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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-2431

2. Registrant Information.

Registrant Reference Number: PROSAR case: 1-40467034

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.

04-MAY-15

5. Location of incident.

Country: UNITED STATES

Prov / State: MISSISSIPPI

6. Date incident was first observed.

04-MAY-15

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. 2596-139

Product Name: UltraGuard Plus Flea/Tick Collar for Cats/Kittens

  • Active Ingredient(s)
    • (S)-METHOPRENE
      • Guarantee/concentration 1.02 %
    • TETRACHLORVINPHOS
      • Guarantee/concentration 14.55 %

7. b) Type of formulation.

Other (specify)

Impregnated collar

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?

Unknown

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

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 )

6

7. Weight (provide a range if necessary )

25

lbs

8. Route(s) of exposure

Skin

Unknown

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 - Death
    • Symptom - Lethargy
  • Nervous and Muscular Systems
    • Symptom - Ataxia
    • Symptom - Muscle tremors
  • Gastrointestinal System
    • Symptom - Anorexia
  • Nervous and Muscular Systems
    • Symptom - Muscle weakness
  • Gastrointestinal System
    • Symptom - Diarrhea
  • Nervous and Muscular Systems
    • Symptom - Bizarre behaviour
    • Symptom - Difficulty walking

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

1-40467034 - The reporter, a pet owner, indicated that her cat was exposed to an insecticidal collar containing the active ingredients tetrachlorvinphos and methoprene. The collar was applied to the reporters 6-year-old, 25 pound, male indoor and outdoor domestic shorthaired cat eight days prior to initial contact with the registrant. The day after the collar was applied the cat was lethargic, it was having trouble walking and it didnt want to eat. The cat was brought to a veterinarian on that day but the veterinarian did not think there was anything wrong with the animal. The following two days the cat still seemed lethargic and weak. The next day (four days after the collar had been applied) the cat was even weaker; it did not move much at all and it looked drunk when it walked. The cat was brought back to a different veterinarian that day and it was treated with atropine and it was sent home with several bags of fluids. The following day the cat had loose stools and muscle twitching. That night the cat was not sleeping in his usual place and when the owner found the cat, the cat bit her on the wrist. The wrist quickly became swollen and red. By the morning (Six days after the collar had been applied) the cat had passed away. The reporter did indicate that the cat was not up to date on its rabies vaccine. The reporter was advised that the described symptoms are not consistent with normal use of the product. A necropsy was recommended to determine a cause for the cats symptoms and to rule out a rabies exposure to the reporter. No additional 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