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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-1238

2. Registrant Information.

Registrant Reference Number: PROSAR case: 1-36455839

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.

14-MAR-14

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

13-MAR-14

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. 25923      PMRA Submission No.       EPA Registration No.

Product Name: UltraGuard Flea/Tick Drops for Dogs/Puppies Under 30 lbs.

  • Active Ingredient(s)
    • PERMETHRIN

7. b) Type of formulation.

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

Dog / Chien

3. Breed

Chihuahua

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.5

7. Weight (provide a range if necessary )

2

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>2 hrs <=8 hrs / > 2 h < = 8 h

11. List all symptoms

System

  • Skin
    • Symptom - Itchy skin
  • Nervous and Muscular Systems
    • Symptom - Shaking
    • Symptom - Muscle twitching

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

14. a) Was the animal hospitalized?

Unknown

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Unknown/Inconnu

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

1-36455839 - The reporter, a pet owner, indicated that his three dogs were exposed to a dog spot-on insecticide containing the active ingredient permethrin. The reporter applied the product to his 6-month-old, 2 pound, male Chihuahua (Subform III #1), to his 6-month-old, 1 pound, male Chihuahua (Subform III #3) and to his 10-year-old, 5 pound, male Chihuahua (Subform III #2) one day prior to initial contact with the registrant. All three dogs became very itchy about 3 hours after the product had been applied and they were shaking as well. The reporter was advised that the active ingredient in the product can cause transient parasthesia in sensitive animals. Bathing with a non-insecticidal soap was recommended and veterinary care was advised for any persistent symptoms. On follow-up call, three days later, the reporter indicated that his 5 year old dog (Subform III #2) was still shaking his head like his ears were bothering him, his 2 pound dog (Subform III #1) was still twitching and his 1 pound dog (Subform III # 3) was twitching intermittently. Veterinary care was recommended for the persistent symptoms. No further information is available.


To be determined by Registrant

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

Minor

19. Provide supplemental information here

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Chihuahua

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

10

7. Weight (provide a range if necessary )

5

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>2 hrs <=8 hrs / > 2 h < = 8 h

11. List all symptoms

System

  • Skin
    • Symptom - Itchy skin
  • Nervous and Muscular Systems
    • Symptom - Shaking

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

14. a) Was the animal hospitalized?

Unknown

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Unknown/Inconnu

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

1-36455839 - The reporter, a pet owner, indicated that his three dogs were exposed to a dog spot-on insecticide containing the active ingredient permethrin. The reporter applied the product to his 6-month-old, 2 pound, male Chihuahua (Subform III #1), to his 6-month-old, 1 pound, male Chihuahua (Subform III #3) and to his 10-year-old, 5 pound, male Chihuahua (Subform III #2) one day prior to initial contact with the registrant. All three dogs became very itchy about 3 hours after the product had been applied and they were shaking as well. The reporter was advised that the active ingredient in the product can cause transient parasthesia in sensitive animals. Bathing with a non-insecticidal soap was recommended and veterinary care was advised for any persistent symptoms. On follow-up call, three days later, the reporter indicated that his 5 year old dog (Subform III #2) was still shaking his head like his ears were bothering him, his 2 pound dog (Subform III #1) was still twitching and his 1 pound dog (Subform III # 3) was twitching intermittently. Veterinary care was recommended for the persistent symptoms. No further information is available.


To be determined by Registrant

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

Minor

19. Provide supplemental information here

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

chihuahua

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.5

7. Weight (provide a range if necessary )

1

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>2 hrs <=8 hrs / > 2 h < = 8 h

11. List all symptoms

System

  • Skin
    • Symptom - Itchy skin
  • Nervous and Muscular Systems
    • Symptom - Shaking
    • Symptom - Muscle twitching

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

14. a) Was the animal hospitalized?

Unknown

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Unknown/Inconnu

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

1-36455839 - The reporter, a pet owner, indicated that his three dogs were exposed to a dog spot-on insecticide containing the active ingredient permethrin. The reporter applied the product to his 6-month-old, 2 pound, male Chihuahua (Subform III #1), to his 6-month-old, 1 pound, male Chihuahua (Subform III #3) and to his 10-year-old, 5 pound, male Chihuahua (Subform III #2) one day prior to initial contact with the registrant. All three dogs became very itchy about 3 hours after the product had been applied and they were shaking as well. The reporter was advised that the active ingredient in the product can cause transient parasthesia in sensitive animals. Bathing with a non-insecticidal soap was recommended and veterinary care was advised for any persistent symptoms. On follow-up call, three days later, the reporter indicated that his 5 year old dog (Subform III #2) was still shaking his head like his ears were bothering him, his 2 pound dog (Subform III #1) was still twitching and his 1 pound dog (Subform III # 3) was twitching intermittently. Veterinary care was recommended for the persistent symptoms. No further information is available.


To be determined by Registrant

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

Minor

19. Provide supplemental information here