Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-4970

2. Registrant Information.

Registrant Reference Number: PROSAR Case #:1-23672067

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-AUG-10

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

Unknown

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. 2596-150

Product Name: UltraGuard Pro Flea Tick Drops Plus for Dogs Puppies

• Active Ingredient(s)
  • (S)-METHOPRENE
  • D-PHENOTHRIN

---

7. b) Type of formulation.

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).

dog product applied to cat

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

No

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 )

6

7. Weight (provide a range if necessary )

8

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

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

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

• Skin
  • Symptom - Lesion
  • Specify - open sores

12. How long did the symptoms last?

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

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

1-23672067- The reporter, a pet owner, indicates her animal has been exposed to an insecticide containing the active ingredients phenothrin and methoprene. The caller indicates she applied the product to her six year eight pound female cat three days prior to the initial contact with the registrant. The caller indicates the animal had excoriated the application site (intrascapular) and developed an open sore between its shoulder blades. The caller was advised concentrated canine pyrethrin/pyrethroid spot-on type products can result in significant problems if inappropriately used on cats. She was advised of signs that may be seen in these circumstances and the threshold at which she might seek veterinary care. She was advised to wash the product off of the animal with a non-insecticidal shampoo. On routine call back the reporter indicated she washed the animal and the sore had healed fully with in three days. No further sign were seen.

---

To be determined by Registrant

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

Minor

19. Provide supplemental information here