Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-7772

2. Registrant Information.

Registrant Reference Number: PROSAR Case 1-15337046

Registrant Name (Full Legal Name no abbreviations): The Hartz Mountain Corporation

Address: 400 Plaza Drive

City: Secaucus

Prov / State: New Jersey

Country: USA

Postal Code: 07094-3688

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

Domestic Animal

4. Date registrant was first informed of the incident.

20-SEP-07

5. Location of incident.

Country: UNITED STATES

Prov / State: NEW YORK

6. Date incident was first observed.

16-SEP-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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No.

Product Name: Advanced Care 2 in 1 Flea + Tick Collar for Cats - 2596-63

• Active Ingredient(s)
  • TETRACHLORVINPHOS
    • Guarantee/concentration 14.55 %

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7. b) Type of formulation.

Other (specify)

Collar

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).

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

Cat / Chat

3. Breed

Domestic Shorthair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

3

7. Weight (provide a range if necessary )

2

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

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

10. Time between exposure and onset of symptoms

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

11. List all symptoms

System

• General
  • Symptom - Lethargy

• Blood
  • Symptom - Anemia

• General
  • 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?

Unknown

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

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

History: Put collar on Sunday (9/16/2007) and has been lethargic since Tuesday. Collar was removed last night and the cat still remains depressed. Has use of similar collars in the past without problems. Assessment: Discussed with caller that symptoms reported are not likely related to product exposure. In addition to having removed the collar, recommend bathing the cat in a mild detergent soap and seeking veterinary examination and treatment of the animal. Discussed testing of hair samples that company will pay for if requested through your Veterinarian. 09/24/07 Follow-Up Cat owner is returning our follow-up call to report that her cat's symptom's worsened following her call to the Health and Safety line. "Stanley" was taken to the vet hospital the following day. The cat was diagnosed with "anemia" at the vet hospital. The necropsy was suggested by her veterinarian. The cat was also treated with the antidotal treatment of 2PAM, in hopes that this would reverse the effects of the flea collar. No improvement in symptoms. The cat died at the hospital on 09/21/07. The body remains in refrigeration at the vet hospital. Her veterinarian suggested necropsy. Assessment: I am sorry to hear of your loss. Reiterated to caller that described symptoms and onset of symptoms are not expected to be related to product use. It is unlikely a cat would develop OP toxicity from a collar that is less than 2% concentration of the active ingredient and with normal, routine use. 09/28/07 Necropsy Results A summary of necropsy results forwarded by Hartz CR "SEVERE chronic cardiomyopathy"

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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