Health Canada
Symbol of the Government of Canada
Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-2367

2. Registrant Information.

Registrant Reference Number: 120170539

Registrant Name (Full Legal Name no abbreviations): Farnam Companies, Inc.

Address: 301 W. Osborn Road

City: Phoenix

Prov / State: Arizona

Country: USA

Postal Code: 85013

3. Select the appropriate subform(s) for the incident.

Domestic Animal

4. Date registrant was first informed of the incident.


5. Location of incident.


Prov / State: OREGON

6. Date incident was first observed.


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.


PMRA Registration No.       PMRA Submission No.       EPA Registration No. 270-373

Product Name: Just One Bite II Bar 16 Oz

  • Active Ingredient(s)
      • Guarantee/concentration .005 %

7. b) Type of formulation.


Application Information

8. Product was applied?


9. Application Rate.

10. Site pesticide was applied to (select all that apply).

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?


Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Other / Autre

specify Goat

3. Breed

Caprine Unspecified

4. Number of animals affected


5. Sex


6. Age (provide a range if necessary )


7. Weight (provide a range if necessary )



8. Route(s) of exposure


9. What was the length of exposure?

>24 hrs <=3 days / >24 h <=3 jours

10. Time between exposure and onset of symptoms

>24 hrs <=3 days / >24 h <=3 jours

11. List all symptoms


  • Gastrointestinal System
    • Symptom - Anorexia
  • Nervous and Muscular Systems
    • Symptom - Disorientation
  • General
    • Symptom - Dehydration
    • Symptom - Death
    • Symptom - Head bobbing
    • Specify - flopping her head back and forth

12. How long did the symptoms last?

Persisted until death

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


14. a) Was the animal hospitalized?


14. b) How long was the animal hospitalized?

15. Outcome of the incident


16. How was the animal exposed?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

On December 10, 2012 the owner contacted the Animal Product Safety Service (APSS) to obtain help after observing that the goat had ingested some of the bait product. The APSS veterinarian stated that the product is a second generation anticoagulant and that doses of concern begin around 0.02 milligrams per kilogram (mg/kg) and higher. Regarding the previous exposure to magnesium sulfate (epsom salts) on December 8, 2012, the APSS veterinarian stated that they can cause elevations in magnesium, leading to signs of nausea, vomiting, ataxia, weakness, arrhythmias, hypotension, bradycardia, respiratory paralysis, and death. The APSS veterinarian also stated that risks include internal bleeding and coagulopathies 3 to 7 days after ingestion. The APSS assistant recommended that the owner take the goat to the veterinarian and have the veterinarian call for information.

To be determined by Registrant

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


19. Provide supplemental information here

The APSS veterinarian stated that the substance was not considered to be related to causing the clinical situation and that the magnesium sulfate (epsom salts) were considered to have an unknown likelihood of causing the clinical situation. On December 13, 2012 the owner called the APSS to update the case. On the evening of December 12, 2012 the owner noticed that the goat was anorexic. On the morning of December 13, 2012 the owner noticed that the goat was disoriented, flopping her head back and forth, and that the goat was also dehydrated. A short time later that morning, the owner observed that the goat died. A necropsy was not available.