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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-5267

2. Registrant Information.

Registrant Reference Number: PROSAR case: 1-38783231

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.

20-OCT-14

5. Location of incident.

Country: UNITED STATES

Prov / State: CONNECTICUT

6. Date incident was first observed.

01-OCT-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. 2596-140

Product Name: UltraGuard Plus Flea/Tick Spray for Cats/Kittens

  • Active Ingredient(s)
    • (S)-METHOPRENE
      • Guarantee/concentration .07 %
    • TETRACHLORVINPHOS
      • Guarantee/concentration 1.08 %

7. b) Type of formulation.

Liquid

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 Longhair

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

18

7. Weight (provide a range if necessary )

9

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>1 wk <=1 mo / > 1 sem < = 1 mois

11. List all symptoms

System

  • Gastrointestinal System
    • Symptom - Vomiting
  • Nervous and Muscular Systems
    • Symptom - Seizure
  • Gastrointestinal System
    • Symptom - Diarrhea
    • Symptom - Salivating excessively
  • Respiratory System
    • Symptom - Respiratory failure
  • Gastrointestinal System
    • Symptom - Inappropriate defecation
  • General
    • Symptom - Death
  • Nervous and Muscular Systems
    • Symptom - Ataxia
    • Specify - Fell over

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

1-38783231 - The reporter, a pet owner, indicated that her two cats were exposed to an insecticidal spray containing the active ingredients tetrachlorvinphos and methoprene. The pet owner applied the spray to her 15-year-old, 9 pound, female cat (Subform III #1) nineteen days prior to initial contact with the registrant and ten days later at about 8:30pm the cat jumped on a counter, fell backwards on to the floor, started seizing and foaming at the mouth and she stopped breathing. The reporter placed the cat in her kennel and at 11:45pm the reporter found the cat dead in the kennel. No veterinary care was sought. The reporter also indicated that she sprayed her 10.5 year old, 14 pound, female cat (Subform III #2) with the product 11 days prior to initial contact with the registrant and the cat stopped eating and did not have a bowel movement for one week. One night prior to initial contact the cat jumped up on the reporters bed and fell on her face. She seized one time, defecated and vomited. The reporter placed the cat in a shoebox where it passed away sometime during the night. The reporter did not seek veterinary care. A necropsy could help determine an underlying cause for death but both cats had already been buried at the time of the initial call. No additional 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

Domestic Shorthair

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

10.5

7. Weight (provide a range if necessary )

14

lbs

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

  • Nervous and Muscular Systems
    • Symptom - Seizure
  • Gastrointestinal System
    • Symptom - Vomiting
    • Symptom - Anorexia
    • Symptom - Constipation
    • Specify - Not defecating for one week
  • 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

1-38783231 - The reporter, a pet owner, indicated that her two cats were exposed to an insecticidal spray containing the active ingredients tetrachlorvinphos and methoprene. The pet owner applied the spray to her 15-year-old, 9 pound, female cat (Subform III #1) nineteen days prior to initial contact with the registrant and ten days later at about 8:30pm the cat jumped on a counter, fell backwards on to the floor, started seizing and foaming at the mouth and she stopped breathing. The reporter placed the cat in her kennel and at 11:45pm the reporter found the cat dead in the kennel. No veterinary care was sought. The reporter also indicated that she sprayed her 10.5 year old, 14 pound, female cat (Subform III #2) with the product 11 days prior to initial contact with the registrant and the cat stopped eating and did not have a bowel movement for one week. One night prior to initial contact the cat jumped up on the reporters bed and fell on her face. She seized one time, defecated and vomited. The reporter placed the cat in a shoebox where it passed away sometime during the night. The reporter did not seek veterinary care. A necropsy could help determine an underlying cause for death but both cats had already been buried at the time of the initial call. No additional 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