Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-4173

2. Registrant Information.

Registrant Reference Number: Prosar case 1-16335327

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.

27-JUN-08

5. Location of incident.

Country: UNITED STATES

Prov / State: PENNSYLVANIA

6. Date incident was first observed.

27-JUN-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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-126

Product Name: Control Flea and Tick Repellent for Cats/Control Flea and Tick Guard

• Active Ingredient(s)
  • TETRACHLORVINPHOS
    • Guarantee/concentration 1.08 %

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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).

The product was applied to the pet the evening of 6/26/08. The product had been used the previous month on two other kittens in the litter who never developed any symptoms.

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

Male

6. Age (provide a range if necessary )

0.33

7. Weight (provide a range if necessary )

3.5

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>8 hrs <=24 hrs / > 8 h < = 24 h

11. List all symptoms

System

• General
  • Symptom - Lethargy

• Nervous and Muscular Systems
  • Symptom - Ataxia
  • Symptom - Paralysis

• 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?

Unknown

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

1-16335327: The reporter called on 6/27/08 to report the application of a topical flea and tick product containing the active ingredient Tetrachlorvinphos to his 4 month old kitten the previous evening. According to the reporter, the kitten had become lethargic and ataxic about 1 hour prior to the call. By the time of the call, the kitten had been bathed and a veterinarian had been called as the kitten was still symptomatic. A recommendation was made to have the kitten evaluated by the veterinarian. A follow-up call on 7/1 revealed the kitten had been seen by a veterinarian, given unknown treatments, and then released with a 50/50 prognosis for survival. According to the reporter, the kitten had become paralyzed as of 6/28 and had passed away by the morning of 6/29/08.

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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