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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-4169

2. Registrant Information.

Registrant Reference Number: 209852

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

Address: 1125 Talbot Street

City: St. Thomas

Prov / State: ON

Country: Canada

Postal Code: N5P 3W7

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

Domestic Animal

4. Date registrant was first informed of the incident.


5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.


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.


PMRA Registration No. 26491      PMRA Submission No.       EPA Registration No.


  • Active Ingredient(s)

7. b) Type of formulation.

Application Information

8. Product was applied?


9. Application Rate.


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?


Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed


4. Number of animals affected


5. Sex


6. Age (provide a range if necessary )


7. Weight (provide a range if necessary )


8. Route(s) of exposure


9. What was the length of exposure?

>15 min <=2 hrs / >15 min <=2 h

10. Time between exposure and onset of symptoms

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

11. List all symptoms


  • General
    • Symptom - Abnormal behaviour
    • Specify - cat started running around,
  • Skin
    • Symptom - Rash
    • Symptom - Bleeding
  • General
    • Symptom - Hiding
    • Specify - hiding in closets.

12. How long did the symptoms last?

Unknown / Inconnu

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


14. a) Was the animal hospitalized?


14. b) How long was the animal hospitalized?

15. Outcome of the incident


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

A few weeks ago, I used your product to treat my 4 year old cat for fleas . I followed the directions on the back of the package exactly, however my cat ended up very ill. About an hour after he was treated with this medication, he started to behave very odd. He is usually a very calm and relaxed cat, however he started running around and hiding closets which he had never done before. I never thought that it could be caused by the flea medication, so I did not think much of it. The next day, my cat broke out with severe rashes on his face and head. I then bathed him with a very mild soap and water, just as your package stated to . The rashes quickly became much worse and started to bleed. I knew at that point that the severe rashes would not disappear on their own, so I took my cat to the vet immediately. The veterinarian said that the rashes on my cat were caused by this product and advised me not to purchase this flea medication again . The cat is now taking Prednisone twice a day, and his rash is slowly starting to heal. However, if his face is to fully heal, it will be scared because of the severity of the rashes, and his fur will most likely not grow back. I am sure that you are just as dedicated to your customers as they are to you, and I am expecting you to do the right thing to take care of this matter. Enclosed is a copy of the invoice I have received from the veterinarian. Vet bills are quite expensive and I cannot afford to put my animals on costly medication to reverse the effects from your products. I have also enclosed the UPC cut from the packaging of the product that has harmed my pet, as well as three photographs of what his face looked like just after I visited the vet office.

To be determined by Registrant

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


19. Provide supplemental information here