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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-4137

2. Registrant Information.

Registrant Reference Number: PROSAR Case 1-16463577

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.

30-JUL-08

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

30-JUL-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. 26489      PMRA Submission No.       EPA Registration No.

Product Name: Control Pet Case System One Spot for Dogs Puppies 14g and Under

  • Active Ingredient(s)
    • (S)-METHOPRENE
    • PERMETHRIN

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).

Product was applied to pet at 10pm on 7/29/2008

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

Shih Tzu

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

11.5

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

>2 hrs <=8 hrs / >2 h <=8 h

10. Time between exposure and onset of symptoms

>2 hrs <=8 hrs / > 2 h < = 8 h

11. List all symptoms

System

  • General
    • Symptom - Lethargy
  • Skin
    • Symptom - Itchy skin
  • Nervous and Muscular Systems
    • Symptom - Difficulty getting up
  • General
    • Symptom - Vocalizing

12. How long did the symptoms last?

>24 hrs <=3 days / >24 h <=3 jours

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

Recvrd resid.effects/Rétabli séquelles

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

1-16463577: The reporter called on 7/30/2008 to report her dog had become ill after the application of a topical flea and tick product containing the active ingredients Permethrim and Methoprene. According to the reporter, the product had been applied at 10pm the evening before the call. The reporter stated that five hours after application, the dog was vocalizing. The reporter bathed the dog and contacted a veterinarian who advised her to monitor the dog. Later that morning the dog was lethargic and itching at the product application site. The dog did not want to get up and would only use his front paws. The reporter did not believe that that dog had ingested the product. The safety profile of the product was discussed including the fact that topical irritation and transient paresthesia could be seen with exposure to the product. Since the patient had already been bathed and the symptoms persisted, it was recommended that the reporter seek veterinary care. A follow-up call revealed that the dog had been taken to a veterinary hospital; however, no treatment was given as the dog¿s symptoms were improving. At the time of the follow-up report, the dog was better but still a bit lethargic.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here