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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2009-5254

2. Registrant Information.

Registrant Reference Number: Prosar 1-20391853

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.

Country: CANADA

Prov / State: ONTARIO

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. 17959      PMRA Submission No.       EPA Registration No.

Product Name: UltraGuard Flea/Tick Powder for Cats (Canada)

  • Active Ingredient(s)

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 product was applied to the cat on 10/12/2009. Following product application, an unknown flea collar was placed on the cat. NOTE: The simultaneous use of a powder and collar is not recommended.

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

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Domestic Shorthair

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

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

11. List all symptoms


  • General
    • Symptom - Hiding
  • Nervous and Muscular Systems
    • Symptom - Agitation
  • Skin
    • Symptom - Itchy skin
    • Specify - scratching at skin
  • Respiratory System
    • Symptom - Heavy breathing
  • Nervous and Muscular Systems
    • Symptom - Numbness
    • Specify - "Legs look numb, not working correctly"
  • General
    • Symptom - Biting

12. How long did the symptoms last?

Unknown / Inconnu

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

1-20391853: A reporter (cat owner) called on 10/12/2009 to report the exposure of his cat to a flea and tick powder containing the active ingredient Tetrachlorvinphos and a unknown flea collar. According to the reporter, the powder was applied to the cat 2 hours prior to the report. Following product application, a flea collar was also applied. Fifteen minutes prior to the report, the cat developed signs of hiding, agitation, biting and scratching at the skin, and heavy breathing. The cat's legs also appeared numb as if they were not working correctly, but then the cat would jump up and run around the house. The reporter was advised that the powder has a low level of toxicity with routine use. Following initial product application, fleas may become more active during the dying process which can be irritating to the cat and may result in bizarre behavior. A recommendation was made to bathe the cat well if signs persist. If signs persist following bathing, consult a veterinarian. The reporter was unable to provide a contact phone number for follow up. No further information was obtained. NOTE: Simultaneous use of the powder and a flea collar is not recommended.

To be determined by Registrant

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


19. Provide supplemental information here