Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2008-4142
2. Registrant Information.
Registrant Reference Number: PROSAR Case 1-16486553
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.
05-AUG-08
5. Location of incident.
Country: UNITED STATES
Prov / State: CALIFORNIA
6. Date incident was first observed.
04-AUG-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. 2724-504-2596
Product Name: UltraGuard Pro Flea and Tick Drops for Cats 5lbs and Over
- Active Ingredient(s)
- (S)-METHOPRENE
- Guarantee/concentration 3.6 %
- ETOFENPROX
- Guarantee/concentration 40 %
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 applied the product to the cat at 10am on 8/4/2008.
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
Mixed breed
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
10
7. Weight (provide a range if necessary )
30
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
>30 min <=2 hrs / >30 min <=2 h
11. List all symptoms
System
- Respiratory System
- Symptom - Difficulty Breathing
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?
Unknown
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
1-16486553: The reporter called on 8/5/2008 to report exposure of her cat to a topical flea and tick product with the active ingredients Etofenprox and Methoprene. According to the reporter, the product was applied to her cat at 10am on 8/4/2008. Within 1.5 hours of application, the cat experienced difficulty breathing and vomited up phlegm. The reporter attempted to wash the product off the cat with a wash cloth and unspecified type of soap, and then rinsed the cat with water. At 5pm, the cat was still vomiting, was given another bath and was then presented to a Veterinarian. Upon arrival at the animal hospital, the patient was placed on Oxygen and given another bath. At approximately 9pm on 8/4/2008, the cat experienced cardiac arrest a total of 4 times. The cat was unable to be resuscitated the 4th time and died. It was the opinion of the attending Veterinarian, that the cat could have experienced an allergic reaction to the flea and tick product.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here