Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2012-0993
2. Registrant Information.
Registrant Reference Number: 110113044
Registrant Name (Full Legal Name no abbreviations): Wellmark International
Address: 100 Stone Road West, Suite 111
City: Guelph
Prov / State: Ontario
Country: Canada
Postal Code: N1G5L3
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
01-SEP-11
5. Location of incident.
Country: CANADA
Prov / State: BRITISH COLUMBIA
6. Date incident was first observed.
01-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. 21744
PMRA Submission No.
EPA Registration No.
Product Name: Zodiac Flea and Tick Spray For Dogs and Cats
- Active Ingredient(s)
- (S)-METHOPRENE
- N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
- PIPERONYL BUTOXIDE
- PYRETHRINS
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).
On September 1, 2011 the owner applied the product to her cat to treat for fleas.
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 )
0.23
7. Weight (provide a range if necessary )
4.00
lbs
8. Route(s) of exposure
Skin
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
<=30 min / <=30 min
11. List all symptoms
System
- Eye
- Symptom - Other
- Specify - Eyes Rolling Back
- Gastrointestinal System
- Symptom - Salivating excessively
12. How long did the symptoms last?
>24 hrs <=3 days / >24 h <=3 jours
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
Fully Recovered / Complètement rétabli
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 September 1, 2011, shortly after the product was applied, the owner noticed the cat was drooling. The owner wiped off the cat's coat and skin with a wet washcloth. A short time later, the owner noticed the cat was symptomatic. Later that evening, the owner contacted the Animal Product Safety Service (APSS) to obtain help. The APSS veterinarian stated that the product contains S-methoprene and pyrethrins and that with this exposure gastrointestinal (GI) upset such as vomiting and hypersalivation could be seen. The APSS technician recommended that the owner take the cat to the veterinarian, have the veterinarian call for information, and call back with the exact product name and details.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
19. Provide supplemental information here
On August 12, 2011 an APSS assistant called the owner to update the case. The owner stated that she did not take the cat to the veterinarian and that he had fully recovered on September 3, 2011.