Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-3211

2. Registrant Information.

Registrant Reference Number: Prosar case 1-16221693

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.

02-JUN-08

5. Location of incident.

Country: CANADA

Prov / State: NOVA SCOTIA

6. Date incident was first observed.

29-MAY-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. 25923      PMRA Submission No.       EPA Registration No.

Product Name: Control Pet Care System Once a Month Flea/Tick Treatment for Dogs

• Active Ingredient(s)
  • PERMETHRIN

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7. b) Type of formulation.

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 applied the product to her pet on 5/28/08.

To be determined by Registrant

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

Unknown

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Cocker Spaniel

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

0.5

7. Weight (provide a range if necessary )

8

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 - Anorexia

• General
  • Symptom - Lethargy

• Nervous and Muscular Systems
  • Symptom - Trembling

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

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

1-16221693: The reporter called on 6/2/08 to report the application of a topical flea and tick product containing the active ingredients Methoprene and Permethrin to the family dog 5 days previously. According to the reporter, the dog had developed anorexia, lethargy, and slight tremors the day after application. The dog had been bathed 2 days after application with hand dish soap. The reporter had an appointment with a veterinarian for the evening of 6/2. The safety profile of the product was discussed, and a recommendation was made to keep the veterinary appointment. Symptomatic and supportive care was recommended, as well as ruling out other causes. A follow-up call on 6/9 revealed the dog had improved and was eating normally again. The dog had been taken to the veterinarian 2 times within the last week. Blood work had been normal.

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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