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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-1656

2. Registrant Information.

Registrant Reference Number: 2008TH006

Registrant Name (Full Legal Name no abbreviations): Bayer Inc.

Address: 77 Belfied Road

City: Toronto

Prov / State: ON

Country: Canada

Postal Code: M9W 1G6

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

Domestic Animal

4. Date registrant was first informed of the incident.

13-FEB-08

5. Location of incident.

Country: CANADA

Prov / State: BRITISH COLUMBIA

6. Date incident was first observed.

13-FEB-08

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. 25128      PMRA Submission No.       EPA Registration No.

Product Name: Advantage 9

  • Active Ingredient(s)
    • IMIDACLOPRID

7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

.4

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).

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

Medical Professional

2. Type of animal affected

Cat / Chat

3. Breed

Domestic short hair

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

9

7. Weight (provide a range if necessary )

4.5

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

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

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Abnormal gait
    • Symptom - Seizure
  • General
    • Symptom - Dehydration
  • Nervous and Muscular Systems
    • Symptom - Recumbent
    • Specify - lateral recumbency
  • General
    • Symptom - Other
    • Specify - Hyperthyriodism
  • Renal System
    • Symptom - Other
    • Specify - Renal Disease
  • General
    • Symptom - Other
    • Specify - Diabetes
  • Renal System
    • Symptom -
    • Specify - Kidney Disease

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

Euthanised / Euthanasie

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

Owner applied advantage 9 approx 1 week before reporting event. Owner reports that during this week the cat seizured and was then having trouble walking. At one point the owner lifted the cat and it was leaking urine. The owner also reports the cat is unspayed and its health had been declining over past 2 years. The owner was directed to have her cat examined. The examining veterinarian found the cat in lateral recumbency and dehydrated. There were no unusual findings on exam. The veterinarian's differential diagnoses included hyperthyroidism, renal disease, diabetes, kidney disease and other systemic infectiious or non-infectious disease. He did not feel that the cat's presentation was related to the advantage application.


To be determined by Registrant

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

Major

19. Provide supplemental information here

Death was secondary to injection of euthanasia solution so the major classification has been used to reflect that the owner reported seeing the cat seizure, however this may have been syncope or secondary to a thrombus or emboli etc. and not a seizure.