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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-6454

2. Registrant Information.

Registrant Reference Number: 130100363

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.


5. Location of incident.


Prov / State: TEXAS

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. 2724-274

Product Name: Starbar Golden Malrin Fly Bait 1% Methomyl

  • Active Ingredient(s)
    • (Z)-9-TRICOSENE
      • Guarantee/concentration .049 %
      • Guarantee/concentration 1 %

7. b) Type of formulation.


Application Information

8. Product was applied?


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?


Subform III: Domestic Animal Incident Report

1. Source of Report

Medical Professional

2. Type of animal affected

Dog / Chien

3. Breed

Miniature Poodle

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

10. Time between exposure and onset of symptoms

<=30 min / <=30 min

11. List all symptoms


  • Nervous and Muscular Systems
    • Symptom - Seizure
  • Gastrointestinal System
    • Symptom - Diarrhea
  • Cardiovascular System
    • Symptom - Cardiac arrest
  • Respiratory System
    • Symptom - Abnormal lung sounds
    • Specify - Increased Lung Sounds
  • 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?

Accidental ingestion/Ingestion accident.

17. Provide any additional details about the incident

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

The dog had ingested about 3 teaspoons (tsp) of the bait product on the evening of July 20, 2013 and was taken to an emergency veterinary clinic. Later that evening the emergency veterinary staff noticed that the dog had a seizure and diarrhea; the dog was given Midazolam and oxygen. A short time later the emergency veterinary staff noticed that the dog was experiencing cardiopulmonary arrest and increased lung sounds; the emergency veterinary staff immediately contacted the Animal Product Safety Service (APSS) to obtain help. The APSS veterinarian stated that Methomyl is a highly toxic carbamate insecticide, and its method of action is anticholinesterase inhibition; it is rapidly absorbed orally, with onset of clinical signs expected within minutes of ingestion. The APSS veterinarian also stated that clinical signs could be muscarinic (salivation, miosis, bradycardia, and dyspnea due to increased bronchial secretions), nicotinic (tremors, weakness, and paralysis), and central nervous system (CNS) seizures. The APSS veterinarian recommended that the emergency veterinarian monitor the dog's cardiovascular function, for CNS signs, for gastrointestinal (GI) signs, for respiratory sounds, and for signs of aspiration; give the dog 0.1 milligram per kilogram (mg/kg) of Atropine, with one quarter given intravenously (IV) and the rest given intramuscularly (IM); give Diazepam; manage seizures as necessary; give Methocarbamol; provide ventilatory support and symptomatic and supportive care; and call back with questions.

To be determined by Registrant

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


19. Provide supplemental information here

On July 24, 2013 an APSS assistant called the emergency veterinary staff to update the case. The emergency veterinary staff stated that the dog had died later on the evening of July 20, 2013 and that the owner took the dog's body home to be buried. A necropsy was not available. Extra label use, product not to be used where pets have access.