Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2017-0132
2. Registrant Information.
Registrant Reference Number: 160052506
Registrant Name (Full Legal Name no abbreviations): Wellmark International
Address: 100 Stone Road West, Suite 111
City: Guelph
Prov / State: Ontario
Country: Canada
Postal Code: N1G5L3
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
15-APR-16
5. Location of incident.
Country: CANADA
Prov / State: ONTARIO
6. Date incident was first observed.
15-APR-16
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. 26494
PMRA Submission No.
EPA Registration No. Unknown
Product Name: ZODIAC POWERSPOT FLEA & TICK CONTROL FOR DOGS UNDER 14KG (30 LBS)
- Active Ingredient(s)
- (S)-METHOPRENE
- PERMETHRIN
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).
On April 15, 2016 the owner applied the product onto the cat and then he licked it off of himself.
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
Domestic Shorthair
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
3.0
7. Weight (provide a range if necessary )
4.0
kg
8. Route(s) of exposure
Skin
Oral
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
<=30 min / <=30 min
11. List all symptoms
System
12. How long did the symptoms last?
Unknown / Inconnu
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
Unknown/Inconnu
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
On April 15, 2016 the cat developed hypersalivation. The attending veterinary clinic technician called the Animal Product Safety Service (APSS) as the owner was reporting that the cat had licked a Zodiac dog product off of the household dog. After the owner arrived to the clinic with the cat, the owner stated that the cat had only been exposed to a cat product and he had licked the product off himself. The APSS veterinarian stated risk is for mild gastrointestinal (GI) upset- taste reaction and signs should be mild and self-limiting. The APSS veterinarian recommended managing vomiting, monitoring for GI and dermatological signs, providing a taste treat, and calling back with questions.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
19. Provide supplemental information here
Signs were expected to be mild and self-limiting.