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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-3941

2. Registrant Information.

Registrant Reference Number: PROSAR 1-21337951

Registrant Name (Full Legal Name no abbreviations): HACCO, Inc.

Address: 110 Hopkins Drive

City: Randolph

Prov / State: Wisconsin

Country: USA

Postal Code: 53956

3. Select the appropriate subform(s) for the incident.

Domestic Animal

4. Date registrant was first informed of the incident.

17-JAN-10

5. Location of incident.

Country: UNITED STATES

Prov / State: MISSOURI

6. Date incident was first observed.

16-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)

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 61282-26

Product Name: Ramik Mini Bars All Weather Rat/Mouse Killer

  • Active Ingredient(s)
    • DIPHACINONE (PRESENT IN FREE FORM OR AS SODIUM SALT)
      • Guarantee/concentration .005 %

7. b) Type of formulation.

Bait

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

10. Site pesticide was applied to (select all that apply).

Site: Res. - In Home / Rés. - à l'int. maison

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

The product was placed inside a residence at an unknown time. The dog was started on calcium tablets and Rimadyl on 01/16/2010.

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

Dog / Chien

3. Breed

Yorkshire Terrier

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

5

7. Weight (provide a range if necessary )

4

lbs

8. Route(s) of exposure

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 - Listless
    • Symptom - Fever
  • Gastrointestinal System
    • Symptom - Vomiting
  • Nervous and Muscular Systems
    • Symptom - Muscle weakness
  • Renal System
    • Symptom - Blood in urine
  • General
    • Symptom - Death
  • Blood
    • Symptom - Bleeding
    • Specify - Blood from mouth after 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?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

16. How was the animal exposed?

Other / Autre

specify Unknown-possible accidental ingestion of pesticide

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

1-21337951: A reporter (dog owner) called on 01/17/2010 to report the possible exposure of her dog to a rodenticide containing the active ingredient Diphacinone. According to the reporter, the product was placed behind the refrigerator and stove inside the home on an unknown date and was not accessible to the dog. On 01/14/2010, the dog whelped 2 puppies. One puppy was healthy and doing well at the time of the report. The other puppy was very large and died shortly after birth. On 01/16/2010, the dog became listless and was taken to the veterinarian as the reporter thought she may have milk fever (hypocalcemia). The veterinarian determined that the dog had a fever, but the rest of the exam was normal. The dog was discharged with calcium tablets to be given every 30 minutes and Rimadyl for pain. The reporter gave the dog a dose of Rimadyl, but she vomited shortly thereafter. The Rimadyl was re-dosed and the dog was able to keep it down. Within 2-3 hours, the dog became more lethargic, was weak in the hind end, and urinated blood. The dog died at home that night. After death, blood came from the dog's mouth. The dog had been cremated at the time of the report. The reporter was advised that the toxic dose of product for her dog is 3.6 grams of bait and works by interfering with blood coagulation. Signs of toxicity include lethargy, difficulty breathing, anorexia, ataxia, or evidence of bleeding from anywhere on the body. The reporter was advised that fever is not consistent with rodenticide toxicity. The reporter was also advised that there can be other causes for coagulopathies. A recommendation was made to consider other causes for the signs given the dog's recent whelping and the presence of a fever, especially if the dog would not have been able to access the product. The reporter was advised that a necropsy may have been able to determine a cause of death. 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

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

4. Number of animals affected

1

5. Sex

Unknown

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

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 - 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?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

16. How was the animal exposed?

Other / Autre

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

1-21337951: A reporter (dog owner) called on 01/17/2010 to report the possible exposure of her dog to a rodenticide containing the active ingredient Diphacinone. According to the reporter, the product was placed behind the refrigerator and stove inside the home on an unknown date and was not accessible to the dog. On 01/14/2010, the dog whelped 2 puppies. One puppy was healthy and doing well at the time of the report. The other puppy was very large and died shortly after birth. On 01/16/2010, the dog became listless and was taken to the veterinarian as the reporter thought she may have milk fever (hypocalcemia). The veterinarian determined that the dog had a fever, but the rest of the exam was normal. The dog was discharged with calcium tablets to be given every 30 minutes and Rimadyl for pain. The reporter gave the dog a dose of Rimadyl, but she vomited shortly thereafter. The Rimadyl was re-dosed and the dog was able to keep it down. Within 2-3 hours, the dog became more lethargic, was weak in the hind end, and urinated blood. The dog died at home that night. After death, blood came from the dog's mouth. The dog had been cremated at the time of the report. The reporter was advised that the toxic dose of product for her dog is 3.6 grams of bait and works by interfering with blood coagulation. Signs of toxicity include lethargy, difficulty breathing, anorexia, ataxia, or evidence of bleeding from anywhere on the body. The reporter was advised that fever is not consistent with rodenticide toxicity. The reporter was also advised that there can be other causes for coagulopathies. A recommendation was made to consider other causes for the signs given the dog's recent whelping and the presence of a fever, especially if the dog would not have been able to access the product. The reporter was advised that a necropsy may have been able to determine a cause of death. 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