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: 2013-4413

2. Registrant Information.

Registrant Reference Number: 130087212

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.

27-JUN-13

5. Location of incident.

Country: UNITED STATES

Prov / State: OHIO

6. Date incident was first observed.

27-JUN-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. 2724-274-11787

Product Name: Starbar Improved Golden Malrin Fly Bait 1% Methomyl

  • Active Ingredient(s)
    • (Z)-9-TRICOSENE
      • Guarantee/concentration .025 %
    • METHOMYL
      • Guarantee/concentration 1 %

7. b) Type of formulation.

Bait

Application Information

8. Product was applied?

Unknown

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?

Unknown

Subform III: Domestic Animal Incident Report

1. Source of Report

Medical Professional

2. Type of animal affected

Dog / Chien

3. Breed

American Pit Bull Terrier

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

1.0

7. Weight (provide a range if necessary )

65.0

lbs

8. Route(s) of exposure

Oral

9. What was the length of exposure?

>15 min <=2 hrs / >15 min <=2 h

10. Time between exposure and onset of symptoms

>30 min <=2 hrs / >30 min <=2 h

11. List all symptoms

System

  • 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?

Intentional poison./Empois. intentionnel

17. Provide any additional details about the incident

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

On June 27, 2013 the owner discovered that the dog had died. Later that morning the owner took the dog to his regular veterinarian, where a necropsy was performed. The stomach contents revealed splintered bones (possibly chicken or pork), plastic, and little yellow granules. The owner's regular veterinarian separated and saved the yellow granules and the food; the regular veterinarian observed that the dog only eats from a self-feeder, but he couldn't guarantee that the dog didn't get into the trash. On the evening of June 27, 2013 the owner's regular veterinarian contacted the Animal Product Safety Service (APSS) to obtain help. The APSS veterinarian stated that Methomyl is a potent, dangerous, carbamate insecticide and that dogs ingesting the product would typically be at risk for acute onset, severe cholinesterase inhibition and toxicosis, including the possibility of acute death. The APSS referred the owner's regular veterinarian to a diagnostic laboratory for toxicology on the dog's stomach contents.


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 an unknown likelihood of causing the clinical situation. Intentional poisoning of dog suspected. Product has not been yellow since 1995.