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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-4255

2. Registrant Information.

Registrant Reference Number: PROSAR case #: 1-34258598

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.

10-JUL-13

5. Location of incident.

Country: UNITED STATES

Prov / State: WEST VIRGINIA

6. Date incident was first observed.

10-JUL-13

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. 2596-147

Product Name: Ultraguard One Spot Flea, Egg/Larvae Treatment for Cats/Kittens

  • Active Ingredient(s)
    • (S)-METHOPRENE
      • Guarantee/concentration 2.9 %

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).

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 )

1

7. Weight (provide a range if necessary )

4.5

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • Gastrointestinal System
    • Symptom - Anorexia
  • General
    • Symptom - Lethargy
  • Nervous and Muscular Systems
    • Symptom - Trembling
  • General
    • Symptom - Hiding
    • Symptom - Death

12. How long did the symptoms last?

Persisted until death

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

Yes

14. a) Was the animal hospitalized?

Yes

14. b) How long was the animal hospitalized?

1

Day(s) / Jour(s)

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

1-34258598 - The reporter, a pet owner, indicated that her cat was exposed to an insecticidal product containing the active ingredient methoprene. The reporter indicated that she applied the product to her 1-year-old, female, 4 pound domestic shorthair two days prior to initial contact with the registrant and later that day the cat was lethargic, hiding and not eating. The reporter bathed the cat with dish soap later that night. One day prior to initial contact with the registrant the cat started twitching. On the morning of initial contact, the reporter took the cat to the veterinarian where it was currently being treated. The reporter was advised that the product is an insect growth regulator with little to no toxicity in mammals. Hair testing for potential pyrethroid exposure was recommended to help determine the cause of the cats symptoms. On follow-up call, one day later, the reporter indicated that the cat was treated by the veterinarian with intravenous fluids and muscle relaxers and was discharged later on the same day that the reporter had initially contacted the registrant. Later that night, the cat died suddenly at home. A necropsy to help determine the cause of death was not offered as the reporter had already buried the cat. No further information is available.


To be determined by Registrant

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

Death

19. Provide supplemental information here