Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-1915

2. Registrant Information.

Registrant Reference Number: Prosar case 1-15692712

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.

15-JAN-08

5. Location of incident.

Country: UNITED STATES

Prov / State: TEXAS

6. Date incident was first observed.

14-JAN-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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-149

Product Name: Advanced Care 3 in 1 Foaming Shampoo for Dogs and Puppies

• Active Ingredient(s)
  • (S)-METHOPRENE
    • Guarantee/concentration .1 %
  • D-CIS, TRANS ALLETHRIN
    • Guarantee/concentration .109 %
  • N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
    • Guarantee/concentration .151 %

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7. b) Type of formulation.

Liquid

Application Information

8. Product was applied?

Yes

9. Application Rate.

.109

Units: %

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

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Mixed Breed

4. Number of animals affected

2

5. Sex

Female

6. Age (provide a range if necessary )

0.54

7. Weight (provide a range if necessary )

32.5

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>8 hrs <=24 hrs / > 8 h < = 24 h

11. List all symptoms

System

• General
  • Symptom - Malaise

• Nervous and Muscular Systems
  • Symptom - Recumbent

• General
  • Symptom - Death

12. How long did the symptoms last?

Persisted until death

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

No

14. a) Was the animal hospitalized?

No

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

1-15692712: The reporter called on 1/15/08 to report that five puppies were experiencing symptoms after being bathed on 1/13/08 with a product containing the active ingredients Allethrin and Methoprene. The next day (1/14/08) all puppies were less energetic than usual and by 1/15/08 four of the five puppies were recumbant. The 5th and largest male puppy seemed to be better and was getting up to greet the reporter. By the afternoon of the 15th one female puppy had died and a 2nd female puppy died later that same evening. On a recheck call to the reporter (1/16/08), the remaining two puppies had been taken to a veterinarian, diagnosed with Parvovirus, and were being treated. The 5th and largest male puppy had been separated from the remaining two puppies and was to be taken to the veterinarian the next day for vaccinations.

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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

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Mixed Breed

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.54

7. Weight (provide a range if necessary )

40

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>8 hrs <=24 hrs / > 8 h < = 24 h

11. List all symptoms

System

• General
  • Symptom - Malaise

12. How long did the symptoms last?

>8 hrs <=24 hrs / > 8 h < = 24 h

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

No

14. a) Was the animal hospitalized?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Fully Recovered / Complètement 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

1-15692712: The reporter called on 1/15/08 to report that five puppies were experiencing symptoms after being bathed on 1/13/08 with a product containing the active ingredients Allethrin and Methoprene. The next day (1/14/08) all puppies were less energetic than usual and by 1/15/08 four of the five puppies were recumbent. The 5th and largest male puppy seemed to be better and was getting up to greet the reporter. By the afternoon of the 15th one female puppy had died and a 2nd female puppy died later that same evening. On a recheck call to the reporter (1/16/08), the remaining two puppies had been taken to a veterinarian, diagnosed with Parvovirus, and were being treated. The 5th and largest male puppy had been separated from the remaining two puppies and was to be taken to the veterinarian the next day for vaccinations.

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To be determined by Registrant

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

Minor

19. Provide supplemental information here

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Mixed Breed

4. Number of animals affected

2

5. Sex

Unknown

6. Age (provide a range if necessary )

0.54

7. Weight (provide a range if necessary )

45

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>8 hrs <=24 hrs / > 8 h < = 24 h

11. List all symptoms

System

• General
  • Symptom - Malaise

• Nervous and Muscular Systems
  • Symptom - Recumbent

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown/Inconnu

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

1-15692712: The reporter called on 1/15/08 to report that five puppies were experiencing symptoms after being bathed on 1/13/08 with a product containing the active ingredients Allethrin and Methoprene. The next day (1/14/08) all puppies were less energetic than usual and by 1/15/08 four of the five puppies were recumbent. The 5th and largest male puppy seemed to be better and was getting up to greet the reporter. By the afternoon of the 15th one female puppy had died and a 2nd female puppy died later that same evening. On a recheck call to the reporter (1/16/08), the remaining two puppies had been taken to a veterinarian, diagnosed with Parvovirus, and were being treated. The 5th and largest male puppy had been separated from the remaining two puppies and was to be taken to the veterinarian the next day for vaccinations.

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To be determined by Registrant

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

Moderate

19. Provide supplemental information here