Incident Report
Subform I: General Information
1. Report Type.
Update the report
Incident Report Number: 2008-3858
2. Registrant Information.
Registrant Reference Number: 080099560
Registrant Name (Full Legal Name no abbreviations): Farnam Companies, Inc.
Address: 301 W. Osborn Road
City: Phoenix
Prov / State: Arizona
Country: USA
Postal Code: 85013
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
06-SEP-08
5. Location of incident.
Country: CANADA
Prov / State: ONTARIO
6. Date incident was first observed.
05-SEP-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. 26921
PMRA Submission No.
EPA Registration No.
Product Name: Bio Spot For Large Dogs Weighing More Than 15kg
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
10. Site pesticide was applied to (select all that apply).
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
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 Unspecified
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
3
7. Weight (provide a range if necessary )
Unknown
8. Route(s) of exposure
Oral
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
12. How long did the symptoms last?
>8 hrs <=24 hrs / > 8 h < = 24 h
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
Euthanised / Euthanasie
16. How was the animal exposed?
Contact treat.area/Contact surf. traitée
specify The owner applied the product to his dog and suspects the cats licked the product.
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
On September 5, 2008 the cat began having tremors. The APSS veterinarian recommended taking the cat to a veterinarian, having the attending veterinarian call for information, administer fluid therapy, give methocarbamol, manage seizures, monitor body temperature, give a bath, call back with questions and provide supportive and symptomatic care as needed.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here
On September 11, the veterinarian called the APSS to say that the owner had refused the treatment recommendations and opted for euthanasia.