthanasia. The pet owner had declined euthanasia and removed the animal from the clinic. The pet owner was advised the label for this product recommends application on animal twelve weeks and older. The pet owner was advised to seek veterinary assistance for the remaining animal. If they are unhappy with the first veterinarian¿s assessment they should seek a second opinion. On follow up the pet owner indicated the second animal had died following the initial call. No further veterinary assistance was indicated. The pet owner indicated the party that had treated the cat with the product initially over applied the product as well as not following the labeled age restrictions. No further information is available.


To be determined by Registrant

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

Death

19. Provide supplemental information here

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

mixed

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

0.083

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>8 hrs <=24 hrs / > 8 h < = 24 h

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Ataxia
  • Gastrointestinal System
    • Symptom - Anorexia
  • General
    • Symptom - Hyperthermia
    • Symptom - Dehydration
    • Symptom - Death

12. How long did the symptoms last?

Persisted until death

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

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

1-26708583- the reporter, a pet owner, indicates her animal had been exposed to an insecticide containing the active ingredient tetrachlorvinphos. The pet owner indicated a party in her household had applied the product to two four week female cats two days prior to the initial contact with the registrant. The pet owner indicated one animal (Subform III, #1) developed signs of lethargy, anorexia, tremors, vomiting, and ataxia within one day of application. The animal had died the day prior to her initial contact with the registrant. The second animal (Subform III, #2) developed ataxia, dehydration, anorexia, and a low body temperature within one day of application. The animal was brought to the veterinarian where the veterinarian had recommended euthanasia. The pet owner had declined euthanasia and removed the animal from the clinic. The pet owner was advised the label for this product recommends application on animal twelve weeks and older. The pet owner was advised to seek veterinary assistance for the remaining animal. If they are unhappy with the first veterinarian¿s assessment they should seek a second opinion. On follow up the pet owner indicated the second animal had died following the initial call. No further veterinary assistance was indicated. The pet owner indicated the party that had treated the cat with the product initially over applied the product as well as not following the labeled age restrictions. No further information is available.


To be determined by Registrant

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

Death

19. Provide supplemental information here