Health Canada
Symbol of the Government of Canada
Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-3194

2. Registrant Information.

Registrant Reference Number: Prosar case 1-16194075

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.

26-MAY-08

5. Location of incident.

Country: UNITED STATES

Prov / State: TEXAS

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. 2596-124

Product Name: Control Flea and Tick Conditioning Shampoo for Cats

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

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 reporter used the product on her two 8 week old kittens on 5/25/08. The product was used contrary to label directions.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

No

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Domestic Shorthair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.17

7. Weight (provide a range if necessary )

Unknown

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

  • General
    • Symptom - Lethargy
    • 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

1-16194075: The reporter called on 5/26/08 to report she had used a flea and tick shampoo containing the products Allethrin and N-Octyl Bicycloheptene Dicarboximide against label directions the previous day. According to the reporter, she had bathed her two 8 week old kittens with the product the previous day. The product is labeled for use on pets 12 weeks and older. The male kitten (1st subform III) had become lethargic and had passed away while the female kitten (2nd subform III) had become lethargic. A recommendation was made to bathe the kitten in hand dish washing detergent and to rinse and dry well. It was further discussed that the kitten should be seen by a veterinarian if the symptoms continued after the bath. A follow-up call the next day revealed the symptoms had resolved by that morning, though the kitten¿¿¿s body ¿¿¿was twisting and bending for a portion of the night¿¿?. The kitten had not been seen by a veterinarian.


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

Cat / Chat

3. Breed

Domestic Shorthair

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

0.17

7. Weight (provide a range if necessary )

Unknown

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

  • General
    • Symptom - Lethargy
  • Nervous and Muscular Systems
    • Symptom - Restlessness

12. How long did the symptoms last?

>24 hrs <=3 days / >24 h <=3 jours

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

1-16194075: The reporter called on 5/26/08 to report she had used a flea and tick shampoo containing the products Allethrin and N-Octyl Bicycloheptene Dicarboximide against label directions the previous day. According to the reporter, she had bathed her two 8 week old kittens with the product the previous day. The product is labeled for use on pets 12 weeks and older. The male kitten (1st subform III) had become lethargic and had passed away while the female kitten (2nd subform III) had become lethargic. A recommendation was made to bathe the kitten in hand dish washing detergent and to rinse and dry well. It was further discussed that the kitten should be seen by a veterinarian if the symptoms continued after the bath. A follow-up call the next day revealed the symptoms had resolved by that morning, though the kitten¿¿¿s body ¿¿¿was twisting and bending for a portion of the night¿¿?. The kitten had not been seen by a veterinarian.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here