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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-3380

2. Registrant Information.

Registrant Reference Number: PROSAR case: 1-37794218

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-JUL-14

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

11-JUL-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.       PMRA Submission No.       EPA Registration No. Unknown

Product Name: Ultraguard One Spot (unspecified)

  • Active Ingredient(s)
    • (S)-METHOPRENE

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

Cat / Chat

3. Breed

Domestic Shorthair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.33

7. Weight (provide a range if necessary )

3

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

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

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Seizure
    • Symptom - Ataxia
    • Symptom - Trembling

12. How long did the symptoms last?

Unknown / Inconnu

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

Yes

14. a) Was the animal hospitalized?

No

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

1-37794218 - The reporter, a pet owner, indicated that her cat was exposed to an insecticidal spot-on product containing the active ingredient methoprene. The reporter no longer had the product packaging and could not provide the product barcode number or registration number. The only product information that was available was the partial name of Ultraguard One Spot Flea and Tick Drops for Cats, which the reporter provided from memory. The reporter indicated that she applied the product to her 4-month-old, 3 pound, male domestic shorthair four days prior to initial contact with the registrant. The following morning the cat was having trouble walking, seizing, and had muscle tremors. The cat was brought to the veterinarian that night where the cat was bathed and intravenous fluids and an anticonvulsant were given. Blood work was run to check for toxins. The results of the blood work were not provided. The cat was sent home that same night on a liquid diet. The reporter indicated that the cats tremors resolved the following day but the cat was still a little slow that day. The reporter was advised that the product has a wide margin of safety and the described symptoms are not consistent with exposure to the product. Pyrethroid hair testing was recommended to rule out possible exposure to a pyrethroid insecticide. The reporter could not be reached on follow-up. No further information is available.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here