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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2012-4638

2. Registrant Information.

Registrant Reference Number: PROSAR Case#: 1-31469301

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.

07-SEP-12

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

03-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. 29930      PMRA Submission No.       EPA Registration No.

Product Name: UltraGuard One Spot Flea Egg and Larva Treatment for Cats and Kittens

  • Active Ingredient(s)
    • (S)-METHOPRENE

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).

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

Female

6. Age (provide a range if necessary )

8

7. Weight (provide a range if necessary )

7.2

lbs

8. Route(s) of exposure

Skin

Unknown

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 - Ataxia
    • Symptom - Muscle twitching
    • Symptom - Seizure
    • Symptom - Convulsions

12. How long did the symptoms last?

>2 hrs <=8 hrs / > 2 h < = 8 h

13. Was medical treatment provided? Provide details in question 17.

Yes

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

1-31469301 - The reporter, a pet owner, indicated that her cat was exposed to an insecticidal product containing the active ingredient methoprene. The pet owner reported that the product was applied to her 8-year-old, 7.2 pound, female cat 5 days prior to initial contact with the registrant. The following day the cat was not walking well and it was convulsing and twitching. That evening, the pet owner brought her cat to a veterinarian where it was sedated, bathed for decontamination, treated intravenously with 150mg of methocarbamol and 5 mg of diazepam and given subcutaneous fluids. Per the owner the cat was sent home after treatment due to limited resources. The reporter indicated that later that same day the cat was eating and drinking, she had no other seizures she just had an occasional twitch of her head. The reporter was advised that the described symptoms are inconsistent with exposure to the active ingredient in this product: The active ingredient in this product has little to no toxicity to mammals. The reporter did indicate that she had recently bathed her dogs with an unknown flea and tick shampoo but she believed the cat did not have contact with the dogs after they had been bathed. 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