Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2009-5022
2. Registrant Information.
Registrant Reference Number: 090107523
Registrant Name (Full Legal Name no abbreviations): Wellmark International
Address: 100 Stone Road West, Suite 111
City: Guelph
Prov / State: Ontario
Country: Canada
Postal Code: N1G5L3
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
24-SEP-09
5. Location of incident.
Country: UNITED STATES
Prov / State: KANSAS
6. Date incident was first observed.
24-SEP-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. 2724-352
Product Name: Zoecon Precor IGR Concentrate
- Active Ingredient(s)
- (S)-METHOPRENE
- Guarantee/concentration 1.2 %
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: Res. - In Home / Rés. - à l'int. maison
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
On September 23, 2009 the owner had a company treat the house with the product, along with another product spray for a flea infestation.
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
Medical Professional
2. Type of animal affected
Cat / Chat
3. Breed
Siamese Mix
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
8
7. Weight (provide a range if necessary )
20
lbs
8. Route(s) of exposure
Unknown
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
>8 hrs <=24 hrs / > 8 h < = 24 h
11. List all symptoms
System
- Respiratory System
- Symptom - Mouth breathing
- Eye
- Symptom - Pupil dilation
- Specify - Mydriasis
- Nervous and Muscular Systems
- 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?
Yes
14. b) How long was the animal hospitalized?
1
Hour(s) / Heure(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
On September 23, 2009 the owners left the house with the cat in the carrier, returning to the house 4 hours after the products were applied. Shortly after the signs were noticed, the owners took the cat into a regular veterinarian, who called the Animal Product Safety Service (APSS). The APSS veterinarian stated that since the cat was not in the house right after the application, inhalation wouldn't be a significant route of exposure. The APSS veterinarian recommended a diagnostic evaluation and symptomatic and supportive care.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here
The APSS veterinarian stated that the substance was considered to have a doubtful likelihood of causing the clinical situation. The clinic reported that the cat died shortly after the APSS consultation on September 24, 2009.