Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2009-5256
2. Registrant Information.
Registrant Reference Number: Prosar 1-20469293
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.
20-OCT-09
5. Location of incident.
Country: UNITED STATES
Prov / State: NEW YORK
6. Date incident was first observed.
19-OCT-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. 2596-140
Product Name: UltraGuard Plus Flea/Tick Spray for Cats 8 fl oz
- Active Ingredient(s)
- (S)-METHOPRENE
- Guarantee/concentration .07 %
- TETRACHLORVINPHOS
- Guarantee/concentration 1.08 %
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 3 week old kitten on 10/19/2009. NOTE: This product is not labeled for use on kittens younger than 12 weeks of age.
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
No
Subform III: Domestic Animal Incident Report
1. Source of Report
Animal's Owner
2. Type of animal affected
Cat / Chat
3. Breed
Domestic Longhair
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
0.06
7. Weight (provide a range if necessary )
Unknown
8. Route(s) of exposure
Skin
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
<=30 min / <=30 min
11. List all symptoms
System
- Respiratory System
- Symptom - Laboured breathing
- Eye
- Symptom - Blindness (permanent)
- Specify - "Blind"
12. How long did the symptoms last?
Persisted until death
13. Was medical treatment provided? Provide details in question 17.
No
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
1-20469293: A reporter (cat owner) called on 10/20/2009 to report the exposure of her 3 week old kitten to a flea and tick spray containing the active ingredients Methoprene and Tetrachlorvinphos. According to the reporter, the product was applied to the kitten on 10/19/2009 to treat a flea infestation. Within 10 minutes of product application, the kitten became listless, but the reporter thought that it was because the kitten was cold. When the reporter returned home from work later that day, the kitten had not moved, was blind, and was "huffing" and "barely breathing." The kitten died later than night and was disposed of. The reporter was advised that the product is not labeled for use in cats younger than 12 weeks of age. When the product is used appropriately, adverse effects are not expected. The reporter was advised that signs of overexposure include salivation, lacrimation, excessive urination, and lethargy. Blindness is not a symptom of overdose, nor would it occur with direct application in the eye. No further information was obtained. NOTE: This product is not labeled for use in cats younger than 12 weeks of age.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here