Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2017-0598

2. Registrant Information.

Registrant Reference Number: ProPharma Group case#: 1-46663146

Registrant Name (Full Legal Name no abbreviations): FMC Corporation

Address: 2929 Walnut Street

City: Philadelphia

Prov / State: Pennsylvania

Country: USA

Postal Code: 19104

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

Domestic Animal

4. Date registrant was first informed of the incident.

26-DEC-16

5. Location of incident.

Country: UNITED STATES

Prov / State: ILLINOIS

6. Date incident was first observed.

Unknown

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. 279-3206

Product Name: TALSTAR P PROFESSIONAL INSECTICIDE

• Active Ingredient(s)
  • BIFENTHRIN

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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: Res. - In Home / Rés. - à l'int. maison

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

Other

2. Type of animal affected

Cat / Chat

3. Breed

Unknown

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

4

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

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

• Nervous and Muscular Systems
  • Symptom - Muscle tremors

• Gastrointestinal System
  • Symptom - Foaming at mouth

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

Died

16. How was the animal exposed?

Contact treat.area/Contact surf. traitée

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

1-46663146 - The reporter, a pet owner, indicated his cat may have been exposed to a pesticide containing the active ingredient bifenthrin. An unknown amount of time before the day of initial contact with the registrant, the caller sprayed the diluted product in his home. At the time of the initial contact, the reporter indicated his 4-year-old, female cat of unknown weight and breed was foaming at the mouth and having muscle tremors. The reporter did not witness an exposure. The reporter bathed the cat, but the symptoms continued. The reporter was informed that the cat needed immediate veterinary care as the product can cause similar symptoms if ingested in large quantities. On follow-up call one day later, the reporter stated that the cat had died a couple of minutes after getting off the phone with the registrant on the day of initial contact. No additional information is available.

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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