Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2009-2708
2. Registrant Information.
Registrant Reference Number: Prosar 1-18788485
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.
11-JUN-09
5. Location of incident.
Country: UNITED STATES
Prov / State: NEW JERSEY
6. Date incident was first observed.
09-JUN-09
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. 2596-147
Product Name: UltraGuard One Spot Flea Egg/Larvae Treatment for Cats/Kittens
- Active Ingredient(s)
- (S)-METHOPRENE
- Guarantee/concentration 2.9 %
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 product was applied to the kitten on 06/09/2009.
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
Domestic Shorthair
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
0.23
7. Weight (provide a range if necessary )
3
lbs
8. Route(s) of exposure
Skin
9. What was the length of exposure?
Unknown / Inconnu
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 - Stiffness
- Symptom - Ataxia
- Respiratory System
- Symptom - Difficulty Breathing
- Specify - "Abnormal breathing patterns"
- Nervous and Muscular Systems
- Symptom - Loss of coordination
- Nervous and Muscular Systems
- Symptom - Unresponsive
- Specify - "Not very responsive"
- Symptom - Skittish
- Specify - "Twitchy, jumpy"
- General
- Symptom - Hypothermia
- 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?
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
1-18788485: A reporter (cat owner) called on 06/11/2009 to report the exposure of her 2 kittens to a flea egg and larvae product containing the active ingredient Methoprene. According to the reporter, the product was applied to 2 kittens on 06/09/2009. On 06/10/2009, Kitten #1 (1st Subform III) was stiff, ataxic, anorexic, not drinking, having abnormal breathing patterns, very lethargic, and falling over. On 06/11/2009, the kitten was not very responsive, twitchy/jumpy, and cold. The kitten was taken to the veterinarian where she was bathed. Other unknown treatments were also given, but the kitten died prior to the report. The other kitten never developed any signs. The reporter was advised that the product is not expected to result in the signs described. A recommendation was made to consider necropsy to determine the cause of death. The company's reimbursement policy was discussed. No further information was obtained.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here