Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-5729

2. Registrant Information.

Registrant Reference Number: 2010TH042

Registrant Name (Full Legal Name no abbreviations): Bayer Inc

Address: 77 Belfield Road

City: Toronto

Prov / State: ON

Country: Canada

Postal Code: M9W 1G6

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: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

18-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)

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PMRA Registration No. 25131      PMRA Submission No.       EPA Registration No.

Product Name: advantage 100

• Active Ingredient(s)
  • IMIDACLOPRID

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7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

.3

Units: mL

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).

Owner applied 0.3 ml of advantage 100 (4 ml tube intended for dogs)

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

Medical Professional

2. Type of animal affected

Cat / Chat

3. Breed

Domestic medium hair

4. Number of animals affected

1

5. Sex

Male

Female

6. Age (provide a range if necessary )

0.5

7. Weight (provide a range if necessary )

2.55

kg

8. Route(s) of exposure

Skin

9. What was the length of exposure?

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

10. Time between exposure and onset of symptoms

>8 hrs <=24 hrs / > 8 h < = 24 h

11. List all symptoms

System

• Nervous and Muscular Systems
  • Symptom - Trembling
  • Symptom - Difficulty walking

• Blood
  • Symptom - Other
  • Specify - elevated platelets
  • Symptom - Hypercalcemia
  • Symptom - Hypernatremia
  • Symptom - Other
  • Specify - eosinophila

• Nervous and Muscular Systems
  • Symptom - Ataxia

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.

Yes

14. a) Was the animal hospitalized?

Yes

14. b) How long was the animal hospitalized?

24

Hour(s) / Heure(s)

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

The owner used 0.3 ml of advantage 100 on Oct 17 2010. The owner had used advantage in this manner before. The owner noticed the cat trembling at approx 4 AM Oct 18 and presented the pet at the clinic at 3 PM Oct 18. The cat was bright but trembling. PLR response was good. The pet was unable to walk due to trembling. Bloodwork shows eosinophila, elevated platelets, hypercalcemia and hypernatremia. The pet was transferred to an emergency clinic for overnight treatment (name). Upon arrival at the emergency clinic for overnight monitoring (17:10), the pet was exhibiting moderate tremors and still could not walk without assistance. By 8:20 on Oct 19 the trembling had ceased and only a mild hind end ataxia remained. Zorro was discharge Oct 19 with instructions that the owners monitor him and keep him indoors for several days. On initial presentation, the cat was given diazepam (0.5 mg/kg) IV and phenobarb 10 mg/kg IV and the cat was placed on IV fluids. At (name) 55/mg/kg methocarbamol was given IV and IV fluids were maintained. No medications were sent home.

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To be determined by Registrant

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

Major

19. Provide supplemental information here

Classed as major as this reaction is possibly a permethrin toxicosis, attributable to another product. Untreated, permethrin toxicosis can be fatal.