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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2008-4169
2. Registrant Information.
Registrant Reference Number: PROSAR Case 1-16513607
Registrant Name (Full Legal Name no abbreviations): The Hartz Mountain Company
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.
12-AUG-085. Location of incident.
Country: UNITED STATES
Prov / State: NORTH CAROLINA
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)PMRA Registration No. PMRA Submission No. EPA Registration No. 2596-147
Product Name: Ultra Guard One Spot Flea Egg and Larvae Treatment for Cats - Kittens
- Active Ingredient(s)
- (S)-METHOPRENE
- Guarantee/concentration 2.9 %
- (S)-METHOPRENE
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).
Product was applied to a 5 week old kitten on 8/9/2008.To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
No
Subform III: Domestic Animal Incident Report
1. Source of Report
Medical Professional
2. Type of animal affected
Cat / Chat
3. Breed
Mixed
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
0.1
7. Weight (provide a range if necessary )
1
lbs
8. Route(s) of exposure
Skin
9. What was the length of exposure?
>3 days <=1 wk / >3 jours <=1 sem
10. Time between exposure and onset of symptoms
Unknown / Inconnu
11. List all symptoms
System
- Cardiovascular System
- Symptom - Bradycardia
- Nervous and Muscular Systems
- Symptom - Ataxia
- Respiratory System
- Symptom - Difficulty Breathing
- General
- Symptom - Death
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
1-16513607: The reporter, a Veterinarian, called on 8/12/2008 to report the exposure of a 5 week old kitten to a flea egg and larvae product containing the active ingredient Methoprene. According to the reporter, the product was applied to the kitten on 8/9/2008. On 8/12/2008, the kitten was presented, in poor condition, to the reporter¿s animal hospital. On presentation the kitten was ataxic, with bradycardia and was having difficulty breathing. Additionally, it was possible the kitten had experience seizure activity (un-witnessed). At the time of the call, the animal hospital had bathed the kitten and placed it in an incubator. Lab work consisting of a CBC and Chemistry panel was in progress at the time of the call, results were not reported. A recommendation was made for supportive care consisting of fluid therapy, tremor control with muscle relaxants, assisted nutritional support and monitoring of vital signs. The reporter asked if the product required Atropine and he was advised that was not necessary. A follow-up call revealed that the kitten had survived approximately one-half day and then died. No further information was reported.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
