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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-0157

2. Registrant Information.

Registrant Reference Number: 090091678

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.

14-AUG-09

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

14-AUG-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. 26494      PMRA Submission No.       EPA Registration No.

Product Name: Zodiac Fleatrol Power Spot Flea and Tick Control for Dogs Under 14 kg

  • Active Ingredient(s)
    • (S)-METHOPRENE
    • PERMETHRIN

7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

2

Other Units: drops

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).

On August 13, 2009 the pet owner inappropriately applied the product to the cat.

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 Mediumhair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

5

7. Weight (provide a range if necessary )

15

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

>8 hrs <= 24 hrs / >8 h <= 24 h

10. Time between exposure and onset of symptoms

>8 hrs <=24 hrs / > 8 h < = 24 h

11. List all symptoms

System

  • General
    • Symptom - Hissing
  • Nervous and Muscular Systems
    • Symptom - Hallucination
    • Specify - Hallucinating
  • Respiratory System
    • Symptom - Panting
  • Nervous and Muscular Systems
    • Symptom - Fasciculations
    • Symptom - Disorientation
  • Eye
    • Symptom - Pupil dilation

12. How long did the symptoms last?

>8 hrs <=24 hrs / > 8 h < = 24 h

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

Fully Recovered / Complètement rétabli

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 August 14, 2009 the pet owner bathed the cat at the application site with soap and water. The APSS veterinarian recommended that the pet owner take the cat to the veterinarian, have the veterinarian call for information, and call back with questions. The pet owner could not take the cat to the veterinarian due to financial constraints. The pet owner bathed the cat a second time and the signs seemed to be resolving. The APSS veterinarian stated that it would be unlikely for the signs to recur after they had subsided, but recommended that the pet owner take the cat to the veterinarian if signs did recur. The APSS veterinarian also asked that the pet owner call back with any additional questions.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here

The owner stated that he bathed the cat twice more the previous evening and fed the cat yogurt and steak. The cat made a full recovery early on the morning of August 15, 2009. On August 19, 2009 an APSS technician spoke to the pet owner. The pet owner stated that he took the cat to the veterinarian on August 15, 2009. The product was not used according to label directions: do not use on cats.