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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2010-4975
2. Registrant Information.
Registrant Reference Number: PROSAR Case #1-23694287
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.
04-AUG-105. Location of incident.
Country: CANADA
Prov / State: ONTARIO
6. Date incident was first observed.
04-AUG-10Product 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. 25922 PMRA Submission No. EPA Registration No.
Product Name: UltraGuard Flea TIck Drops for Dogs Puppies Over 30 lbs
- Active Ingredient(s)
- PERMETHRIN
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 catTo 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
domestic shorthair
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
10
7. Weight (provide a range if necessary )
10
lbs
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
- Nervous and Muscular Systems
- Symptom - Agitation
- Skin
- Symptom - Pruritus
12. How long did the symptoms last?
>8 hrs <=24 hrs / > 8 h < = 24 h
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
1-23694287- The reporter, a pet owner, calls to indicate her animals have been exposed to an insecticide containing the active ingredient permethrin. The caller indicates her husband applied the product, a topical flea and tick drop labeled for use in dogs only, to their two cats one hour prior to the initial contact with the registrant. Shortly after application they realized the error. Their female ten year ten pound domestic short hair cat (Subform III, #1) was agitated and pruritic at the time of the initial contact and their eight year twenty pound domestic shorthair cat (Subform III, #2) was also reported to be agitated and pruritic. The caller was advised concentrated canine pyrethrin/pyrethroid spot-on type products can result in significant problems if inappropriately used on cats. They were advised of signs commonly seen in such circumstances, the threshold at which veterinary care should be sought, treatment protocols, and prognosis. It was advised she decontaminate the animals by washing with a non-insecticidal shampoo and monitor. The reporter called back spontaneously twice in the course of three hours to indicate she had washed the animals She reported the female animal remained stable but the male developed the additional signs of excessive salivation and panting/tachypnea. On routine call back the pet owner indicated the female resolved spontaneously and the male was eventually brought to the veterinarian where they bathed the animal again and indicated a good prognosis. 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
Cat / Chat
3. Breed
domestic shorthair
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
8
7. Weight (provide a range if necessary )
20
lbs
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
- Nervous and Muscular Systems
- Symptom - Agitation
- Skin
- Symptom - Pruritus
- Respiratory System
- Symptom - Tachypnea
- Gastrointestinal System
- Symptom - Salivating excessively
- Respiratory System
- Symptom - Panting
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
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
1-23694287- The reporter, a pet owner, calls to indicate her animals have been exposed to an insecticide containing the active ingredient permethrin. The caller indicates her husband applied the product, a topical flea and tick drop labeled for use in dogs only, to their two cats one hour prior to the initial contact with the registrant. Shortly after application they realized the error. Their female ten year ten pound domestic short hair cat (Subform III, #1) was agitated and pruritic at the time of the initial contact and their eight year twenty pound domestic shorthair cat (Subform III, #2) was also reported to be agitated and pruritic. The caller was advised concentrated canine pyrethrin/pyrethroid spot-on type products can result in significant problems if inappropriately used on cats. They were advised of signs commonly seen in such circumstances, the threshold at which veterinary care should be sought, treatment protocols, and prognosis. It was advised she decontaminate the animals by washing with a non-insecticidal shampoo and monitor. The reporter called back spontaneously twice in the course of three hours to indicate she had washed the animals She reported the female animal remained stable but the male developed the additional signs of excessive salivation and panting/tachypnea. On routine call back the pet owner indicated the female resolved spontaneously and the male was eventually brought to the veterinarian where they bathed the animal again and indicated a good prognosis. No further information is available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
