Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2014-6190
2. Registrant Information.
Registrant Reference Number: 140077652
Registrant Name (Full Legal Name no abbreviations): Wellmark International
Address: 100 Stone Road West, Suite 111
City: Guelph
Prov / State: Ontario
Country: Canada
Postal Code: N1G5L3
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
24-JUN-14
5. Location of incident.
Country: CANADA
Prov / State: BRITISH COLUMBIA
6. Date incident was first observed.
19-JUN-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. 2724-814
Product Name: Kirkland Signature Flea and Tick Control for Cats 5 Lbs and Over
- Active Ingredient(s)
- (S)-METHOPRENE
- ETOFENPROX
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
1.8
Units: mL
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).
On June 17, 2014 the owner applied the unregistered in Canada product onto the cat.
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
Yes
Subform III: Domestic Animal Incident Report
1. Source of Report
Animal's Owner
2. Type of animal affected
Cat / Chat
3. Breed
Abyssinian
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
8.0
7. Weight (provide a range if necessary )
7.0
lbs
8. Route(s) of exposure
Skin
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
>24 hrs <=3 days / >24 h <=3 jours
11. List all symptoms
System
- Gastrointestinal System
- Symptom - Diarrhea
- Symptom - Anorexia
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
Fully Recovered / Complètement rétabli
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
On June 19, and June 20, 2014 the cat developed symptoms On June 20, 2014 the cat developed anorexia and adipsia. On June 21, 2014 the owner took the cat to the veterinarian where kaopectate was given. On June 24, 2014 the owner contacted the Animal Product Safety Service (APSS) and stated the cat had fully recovered. The APSS veterinarian stated the ingredients in this agent have a good margin of safety in cats. The APSS veterinarian stated that this clinical picture would not be expected.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Moderate
19. Provide supplemental information here
The APSS veterinarian stated that the substance was considered to have a doubtful likelihood of causing the clinical situation. This product is not registered in Canada.