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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-6343

2. Registrant Information.

Registrant Reference Number: 1-35216941

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.


5. Location of incident.


Prov / State: FLORIDA

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. 2596-79

Product Name: UltraGuard Flea/Tick Powder for Dogs

  • Active Ingredient(s)
      • Guarantee/concentration 3.3 %

PMRA Registration No.       PMRA Submission No.       EPA Registration No.

Product Name: advantage

  • Active Ingredient(s)

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).

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

Cat / Chat

3. Breed


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?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms


  • Blood
    • Symptom - Anemia
    • Symptom - Other
    • Specify - White Blood Cell "problems"
  • General
    • Symptom - Lethargy
  • Gastrointestinal System
    • Symptom - Anorexia
  • Respiratory System
    • Symptom - Difficulty Breathing
  • Nervous and Muscular Systems
    • Symptom - Seizure
  • General
    • Symptom - Death

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?

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

1-35216941 - The reporter, a pet owner, indicated that her cat was exposed to a dog insecticidal powder containing the active ingredient tetrachlorvinphos and to a non-registrant spot-on flea and tick product called advantage with unknown active ingredients. The reporter applied the registrant product to all the cats and dogs in her house three days prior to initial contact with the registrant to treat a significant flea infestation. The non-registrant spot-on product was applied to her 8 year old, male cat two weeks prior to initial contact with the registrant but per the reporter it was not effective at controlling the fleas. Within 24 hours of applying the registrant powder the reporters male, 8-year-old cat was lethargic, anorexic and having difficulty breathing. At the time of the initial call the cat was at the veterinary clinic where blood work showed that the cat was anemic and had some white blood cell problems. The veterinarian had not yet come to a definitive diagnosis but she was currently treating the cat with an unknown steroid and an unknown antibiotic. The reporter was advised that per package labeling this product is only meant to be used on dogs. The reporter was further advised that the described blood abnormalities are not consistent with exposure to the product and continued veterinary care was recommended to determine an underlying cause and appropriate treatment. Blood cholinesterase testing was also recommended to assist in reaching a diagnosis. On follow-up call, two days later, the reporter indicated that she brought the cat home from the veterinarian and was in the process of bathing the cat when it had a seizure and died. No further information is available.

To be determined by Registrant

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


19. Provide supplemental information here