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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-2827

2. Registrant Information.

Registrant Reference Number: 080066309

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.

19-JUN-08

5. Location of incident.

Country: UNITED STATES

Prov / State: VERMONT

6. Date incident was first observed.

Unknown

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. 10375

Product Name: Wipe Liquid Wipe On Fly Protectant (Canadian Product)

  • Active Ingredient(s)
    • BUTOXYPOLYPROPYLENE GLYCOL
      • Guarantee/concentration 20 %
    • DI-N-PROPYL ISOCINCHOMERONATE
      • Guarantee/concentration 1 %
    • PIPERONYL BUTOXIDE
      • Guarantee/concentration .5 %
    • PYRETHRINS
      • Guarantee/concentration .2 %

7. b) Type of formulation.

Liquid

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

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).

The owner applied the product twice a week from May 1, 2004 to June 5, 2008. Other pyrethroid products and a homemade vinegar solution were also used.

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

Horse / Cheval

3. Breed

Canadian Warmblood Mix

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

15

7. Weight (provide a range if necessary )

1350

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Collapse
  • Liver
    • Symptom - Hepatic failure
    • Symptom - Elevated liver enzymes

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

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

In 2006 and again on May 4, 2008, the horse collapsed. The attending veterinarian drew and tested the horse's blood and found that the horse had acute hepatic failure and elevated liver enzymes. On June 19, 2008, the owner contacted the APSS. The APSS veterinary technician stated that the signs were not consistent with the product. The APSS veterinary technician recommended that a diagnostic evaluation be performed on the horse to rule out other causes.


To be determined by Registrant

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

Major

19. Provide supplemental information here

On July 1, 2008, the owner contacted the APSS with additional questions about pyrethroids. The APSS veterinarian stated that the liver signs seen in her horse would not be caused by this product.