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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-4993

2. Registrant Information.

Registrant Reference Number: PROSAR Case # 1-23886859

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.

23-AUG-10

5. Location of incident.

Country: UNITED STATES

Prov / State: NEW JERSEY

6. Date incident was first observed.

19-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.       PMRA Submission No.       EPA Registration No. 2596-78

Product Name: Advanced Care 2 in 1 Flea Tick Powder for Dogs

  • Active Ingredient(s)
    • TETRACHLORVINPHOS
      • Guarantee/concentration 3.3 %

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-78

Product Name: 2 in 1 Flea Tick Powder for Cats

  • Active Ingredient(s)
    • TETRACHLORVINPHOS
      • Guarantee/concentration 3.3 %

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-22

Product Name: UltraGuard Rid Flea Dog Shampoo Refreshing Fresh Citrus

  • Active Ingredient(s)
    • N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
      • Guarantee/concentration .149 %
    • PIPERONYL BUTOXIDE
      • Guarantee/concentration .089 %
    • PYRETHRINS
      • Guarantee/concentration .045 %

7. b) Type of formulation.

Liquid

Dust

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

Persian

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

15

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>3 days <=1 wk / >3 jours <=1 sem

11. List all symptoms

System

  • General
    • Symptom - Vocalizing
    • Symptom - Hyperactivity
  • Gastrointestinal System
    • Symptom - Anorexia
  • General
    • Symptom - Lethargy
    • 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

1-23886859- The reporter, a pet owner, indicates exposure of his animals to multiple insecticidal products. Two containing the active ingredient tetrachlorvinphos, one containing pyrethrins, piperonyl butoxide, and N-octyl bicycloheptene dicarboximide. The last product the caller could not accurately identify. The caller indicated he applied a topical flea and tick powder (tetrachlorvinphos containing product) and an un identified flea and tick spray to his twelve year fifteen pound male Persian cat (Sub-form III, #1) approximately one week prior to the initial contact with the registrant. The caller reports four days prior to the initial contact with the registrant the animal began vocalizing, became hyperactive, refused food, became lethargic and died two days prior to the initial call placed to the registrant. The caller did not seek veterinary assistance at any point during the reported illness. The caller was advised that the product identified was not expected to yield the described signs when used according to the label. The caller was advised of registrant supported necropsy to determine cause of death. This product is not labeled for cats older than ten years of age. The caller was advised using multiple overlapping products of a single class may increase the likelihood of side effects. The caller also indicated he had applied the product containing pyrethrins, piperonyl butoxide, and N-octyl bicycloheptene dicarboximide (a flea and tick shampoo) and a tetrachlorvinphos spray to his fifty pound twelve year mixed breed dog within two weeks of his initial contact with the registrant. The reporter indicated his animal had begun to twitch at some unspecified point after application. The caller had stated he could not tell if the animal was experiencing muscle tremors or pruritis. The caller was advised to wash his animal with a noninsecticidal shampoo and seek veterinary assistance if the signs persist or worsen. The caller was advised using multiple overlapping products of a single class may increase the likelihood of side effects. 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

Dog / Chien

3. Breed

mixed breed

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

12

7. Weight (provide a range if necessary )

50

lbs

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

  • Nervous and Muscular Systems
    • Symptom - Muscle tremors

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

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

1-23886859- The reporter, a pet owner, indicates exposure of his animals to multiple insecticidal products. Two containing the active ingredient tetrachlorvinphos, one containing pyrethrins, piperonyl butoxide, and N-octyl bicycloheptene dicarboximide. The last product the caller could not accurately identify. The caller indicated he applied a topical flea and tick powder (tetrachlorvinphos containing product) and an un identified flea and tick spray to his twelve year fifteen pound male Persian cat (Sub-form III, #1) approximately one week prior to the initial contact with the registrant. The caller reports four days prior to the initial contact with the registrant the animal began vocalizing, became hyperactive, refused food, became lethargic and died two days prior to the initial call placed to the registrant. The caller did not seek veterinary assistance at any point during the reported illness. The caller was advised that the product identified was not expected to yield the described signs when used according to the label. The caller was advised of registrant supported necropsy to determine cause of death. This product is not labeled for cats older than ten years of age. The caller was advised using multiple overlapping products of a single class may increase the likelihood of side effects. The caller also indicated he had applied the product containing pyrethrins, piperonyl butoxide, and N-octyl bicycloheptene dicarboximide (a flea and tick shampoo) and a tetrachlorvinphos spray to his fifty pound twelve year mixed breed dog within two weeks of his initial contact with the registrant. The reporter indicated his animal had begun to twitch at some unspecified point after application. The caller had stated he could not tell if the animal was experiencing muscle tremors or pruritis. The caller was advised to wash his animal with a noninsecticidal shampoo and seek veterinary assistance if the signs persist or worsen. The caller was advised using multiple overlapping products of a single class may increase the likelihood of side effects. 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