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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-4189

2. Registrant Information.

Registrant Reference Number: Prosar case 1-16381647

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.


5. Location of incident.


Prov / State: OHIO

6. Date incident was first observed.


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.


PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-79

Product Name: UltraGuard Flea and Tick Powder for Dogs

  • Active Ingredient(s)
      • Guarantee/concentration 3.3 %

7. b) Type of formulation.


Application Information

8. Product was applied?


9. Application Rate.


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 her dog the week prior to the call. The reporter's cat usually kept in close contact with the dog. The reporter suspected dermal exposure to the cat from close contact with the dog.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?


Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Domestic Shorthair

4. Number of animals affected


5. Sex


6. Age (provide a range if necessary )


7. Weight (provide a range if necessary )



8. Route(s) of exposure


9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms


  • Nervous and Muscular Systems
    • Symptom - Depression
    • Symptom - Recumbent
  • General
    • Symptom -
    • Specify - Lack of normal grooming behavior/rough coat
    • Symptom - Vocalizing
  • Respiratory System
    • Symptom - Rapid breathing
  • Gastrointestinal System
    • Symptom - Salivating excessively
  • General
    • Symptom - Other
    • Specify - rought coat

12. How long did the symptoms last?

Persisted until death

13. Was medical treatment provided? Provide details in question 17.


14. a) Was the animal hospitalized?


14. b) How long was the animal hospitalized?

15. Outcome of the incident


16. How was the animal exposed?

Other / Autre

specify Product had been applied to the reporter's dog. Reporter suspected dermal exposure to the cat from close contact with the dog.

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

1-16381647: The reporter called on 7/10/08 to report the possible exposure of her 2 year old male cat to a canine topical flea and tick product (powder) containing the active ingredient Tetrachlorvinphos. According to the reporter, she had applied the product to her dog the week prior to the call. The reporter's cat had kept in close contact with the dog and she suspected dermal exposure to the cat from close contact with the dog. Per the reporter, the cat had been ill for the previous 4 days. Initial symptoms had included a lack of normal grooming behavior and depression. By the evening of 7/9, the cat had become anorexic and could not get up. About 30 minutes prior to the call, the cat had begun to vocalize, to breathe rapidly, and to salivate. The safety profile of the product was discussed, including the fact that the timing of exposure and progression of symptoms would be inconsistent with the product. A recommendation was made to take the cat to a veterinarian immediately. A follow-up call on 7/11 revealed that the cat had passed away a few minutes after the initial call, just as the owners were getting ready to take him to see an emergency veterinarian.

To be determined by Registrant

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


19. Provide supplemental information here