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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2017-1876

2. Registrant Information.

Registrant Reference Number: 170048160

Registrant Name (Full Legal Name no abbreviations): Farnam Companies, Inc.

Address: 301 W. Osborn Road

City: Phoenix

Prov / State: Arizona

Country: USA

Postal Code: 85013

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

Domestic Animal

4. Date registrant was first informed of the incident.

27-MAR-17

5. Location of incident.

Country: UNITED STATES

Prov / State: CALIFORNIA

6. Date incident was first observed.

25-MAR-17

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. 270-263

Product Name: Farnam Bronco Gold Equine Fly Spray

  • Active Ingredient(s)
    • BUTOXYPOLYPROPYLENE GLYCOL
      • Guarantee/concentration 7.5 %
    • PIPERONYL BUTOXIDE
      • Guarantee/concentration 1 %
    • PYRETHRINS
      • Guarantee/concentration .1 %

7. b) Type of formulation.

Liquid

Application Information

8. Product was applied?

Unknown

9. Application Rate.

10. Site pesticide was applied to (select all that apply).

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

Bird / Oiseau

3. Breed

Pigeon Unspecified

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

5.0

7. Weight (provide a range if necessary )

10.0

oz (wts) / oz (pds)

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

  • Respiratory System
    • Symptom - Laboured breathing
  • Gastrointestinal System
    • Symptom - Loss of appetite
  • General
    • Symptom - Adipsia
    • Symptom - Death

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?

Spray drift / Dérive de pulvérisation

17. Provide any additional details about the incident

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

On March 25, 2017 the owner noticed the bird had labored breathing, was inappetent, and wasn't drinking. The owner suspects the bird, her food, or her water was accidentally sprayed with the product. On March 27, 2017 the bird was taken to a veterinarian. The veterinarian suspected the bird had pneumonia, and the bird was sent home with antibiotics. Later that day, the owner contacted the Animal Product Safety Service (APSS). The APSS veterinarian stated that birds can be sensitive to hydrocarbons and other aerosols. The APSS veterinarian stated that if the bird was sprayed in an enclosed, poorly ventilated area, there could be respiratory signs acutely. The APSS veterinarian also stated that birds generally tolerate pyrethroids well, so these is not expected to be a risk. The APSS veterinarian further stated that depending upon the environment the bird is in, other rule outs could be infectious, inflammatory, or neoplastic causes for the bird's respiratory signs.


To be determined by Registrant

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

Death

19. Provide supplemental information here

The APSS veterinarian stated that the substance was considered to have an unknown likelihood of causing the clinical situation. On March 29, 2017 an APSS technician followed up the case. The bird passed away on March 28, 2017. The APSS technician recommended a necropsy but the owner declined.