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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2011-5269

2. Registrant Information.

Registrant Reference Number: PROSAR Case #: 1-27577614

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.

30-SEP-11

5. Location of incident.

Country: UNITED STATES

Prov / State: TEXAS

6. Date incident was first observed.

28-SEP-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?

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

2

5. Sex

Male

6. Age (provide a range if necessary )

0.23

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

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

  • Nervous and Muscular Systems
    • Symptom - Muscle weakness
    • Symptom - Confusion
  • Gastrointestinal System
    • Symptom - Anorexia
  • Nervous and Muscular Systems
    • Symptom - Ataxia

12. How long did the symptoms last?

Unknown / Inconnu

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

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

1-27577614- The reporter, a pet owner, indicated her animal had been exposed to an insecticidal product containing the active ingredient tetrachlorvinphos and methoprene. The caller reports she applied the product to three twelve week kittens two days prior to her initial contact with the registrant. The pet owner commented she noted the day following application she noted ataxia, muscle weakness, loss of appetite, and confusion in all animals. That same day she then bathed all of the animals with a flea and tick shampoo labeled for use on dogs. She was unable to definitively identify the subsequent product used. She reported two of the animals (Subform III, #1) were improved as of the night prior to her report, but the third animal (Subform III, #2) was experiencing shortness of breath and deteriorating. The pet owner was advised that use of the product as labeled would not be expected to result in the signs seen. She was further advised that the use of canine insecticidal products on cats can result in serious health consequences but without product identification specific recommendations would be impossible. She was advised to bathe all animals in a noninsecticidal shampoo and seek immediate veterinary assistance. On follow up the pet owner indicated she did not see the veterinarian due to financial constraints. The animal that had been struggling prior (Subform III, #2) had died. She did not provide information about the remaining animals. The caller was advised of registrant supported necropsy to assist in determining cause of death. It is unclear if she pursued this program. No further information is available.


To be determined by Registrant

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

Moderate

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

Female

6. Age (provide a range if necessary )

0.23

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

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

  • Nervous and Muscular Systems
    • Symptom - Confusion
    • Symptom - Ataxia
    • Symptom - Muscle weakness
  • Gastrointestinal System
    • Symptom - Anorexia
  • Respiratory System
    • Symptom - Shortness of breath
  • 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

1-27577614- The reporter, a pet owner, indicated her animal had been exposed to an insecticidal product containing the active ingredient tetrachlorvinphos and methoprene. The caller reports she applied the product to three twelve week kittens two days prior to her initial contact with the registrant. The pet owner commented she noted the day following application she noted ataxia, muscle weakness, loss of appetite, and confusion in all animals. That same day she then bathed all of the animals with a flea and tick shampoo labeled for use on dogs. She was unable to definitively identify the subsequent product used. She reported two of the animals (Subform III, #1) were improved as of the night prior to her report, but the third animal (Subform III, #2) was experiencing shortness of breath and deteriorating. The pet owner was advised that use of the product as labeled would not be expected to result in the signs seen. She was further advised that the use of canine insecticidal products on cats can result in serious health consequences but without product identification specific recommendations would be impossible. She was advised to bathe all animals in a noninsecticidal shampoo and seek immediate veterinary assistance. On follow up the pet owner indicated she did not see the veterinarian due to financial constraints. The animal that had been struggling prior (Subform III, #2) had died. She did not provide information about the remaining animals. The caller was advised of registrant supported necropsy to assist in determining cause of death. It is unclear if she pursued this program. 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