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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2010-5874

2. Registrant Information.

Registrant Reference Number: 694744

Registrant Name (Full Legal Name no abbreviations): S.C. Johnson and Son, Limited

Address: 1 Webster Street

City: Brantford

Prov / State: ON

Country: Canada

Postal Code: N3T 5R1

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

Domestic Animal

4. Date registrant was first informed of the incident.

20-SEP-10

5. Location of incident.

Country: UNITED STATES

Prov / State: NORTH CAROLINA

6. Date incident was first observed.

02-SEP-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. 4822-229

Product Name: Raid Flea Killer Plus Fogger

  • Active Ingredient(s)
    • (S)-METHOPRENE
    • N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
      • Guarantee/concentration 1.67 %
    • PIPERONYL BUTOXIDE
      • Guarantee/concentration 1 %
    • PYRETHRINS
      • Guarantee/concentration .5 %

PMRA Registration No.       PMRA Submission No.       EPA Registration No. Unknown

Product Name: Advantage 9

  • Active Ingredient(s)
    • IMIDACLOPRID
      • Unknown

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: Res. - In Home / Rés. - à l'int. maison

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

Yes

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Domestic longhair

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

4

7. Weight (provide a range if necessary )

6.00

lbs

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

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

11. List all symptoms

System

  • General
    • 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?

Contact treat.area/Contact surf. traitée

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

9/20/2010 Caller used one can of the product in the home 18 days ago. Caller's cats were removed from the house before fogging began and until several hours after fogging was complete. Approximately one week later one of caller's cats became lethargic. The cat was smaller than the other two cats, and had many fleas on her. Caller bathed the cat with mild cat shampoo when she became lethargic. The cat died approximately a week later. Caller states that the other two cats are asymptomatic. None of the cats have been evaluated by a veterinarian. Caller has been treating all three cats with a topical flea treatment for the past two years using Advantage 9. 9/28/2010 Callback to the original caller for follow up information. The two cats are still resistant to walking on the carpet. Both cats seem to be a little lethargic. The cats have not been evaluated by a veterinarian.


To be determined by Registrant

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

Death

19. Provide supplemental information here

The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified in the telephone interviews. Even had casual or incidental contact with the dried residues of the product on carpeting occurred, such profound illness reported in 1 out 3 cats in the home is unexpected. Even if true pesticide toxicity were to occur in this case it would manifest with acute neurological complications, primarily in the form of tremors and ataxia which were not reported in this incident. The owner admitted this small cat had a bad flea infestation which conceivably may lead to cat mortality. Finally, this cat was never properly evaluated and treated by a DVM nor was a necropsy performed to determine a possible cause of death.

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Domestic longhair

4. Number of animals affected

2

5. Sex

Unknown

6. Age (provide a range if necessary )

4

7. Weight (provide a range if necessary )

6

lbs

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

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

11. List all symptoms

System

  • General
    • Symptom - Lethargy

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

Unknown/Inconnu

16. How was the animal exposed?

Contact treat.area/Contact surf. traitée

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

9/20/2010 Caller used one can of the product in the home 18 days ago. Caller's cats were removed from the house before fogging began and until several hours after fogging was complete. Approximately one week later one of caller's cats became lethargic. The cat was smaller than the other two cats, and had many fleas on her. Caller bathed the cat with mild cat shampoo when she became lethargic. The cat died approximately a week later. Caller states that the other two cats are asymptomatic. None of the cats have been evaluated by a veterinarian. Caller has been treating all three cats with a topical flea treatment for the past two years using Advantage 9. 9/28/2010 Callback to the original caller for follow up information. The two cats are still resistant to walking on the carpet. Both cats seem to be a little lethargic. The cats have not been evaluated by a veterinarian.


To be determined by Registrant

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

Minor

19. Provide supplemental information here

The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified in the telephone interviews. Even had casual or incidental contact with the dried residues of the product on carpeting occurred, such profound illness reported in 1 out 3 cats in the home is unexpected. Even if true pesticide toxicity were to occur in this case it would manifest with acute neurological complications, primarily in the form of tremors and ataxia which were not reported in this incident. The owner admitted this small cat had a bad flea infestation which conceivably may lead to cat mortality. Finally, this cat was never properly evaluated and treated by a DVM nor was a necropsy performed to determine a possible cause of death.