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Sécurité des produits de consommation

Déclaration d'incident

Sous-formulaire I: Renseignements généraux

1.Type de rapport.

Nouvelle déclaration d'incident

No de la demande: 2013-1308

2. Renseignements concernant le titulaire.

Numéro de référence du titulaire d'homologation: 1022612

Nom du titulaire (nom légal complet, aucune abbréviation): S.C. Johnson and Son, Limited

Adresse: 1 Webster Street

Ville: Brantford

État: ON

Pays: Canada

Code postal /Zip: N3T 5R1

3.Choisir le (les) sous-formulaire(s) correspondant à l'incident.

Incident chez un animal domestique

4. Date à laquelle le titulaire d'homologation a été informé pour la première fois de l'incident.

10-AUG-12

5. Lieu de l'incident.

Pays: CANADA

État: BRITISH COLUMBIA

6. Date de la première observation de l'incident.

04-AUG-12

Description du produit

7. a) Donner le nom de la matière active et, si disponibles, le numéro d'homologation et le nom du produit (incluant tous les mélanges). Si le produit n'est pas homologué, donner le numéro de la demande d'homologation.

Matière(s) active(s)

ARLA No d'homologation 28690      ARLA No de la demande d'homologation       EPA No d'homologation.

Nom du produit: Raid Outdoor Ant Nest Destroyer 400g - Canada

  • Matière active
    • D-TRANS ALLETHRIN
    • N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
    • PERMETHRIN

7. b) Type de formulation.

Renseignments sur l'application

8. Est-ce que le produit a été appliqué?

Oui

9. Dose d'application.

Inconnu

10. Site d'application (choisir tout ce qui s'applique).

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

11. Donner tout renseignement additionnel concernant l'application (comment le produit a été appliqué, la quantité utilisée, la superficie de la zone traitée, etc.)

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

À être déterminé par le titulaire

12. Selon vous, le produit a-t-il été utilisé en conformité avec le mode d'emploi de L'étiquette?

Non

Sous-formulaire III : Animal domestique

1. Source de la déclaration

Propriétaire de l'animal

2.Type d'animal touché

Cat / Chat

3. Race

Domestic short hair

4. Nombre d'animaux touchés

1

5. Sexe:

Femme

6. Âge (fournir un ordre de grandeur si nécessaire)

7

7. Poids (fournir un ordre de grandeur si nécessaire)

12.00

lbs

8. Voie(s) d'exposition:

Inconnu

9. Durée de l'exposition?

<=15 min / <=15 min

10. Temps écoulé entre l'exposition et l'apparition des symptômes

>24 hrs <=3 days / >24 h <=3 jours

11. Énumérer tous les symptômes

Système

  • Système gastro-intestinal
    • Symptôme - Anorexie
  • General
    • Symptôme - Mort
  • Systèmes nerveux et musculaire
    • Symptôme - Ataxie

12. Quelle a été la durée des symptômes?

Persisted until death

13. Des soins médicaux ont-ils été prodigués? Donner les détails à la question 17.

Oui

14. a) Est-ce que l'animal a-t-il été hospitalisé?

Non

14. b) Combien de temps l'animal était-il hospitalisé?

15. Issue de l'incident

Mort

16. De quelle manière l'animal a-t-il été exposé?

Other / Autre

préciser There was no known or witnessed exposure. Exposure is based on speculation.

17. Donnez tout détail additionnel au sujet de l'incident

(p.ex. description des symptômes tels que la fréquence et la gravité

August 10, 2012 Caller admits that her boyfriend did not read the directions and applied an outdoor use-only pesticide labeled in her bathroom on August 4, 2012. On August, 6, one of her 5 cats fell ill with ataxia and anorexia. The was no known or witnessed exposure to the pesticide. The caller speculates that the cat could have licked a surface in the bathroom that was exposed to the pesticide. The cat was taken to a local veterinarian on August 7 and subsequently treated with IV fluids. The caller was not able to afford diagnostic testing or further treatments so the cat was taken home. The veterinarian was not able to determine a cause for the illness. The cat died on August 10, 2012. Caller then states she has a second cat that has started to fall ill with lethargy, anorexia and ataxia. The caller indicated she cannot afford to take this second cat to the veterinarian. August 14, 2012 Follow-up was attempted with the consumer. A message was left requesting follow-up from the owner. As of Sept. 18, 2012 the owner has not called back.


À être déterminé par le titulaire

Classification selon la gravité (s'il y a plus d'une catégorie possible, veuillez choisir la plus grave)

Mort

19. Donner des renseignements additionnels ici

The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified in the telephone interviews. Any relationship between the use of this product and the delayed development of the complications reported in this case is inconceivable and lacks and biological plausibility. Secondly, the product use history is extremely vague and lacks any description of a known or defined point of direct exposure to this product. Even had casual or incidental contact with a surface treated with this pesticide occurred, such illness reported in 2 out 5 cats in the home would be unexpected. Even if true pyrethroid toxicity were to occur in this case it would manifest with acute neurological complications, primarily in the form of tremors, seizures and ataxia. Furthermore, these animals were never properly evaluated and treated by a DVM. Finally, it is important to note that this product is clearly labeled for outdoor use, and the consumer chose to misapply this product indoors.

Sous-formulaire III : Animal domestique

1. Source de la déclaration

Propriétaire de l'animal

2.Type d'animal touché

Cat / Chat

3. Race

Domestic long hair

4. Nombre d'animaux touchés

1

5. Sexe:

Femme

6. Âge (fournir un ordre de grandeur si nécessaire)

10

7. Poids (fournir un ordre de grandeur si nécessaire)

8.00

lbs

8. Voie(s) d'exposition:

Inconnu

9. Durée de l'exposition?

<=15 min / <=15 min

10. Temps écoulé entre l'exposition et l'apparition des symptômes

>3 days <=1 wk / >3 jours <=1 sem

11. Énumérer tous les symptômes

Système

  • Système gastro-intestinal
    • Symptôme - Anorexie
  • General
    • Symptôme - Lethargie
  • Systèmes nerveux et musculaire
    • Symptôme - Ataxie

12. Quelle a été la durée des symptômes?

Unknown / Inconnu

13. Des soins médicaux ont-ils été prodigués? Donner les détails à la question 17.

Non

14. a) Est-ce que l'animal a-t-il été hospitalisé?

Inconnu

14. b) Combien de temps l'animal était-il hospitalisé?

15. Issue de l'incident

Unknown/Inconnu

16. De quelle manière l'animal a-t-il été exposé?

Other / Autre

préciser There was no known or witnessed exposure. Exposure is based on speculation.

17. Donnez tout détail additionnel au sujet de l'incident

(p.ex. description des symptômes tels que la fréquence et la gravité

August 10, 2012 Caller admits that her boyfriend did not read the directions and applied an outdoor use-only pesticide labeled in her bathroom on August 4, 2012. On August, 6, one of her 5 cats fell ill with ataxia and anorexia. The was no known or witnessed exposure to the pesticide. The caller speculates that the cat could have licked a surface in the bathroom that was exposed to the pesticide. The cat was taken to a local veterinarian on August 7 and subsequently treated with IV fluids. The caller was not able to afford diagnostic testing or further treatments so the cat was taken home. The veterinarian was not able to determine a cause for the illness. The cat died on August 10, 2012. Caller then states she has a second cat that has started to fall ill with lethargy, anorexia and ataxia. The caller indicated she cannot afford to take this second cat to the veterinarian. August 14, 2012 Follow-up was attempted with the consumer. A message was left requesting follow-up from the owner. As of Sept. 18, 2012 the owner has not called back.


À être déterminé par le titulaire

Classification selon la gravité (s'il y a plus d'une catégorie possible, veuillez choisir la plus grave)

Modérée

19. Donner des renseignements additionnels ici

The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified in the telephone interviews. Any relationship between the use of this product and the delayed development of the complications reported in this case is inconceivable and lacks and biological plausibility. Secondly, the product use history is extremely vague and lacks any description of a known or defined point of direct exposure to this product. Even had casual or incidental contact with a surface treated with this pesticide occurred, such illness reported in 2 out 5 cats in the home would be unexpected. Even if true pyrethroid toxicity were to occur in this case it would manifest with acute neurological complications, primarily in the form of tremors, seizures and ataxia. Furthermore, these animals were never properly evaluated and treated by a DVM. Finally, it is important to note that this product is clearly labeled for outdoor use, and the consumer chose to misapply this product indoors.