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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-5533

2. Registrant Information.

Registrant Reference Number: 100135735

Registrant Name (Full Legal Name no abbreviations): Farnam Companies, Inc.

Address: 301 W. Osborn Road

City: Phoenix

Prov / State: Arizona

Country: USA

Postal Code: 85013

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

Domestic Animal

4. Date registrant was first informed of the incident.

18-OCT-10

5. Location of incident.

Country: UNITED STATES

Prov / State: TENNESSEE

6. Date incident was first observed.

17-OCT-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. 270-348

Product Name: Adams Water Based Flea and Tick Mist for Dogs Puppies Cats Kittens

  • Active Ingredient(s)
    • N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
      • Guarantee/concentration 2 %
    • PIPERONYL BUTOXIDE
      • Guarantee/concentration .75 %
    • PYRETHRINS
      • Guarantee/concentration .2 %

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 270-341

Product Name: Adams Flea and Tick Shampoo for Dogs Puppies Cats Kittens

  • Active Ingredient(s)
    • N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
      • Guarantee/concentration .51 %
    • PIPERONYL BUTOXIDE
      • Guarantee/concentration 1.5 %
    • PYRETHRINS
      • Guarantee/concentration .15 %

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).

On October 2, 2010 the owner sprayed the cat with the mist and also bathed the cat with the shampoo to treat a flea infestation. That same day, the owner also applied an Adams flea and tick collar. On October 4, 2010 the owner removed the collar, sprayed the cat again and re-bathed the cat with the shampoo, then reapplied the collar. Again on October 15, 2010 the owner re-bathed the cat with the shampoo and sprayed the cat with the mist.

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 )

0.5

7. Weight (provide a range if necessary )

2

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>24 hrs <=3 days / >24 h <=3 jours

11. List all symptoms

System

  • Gastrointestinal System
    • Symptom - Rectal hemorrhage
  • Renal System
    • Symptom - Inappropriate urination
  • Respiratory System
    • Symptom - Dyspnea
  • General
    • Symptom - Vocalizing
  • Blood
    • Symptom - Anemia
  • General
    • Symptom - Death

12. How long did the symptoms last?

Persisted until death

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

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

On October 17, 2010 the owner noticed the cat had some rectal bleeding. The next day, October 18, the owner found the cat vocalizing, breathing hard, bleeding out of his rectum, and inappropriately urinating on himself, so the owner took the cat to the veterinarian, where she was told the cat was anemic. The cat died shortly after. The owner then contacted the Animal Product Safety Service (APSS). The APSS veterinarian stated use of flea and tick sprays and shampoos as per label directions are not expected to cause significant clinical signs and the concentration of active ingredients is typically quite low, so even ingestion of the agents via licking does not pose a significant threat of toxicity. The APSS veterinarian recommended calling the manufacturer to discuss product efficiency and calling the veterinarian regarding flea control and preventative for the other household pets.


To be determined by Registrant

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

Death

19. Provide supplemental information here

The APSS veterinarian stated that the substances were not considered to be related to causing the clinical situation. A follow up was not performed, because additional information was not expected.