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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-3951

2. Registrant Information.

Registrant Reference Number: Prosar 1-19325907

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.

28-JUL-09

5. Location of incident.

Country: UNITED STATES

Prov / State: MISSISSIPPI

6. Date incident was first observed.

28-JUL-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. 2596-125

Product Name: UltraGuard Flea and Tick Spray for Dogs

  • Active Ingredient(s)
    • TETRACHLORVINPHOS
      • Guarantee/concentration 1,08 %

7. b) Type of formulation.

Liquid

Application Information

8. Product was applied?

No

9. Application Rate.

10. Site pesticide was applied to (select all that apply).

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

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

Female

6. Age (provide a range if necessary )

0.58

7. Weight (provide a range if necessary )

6

lbs

8. Route(s) of exposure

Skin

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>30 min <=2 hrs / >30 min <=2 h

11. List all symptoms

System

  • Gastrointestinal System
    • Symptom - Salivating excessively
  • Nervous and Muscular Systems
    • Symptom - Trembling
  • 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?

Unknown

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

16. How was the animal exposed?

Other / Autre

specify The products were chewed into, the contents were spilled, and the cat ingested and possibly rolled in the spilled contents.

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

1-19325907: The reporter, an animal owner, called on 7/28/09 to report the exposure of his 7 month old cat to two OTC flea and tick products one hour prior to the call. According to the reporter, the cat had chewed into the product containers; spilling the contents of both a canine Tetrachlorvinphos based flea and tick spray and a non-company canine flea and tick topical (drops) product. The reporter believed that the cat had ingested as well as possibly rolled in some of the contents. By the time of the call the cat was salivating and had developed tremors. A recommendation was made to bathe the cat and to seek immediate veterinary care. Contact with the reporter was re-established on 7/29, at which time it was revealed that the cat had died while under veterinary care. The company-sponsored necropsy program was discussed but the reporter declined as the cat had already been buried.


To be determined by Registrant

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

Death

19. Provide supplemental information here

The cat was exposed both a canine Tetrachlorvinphos based flea and tick spray and a non-company canine flea and tick topical (drops) product. The products were chewed into, the contents were spilled, and the cat ingested and possibly rolled in the spilled contents.