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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2012-5472
2. Registrant Information.
Registrant Reference Number: 120132812
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.
21-SEP-125. Location of incident.
Country: UNITED STATES
Prov / State: OREGON
6. Date incident was first observed.
07-SEP-12Product 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. 2724-504
Product Name: Zodiac Spot On Plus Flea And Tick Control For Cats 5 Pounds And Over
- Active Ingredient(s)
- (S)-METHOPRENE
- Guarantee/concentration 3.6 %
- ETOFENPROX
- Guarantee/concentration 40 %
- (S)-METHOPRENE
7. b) Type of formulation.
Liquid
Application Information
8. Product was applied?
Yes
9. Application Rate.
1.8Units: mL
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 7, 2012 the owner applied the product to the cat.To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
YesSubform III: Domestic Animal Incident Report
1. Source of Report
Animal's Owner
2. Type of animal affected
Cat / Chat
3. Breed
Maine Coon
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
6.0
7. Weight (provide a range if necessary )
9.0
lbs
8. Route(s) of exposure
Skin
9. What was the length of exposure?
>1 wk <=1 mo / > 1 sem < = 1 mois
10. Time between exposure and onset of symptoms
<=30 min / <=30 min
11. List all symptoms
System
- Nervous and Muscular Systems
- Symptom - Ataxia
- Symptom - Abasia
- 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 September 7, 2012 the owner noticed that the cat was symptomatic. A short time later that day, the owner rinsed the cat's coat and skin with water, and the owner observed that the cat improved slightly, but not much. Between September 16 and September 20, 2012 the cat died; the owner found the cat's body some time after death occurred. On September 21, 2012 the owner contacted the Animal Product Safety Service (APSS) to obtain help. The APSS veterinarian stated that with normal use of the product, mild dermal irritation or gastrointestinal (GI) upset could be seen in sensitive animals and that skin tingling is also possible and may result in a transient reluctance to move, hyperactivity, or an abnormal gait. The APSS veterinarian stated that the signs would be expected to resolve within a few days. A necropsy was not available.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here
The APSS veterinarian stated that the substance was considered to have a doubtful likelihood of causing the clinical situation; the initial abnormal gait was likely related to product use, but signs would not be expected to last more than a few days and death would not be expected. A follow up was not performed, because additional information was not expected.
