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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-3899

2. Registrant Information.

Registrant Reference Number: PROSAR Case # 1-23524506

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.

21-JUL-10

5. Location of incident.

Country: UNITED STATES

Prov / State: LOUISIANA

6. Date incident was first observed.

30-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)

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-86

Product Name: UltraGuard Flea Tick Dip for Dogs Cats Concentrate

  • Active Ingredient(s)
    • N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
      • Guarantee/concentration 1.11 %
    • PIPERONYL BUTOXIDE
      • Guarantee/concentration .67 %
    • PYRETHRINS
      • Guarantee/concentration .33 %

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

Domestic shorthair

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

3

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

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

11. List all symptoms

System

  • General
    • Symptom - Lethargy
  • Gastrointestinal System
    • Symptom - Fecal incontinence
  • Skin
    • Symptom - Discolouration
    • Specify - bright yellow
  • General
    • Symptom - Dehydration
    • Symptom - Death
  • Renal System
    • Symptom - Urinary incontinence

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

1-23524506- The reporter, a pet owner, indicates exposure of several animals to an insecticide containing the active ingredients pyrethrins, Piperonyl butoxide, and N-octyl bicycloheptene dicarboximide. The caller reports she has used the product per the label instructions on a total of 14 cats and one dog. She indicates she applied the product to the animals on 06/30/10. She reports three cats (Subform III, #2), all one year domestic shorthair cats, began to cough within one hour of use. Their symptoms persisted for "a few weeks". She reports the dog (Subform III, #3), a one and one half year female mixed breed dog, developed dermal redness immediately following product use and generalized dermal hives by the next day. She reports she used a topical product provided by a family member (unspecified) on the animal and its signs resolve within "a few weeks". One cat (Subform III, #1), a three year female domestic shorthair, was reported to have died within four days of application. The pet owner reported within 24 hours of application the animal developed the signs of lethargy, urinary, and fecal incontinence. Within another two days the animal developed bright yellow skin and dehydration. The animal was dead by the next morning. The caller, lastly, adds that two additional cats (subform III, #4), four month male domestic shorthair cats, have developed dermatologic signs described as "skin and fur rolling off of their back legs" one week following the application of the product. She does not indicate if these symptoms are persistent. All other animals remained asymptomatic at the point of the call. The caller had not brought the animals to the veterinarian at any point during the described events. No necropsy has been performed. The caller was advised both the symptoms and outcome described would be unexpected following exposure to these active ingredients and the use of this product. Necropsy would be helpful at determining the cause of death of the animal that had passed. She indicated it had been buried. Lastly veterinary care would be recommended to assist in both diagnosis and humane care of the animals. No further information is available.


To be determined by Registrant

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

Death

19. Provide supplemental information here

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

domestic shorthair

4. Number of animals affected

3

5. Sex

Unknown

6. Age (provide a range if necessary )

1

7. Weight (provide a range if necessary )

Unknown

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 <=2 hrs / >30 min <=2 h

11. List all symptoms

System

  • Respiratory System
    • Symptom - Coughing

12. How long did the symptoms last?

>1 wk <=1 mo / > 1 sem < = 1 mois

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

1-23524506- The reporter, a pet owner, indicates exposure of several animals to an insecticide containing the active ingredients pyrethrins, Piperonyl butoxide, and N-octyl bicycloheptene dicarboximide. The caller reports she has used the product per the label instructions on a total of 14 cats and one dog. She indicates she applied the product to the animals on 06/30/10. She reports three cats (Subform III, #2), all one year domestic shorthair cats, began to cough within one hour of use. Their symptoms persisted for "a few weeks". She reports the dog (Subform III, #3), a one and one half year female mixed breed dog, developed dermal redness immediately following product use and generalized dermal hives by the next day. She reports she used a topical product provided by a family member (unspecified) on the animal and its signs resolve within "a few weeks". One cat (Subform III, #1), a three year female domestic shorthair, was reported to have died within four days of application. The pet owner reported within 24 hours of application the animal developed the signs of lethargy, urinary, and fecal incontinence. Within another two days the animal developed bright yellow skin and dehydration. The animal was dead by the next morning. The caller, lastly, adds that two additional cats (subform III, #4), four month male domestic shorthair cats, have developed dermatologic signs described as "skin and fur rolling off of their back legs" one week following the application of the product. She does not indicate if these symptoms are persistent. All other animals remained asymptomatic at the point of the call. The caller had not brought the animals to the veterinarian at any point during the described events. No necropsy has been performed. The caller was advised both the symptoms and outcome described would be unexpected following exposure to these active ingredients and the use of this product. Necropsy would be helpful at determining the cause of death of the animal that had passed. She indicated it had been buried. Lastly veterinary care would be recommended to assist in both diagnosis and humane care of the animals. No further information is available.


To be determined by Registrant

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

Minor

19. Provide supplemental information here

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

mixed breed

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 )

Unknown

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

  • Skin
    • Symptom - Erythema
    • Symptom - Hives

12. How long did the symptoms last?

>1 wk <=1 mo / > 1 sem < = 1 mois

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

1-23524506- The reporter, a pet owner, indicates exposure of several animals to an insecticide containing the active ingredients pyrethrins, Piperonyl butoxide, and N-octyl bicycloheptene dicarboximide. The caller reports she has used the product per the label instructions on a total of 14 cats and one dog. She indicates she applied the product to the animals on 06/30/10. She reports three cats (Subform III, #2), all one year domestic shorthair cats, began to cough within one hour of use. Their symptoms persisted for "a few weeks". She reports the dog (Subform III, #3), a one and one half year female mixed breed dog, developed dermal redness immediately following product use and generalized dermal hives by the next day. She reports she used a topical product provided by a family member (unspecified) on the animal and its signs resolve within "a few weeks". One cat (Subform III, #1), a three year female domestic shorthair, was reported to have died within four days of application. The pet owner reported within 24 hours of application the animal developed the signs of lethargy, urinary, and fecal incontinence. Within another two days the animal developed bright yellow skin and dehydration. The animal was dead by the next morning. The caller, lastly, adds that two additional cats (subform III, #4), four month male domestic shorthair cats, have developed dermatologic signs described as "skin and fur rolling off of their back legs" one week following the application of the product. She does not indicate if these symptoms are persistent. All other animals remained asymptomatic at the point of the call. The caller had not brought the animals to the veterinarian at any point during the described events. No necropsy has been performed. The caller was advised both the symptoms and outcome described would be unexpected following exposure to these active ingredients and the use of this product. Necropsy would be helpful at determining the cause of death of the animal that had passed. She indicated it had been buried. Lastly veterinary care would be recommended to assist in both diagnosis and humane care of the animals. No further information is available.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here

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

2

5. Sex

Male

6. Age (provide a range if necessary )

0.33

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>1 wk <=1 mo / > 1 sem < = 1 mois

11. List all symptoms

System

  • Skin
    • Symptom - Peeling skin
    • Symptom - Hair loss

12. How long did the symptoms last?

Unknown / Inconnu

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

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

1-23524506- The reporter, a pet owner, indicates exposure of several animals to an insecticide containing the active ingredients pyrethrins, Piperonyl butoxide, and N-octyl bicycloheptene dicarboximide. The caller reports she has used the product per the label instructions on a total of 14 cats and one dog. She indicates she applied the product to the animals on 06/30/10. She reports three cats (Subform III, #2), all one year domestic shorthair cats, began to cough within one hour of use. Their symptoms persisted for "a few weeks". She reports the dog (Subform III, #3), a one and one half year female mixed breed dog, developed dermal redness immediately following product use and generalized dermal hives by the next day. She reports she used a topical product provided by a family member (unspecified) on the animal and its signs resolve within "a few weeks". One cat (Subform III, #1), a three year female domestic shorthair, was reported to have died within four days of application. The pet owner reported within 24 hours of application the animal developed the signs of lethargy, urinary, and fecal incontinence. Within another two days the animal developed bright yellow skin and dehydration. The animal was dead by the next morning. The caller, lastly, adds that two additional cats (subform III, #4), four month male domestic shorthair cats, have developed dermatologic signs described as "skin and fur rolling off of their back legs" one week following the application of the product. She does not indicate if these symptoms are persistent. All other animals remained asymptomatic at the point of the call. The caller had not brought the animals to the veterinarian at any point during the described events. No necropsy has been performed. The caller was advised both the symptoms and outcome described would be unexpected following exposure to these active ingredients and the use of this product. Necropsy would be helpful at determining the cause of death of the animal that had passed. She indicated it had been buried. Lastly veterinary care would be recommended to assist in both diagnosis and humane care of the animals. No further information is available.


To be determined by Registrant

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

Minor

19. Provide supplemental information here