Health Canada
Symbol of the Government of Canada
Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-4973

2. Registrant Information.

Registrant Reference Number: PROSAR Case #:1-23700365

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.

05-AUG-10

5. Location of incident.

Country: UNITED STATES

Prov / State: NEW YORK

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. 2596-126

Product Name: UltraGuard Flea Tick Cat Spray

  • Active Ingredient(s)
    • TETRACHLORVINPHOS
      • Guarantee/concentration 1.08 %

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

Male

6. Age (provide a range if necessary )

0.6

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

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

System

  • Nervous and Muscular Systems
    • Symptom - Seizure
  • Gastrointestinal System
    • Symptom - Salivating excessively
  • Renal System
    • Symptom - Urinary incontinence
  • Nervous and Muscular Systems
    • Symptom - Muscle spasm
  • General
    • Symptom - Death

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

1-23700365- The reporter, a pet owner, indicates her animal have been exposed to an insecticide containing the active ingredient tetrachlorvinphos. The caller indicated she applied the product to her eight month male domestic shorthair cat (Subform III, #1)one month prior to the initial contact with the registrant. The animal within 45 minutes of application developed signs described as seizure, salivation, urinary incontinence, and muscle spasms. The signs persisted unto death (time frame not given), no veterinary assistance was sought. The owner reports she had just used the product on the previous animals sibling, another eight month male domestic shorthair cat (subform III, #2), and the animal developed signs of salivation, agitation, and mydriasis. Time frame and application technique/rate not clarified. The caller indicates she had washed the animal and it was currently asymptomatic. The caller was informed the signs seen would be unexpected if the product was used according to the product label. Overdosage can occur if used improperly. The caller was advised of signs consistent with overdosage and advised to wash her animal with a non insecticidal shampoo. She was advised to seek veterinary care and of registrant supported cholinesterase testing. The reporter¿s veterinarian called back later the same day and discussed treatment advice and was provided submission information regarding cholinesterase testing. 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

1

5. Sex

Male

6. Age (provide a range if necessary )

0.6

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

Unknown / Inconnu

11. List all symptoms

System

  • Gastrointestinal System
    • Symptom - Salivating excessively
  • Nervous and Muscular Systems
    • Symptom - Agitation
  • Eye
    • Symptom - Pupil dilation

12. How long did the symptoms last?

Unknown / Inconnu

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

Yes

14. a) Was the animal hospitalized?

Unknown

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

1-23700365- The reporter, a pet owner, indicates her animal have been exposed to an insecticide containing the active ingredient tetrachlorvinphos. The caller indicated she applied the product to her eight month male domestic shorthair cat (Subform III, #1)one month prior to the initial contact with the registrant. The animal within 45 minutes of application developed signs described as seizure, salivation, urinary incontinence, and muscle spasms. The signs persisted unto death (time frame not given), no veterinary assistance was sought. The owner reports she had just used the product on the previous animals sibling, another eight month male domestic shorthair cat (subform III, #2), and the animal developed signs of salivation, agitation, and mydriasis. Time frame and application technique/rate not clarified. The caller indicates she had washed the animal and it was currently asymptomatic. The caller was informed the signs seen would be unexpected if the product was used according to the product label. Overdosage can occur if used improperly. The caller was advised of signs consistent with overdosage and advised to wash her animal with a non insecticidal shampoo. She was advised to seek veterinary care and of registrant supported cholinesterase testing. The reporter¿s veterinarian called back later the same day and discussed treatment advice and was provided submission information regarding cholinesterase testing. 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