Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2011-4941
2. Registrant Information.
Registrant Reference Number: 2011TH080
Registrant Name (Full Legal Name no abbreviations): Bayer Inc
Address: 77 Belfield Rd
City: Toronto
Prov / State: ON
Country: Canada
Postal Code: M9W 1G6
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
06-OCT-11
5. Location of incident.
Country: CANADA
Prov / State: BRITISH COLUMBIA
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.
PMRA Submission No.
EPA Registration No. Unknown
Product Name: advantage
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).
Owner brought kitten into clinic, clinic was unable to examine kitten and requested owner take the kitten elsewhere to be seen as they were busy and unable to see the kitten. The appeared to be 2-3 weeks old. The owner admitted to applying advantage to the kitten about 4 days earlier. The kitten seemed vigourous but was demonstrating some unusual behaviour. The clinic believes that the owner did not take the kitten elsewhere and it died.
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
Cat / Chat
3. Breed
unknown
4. Number of animals affected
1
5. Sex
Unknown
6. Age (provide a range if necessary )
0.04
7. Weight (provide a range if necessary )
Unknown
8. Route(s) of exposure
Skin
9. What was the length of exposure?
>3 days <=1 wk / >3 jours <=1 sem
10. Time between exposure and onset of symptoms
Unknown / Inconnu
11. List all symptoms
System
- General
- Symptom - Death
- Symptom - Abnormal behaviour
- Specify - acting oddly at times
12. How long did the symptoms last?
Persisted until death
13. Was medical treatment provided? Provide details in question 17.
Unknown
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
Owner went into clinic with kitten but clinic was fully booked and unable to give her an appointment. The kitten appeared 2-3 weeks of age. The kitten was vigorous but acting oddly at times. The owner admitted to applying advantage to the kitten about 4 days prior. The clinic does not think that the owner sought veterinary care elsewhere and based on later contact from the owner, they believe the kitten died.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here
Advantage is approved for use in kittens over 8 weeks of age.