Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2008-4146
2. Registrant Information.
Registrant Reference Number: PROSAR Case 1-16492877
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.
06-AUG-08
5. Location of incident.
Country: UNITED STATES
Prov / State: PENNSYLVANIA
6. Date incident was first observed.
02-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. 2596-147
Product Name: UltraGuard One Spot Flea Egg and Larvae Treatment for Cats and Kittens
- Active Ingredient(s)
- (S)-METHOPRENE
- Guarantee/concentration 2.9 %
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 for the first time to her cat on 8/2/2008.
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
Persian
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
5
7. Weight (provide a range if necessary )
22
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
- Gastrointestinal System
- Symptom - Salivating excessively
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
1-16492877: The reporter called on 8/6/2008, to report exposure of her cat to a Flea, Egg and Larvae product containing the active ingredient Methoprene. According to the reporter, she applied the product for the first time to her cat on 8/2/2008. Within three hours of product application, the cat had excessive salivation. The owner immediately bathed the cat to remove the remaining product. The following day the cat was found dead. A necropsy was performed on 8/3/2008 at a Veterinary hospital with the cause of death listed as flea medicine. The safety profile of the product was discussed including the fact that the product has a wide margin of safety with a low level of toxicity when used according to labeled directions. It was also discussed that drooling can develop after grooming from getting a bad taste in the mouth, but that such symptoms are typically self-limiting.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here