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: 2008-3625

2. Registrant Information.

Registrant Reference Number: Prosar case 1-15876836

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.

10-MAR-08

5. Location of incident.

Country: UNITED STATES

Prov / State: MICHIGAN

6. Date incident was first observed.

08-MAR-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. 2596-124

Product Name: Advanced Care 2 in 1 Rid Flea Cat Shampoo

  • 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.

.109

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).

The reporter applied the product on 3/8/08. He bathes his cats with the product about 2 times a year and had used the product in the past with no problems.

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

Unknown breed

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

5

7. Weight (provide a range if necessary )

20

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

<=15 min / <=15 min

10. Time between exposure and onset of symptoms

<=30 min / <=30 min

11. List all symptoms

System

  • Respiratory System
    • Symptom - Choking
  • Nervous and Muscular Systems
    • Symptom - Shaking
  • 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?

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

1-15876836: The reporter called on 3/10/08 to report that his 5 year old male cat died on 3/8/08 about 15 minutes after being bathed in a shampoo which contained the active ingredients D-CIS, TRANS ALLETHRIN and N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE. The reporter stated that after the bath, he towel dried the cat and the cat proceeded to groom himself. Within minutes the cat made a choking sound and started to shake really bad. The reporter immediately took the cat to a nearby veterinarian for evaluation. The cat died while at the veterinarian's office. The reporter stated he bathes his cats with the product about 2 times a year and had used the product in the past with no problems. The safety profile of the product was discussed and a necropsy of the pet was offered. The reporter elected to pursue necropsy and the appropriate forms were faxed to the attending veterinarian on 3/10/08. The final necropsy report was received 4/16/08. Results were as follows = Morphological diagnosis: Minimal Left Ventricular Hypertrophy (presumptive), however this was not substantiated microscopically. Microscopic diagnosis: Moderate to Severe Autolysis. Toxicology results: Brain acetylcholinesterase spectrophotometrics 5.76 um/g/min. The Acetylcholinesterase level is slightly depressed from this labs normal levels for Feline brain at 5.88 - 9.06 um/g/min.


To be determined by Registrant

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

Death

19. Provide supplemental information here