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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-1441

2. Registrant Information.

Registrant Reference Number: PROSAR 1-22108659

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.

31-MAR-10

5. Location of incident.

Country: UNITED STATES

Prov / State: ALASKA

6. Date incident was first observed.

Unknown

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. 2724-504-2596

Product Name: InControl Flea/Tick Drops for Cats Under 5 lbs

  • Active Ingredient(s)
    • (S)-METHOPRENE
      • Guarantee/concentration 3.6 %
    • ETOFENPROX
      • Guarantee/concentration 40 %

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-150

Product Name: UltraGuard Plus Flea/Tick Drops Plus for Dogs/Puppies 31-60 lbs

  • Active Ingredient(s)
    • (S)-METHOPRENE
      • Guarantee/concentration 2.3 %
    • D-PHENOTHRIN
      • Guarantee/concentration 85.7 %

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-150

Product Name: UltraGuard Plus Flea/Tick Drops Plus for Dogs/Puppies 4-15 lbs

  • Active Ingredient(s)
    • (S)-METHOPRENE
      • Guarantee/concentration 2.3 %
    • D-PHENOTHRIN
      • Guarantee/concentration 85.7 %

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 canine product for dogs weighing 4-15 pounds was applied to the 10 pound dog on an unspecified date. The other two products were reportedly applied appropriately to the other pets in the home at an unspecified time.

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

Dog / Chien

3. Breed

Unknown breed

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

4

7. Weight (provide a range if necessary )

10

lbs

8. Route(s) of exposure

Skin

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • General
    • Symptom - Lethargy
  • Gastrointestinal System
    • Symptom - Vomiting
    • Symptom - Diarrhea
  • General
    • Symptom - Death

12. How long did the symptoms last?

Persisted until death

13. Was medical treatment provided? Provide details in question 17.

Unknown

14. a) Was the animal hospitalized?

Unknown

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

1-22108659: A reporter (veterinary technician) called on 03/31/2010 to report the exposure of a dog to a canine flea and tick product for dogs weighing 4-15 pounds containing the active ingredients Methoprene and Phenothrin. According to the reporter, the product was applied to the dog on an unknown date. A feline flea and tick product containing the active ingredients Methoprene and Etofenprox and the same canine product but for dogs weighing 31-60 pounds were also applied to the appropriate pets in the household at an unknown time. It was thought that the dog may have ingested product off of one of the other treated pets. The dog presented to the veterinary clinic with vomiting. The reporter was advised that the signs described would not be expected following routine use of the product. in cases of overdose or individual sensitivity, the signs typically develop within 30 minutes to 3 hours, but may be delayed for up to 24-72 hours. Signs of overdose were reviewed, as were the treatment recommendations should the signs be determined to be from product exposure. The reporter called back on 03/31/2010 to report that the dog developed lethargy and explosive diarrhea before passing away. The company's necropsy policy was discussed and the appropriate forms were sent via fax. No further information was obtained.


To be determined by Registrant

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

Death

19. Provide supplemental information here