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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2008-4228
2. Registrant Information.
Registrant Reference Number: Prosar case 1-16293409
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.
17-JUN-085. Location of incident.
Country: CANADA
Prov / State: NEWFOUNDLAND
6. Date incident was first observed.
17-JUN-08Product 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. 25922 PMRA Submission No. EPA Registration No.
Product Name: Control Pet Care System Once a Month Flea and Tick Treatment for Dogs
- Active Ingredient(s)
- PERMETHRIN
7. b) Type of formulation.
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 a topical flea and tick product designed for dogs to her 8 month old cat.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
Animal's Owner
2. Type of animal affected
Cat / Chat
3. Breed
Domestic Shorthair
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
0.67
7. Weight (provide a range if necessary )
8
lbs
8. Route(s) of exposure
Skin
9. What was the length of exposure?
>8 hrs <= 24 hrs / >8 h <= 24 h
10. Time between exposure and onset of symptoms
>2 hrs <=8 hrs / > 2 h < = 8 h
11. List all symptoms
System
- Nervous and Muscular Systems
- Symptom - Trembling
- Gastrointestinal System
- Symptom - Salivating excessively
- Nervous and Muscular Systems
- Symptom - Anxiety
- Specify - Acting Scared
12. How long did the symptoms last?
>8 hrs <=24 hrs / > 8 h < = 24 h
13. Was medical treatment provided? Provide details in question 17.
Unknown
14. a) Was the animal hospitalized?
Unknown
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Fully Recovered / Complètement rétabli
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
1-16293409: The reporter called on a 6/17/08 to report the application of a canine topical flea and tick product containing the active ingredient Permethrin to her cat several hours previously. According to the reporter, the cat had developed tremors, excessive salivation, and was acting scared. She had tried to wash the product off the areas of application. A recommendation was made to bathe the cat in hand dish washing soap and to seek veterinary care if the symptoms continued. The reporter called about 10 hours later, and stated she had given the cat a bath at home but had not been able to take the cat to a veterinarian until several hours after the bath. The reporter inquired about and was given information regarding prognosis. Several follow-up calls were placed. Contact with the reporter was re-established on 6/24 ¿ the cat symptoms had resolved after about 1 day.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Moderate
