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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-1585

2. Registrant Information.

Registrant Reference Number: Prosar case 1-15971963

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.

03-APR-08

5. Location of incident.

Country: UNITED STATES

Prov / State: GEORGIA

6. Date incident was first observed.

03-APR-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. 2596-22

Product Name: Advanced Care 2 in 1 Rid Flea Dog Shampoo

  • Active Ingredient(s)
    • N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
      • Guarantee/concentration .135 %
    • PIPERONYL BUTOXIDE
      • Guarantee/concentration .08 %
    • PYRETHRINS
      • Guarantee/concentration .04 %

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's two 6 week old puppies were bathed with the product on 4/3/08.

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

Dog / Chien

3. Breed

Mixed Breed

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.12

7. Weight (provide a range if necessary )

2

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>2 hrs <=8 hrs / > 2 h < = 8 h

11. List all symptoms

System

  • Gastrointestinal System
    • Symptom - Vomiting
  • 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?

Yes

14. b) How long was the animal hospitalized?

4

Day(s) / Jour(s)

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

1-15971963: The reporter called on 4/3/08 to report one of two 6 week old puppies had begun vomiting after being given a bath with a shampoo product containing the active ingredients Pyrethrins, Piperonyl Butoxide, and N-Octyl Bicyloheptene Dicarboximide. The puppy had been bathed within the last 5 hours, and the reporter had seen him lap up some of the bath water. The puppy had vomited 7-8 times since the bath. The reporter had consulted with her veterinarian, who recommend giving the puppy a small amount of Pepto-Bismol. She had done so and had also begun to withhold food. The safety profile of the product was discussed and electrolyte supplementation was recommended. The reporter was also advised to have the puppy evaluated by a veterinarian if symptoms persisted or worsened. The second puppy was reported to be asymptomatic. A follow-up call was placed the following day but the owner could not be reached. During a second follow-up call (4/9/08), the reporter was contacted and she revealed that puppy had been taken to the veterinarian. He had tested positive for Parvovirus on 4/4/08 and passed away on 4/7/08.


To be determined by Registrant

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

Death

19. Provide supplemental information here