Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-1428

2. Registrant Information.

Registrant Reference Number: PROSAR 1-21565125

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.

02-FEB-10

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

27-JAN-10

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)

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PMRA Registration No. 25655      PMRA Submission No.       EPA Registration No.

Product Name: Control Pet Care System Flea/Tick Guard for Cats (Canada)

• Active Ingredient(s)
  • TETRACHLORVINPHOS

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PMRA Registration No. 24653      PMRA Submission No.       EPA Registration No.

Product Name: UltraGuard Plus Flea/Tick Home Spray (Canada)

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

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7. b) Type of formulation.

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 feline spray was applied to the cat on 01/27/2010. The home spray was used at an unknown time, and the cat's potential exposure to the product was not specified.

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

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Domestic Longhair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

8

7. Weight (provide a range if necessary )

11.5

lbs

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

• General
  • Symptom - Hiding

• Gastrointestinal System
  • Symptom - Salivating excessively
  • Symptom - Vomiting

• Eye
  • Symptom - Pupil dilation

• General
  • Symptom - Malaise

• Nervous and Muscular Systems
  • Symptom - Muscle tremors

• General
  • Symptom - Fever
  • Symptom - Weakness

12. How long did the symptoms last?

Unknown / Inconnu

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?

2

Day(s) / Jour(s)

15. Outcome of the incident

Unknown/Inconnu

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

1-21565125: A reporter (cat owner) called on 02/02/2010 to report the exposure of her cat to a flea and tick spray containing the active ingredient Tetrachlorvinphos, and possible exposure to a flea and tick home spray containing the active ingredients Tetrachlorvinphos and Permethrin. According to the reporter, the cat spray was applied to the cat on 01/27/2010. The reporter wiped the cat down with a towel 10 minutes following product application, and the cat hid in the home. Several hours following product application, the cat was salivating, vomiting, having occasional muscle tremors, had dilated pupils and was depressed. The cat was evaluated by a veterinarian on 01/30/2010 where it received subcutaneous fluids. The reporter declined hospitalization, and the cat was not bathed. At the time of the report, the cat was still depressed and had a fever of 105.8 degrees F. It was not specified when the home spray was used or what the cat's potential exposure may have been. The reporter was advised that the cat should be bathed in a mild non-insecticidal shampoo and evaluated by a veterinarian given the persistent signs. The reporter was also advised of the company's cholinesterase testing program. On follow up on 02/05/2010, the reporter stated that the cat was taken back to the veterinarian on 02/03/2010 and hospitalized for 2 nights. At the time of the follow up, the reporter stated that the cat was doing better and would be discharged later that day. The reporter called back spontaneously and reported that the cat was doing better every day and just seemed a little bit weak. No further information was obtained.

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To be determined by Registrant

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

Moderate

19. Provide supplemental information here