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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-5355

2. Registrant Information.

Registrant Reference Number: 1-24017767

Registrant Name (Full Legal Name no abbreviations): Hartz Canada, Inc.

Address: 1125 Talbot Street

City: St. Thomas

Prov / State: ON

Country: Canada

Postal Code: N5P 3W7

3. Select the appropriate subform(s) for the incident.

Domestic Animal

4. Date registrant was first informed of the incident.

06-SEP-10

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

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. 25655      PMRA Submission No.       EPA Registration No.

Product Name: HARTZ ULTRAGUARD FLEA TICK SPRAY FOR CATS

  • Active Ingredient(s)
    • TETRACHLORVINPHOS

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).

Applied to 3 kittens about 1 month old. Product not registered on 1 month kittens.

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

Unknown

6. Age (provide a range if necessary )

.08

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Unknown

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 / <=30 min

11. List all symptoms

System

  • General
    • Symptom - Vocalizing
    • Specify - vocalization
  • 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

Caller states product was applied last night (10 hours ago) and within 15 minutes of product application all 3 kittens were vocalizing. Caller states they went to bed and this morning one kitten is twitching (tremoring) and the two other kittens are disoriented (confused). Caller is uncertain of actual age of the kittens but believes they are at least 1 month old. Informed caller that each kitten needs to be bathed in a mild detergent soap (dishwashing liquid) and then immediately transported to local DVM for examination and treatment. I Did not discuss cholinesterase testing with the caller due to the emergency nature of the kittens needing treatment and the owner was not able to accurately identify the product (not able to find UPC code and name given off the product is not a complete match for the tetrachlorvinphos product). Instructed caller or her DVM to call back with addtional questions or concerns.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here

Applied to 3 kittens about 1 month old. Product not registered on 1 month kittens.

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

2

5. Sex

Unknown

6. Age (provide a range if necessary )

0.08

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

<=15 min / <=15 min

10. Time between exposure and onset of symptoms

<=30 min / <=30 min

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Confusion
  • General
    • Symptom - Vocalizing
    • Specify - Vocalization

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

Caller states product was applied last night (10 hours ago) and within 15 minutes of product application all 3 kittens were vocalizing. Caller states they went to bed and this morning one kitten is twitching (tremoring) and the two other kittens are disoriented (confused). Caller is uncertain of actual age of the kittens but believes they are at least 1 month old. Informed caller that each kitten needs to be bathed in a mild detergent soap (dishwashing liquid) and then immediately transported to local DVM for examination and treatment. I Did not discuss cholinesterase testing with the caller due to the emergency nature of the kittens needing treatment and the owner was not able to accurately identify the product (not able to find UPC code and name given off the product is not a complete match for the tetrachlorvinphos product). Instructed caller or her DVM to call back with additional questions or concerns.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here

Applied to 3 kittens about 1 month old. Product not registered on 1 month kittens.