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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-6842

2. Registrant Information.

Registrant Reference Number: PROSAR case #: 1-35599851

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.

23-NOV-13

5. Location of incident.

Country: UNITED STATES

Prov / State: LOUISIANA

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)

PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-83

Product Name: Ultraguard Flea and Tick Collar for Cats and Kittens

  • Active Ingredient(s)
    • TETRACHLORVINPHOS
      • Guarantee/concentration 14.55 %

7. b) Type of formulation.

Other (specify)

Impregnated flea and tick collar

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

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?

Unknown

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Unknown

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

2

7. Weight (provide a range if necessary )

Unknown

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

  • Gastrointestinal System
    • Symptom - Anorexia
  • General
    • Symptom - Death
  • Renal System
    • Symptom - Anuria
  • Gastrointestinal System
    • Symptom - Constipation
    • Specify - Stopped defecating
  • General
    • Symptom - Dehydration

12. How long did the symptoms last?

Persisted until death

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?

Treatment / Traitement

17. Provide any additional details about the incident

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

1-35599851 - The reporter, a pet owner, indicated that his two cats were exposed to an insecticidal collar containing the active ingredient tetrachlorvinphos. The reporter did not have product packaging and could not provide the EPA registration number or the full name of the product but was able to provide a bar code number from a receipt. The reporter indicated that he placed the collar on his 1 year old, female, outdoor cat (Subform III #2) about one week prior to initial contact with the registrant. A few days after applying the collar the cat stopped eating, stopped urinating and defecating and then it was found dead. About 4 days prior to initial contact with the registrant the reporter applied the same type of collar to his 2 year old, male indoor cat (Subform III #1) and within 24 hours of applying the collar the reporters indoor cat was anorexic, not urinating or defecating and it became dehydrated. The reporter brought this cat to an emergency veterinarian but due to financial constraints no treatment was provided, the cat was brought home from the eclinic and died within 2 hours of leaving the clinic. A necropsy was recommended to help determine the cause of death but it was declined. No further information is available.


To be determined by Registrant

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

Death

19. Provide supplemental information here

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Unknown

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

1

7. Weight (provide a range if necessary )

Unknown

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

  • Gastrointestinal System
    • Symptom - Anorexia
    • Symptom - Constipation
    • Specify - Stopped defecating
  • Renal System
    • Symptom - Anuria
  • General
    • Symptom - Death

12. How long did the symptoms last?

Persisted until death

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?

Treatment / Traitement

17. Provide any additional details about the incident

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

1-35599851 - The reporter, a pet owner, indicated that his two cats were exposed to an insecticidal collar containing the active ingredient tetrachlorvinphos. The reporter did not have product packaging and could not provide the EPA registration number or the full name of the product but was able to provide a bar code number from a receipt. The reporter indicated that he placed the collar on his 1 year old, female, outdoor cat (Subform III #2) about one week prior to initial contact with the registrant. A few days after applying the collar the cat stopped eating, stopped urinating and defecating and then it was found dead. About 4 days prior to initial contact with the registrant the reporter applied the same type of collar to his 2 year old, male indoor cat (Subform III #1) and within 24 hours of applying the collar the reporters indoor cat was anorexic, not urinating or defecating and it became dehydrated. The reporter brought this cat to an emergency veterinarian but due to financial constraints no treatment was provided, the cat was brought home from the eclinic and died within 2 hours of leaving the clinic. A necropsy was recommended to help determine the cause of death but it was declined. No further information is available.


To be determined by Registrant

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

Death

19. Provide supplemental information here