Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2012-4533
2. Registrant Information.
Registrant Reference Number: 2012-US-06128
Registrant Name (Full Legal Name no abbreviations): Merck Animal Health (Intervet Canada Corp)
Address: 16750 Transcanada Highway
City: Kirkland
Prov / State: Quebec
Country: Canada
Postal Code: H9H 4M7
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
06-SEP-12
5. Location of incident.
Country: UNITED STATES
Prov / State: VIRGINIA
6. Date incident was first observed.
04-SEP-12
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. 773-92
Product Name: Ultra Saber Pour On
- Active Ingredient(s)
- LAMBDA-CYHALOTHRIN
- Guarantee/concentration 1 %
- PIPERONYL BUTOXIDE
PMRA Registration No.
PMRA Submission No.
EPA Registration No.
Product Name: Pyramid Presponse
PMRA Registration No.
PMRA Submission No.
EPA Registration No.
Product Name: Safeguard Drench
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).
Lack of Efficacy. On 6 September 2012 a producer reported that Zuprevo did not work. On arrival the producer gave 82 calves Pyramid Presponse, Safeguard drench and pours with Ultra Saber, he also used Zuprevo on 82 head, 21 showed signs of respiratory distress and 5 died. Diagnostic work pending. Follow-up on 27 September 2012: Lab Resluts show Mannheimia Haemolytica. The case is closed.
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
Medical Professional
2. Type of animal affected
Cow / Vache
3. Breed
Angus
4. Number of animals affected
21
5. Sex
Unknown
6. Age (provide a range if necessary )
0.25
7. Weight (provide a range if necessary )
500
lbs
8. Route(s) of exposure
Skin
9. What was the length of exposure?
<=15 min / <=15 min
10. Time between exposure and onset of symptoms
>24 hrs <=3 days / >24 h <=3 jours
11. List all symptoms
System
- Respiratory System
- Symptom - Respiratory distress
- General
- Symptom - Death
- Symptom - Parasitism
- Specify - Mannheimia Haemolytica
12. How long did the symptoms last?
Unknown / Inconnu
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
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
82 cows were treated in total, 21 reacted, 5 died, 16 unknown.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here