Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2008-3626
2. Registrant Information.
Registrant Reference Number: Prosar case 1-16025605
Registrant Name (Full Legal Name no abbreviations): The Hartz Mountain Coporation
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.
15-APR-08
5. Location of incident.
Country: UNITED STATES
Prov / State: MASSACHUSETTS
6. Date incident was first observed.
15-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. 2596-147
Product Name: Control One Spot Flea Egg and Tick Treatment for Cats (non-specific)
- Active Ingredient(s)
- (S)-METHOPRENE
- Guarantee/concentration 2.9 %
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 product was applied the evening of 4/14/08.
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
Cat / Chat
3. Breed
Domestic Shorthair
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
5
7. Weight (provide a range if necessary )
12
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
- Nervous and Muscular Systems
- Symptom - Ataxia
- Symptom - Confusion
- Symptom - Muscle weakness
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?
Yes
14. b) How long was the animal hospitalized?
1
Day(s) / Jour(s)
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
1-16025605: The reporter, a veterinarian, called on 4/15/08 to report he had just examined a 5 year old cat presenting with anemia (HCT less than 12%), ataxia, confusion, and weakness. The cat's owner had applied a flea and tick topical product the previous evening (active ingredient Methoprene). The safety profile of the product was discussed with the reporter, along with the fact that hematologic disorders would not be part of the product's toxicosis. Recommendations for first aid were given, which included bathing for decontamination, and symptomatic and supportive care (fluids, control of any tremors, nutritional support). A follow-up call the next day revealed that the cat had been transferred to an emergency clinic for the evening, where she had passed away. Whether or not she received a blood transfusion or not was unknown. Company sponsored hair testing and necropsy were discussed but never acted upon.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here