Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2008-5525
2. Registrant Information.
Registrant Reference Number: 2008CP037
Registrant Name (Full Legal Name no abbreviations): Bayer Inc
Address: 77 Belfield rd
City: Toronto
Prov / State: ON
Country: Canada
Postal Code: M9W 1G6
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
10-SEP-08
5. Location of incident.
Country: CANADA
Prov / State: NEWFOUNDLAND
6. Date incident was first observed.
09-SEP-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. 25129
PMRA Submission No.
EPA Registration No.
Product Name: advantage 18
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
.8
Units: mL
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).
one tube of advantage 18 was didvided between one nursing female and 5 kittens; 2 drops were put on each kitten
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
domestic short hair
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
2.04
7. Weight (provide a range if necessary )
Unknown
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 - Convulsions
- Symptom - Muscle tremors
- Symptom - Seizure
- Symptom - Muscle twitching
- Specify - Facial twitches
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.
Yes
14. a) Was the animal hospitalized?
Yes
14. b) How long was the animal hospitalized?
1
Day(s) / Jour(s)
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
cat had facial twitches 4 hours after application, had full seizures 7 hours later; this is a nursing female; two drops of advantage were also applied to 5 kittens and they did not have any reaction; IV fluids, methocarbamol, IV then orally
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Major
19. Provide supplemental information here
advantage is a very safe product; the cat presented signs of pyrethrin toxicity and responded to appropriate treatment; owner to look for possible source of pyrethrin in the cat's environment; the kittens did not have any side effects from the treatment