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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-5167

2. Registrant Information.

Registrant Reference Number: 110132228

Registrant Name (Full Legal Name no abbreviations): Farnam Companies, Inc.

Address: 301 W. Osborn Road

City: Phoenix

Prov / State: Arizona

Country: USA

Postal Code: 85013

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

Domestic Animal

4. Date registrant was first informed of the incident.

15-OCT-11

5. Location of incident.

Country: UNITED STATES

Prov / State: TEXAS

6. Date incident was first observed.

10-OCT-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. 270-263

Product Name: Wipe II Brand Fly Spray With Citronella

  • Active Ingredient(s)
    • BUTOXYPOLYPROPYLENE GLYCOL
      • Guarantee/concentration 7.5 %
    • PIPERONYL BUTOXIDE
      • Guarantee/concentration 1 %
    • PYRETHRINS
      • Guarantee/concentration .1 %

PMRA Registration No.       PMRA Submission No.       EPA Registration No.

Product Name: Horsemans Dream Fung A Way Topicals Solution for Use On HorsesDogsCats

  • Active Ingredient(s)
    • BENZALKONIUM CHLORIDE

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).

Starting on October 3, 2011 and continuing until October 9, 2011 the owner applied the spray product, along with a fungicide product, to the horse as a form of prevention. The owner used the spray product almost daily, and used the fungicide product twice during the week.

To be determined by Registrant

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

Yes

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Horse / Cheval

3. Breed

Friesian

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

5.5

7. Weight (provide a range if necessary )

1300.0

lbs

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

>3 days <=1 wk / >3 jours <=1 sem

11. List all symptoms

System

  • General
    • 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

On October 10, 2011 the owner found her horse dead. On October 11, 2011 the owner's regular veterinarian performed a necropsy on the horse, and the findings were unremarkable other than to show that the horse was pregnant. On October 15, 2011 the owner contacted the Animal Product Safety Service (APSS) to obtain help. The APSS toxicologist stated that with the spray product and also with the fungicide product, dermal reactions are possible and are expected to be self-limiting. The APSS toxicologist recommended that the owner consult with her regular veterinarian regarding appropriate fly spray use and obtain necropsy information and send the results to the APSS.


To be determined by Registrant

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

Death

19. Provide supplemental information here

The APSS toxicologist stated that the spray and fungicide products were not considered to be related to causing the clinical situation. On October 21, 2011 the APSS toxicologist called the owner to update the case. The owner provided necropsy information. Per necropsy results, the cecum revealed that there was severe, partial thickness, mucosal necrosis, and hemorrhage, that the submucosa was markedly edematous, and that the surface was overgrown by mixed bacteria; the kidney revealed that the medulla was diffusely congested; and the stomach and esophagus revealed no significant microscopic lesions. The histopathologic diagnosis was severe, diffuse, acute, necrotizing, and hemorrhagic typhlitis. The results revealed that the most significant lesions were in the cecum. The necropsy report also stated that potential causes for colitis in horses include various bacterial species such as Salmonella spp. and Clostridium ssp., Ehrlichia risticii, cyathostomes, non-steroidal anti-inflammatory (NSAIDs) drugs, cantharadin, chronic sand impaction, and in some cases toxins such as heavy metals and mycotoxins could be involved. The APSS toxicologist stated that typhlitis was considered to have a high likelihood of causing the clinical situation.