Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2011-2582
2. Registrant Information.
Registrant Reference Number: 2010CA00817
Registrant Name (Full Legal Name no abbreviations): Intervet Canada Corp.
Address: 16750 Transcanada Highway
City: Kirkland
Prov / State: Quebec
Country: Canada
Postal Code: H9H 4M7
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
18-NOV-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)
PMRA Registration No. 25488
PMRA Submission No.
EPA Registration No.
Product Name: Boss Pour On
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).
Adverse Reaction: The reporting vet advised me that another vet had prescribed Boss Pour-On insecticide for the 2 horses for the control of ectoparasites. The owner administered the product on both horses' backs as per instructions for cattle. This product is not licensed for horses. Quantity administered is unknown , but should have been in the order of 39ml as per cattle weight recommendations. Approximately 5 days later, the horses were observed to have hair loss starting over the back then progressing to the underline. Pruritus was also reported; it is not known if the horses were pruritic prior to treatment. The reporting veterinarian examined both horses on 20 Oct 2010 and also noted numerous oral ulcers 1-2cm in diameter. No ectoparasites were found, but both horses were subsequently treated with 3 weeks oral Sulfa Trimethoprim, a double dose of ivermectin and Drikill (rotenone) ectoparasite dusting powder. The condition of the animals has not changed since the reporting veterinarian's first examination. Case closed.
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
Horse / Cheval
3. Breed
unknown
4. Number of animals affected
2
5. Sex
Unknown
6. Age (provide a range if necessary )
5
7. Weight (provide a range if necessary )
600
kg
8. Route(s) of exposure
Skin
9. What was the length of exposure?
<=15 min / <=15 min
10. Time between exposure and onset of symptoms
>3 days <=1 wk / >3 jours <=1 sem
11. List all symptoms
System
- Skin
- Symptom - Pruritus
- Symptom - Hair loss
- Symptom - Lesion
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?
No
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
treated with 3 weeks oral Sulfa Trimethoprim, a double dose of ivermectin and Drikill (rotenone) ectoparasite dusting powder.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
19. Provide supplemental information here