Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-4128

2. Registrant Information.

Registrant Reference Number: 2014CK287

Registrant Name (Full Legal Name no abbreviations): Bayer Inc

Address: 77 Belfield Rd

City: Toronto

Prov / State: ON

Country: Canada

Postal Code: M9W 1G6

3. Select the appropriate subform(s) for the incident.

Domestic Animal

4. Date registrant was first informed of the incident.

21-JUL-14

5. Location of incident.

Country: CANADA

Prov / State: NEW BRUNSWICK

6. Date incident was first observed.

21-JUL-14

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. 25128      PMRA Submission No.       EPA Registration No.

Product Name: Advantage 9

• Active Ingredient(s)
  • IMIDACLOPRID

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7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

.4

Units: mL

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).

An 8m 8lb male intact domestic long hair cat was treated with advantage 9 on july 20th 2014

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

Yes

Subform III: Domestic Animal Incident Report

1. Source of Report

Medical Professional

2. Type of animal affected

Cat / Chat

3. Breed

dlh

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.5

7. Weight (provide a range if necessary )

8

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

>1 wk <=1 mo / > 1 sem < = 1 mois

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 - Muscle trembling

• General
  • Symptom - Fever

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.

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

Fully Recovered / Complètement rétabli

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

The next morning the cat was agitated and has muscle tremors (trembling). Later the cat became recumbent and was taken to a veterinary clinic. The cat was examined by a veterinarian who suspected permethrin toxicosis (of unknown origin). The cat had an elevated temperature (40.2C), muscle tremors. The cat was bathed and treated with methocarbamol administered rectally and later orally. The methocarbamol produced a dramatic improvement in clinical signs. the cat was hospitalized overnight for monitoring. On july 22nd the cat was discharged from the clinic. The cat continued to have mild muscle tremors when stressed on july 23rd. The cat was fully recovered on July 24th 2014.

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To be determined by Registrant

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

Major

19. Provide supplemental information here

Note: This cat has been treated with advantage 9 monthly with no previous adverse effects. The location of purchase of the product could not be confirmed. The owner reported purchasing the product from a different veterinary clinic that did not maintain purchase records for advantage. The attending veterinarian did not believe that the advantage 9 was the cause of the cat's clinical signs.