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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-4472

2. Registrant Information.

Registrant Reference Number: 1175896

Registrant Name (Full Legal Name no abbreviations): McLaughlin Gormley King Company

Address: 8810 Tenth Ave North

City: Minneapolis

Prov / State: MN

Country: USA

Postal Code: 55427-4319

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: GEORGIA

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. 1021 1704 85495

Product Name: Flea and Tick Spray for Cats Over 7 Months and Dogs Over 6 Mon

  • Active Ingredient(s)
      • Guarantee/concentration .957 %
      • Guarantee/concentration .18 %
      • Guarantee/concentration .125 %

7. b) Type of formulation.


Application Information

8. Product was applied?


9. Application Rate.


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).

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

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

Dog / Chien

3. Breed

Labrador Retriever

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?

<=15 min / <=15 min

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms


  • Gastrointestinal System
    • Symptom - Anorexia
    • Symptom - Vomiting
  • General
    • Symptom - Death
    • Symptom - Lethargy
  • Nervous and Muscular Systems
    • Symptom - Agitation
    • Symptom - Muscle twitching
  • Renal System
    • Symptom - Renal failure
  • Cardiovascular System
    • Symptom - Cardiac arrest

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?


Day(s) / Jour(s)

15. Outcome of the incident


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

This incident describing a canine fatality was forwarded to MGK on August 24 by a US subregistrant. The subregistrant was informed of the event in June 29, 2013. The information provided on the subregistrant report indicated that a dog was sprayed with product on the paws, neck and base of the tail on May 24, 2013 for a flea infestation. The dog was 12 months old, spayed and considered healthy previously. On May 25 and 26, the dog developed lethargy, agitation, twitching, anorexia and vomiting. The dog was eventually taken to a veterinary hospital on May 27. The dog tested as Parvo negative however lab results indicated it was in renal failure. While placing a catheter in the dog, the dog went into cardiac arrest and died. A necropsy performed by the veterinarian revealed small misshapen kidneys indicating that the dog at a congenital kidney defect that was likely present at birth. The veterinarian did not think the flea and tick spray had anything to do with the dogs renal failure and eventual death. It is important to note that another dog was also treated with the flea and tick spray and did not encounter any complications.

To be determined by Registrant

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


19. Provide supplemental information here

The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified in the telephone interviews. The clinical presentation of this dog is not consistent with the toxicological profile of this pesticide given the application concentrations of the active ingredients. Furthermore, the treating veterinarian confirmed that the dog died of a congenital kidney defect that already existed prior to the pesticide application.