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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-3927

2. Registrant Information.

Registrant Reference Number: PROSAR Case # 1-26785530

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.

11-JUL-11

5. Location of incident.

Country: UNITED STATES

Prov / State: DELAWARE

6. Date incident was first observed.

09-JUL-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. 2596-140

Product Name: UltraGuard Plus Flea Tick Spray for Cats

  • Active Ingredient(s)
    • (S)-METHOPRENE
      • Guarantee/concentration .07 %
    • TETRACHLORVINPHOS
      • Guarantee/concentration 1.08 %

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?

Unknown

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Domestic shorthair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

1

7. Weight (provide a range if necessary )

8

lbs

8. Route(s) of exposure

Skin

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

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

11. List all symptoms

System

  • Gastrointestinal System
    • Symptom - Vomiting
    • Symptom - Salivating excessively
  • Nervous and Muscular Systems
    • Symptom - Aggressive behaviour
  • Gastrointestinal System
    • Symptom - Anorexia
  • General
    • Symptom - Pain
  • Renal System
    • Symptom - Anuria
  • Gastrointestinal System
    • Symptom - Constipation
  • Nervous and Muscular Systems
    • Symptom - Muscle tremors
  • General
    • Symptom - Lethargy
  • Gastrointestinal System
    • Symptom - Bloating
  • Renal System
    • Symptom - Other
    • Specify - urinary blockage
  • General
    • Symptom - Death
    • Symptom - Hiding

12. How long did the symptoms last?

Persisted until death

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

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

1-26785530- The reporter, a pet owner, indicated her animal was exposed to an insecticide containing the active ingredient tetrachlorvinphos and methoprene. The pet owner indicated she applied the product to her one year male eight pound domestic shorthair cat three days prior to her initial contact with the registrant. The pet owner indicated the next morning the animal was found hiding in a kitchen cabinet shaking. The pet owner bathed the animal with a non insecticidal shampoo at this point. The animal was further observed later in the day salivating, refusing food, and still hiding. The animal was bathed again at this point. The following day the animal was observed refusing food, salivating, abdominal distention was noted, he had vomited, he was unable to urinate or defecate, and the animal would growl at the owner when she attempted to pick it up. At the point of initial contact the pet owner reported the animal was unable to urinate or defecate, it had vomited, was lethargic, and its abdomen was swollen. The pet owner was advised the spectrum of signs seen were inconsistent with the toxicity profile of the active ingredients. She was advised due to the serious and prolonged nature of the signs seen the animal should be promptly taken to the veterinarian for care. On follow up the pet owner indicated the animal was found to have a urinary obstruction. The veterinarian attempted surgery but the animal did not survive the surgery. 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