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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-3072

2. Registrant Information.

Registrant Reference Number: PROSAR Case #: 1-26430715

Registrant Name (Full Legal Name no abbreviations): The Hartz Mountain Corporation

Address: 400 Plaza Drive

City: Secaucus

Prov / State: New Jersey

Country: USA

Postal Code: 07094-3688

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

Domestic Animal

4. Date registrant was first informed of the incident.

08-JUN-11

5. Location of incident.

Country: UNITED STATES

Prov / State: ARKANSAS

6. Date incident was first observed.

07-JUN-11

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. 2596-147

Product Name: UltraGuard One Spot Flea Egg Larvae Treatment for Cats Kittens

  • Active Ingredient(s)
    • (S)-METHOPRENE
      • Guarantee/concentration 2.9 %

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).

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

unknown

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

12

7. Weight (provide a range if necessary )

20

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Ataxia
  • General
    • Symptom - Abnormal behaviour
  • Renal System
    • Symptom - Painful urination
    • Specify - stranguria
  • General
    • Symptom - Vocalizing
    • 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?

Treatment / Traitement

17. Provide any additional details about the incident

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

1-26430715 The reporter, a pet owner, called to indicate her animals had been exposed to an insecticide containing the active ingredient methoprene. The pet owner indicated she had applied the product to her two cat three days prior to her initial contact with the registrant. The caller reports her twelve year twenty pound male cat (Subform III, 1) had died the day prior to her initial contact The reporter indicated at some time frame (not specified) following application the animal demonstrated the signs of ataxia, vocalizing, difficulty urinating, and abnormal behavior. She did not seek veterinary care and indicated no treatment prior to the animal demise. The owner indicated her one year twenty pound male cat (Subform III, 2) 'freaked out' following application and hid upon an entertainment center. The animal urinated on himself, vocalized, vomited, and refused to eat. The pet owner indicated she was in the middle of moving her household and the animal may be stressed due to the upheaval as well. The pet owner was advised the signs described were inconsistent with the toxicity profile of the active ingredient. She was advised to seek immediate veterinary care for the animal in efforts to determine the appropriate diagnosis and care. On follow up the pet owner indicated she had not sought veterinary care for her remaining animal due to financial constraints. The animal died at home the day following her initial contact. The signs and out come described are inconsistent with use of the product as labeled. No further information is available.


To be determined by Registrant

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

Death

19. Provide supplemental information here

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

unknown

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

1

7. Weight (provide a range if necessary )

20

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Bizarre behaviour
  • Gastrointestinal System
    • Symptom - Anorexia
    • Symptom - Vomiting
  • Renal System
    • Symptom - Urinary incontinence
  • General
    • Symptom - Vocalizing
    • 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?

Treatment / Traitement

17. Provide any additional details about the incident

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

1-26430715 The reporter, a pet owner, called to indicate her animals had been exposed to an insecticide containing the active ingredient methoprene. The pet owner indicated she had applied the product to her two cat three days prior to her initial contact with the registrant. The caller reports her twelve year twenty pound male cat (Subform III, 1) had died the day prior to her initial contact The reporter indicated at some time frame (not specified) following application the animal demonstrated the signs of ataxia, vocalizing, difficulty urinating, and abnormal behavior. She did not seek veterinary care and indicated no treatment prior to the animal demise. The owner indicated her one year twenty pound male cat (Subform III, 2) 'freaked out' following application and hid upon an entertainment center. The animal urinated on himself, vocalized, vomited, and refused to eat. The pet owner indicated she was in the middle of moving her household and the animal may be stressed due to the upheaval as well. The pet owner was advised the signs described were inconsistent with the toxicity profile of the active ingredient. She was advised to seek immediate veterinary care for the animal in efforts to determine the appropriate diagnosis and care. On follow up the pet owner indicated she had not sought veterinary care for her remaining animal due to financial constraints. The animal died at home the day following her initial contact. The signs and out come described are inconsistent with use of the product as labeled. No further information is available.


To be determined by Registrant

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

Death

19. Provide supplemental information here