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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-5803

2. Registrant Information.

Registrant Reference Number: 070080055

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

Address: 301 W. Osborn Rd.

City: Phoenix

Prov / State: AZ

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.

30-JUL-07

5. Location of incident.

Country: UNITED STATES

Prov / State: TEXAS

6. Date incident was first observed.

27-JUL-07

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. 270-278

Product Name: Bio Spot Flea & Tick Control for Dogs 15 lbs & Under

  • Active Ingredient(s)
    • PERMETHRIN
      • Guarantee/concentration 45 %
    • PYRIPROXYFEN
      • Guarantee/concentration 5 %

7. b) Type of formulation.

Liquid

Application Information

8. Product was applied?

Yes

9. Application Rate.

1

Units: mL

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 July 27, 2007 at 5:00 p.m. CDT, the owner applied the product to her dog. The product was applied dermally to prevent fleas and ticks, and the use was appropriate.

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

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Pomeranian

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

.26

7. Weight (provide a range if necessary )

2.5

lbs

8. Route(s) of exposure

Skin

Oral

9. What was the length of exposure?

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

10. Time between exposure and onset of symptoms

>2 hrs <=8 hrs / > 2 h < = 8 h

11. List all symptoms

System

  • Gastrointestinal System
    • Symptom - Drooling
  • General
    • Symptom - Lethargy
  • Nervous and Muscular Systems
    • Symptom - Seizure
    • Symptom - Muscle weakness
    • Specify - muscle laxity
    • Symptom -
    • Specify - jaw clamping
  • General
    • Symptom - Vocalizing
    • Symptom - Death

12. How long did the symptoms last?

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

13. Was medical treatment provided? Provide details in question 17.

Yes

14. a) Was the animal hospitalized?

Yes

14. b) How long was the animal hospitalized?

1

Day(s) / Jour(s)

15. Outcome of the incident

Not recovered / Non rétabli

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 July 27, 2007 at 9:00 p.m. CDT, the caller noticed that the patient was hypersalivating. This ended at 9:30 p.m. on the same day. On July 28, 2007 at 4:30 a.m. CDT, the caller noticed that the patient was lethargic. On July 29, 2007 at 8:00 a.m. CDT, the caller took the patient to the regular veterinarian where supportive and symptomatic care was given. On July 29, 2007 at 3:00 p.m. CDT, the regular veterinary staff noticed that the patient was showing muscle laxity and jaw clamping. At that time, the staff gave the patient Nutri-Cal, and at 4:00 p.m. CDT that same day, the patient began having seizures and vocalizing. All signs ended on July 30, 2007 at 5:19 a.m. CDT when the patient died. When the patient's owner called the Animal Product Safety Service (APSS) on July 30, 2007 at 11:58 a.m. CDT, the APSS staff told her that a local reaction to this product would be expected, but severe signs are not. The APSS staff recommended a necropsy be performed on this patient, as well as a rabies test. On August 8, 2007 at 4:20 p.m. the APSS staff received the preliminary necropsy results and rabies results. The gross necropsy showed no evidence of a hepatic shunt. The lab test for rabies was negative.


To be determined by Registrant

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

Death

19. Provide supplemental information here

On August 13, 2007 at 3:58 p.m. CDT, the histopathology results arrived at the APSS center. These results indicated that the patient suffered fibrinous pneumonia, compatible with a bacterial infection, and possible parasite larva migration into the lungs, contributing to his death.