Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-3764

2. Registrant Information.

Registrant Reference Number: PROSAR Case # 1-22864752

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.

03-JUN-10

5. Location of incident.

Country: UNITED STATES

Prov / State: NORTH CAROLINA

6. Date incident was first observed.

01-JUN-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.       PMRA Submission No.       EPA Registration No. 2596-139

Product Name: UltraGuard Plus Flea/Tick Collar for Cats/Kittens Safety Release

• Active Ingredient(s)
  • (S)-METHOPRENE
    • Guarantee/concentration 1.02 %
  • TETRACHLORVINPHOS
    • Guarantee/concentration 14.55 %

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7. b) Type of formulation.

Other (specify)

Treated collar

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).

Product was applied on 5/31 to 2 cats. One (8 months old) developed symptoms within 24 hours; the other was asymptomatic.

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

Other

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 )

0.67

7. Weight (provide a range if necessary )

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

Unknown / Inconnu

11. List all symptoms

System

• Gastrointestinal System
  • Symptom - Vomiting

• General
  • Symptom - Lethargy

• Nervous and Muscular Systems
  • Symptom - Seizure

• Respiratory System
  • Symptom - Difficulty Breathing
  • Symptom - Respiratory failure

• General
  • Symptom - Death

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

1-22864752: The reporter called on 6/3/10 to report the death of her parent¿s kitten (8 month old, male DLH) after the kitten was exposed to a flea and tick collar containing the active ingredients Methoprene and Tetrachlorvinphos. According to the reporter, a collar had been applied to her parent's 2 cats (a cat and a kitten) on 5/31/10. The kitten became lethargic and developed vomiting within 24 hours of product application. The owners removed the collar and contacted their veterinarian, who instructed them to bathe the kitten and keep him hydrated. The kitten's symptoms continued throughout the day, so the owners repeated their call to the veterinarian. They were told that the symptoms should pass; however, the kitten¿s symptoms continued to persist and the owners planned to bring him in to the veterinarian on 6/3. During the evening of 6/2/10, the kitten had a seizure, experienced difficulty breathing, and went into respiratory arrest. The kitten died and was buried. The reporter speculated that in addition to the dermal exposure from the collar itself, the kitten may have ingested the collar¿s powder off his coat during grooming. During the 6/3 call, the safety profile of the product was discussed, including the fact that the symptoms as described would not be expected with labeled use.

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To be determined by Registrant

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

Death

19. Provide supplemental information here