Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-4141

2. Registrant Information.

Registrant Reference Number: PROSAR Case 1-16453020

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.

28-JUL-08

5. Location of incident.

Country: UNITED STATES

Prov / State: MICHIGAN

6. Date incident was first observed.

Unknown

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. 2724-504-2596

Product Name: UltraGuard Plus Drops for Cats

• Active Ingredient(s)
  • (S)-METHOPRENE
    • Guarantee/concentration 3.6 %
  • ETOFENPROX
    • Guarantee/concentration 40 %

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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).

Reporter applied product to his two cats (5 years old, 7 years old) on 7/22/2008.

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

Cat / Chat

3. Breed

Unknown

4. Number of animals affected

1

5. Sex

Unknown

6. Age (provide a range if necessary )

7

7. Weight (provide a range if necessary )

Unknown

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

• Gastrointestinal System
  • Symptom - Anorexia

• Skin
  • Symptom - Hair loss

12. How long did the symptoms last?

Unknown / Inconnu

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

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

1-16453020: The reporter called on 7/28/2008 to report exposure of his two cats to a topical flea and tick product containing the active ingredients Etofenprox and Methoprene. According to the initial report, the reporter applied the product to his 5 year old (2nd subform III) and 7 year old (1st subform III) cats on 7/22/08. At some unknown point after product application both cats had stopped eating. At the time of the call, the 5 year old cat had been hiding for two days. The safety profile of the product was discussed in that the symptoms reported were atypical following dermal exposure. Due to the severity of the symptoms described by the reporter, a recommendation was made to have the pets evaluated by a Veterinarian immediately. It was also recommended that the pets be bathed for 15 minutes with a mild detergent. Follow-up calls revealed that neither cat was presented to a Veterinarian. The 5 year old cat had been bathed, had not eaten for a week and had been drinking minimal amounts of liquid (water, milk). The cat had subsequently passed away on 7/29/2008. The 7 year old cat had been bathed as well and was improving, but would only eat small amounts of human food (chicken, lunch meat, etc.). The 7 year old cat was experiencing fur loss at the application site as well.

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To be determined by Registrant

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

Moderate

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

Unknown

4. Number of animals affected

1

5. Sex

Unknown

6. Age (provide a range if necessary )

5

7. Weight (provide a range if necessary )

Unknown

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

• Gastrointestinal System
  • Symptom - Anorexia

• General
  • Symptom - Hiding
  • 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

1-16453020: The reporter called on 7/28/2008 to report exposure of his two cats to a topical flea and tick product containing the active ingredients Etofenprox and Methoprene. According to the initial report, the reporter applied the product to his 5 year old (2nd subform III) and 7 year old (1st subform III) cats on 7/22/08. At some unknown point after product application both cats had stopped eating. At the time of the call, the 5 year old cat had been hiding for two days. The safety profile of the product was discussed in that the symptoms reported were atypical following dermal exposure. Due to the severity of the symptoms described by the reporter, a recommendation was made to have the pets evaluated by a Veterinarian immediately. It was also recommended that the pets be bathed for 15 minutes with a mild detergent. Follow-up calls revealed that neither cat was presented to a Veterinarian. The 5 year old cat had been bathed, had not eaten for a week and had been drinking minimal amounts of liquid (water, milk). The cat had subsequently passed away on 7/29/2008. The 7 year old cat had been bathed as well and was improving, but would only eat small amounts of human food (chicken, lunch meat, etc.). The 7 year old cat was experiencing fur loss at the application site as well.

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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