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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-4854

2. Registrant Information.

Registrant Reference Number: PROSAR case: 1-38488131

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.

18-SEP-14

5. Location of incident.

Country: UNITED STATES

Prov / State: MICHIGAN

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. 2596-22

Product Name: UltraGuard Rid Flea/Tick Shampoo for Cats

  • Active Ingredient(s)
    • N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
      • Guarantee/concentration .149 %
    • PIPERONYL BUTOXIDE
      • Guarantee/concentration .089 %
    • PYRETHRINS
      • Guarantee/concentration .045 %

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

Product Name: UltraGuard Flea/Tick Collar for Cats

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

7. b) Type of formulation.

Liquid

Other (specify)

Impregnated 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?

No

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

Unknown

6. Age (provide a range if necessary )

0.16

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

  • General
    • Symptom - Death
  • Respiratory System
    • Symptom - Other
    • Specify - suffocated

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

1-38488131 - The reporter, a pet owner, indicated that four kittens and a mother cat were exposed to an insecticidal shampoo containing the active ingredients pyrethrins, n-octyl bicycloheptene dicarboximide and piperonyl butoxide and to an insecticidal collar containing the active ingredient tetrachlorvinphos. The pet owner used the insecticidal shampoo, to treat an active flea infestation, on his four 8-week-old kittens and the mother cat a few days prior to initial contact with the registrant. The pet owner applied the insecticidal collar to the mother cat shortly after she was bathed. Two of the kittens died after use of the product. One kitten (Subform III #1) was found trapped and suffocated in a small area and another kitten (Subform III #2) was found dead under a piece of furniture. At the time of the initial call the other two kittens had diarrhea. The reporter was advised that per package labeling the products are not meant to be used on 8 week old animals. The reporter was further advised that there are numerous possible causes for the described symptoms especially in young unvaccinated animals. Immediate veterinary care was recommended for the two remaining kittens to determine and underlying cause and appropriate treatment. 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

Unknown

6. Age (provide a range if necessary )

0.166

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

  • General
    • Symptom - Death

12. How long did the symptoms last?

Anticip. permanent/Permanence anticipée

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

1-38488131 - The reporter, a pet owner, indicated that four kittens and a mother cat were exposed to an insecticidal shampoo containing the active ingredients pyrethrins, n-octyl bicycloheptene dicarboximide and piperonyl butoxide and to an insecticidal collar containing the active ingredient tetrachlorvinphos. The pet owner used the insecticidal shampoo, to treat an active flea infestation, on his four 8-week-old kittens and the mother cat a few days prior to initial contact with the registrant. The pet owner applied the insecticidal collar to the mother cat shortly after she was bathed. Two of the kittens died after use of the product. One kitten (Subform III #1) was found trapped and suffocated in a small area and another kitten (Subform III #2) was found dead under a piece of furniture. At the time of the initial call the other two kittens had diarrhea. The reporter was advised that per package labeling the products are not meant to be used on 8 week old animals. The reporter was further advised that there are numerous possible causes for the described symptoms especially in young unvaccinated animals. Immediate veterinary care was recommended for the two remaining kittens to determine and underlying cause and appropriate treatment. 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