Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2013-5190
2. Registrant Information.
Registrant Reference Number: 2013-US-06230
Registrant Name (Full Legal Name no abbreviations): Merck Animal Health (Intervet Canada Corp)
Address: 16750 Transcanada Highway
City: Kirkland
Prov / State: Quebec
Country: Canada
Postal Code: H9H 4M7
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
23-JUL-13
5. Location of incident.
Country: UNITED STATES
Prov / State: SOUTH CAROLINA
6. Date incident was first observed.
23-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. 773 95
Product Name: ACTIVYL TICK PLUS
- Active Ingredient(s)
- INDOXACARB TECHNICAL
- PERMETHRIN
- Guarantee/concentration 42.5 %
7. b) Type of formulation.
Liquid
Application Information
8. Product was applied?
Yes
9. Application Rate.
1
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).
On 23 Jul 2013, an emergency veterinarian reported, to the ASPCA, that a cat received an application of Activyl Tick Plus for Dogs and Puppies (over 11 lb and up to 22 lb) and had a reaction. The product was purchased from another veterinary clinic. The dog product was accidently applied to the cat to treat fleas. The cat had an isolated seizure and tremors. ASPCA recommended to bathe the cat and provide supportive care. Extra label use due to accidental application on incorrect species. The lot number is not available due to not being provided in ASPCA report. Follow up pending. Follow-up on 29 Jul 2013, by the ASPCA, revealed the cat died on 25 Jul 2013. No further details were available in the ASPCA report. Follow-up with the emergency veterinarian revealed that treatment was being provided to the cat, the cat declined, became unresponsive and died on 25 Jul 2013. A necropsy was not performed. No further information expected.
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
Medical Professional
2. Type of animal affected
Cat / Chat
3. Breed
Domestic long hair cross
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
8
7. Weight (provide a range if necessary )
15.8
lbs
8. Route(s) of exposure
Skin
9. What was the length of exposure?
<=15 min / <=15 min
10. Time between exposure and onset of symptoms
>2 hrs <=8 hrs / > 2 h < = 8 h
11. List all symptoms
System
- Nervous and Muscular Systems
- Nervous and Muscular Systems
- Symptom - Seizure
- Symptom - Unresponsive
12. How long did the symptoms last?
>24 hrs <=3 days / >24 h <=3 jours
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?
2
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
On 23 Jul 2013, an emergency veterinarian reported, to the ASPCA, that a cat received an application of Activyl Tick Plus for Dogs and Puppies (over 11 lb and up to 22 lb) and had a reaction. The product was purchased from another veterinary clinic. The dog product was accidently applied to the cat to treat fleas. The cat had an isolated seizure and tremors. ASPCA recommended to bathe the cat and provide supportive care. Extra label use due to accidental application on incorrect species. The lot number is not available due to not being provided in ASPCA report. Follow-up pending. Follow-up on 29 Jul 2013, by the ASPCA, revealed the cat died on 25 Jul 2013. No further details were available in the ASPCA report. Follow-up with the emergency veterinarian revealed that treatment was being provided to the cat, the cat declined, became unresponsive and died on 25 Jul 2013. A necropsy was not performed. No further information expected.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here