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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-3984

2. Registrant Information.

Registrant Reference Number: Prosar 1-19441101

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.


5. Location of incident.


Prov / State: NEW YORK

6. Date incident was first observed.


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.


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)
      • Guarantee/concentration 2.9 %

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-149

Product Name: Advanced Care 3 in 1 Foaming Shampoo (non-specific)

  • Active Ingredient(s)
      • Guarantee/concentration .1 %
      • Guarantee/concentration .109 %
      • Guarantee/concentration .151 %

7. b) Type of formulation.


Application Information

8. Product was applied?


9. Application Rate.


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 spot on product and shampoo were applied to the cat at an unknown time within 3 days of the report. A company "powder" product was also applied (unknown formulation) and a non-company flea and tick spray was also used during the 3 days prior to the report.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?


Subform III: Domestic Animal Incident Report

1. Source of Report

Medical Professional

2. Type of animal affected

Cat / Chat

3. Breed

Unknown breed

4. Number of animals affected


5. Sex


6. Age (provide a range if necessary )


7. Weight (provide a range if necessary )


8. Route(s) of exposure


9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms


  • General
    • Symptom - Dehydration
  • Gastrointestinal System
    • Symptom - Anorexia
  • Nervous and Muscular Systems
    • Symptom - Ataxia
  • Blood
    • Symptom - Anemia
  • General
    • Symptom - Hypothermia
  • Renal System
    • Symptom - Other
    • Specify - "Elevated renal values"
  • General
    • Symptom - Death

12. How long did the symptoms last?

Persisted until death

13. Was medical treatment provided? Provide details in question 17.


14. a) Was the animal hospitalized?


14. b) How long was the animal hospitalized?

15. Outcome of the incident


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

1-19441101: A reporter (veterinarian) called on 08/07/2009 to report the exposure of a cat to a flea egg and larvae product containing the active ingredient Methoprene, and a flea and tick shampoo containing the active ingredients d-trans-Allethrin, NOBD, and Methoprene. According to the reporter, the spot on product, shampoo, company "powder" product (formulation unknown), and a non-company flea and tick spray were applied to the cat within the 3 days prior to the report. The cat presented to the reporter on 08/07/2009 with dehydration, anorexia, ataxia, anemia, hypothermia, and elevated renal values. The reporter was trying to determine what signs may be from flea anemia and what may be product-related. The reporter did not have time to go through the products on the phone, but he was advised that the spot-on product is not expected to have any adverse effects due to its minimal to non-existent mammalian toxicity. The Material Safety Data Sheets for the shampoo and spot on product were faxed to the reporter. Attempts to follow up with the reporter were unsuccessful, but a veterinary clinic employee did report that the cat died the day of the initial report. A recommendation was made to consider necropsy to determine the cause of death. No additional information was obtained. NOTE: It is recommended to avoid the use of multiple flea and tick products at once due to increased risk of overdose and toxicity.

To be determined by Registrant

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


19. Provide supplemental information here