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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2015-0364
2. Registrant Information.
Registrant Reference Number: 140091296
Registrant Name (Full Legal Name no abbreviations): Farnam Companies, Inc.
Address: 301 W. Osborn Road
City: Phoenix
Prov / State: Arizona
Country: USA
Postal Code: 85013
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
22-JUL-145. Location of incident.
Country: CANADA
Prov / State: ALBERTA
6. Date incident was first observed.
21-JUL-14Product 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. 13922 PMRA Submission No. EPA Registration No.
Product Name: Swat Fly Repellent Cream for Wounds and Sores
- Active Ingredient(s)
- DI-N-PROPYL ISOCINCHOMERONATE
- PIPERONYL BUTOXIDE
- PYRETHRINS
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).
On July 15, 2014 the horse had surgery. On July 21, 2014 the horse went home and the attending veterinarian recommended the owner to apply fly cream on the stitches, which the owner did that evening.To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
YesSubform III: Domestic Animal Incident Report
1. Source of Report
Medical Professional
2. Type of animal affected
Horse / Cheval
3. Breed
Standardbred
4. Number of animals affected
1
5. Sex
Female
6. Age (provide a range if necessary )
3.0
7. Weight (provide a range if necessary )
475.0
kg
8. Route(s) of exposure
Skin
9. What was the length of exposure?
>15 min <=2 hrs / >15 min <=2 h
10. Time between exposure and onset of symptoms
>30 min <=2 hrs / >30 min <=2 h
11. List all symptoms
System
- Skin
- Symptom - Edema
- Specify - Edema of the Face
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
On July 21, 2014 the owner noticed the horse developed edema of the face. The owner then contacted the attending veterinarian, who came out and provided dermal decontamination (rinsing the horse's face with water) and giving symptomatic care (anti-inflammatory injection). On July 22, 2014 he horse's edema of the face became milder. The attending veterinarian then called the Animal Product Safety Service (APSS) to see if hypersensitivity reactions have been seen with this product before. The APSS veterinarian stated as with any topical exposure, dermal irritation or hypersensitivity reactions are possible. The APSS veterinarian also stated paresthesia (abnormal tingling sensation) can also occur from topical pyrethrins. The APSS veterinarian recommended calling back with questions and she referred to the manufacturer to discuss the attending veterinarian's concerns over labeling of the product and financial compensation for medical care.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Moderate
19. Provide supplemental information here
Product is considered to have a medium likelihood of causing the clinical situation. A follow up was not performed, because signs were expected to be mild and self-limiting. Therefore, the outcome of this case is unknown.
