Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2008-0461
2. Registrant Information.
Registrant Reference Number: 070043592
Registrant Name (Full Legal Name no abbreviations): Wellmark International
Address: 100 Stone Rd. West, Suite 111
City: Guelph
Prov / State: Ontario
Country: Canada
Postal Code: NIG5L3
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
05-MAY-07
5. Location of incident.
Country: CANADA
Prov / State: ONTARIO
6. Date incident was first observed.
05-MAY-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. 26496
PMRA Submission No.
EPA Registration No.
Product Name: Zodiac Spot On Flea Control For Cats And Kittens
7. b) Type of formulation.
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 May 5, 2007 at 8:15 am CDT, the owner applied the product to her 3 year old, 8 pound, female, spayed Persian cat. The product was applied dermally to the animal as directed on the label. The owner applied this product as a preventative measure.
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
Cat / Chat
3. Breed
Persian
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
3
7. Weight (provide a range if necessary )
8
lbs
8. Route(s) of exposure
Skin
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
<=30 min / <=30 min
11. List all symptoms
System
- General
- Symptom - Abnormal behaviour
12. How long did the symptoms last?
Unknown / Inconnu
13. Was medical treatment provided? Provide details in question 17.
Unknown
14. a) Was the animal hospitalized?
Unknown
14. b) How long was the animal hospitalized?
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 May 5, 2007 at 8:30 am CDT, the owner noticed that her cat was exhibiting anti social behavior 15 minutes after the product was applied. The owner called on May 5, 2007 at 8:42 am CDT, to report the exposure. The APSS veterinarian explained to the owner that the cat may just be unhappy with the sensation of wetness. The APSS veterinarian also recommended that the owner could monitor the cat for any signs of discomfort, and if the cat begins to exhibit signs to bathe the cat.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
19. Provide supplemental information here
A follow-up on this case was not deemed necessary, therefore the outcome is unknown.