Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-4508

2. Registrant Information.

Registrant Reference Number: 2013AM251

Registrant Name (Full Legal Name no abbreviations): Bayer Inc

Address: 77 Belfield Rd

City: Toronto

Prov / State: ON

Country: Canada

Postal Code: M9W 1G6

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

Domestic Animal

4. Date registrant was first informed of the incident.

13-AUG-13

5. Location of incident.

Country: UNITED STATES

Prov / State: UNKNOWN

6. Date incident was first observed.

Unknown

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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 11556-141

Product Name: K9 Advantix II small dog

• Active Ingredient(s)
  • IMIDACLOPRID
    • Guarantee/concentration 8.8 %
  • PERMETHRIN
    • Guarantee/concentration 44 %
  • PYRIPROXYFEN
    • Guarantee/concentration .44 %

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7. b) Type of formulation.

Liquid

Application Information

8. Product was applied?

Yes

9. Application Rate.

.4

Units: 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).

One vial of K9 Advantix II small dog was applied topically by the owner to one spot on the dorsal midline.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

No

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

Male

6. Age (provide a range if necessary )

5

7. Weight (provide a range if necessary )

10

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

• General
  • Symptom - Death

• Nervous and Muscular Systems
  • Symptom - Muscle tremors

• General
  • Symptom - Lethargy
  • Symptom - Fever
  • Symptom - Listless

• Gastrointestinal System
  • Symptom - Anorexia

• General
  • Symptom - Adipsia

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

14. a) Was the animal hospitalized?

Unknown

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 25-Jun-2013, a 5 year old, 10.00 pound, male, Domestic Shorthair feline, in good condition, with no known concomitant medical conditions, was possible exposed to unknown amount of K9 Advantix II Small Dog (Imidacloprid-Permethrin-Pyriproxyfen) from contact with a treated dog in the home. On 27Jun2013 the cat was lethargic. On 28Jun2013 the cat was examined by the veterinarian and blood work was performed. The cat had a fever and was listless. The cat was sent home on antibiotics. The cat was anorexic and adipsic. On 30Jun2013 the cat had tremors and then died. No necropsy was performed.

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To be determined by Registrant

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

Death

19. Provide supplemental information here

Suspected secondary contact with treated dog. Lethargy is a very unspecific sign in cats and may have multiple potential causes. Fever was reported. Anorexia and adipsia likely consequence of lethargic status and fever. Even though tremors are typical signs of permethrin toxicity in cats, they are not life threatening and cats usually have a good chance to recover if adequate treatment applied in time. No treatment of permethrin toxicosis was provided. Time to onset for tremors rather long (5 days) and thus unlikely a result of secondary exposure to the product. No necropsy available. Considering all aspects, other unrelated causes were considered more likely anda product connection is deemed to be unlikely.