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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-6496

2. Registrant Information.

Registrant Reference Number: 130134252

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.

24-SEP-13

5. Location of incident.

Country: UNITED STATES

Prov / State: CALIFORNIA

6. Date incident was first observed.

24-SEP-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. 2724-808-270

Product Name: Adams Plus Flea And Tick Indoor Fogger Can

  • Active Ingredient(s)
    • (S)-METHOPRENE
      • Guarantee/concentration .09 %
    • ETOFENPROX
      • Guarantee/concentration .5 %
    • N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
      • Guarantee/concentration .5 %
    • TETRAMETHRIN
      • Guarantee/concentration .4 %

7. b) Type of formulation.

Other (specify)

aerosol

Application Information

8. Product was applied?

Yes

9. Application Rate.

3

Units: oz (fl) / oz (liquide)

10. Site pesticide was applied to (select all that apply).

Site: Res. - In Home / Rés. - à l'int. maison

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

On September 17, 2013 the owner applied a spot on flea and tick product to the cat. On September 23, 2013 the owner used the fogger product in the home, returned 2 hours later to ventilate the home, and then brought the cat back into the home around 3 hours later; the cat may have been exposed to some of the product's fumes.

To be determined by Registrant

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

Yes

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Somali

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

14.0

7. Weight (provide a range if necessary )

6.0

lbs

8. Route(s) of exposure

Respiratory

9. What was the length of exposure?

>8 hrs <= 24 hrs / >8 h <= 24 h

10. Time between exposure and onset of symptoms

>8 hrs <=24 hrs / > 8 h < = 24 h

11. List all symptoms

System

  • General
    • Symptom - Death
    • Symptom - Abnormal behaviour
    • Symptom - Lethargy

12. How long did the symptoms last?

Unknown / Inconnu

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

No

14. a) Was the animal hospitalized?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

16. How was the animal exposed?

Contact treat.area/Contact surf. traitée

17. Provide any additional details about the incident

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

On September 16, 2013 the owner noticed that the cat experienced a behavior change, and on September 22, 2013 the owner noticed that the cat was lethargic. On September 23, 2013 the owner used the fogger product in her home. On the morning of September 24, 2013 the owner observed that the cat had died. Later that morning the owner contacted the Animal Product Safety Service (APSS) to obtain help. The APSS veterinarian stated that the ingredients in the flea and tick spot on product have a wide margin of safety in cats and that although dermal reactions could be seen in sensitive individuals, significant systemic effects would not be expected. Regarding the fogger product, the APSS veterinarian stated that the ingredients in the product have a wide margin of safety when used per label and that minimal signs would be expected from an exposure to the product; a mild taste reaction could be seen if the cat licked a surface with a small amount of product residue. The APSS veterinarian recommended a necropsy.


To be determined by Registrant

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

Death

19. Provide supplemental information here

The APSS veterinarian stated that both products were considered to have a doubtful likelihood of causing the clinical situation. On the afternoon of September 24, 2013 an APSS technician called the owner to see if she wanted to pursue a necropsy; the owner wanted to take some time to consider it. Later that afternoon the owner called the APSS to decline a necropsy.