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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-4976

2. Registrant Information.

Registrant Reference Number: PROSAR Case #1-23700146

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: CANADA

Prov / State: NEW BRUNSWICK

6. Date incident was first observed.

04-AUG-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. 26490      PMRA Submission No.       EPA Registration No.

Product Name: UltraGuard Plus Flea Tick Drops for Dogs Puppies Over 30 lbs

  • Active Ingredient(s)
    • (S)-METHOPRENE
    • 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).

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

domestic shorthair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.4

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

>2 hrs <=8 hrs / > 2 h < = 8 h

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Seizure
  • Respiratory System
    • Symptom - Laboured breathing

12. How long did the symptoms last?

>2 hrs <=8 hrs / > 2 h < = 8 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

1-23700146- The reporter, a pet owner indicates exposure of his animal to an insecticide containing the active ingredient permethrin and methoprene. The caller initially stated the product, a topical flea and tick drop labeled only for use on dogs, was place on his five month male domestic shorthair cat the night prior to the initial contact with the registrant. The caller then revised his story to indicate the product was applied to the family dog and the cat had been rubbing against the dog. It remains unclear which is actually the case. The caller stated within three hours of application the cat developed seizures and began gasping for breath. The animal was bathed and sign resolved within six hours. No veterinary assistance was sought. The caller asks if the animal will remain asymptomatic. 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. The caller was advised to closely monitor the animal for 72 hours and seek veterinary assistance should signs recur. No further information is available.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here