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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-1916

2. Registrant Information.

Registrant Reference Number: Prosar case 1-15683404

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.

12-JAN-08

5. Location of incident.

Country: UNITED STATES

Prov / State: TENNESSEE

6. Date incident was first observed.

11-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)

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-140

Product Name: Advanced Care 3 in 1 Cat Spray

  • Active Ingredient(s)
    • (S)-METHOPRENE
      • Guarantee/concentration .1 %
    • TETRACHLORVINPHOS
      • Guarantee/concentration 2 %

7. b) Type of formulation.

Other (specify)

Emulsion

Application Information

8. Product was applied?

Yes

9. Application Rate.

2

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).

Product contains LESS THAN 2% Tetrachlorvinphos and LESS THAN 0.1 % (S)-Methoprene as the active ingredients.

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

Mixed Breed

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.67

7. Weight (provide a range if necessary )

6

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

  • Gastrointestinal System
    • Symptom - Vomiting
    • Symptom - Anorexia
  • Nervous and Muscular Systems
    • Symptom - Depression
    • Symptom - Ataxia
  • Renal System
    • Symptom - Other
    • Specify - Urinary Tract Infection
    • Symptom - Other
    • Specify - Urinary Tract Blockage
  • 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?

Yes

14. b) How long was the animal hospitalized?

Unknown

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

1-15683404: The reporter called on 1/12/08 to report she had applied a product containing the active ingredients Tetrachlorvinphos and Methoprene to her 8 month old male cat, who 24 hours later began vomiting and developed ataxia. At time of the reporter┐s call, 48 hours had passed since the product had been used and the cat┐s symptoms were worsening. The reporter was advised to seek medical care for the cat. On callback later on 1/12/08, the reporter had spoken to but not seen a veterinarian and the cat was being force fed a liquid diet at home. The reporter was advised to seek medical care for the cat if its symptoms worsened. As of 1/13/08, the reporter had decontaminated the cat with a bath using a non-medicated hand dish washing detergent, but the cat┐s condition had deteriorated and he had become anorexic and depressed. The cat was subsequently seen by a veterinarian that same day and hospitalized for a urinary tract blockage. The cat died in hospital during the night of 1/13/08.


To be determined by Registrant

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

Death

19. Provide supplemental information here