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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-2549

2. Registrant Information.

Registrant Reference Number: 080035428

Registrant Name (Full Legal Name no abbreviations): Farnam Companies, Inc.

Address: 301 W. Osborn Road

City: Phoenix

Prov / State: Arizona

Country: USA

Postal Code: 85013

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

Domestic Animal

4. Date registrant was first informed of the incident.

08-APR-08

5. Location of incident.

Country: UNITED STATES

Prov / State: FLORIDA

6. Date incident was first observed.

08-APR-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. 270-278

Product Name: Bio Spot Flea And Tick Control For Dogs 15 lbs And Under

  • Active Ingredient(s)
    • PERMETHRIN
      • Guarantee/concentration 45 %
    • PYRIPROXYFEN
      • Guarantee/concentration 5 %

7. b) Type of formulation.

Liquid

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 April 7, 2008, the owner applied the product to her dog 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

Dog / Chien

3. Breed

Chihuahua

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

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

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

10. Time between exposure and onset of symptoms

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

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Trembling
  • Respiratory System
    • Symptom - Coughing
  • Skin
    • Symptom - Pallor
  • Nervous and Muscular Systems
    • Symptom - Seizure
  • Gastrointestinal System
    • Symptom - Salivating excessively
    • Symptom - Vomiting
  • General
    • Symptom - Death

12. How long did the symptoms last?

>2 mos and <=6mos />2 mois et <=6mois

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

On April 8, 2008, prior to the animal developing signs, the owner bathed the animal in liquid dish washing detergent. On the same day, the animal began to tremble and cough, and her tongue turned white. The owner gave the animal Nutri-Cal, and shortly after the animal stopped trembling, and her tongue returned to its normal color. On April 9, 2008, the animal seizured once. On April 11, 2008, the animal began to hypersalivate and vomit. The owner took the animal into the local veterinary clinic where diagnostic tests were ran and symptomatic and supportive care were provided.


To be determined by Registrant

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

Death

19. Provide supplemental information here

On June 12, 2008, the owner called the APSS to update the case. On June 11, 2008, the animal had a seizure. She was found dead on June 12, 2008. The owner stated that the animal had had several seizures since application of the product in April 2008. The APSS veterinarian recommended the owner have the animal necropsied. The owner rejected the necropsy and opted to cremate the animal. This report is an update to incident report no. 2008-1468.