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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-2430

2. Registrant Information.

Registrant Reference Number: PROSAR case: 1-40473898

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.

04-MAY-15

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

04-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. Unknown

Product Name: HARTZ ULTRAGUARD PRO FLEA/TICK TREATMENT FOR DOGS AND PUPPIES

  • Active Ingredient(s)
    • (S)-METHOPRENE
    • PERMETHRIN

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).

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

Medical Professional

2. Type of animal affected

Cat / Chat

3. Breed

Unknown

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

6

7. Weight (provide a range if necessary )

23

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 - Muscle twitching

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?

Unknown

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

1-40473898 - The reporter, a veterinarian, indicated that a cat was exposed to a dog insecticidal spot-on product containing the active ingredients permethrin and methoprene. The reporter was not able to provide the registration number for the product but did indicate that the product was called Ultraguard pro for large dogs. The pet owner applied about of an applicator to their 6 year old, 23 pound cat two days prior to initial contact with the registrant and as they were applying the product they realized that it was the dog product. They immediately bathed the cat but a few hours after application the pet owner noted fine muscle tremors in the cats back. The following day the pet owner bathed the cat again but the tremors continued. At the time of the call, the reporter indicated that the cat had just presented to the clinic, it seemed fine on physical exam but it did have occasional small muscle fasciculations in its back. The reporter was advised that per package labeling the dog product is not meant to be applied to cats. The reporter was further advised that CNS symptoms typically resolve in about 72 hours and a short course of muscle relaxants were recommended to help control the tremors. No additional information is available.


To be determined by Registrant

18. Severity classification (if there is more than 1 possible classification

Moderate

19. Provide supplemental information here