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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-1865

2. Registrant Information.

Registrant Reference Number: 1-25728414

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.

30-MAR-11

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. 26491      PMRA Submission No.       EPA Registration No.

Product Name: HARTZ ULTRAGUARD ONE SPOT TREATMENT FOR CATS KITTENS

  • Active Ingredient(s)
    • (S)-METHOPRENE

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).

The caller states that she is a DVM. The caller states that a cat presented to her clinic yesterday (03/30/2011) not eating and being nauseated over the past couple of days. The caller states that the owners are not sure when the product was applied to the cat, but that they think they applied the product 3 days ago. The caller states that no ingestion of the product was witnessed, but the cat may have licked the area where the product was applied. The caller states that she has just recently started to see this cat, so the cat does not have any underlying medical conditions that she is aware of. The caller states that on top of the cat not eating and being nauseated, the cat has lost 3 Ibs since the last DVM visit (caller did not have the date in front of her), and that the cat's blood sample came back reading renal failure. The caller states that the cat's BUN is 44 (normal range is less than 10.7) and the cat's creatinine is 853 (normal range is 0-175). The caller is wondering if this product is toxic or may have caused these symptoms. The cat is doing a bit better -is eating and seems to have a good appetite. Is still on IV fluids; they have not yetrechecked blood work. Cat is urinating a lot.

To be determined by Registrant

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

Unknown

Subform III: Domestic Animal Incident Report

1. Source of Report

Medical Professional

2. Type of animal affected

Cat / Chat

3. Breed

Domestic long hair

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

4.5

7. Weight (provide a range if necessary )

13

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 - Anorexia
    • Symptom - Nausea
    • Symptom - Weight loss
  • Renal System
    • Symptom -
    • Symptom - Renal failure

12. How long did the symptoms last?

Unknown / Inconnu

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

Yes

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

The caller states that she is a DVM. The caller states that a cat presented to her clinic yesterday (03/30/2011) not eating and being nauseated over the past couple of days. The caller states that the owners are not sure when the product was applied to the cat, but that they think they applied the product 3 days ago. The caller states that no ingestion of the product was witnessed, but the cat may have licked the area where the product was applied. The caller states that she has just recently started to see this cat, so the cat does not have any underlying medical conditions that she is aware of. The caller states that on top of the cat not eating and being nauseated, the cat has lost 3 Ibs since the last DVM visit (caller did not have the date in front of her), and that the cat's blood sample came back reading renal failure. The caller states that the cat's BUN is 44 (normal range is less than 10.7) and the cat's creatinine is 853 (normal range is 0-175). The caller is wondering if this product is toxic or may have caused these symptoms. The cat is doing a bit better -is eating and seems to have a good appetite. Is still on IV fluids; they have not yetrechecked blood work. Cat is urinating a lot.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here