Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-3648

2. Registrant Information.

Registrant Reference Number: Prosar case 1-16119352

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.

08-MAY-08

5. Location of incident.

Country: UNITED STATES

Prov / State: KENTUCKY

6. Date incident was first observed.

07-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.       PMRA Submission No.       EPA Registration No. 2596-124

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

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

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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 to bathe her 2 cats on 5/7/08.

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 )

0.33

7. Weight (provide a range if necessary )

4

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 - Difficulty walking

• Respiratory System
  • Symptom - Mouth breathing

• Eye
  • Symptom - Glazed eye

• General
  • Symptom - Pale mucous membrane colour
  • 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

1-16119352: The reporter called on 5/8/08 to report she had applied a topical flea and tick shampoo containing the active ingredients Allethrin and N-Octyl Bicycloheptene Dicarboximide to her 2 cats the previous evening. According to the reporter, sometime later that evening the female cat (1st subform III) had begun stumbling, had exhibited pale white gums with open-mouth breathing, and had developed a glazed look to her eye. The male cat (2nd subform III) had developed hair loss down his back, and on his hips and hind end. The reporter had then bathed the cats to remove the product. The female cat had passed away the morning of the call. According to the reporter, she had consulted with her veterinarian over the phone but had not taken the cats in for an exam. The safety profile of the product was discussed, as was the company sponsored necropsy program.

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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 Short hair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.67

7. Weight (provide a range if necessary )

6

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

• Skin
  • Symptom - Hair loss

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

1-16119352: The reporter called on 5/8/08 to report she had applied a topical flea and tick shampoo containing the active ingredients Allethrin and N-Octyl Bicycloheptene Dicarboximide to her 2 cats the previous evening. According to the reporter, sometime later that evening the female cat (1st subform III) had begun stumbling, had exhibited pale white gums with open-mouth breathing, and had developed a glazed look to her eye. The male cat (2nd subform III) had developed hair loss down his back, and on his hips and hind end. The reporter had then bathed the cats to remove the product. The female cat had passed away the morning of the call. According to the reporter, she had consulted with her veterinarian over the phone but had not taken the cats in for an exam. The safety profile of the product was discussed, as was the company sponsored necropsy program.

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To be determined by Registrant

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

Minor

19. Provide supplemental information here