Incident Report
Subform I: General Information
1. Report Type.
Update the report
Incident Report Number: 2015-2282
2. Registrant Information.
Registrant Reference Number: 2015-US-04835
Registrant Name (Full Legal Name no abbreviations): Merck Animal Health (Intervet Canada Corp)
Address: 16750 Transcanada Highway
City: Kirkland
Prov / State: Quebec
Country: Canada
Postal Code: H9H 4M7
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
11-MAY-15
5. Location of incident.
Country: UNITED STATES
Prov / State: IOWA
6. Date incident was first observed.
11-MAY-15
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. 773-74
Product Name: Saber Pour On
- Active Ingredient(s)
- LAMBDA-CYHALOTHRIN
- Guarantee/concentration 1 %
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
Préciser le type: calves
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
Adverse Reaction. On 11 May 2015 a producer reported that they vaccinated 27 head of 200 lb calves with 20/20 Vision 7, Vista Once, Panacur Susp 10%, Ralgro and Saber Pour On. When the producer checked the calves a couple hours later he found 1 calf dead. The veterinarian necropsied the calf and grossly only found wet heavy lungs. Samples submitted for diagnostics. Follow up pending.
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
Medical Professional
2. Type of animal affected
Cow / Vache
3. Breed
Angus
4. Number of animals affected
1
5. Sex
Unknown
6. Age (provide a range if necessary )
0.4
7. Weight (provide a range if necessary )
200
lbs
8. Route(s) of exposure
Skin
9. What was the length of exposure?
<=15 min / <=15 min
10. Time between exposure and onset of symptoms
>2 hrs <=8 hrs / > 2 h < = 8 h
11. List all symptoms
System
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
Nothing to add.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here
Nothing to add. Status update September 23 2015: Follow up 17 September 2015: lab results show no significant growth of lung. Liver: Sinusoids are congested and contain low numbers of eosinophils. Heart: There is diffuse vascular congestion and rare eosinophils. Kidney: There is diffuse vascular congestion. All consistent with anaphylaxis. No more information expected.