Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-3897

2. Registrant Information.

Registrant Reference Number: PROSAR Case# 1-23347791

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.

06-JUL-10

5. Location of incident.

Country: UNITED STATES

Prov / State: SOUTH DAKOTA

6. Date incident was first observed.

03-JUL-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. Unknown

Product Name: Control One Spot Flea Tick Treatment for Cats

• Active Ingredient(s)
  • (S)-METHOPRENE
    • Guarantee/concentration 2.9 %

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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).

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

Unknown

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

1.5

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

>24 hrs <=3 days / >24 h <=3 jours

11. List all symptoms

System

• Nervous and Muscular Systems
  • Symptom - Seizure

• General
  • Symptom - Malaise

• Respiratory System
  • Symptom - Panting

• Gastrointestinal System
  • Symptom - Other
  • Specify - clenching jaw

• Nervous and Muscular Systems
  • Symptom - Muscle tremors

• General
  • Symptom - Death

12. How long did the symptoms last?

Persisted until death

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

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

1-23347791- The reporter, a pet owner, calls to indicate exposure of her animal to a pesticide containing the active ingredient S-methoprene. The pet owner indicates at initial contact with the registrant she applied the product (topical flea drops) 4 days prior to her five pound eighteen month female cat. The owner stated the animal began acting "sick" the day after application but did not qualify the signs seen. The pet owner stated the animal began having seizures three days after application and had been hospitalized since that point. The caller stated the veterinarian had indicated the animal had a "pyrethrin" toxicity and asked for treatment recommendations. She also revealed she had 4 other cats and 2 dogs in the home, all asymptomatic, to which various products had been applied (she did not specify those products). The caller was advised the active ingredient in the product she applied to her cat is S-methoprene, not a pyrethroid. The caller was advised this active ingredient carries minimal toxicity and would not be expected to elicit the symptoms described. The caller was advised to seek out other causes of her animal's illness. It was suggested to the pet owner that product transfer from one of the other treated animals in the home should be explored. The caller was advised of supportive care that may be helpful and of registrant supported hair testing that might help rule in or out pyrethroid toxicity. On routine call back the pet owner indicated the animal had died 5 days after application. She indicated the animals signs prior to its death persisted and included seizures, twitching, open mouth breathing, and clenching of the jaw. The only treatment that was indicated was washing the animal with a non-insecticidal shampoo. Necropsy was not done as the animal had already been buried. The reporter indicated the veterinarian had saved hair from the animal for pyrethroid testing but had not submitted at the point of the final contact with the registrant. No further information is available.

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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