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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-4986

2. Registrant Information.

Registrant Reference Number: Prosar case 1-16291601

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-08

5. Location of incident.

Country: UNITED STATES

Prov / State: GEORGIA

6. Date incident was first observed.

17-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)

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-140

Product Name: UltraGuard Plus Flea and Tick Spray for Cats 8 fl oz.

  • Active Ingredient(s)
    • (S)-METHOPRENE
      • Guarantee/concentration .07 %
    • TETRACHLORVINPHOS
      • Guarantee/concentration 1.08 %

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 to six 3 month old kittens on 6/16/08.

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

Unknown

6. Age (provide a range if necessary )

0.25

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

9. What was the length of exposure?

>24 hrs <=3 days / >24 h <=3 jours

10. Time between exposure and onset of symptoms

>24 hrs <=3 days / >24 h <=3 jours

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Paralysis
  • Respiratory System
    • Symptom - Runny nose
  • Eye
    • Symptom - Discharge eye
    • Specify - Ocular discharge
  • General
    • Symptom - Death
  • Gastrointestinal System
    • Symptom - Inappropriate defecation

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

1-16291601: The reporter called on 6/17/08 to report the application of a topical flea and tick product containing the active ingredients Methoprene and Tetrachlorvinphos to six 3 month old kittens the previous evening. According to the reporter, he had woken up to find that one of the male kittens had become ┐┐┐paralyzed┐┐┐ and had defecated inappropriately. He had immediately taken the kitten to a veterinarian where he eventually had it euthanized. The reporter called back on 6/19 to report that on the evening of 6/18, a second kitten in the litter had started to develop similar symptoms (┐┐┐paralysis┐┐┐) as the 1st. This second kitten had also developed nasal and ocular discharge. The kitten had passed away during the night before the reporter could seek veterinary care. The company sponsored necropsy was discussed and the appropriate forms were faxed to the reporter┐┐┐s veterinarian. Four kittens remained asymptomatic as of 6/19. No additional information is available.


To be determined by Registrant

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

Death

19. Provide supplemental information here