Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2016-0051
2. Registrant Information.
Registrant Reference Number: 150005440
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.
13-JAN-15
5. Location of incident.
Country: CANADA
Prov / State: ALBERTA
6. Date incident was first observed.
12-JAN-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. 26494
PMRA Submission No.
EPA Registration No.
Product Name: Zodiac Powerspot Flea And Tick Control For Dogs Under 14 kg (30 lbs)
- Active Ingredient(s)
- (S)-METHOPRENE
- PERMETHRIN
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
1
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 January 11, 2015 the shelter employee applied the product onto 25 dogs.
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
Other
2. Type of animal affected
Dog / Chien
3. Breed
Miniature Pinscher
4. Number of animals affected
8
5. Sex
Male
Female
6. Age (provide a range if necessary )
5.0
7. Weight (provide a range if necessary )
17.0
lbs
8. Route(s) of exposure
Skin
9. What was the length of exposure?
Unknown / Inconnu
10. Time between exposure and onset of symptoms
>8 hrs <=24 hrs / > 8 h < = 24 h
11. List all symptoms
System
- Nervous and Muscular Systems
- Symptom - Shaking
- Specify - Paw Shaking
12. How long did the symptoms last?
Unknown / Inconnu
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
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 January 12, 2015 the dogs developed symptoms. On January 13, 2015 the shelter employee contacted the Animal Product Safety Service (APSS). The APSS veterinarian stated the ingredients in this agent have a wide margin of safety in dogs. The APSS veterinarian also stated dermal and dermal paresthesia reactions in sensitive individuals can be seen and significant systemic effects are not expected. The APSS veterinarian further stated if the dogs were able to scratch the application site with their foot they could be experiencing a tingling sensation, or they could be shaking their foot in response to a tingling sensation at the application site. The APSS assistant recommended monitoring the dogs at the shelter, bathing the dogs (with dish soap), and calling back with questions.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
19. Provide supplemental information here
No significant signs were expected.