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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2016-0054

2. Registrant Information.

Registrant Reference Number: 150040550

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.

31-MAR-15

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

30-MAR-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. 25738      PMRA Submission No.       EPA Registration No.

Product Name: Zodiac Premise 1000 Flea Spray

  • 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: Res. - In Home / Rés. - à l'int. maison

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

On March 30, 2015 the owner used the spray in her home.

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

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Domestic Longhair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

10.0

7. Weight (provide a range if necessary )

18.0

lbs

8. Route(s) of exposure

Skin

Oral

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 - Disorientation
    • Symptom - Trembling
    • Symptom - Staggering

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

Not recovered / Non rétabli

16. How was the animal exposed?

Contact treat.area/Contact surf. traitée

17. Provide any additional details about the incident

(eg. description of the frequency and severity of the symptoms

On March 30, 2015 the cat rolled on the treated furniture and ingested the product. Shortly after the cat became symptomatic. The owner then took the cat to the veterinarian, where they bathed the cat, gave methocarbamol (1.5 milliliters of 100 milligrams per milliliter three times daily), and a complete blood count was done. On March 31, 2015 the owner contacted the Animal Product Safety Service (APSS). The owner stated the attending veterinarian had sent the cat home on March 30, 2015. The APSS veterinarian stated and severe systemic signs are unlikely at 0.8% concentration of permethrin. The APSS assistant recommended calling back with questions (if symptoms continue), calling the veterinarian (to discuss increasing methocarbamol dose), bathing (with dish washing soap), and giving a taste treat (canned tuna, chicken flavored baby food).


To be determined by Registrant

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

Moderate

19. Provide supplemental information here

On April 6, 2015 an APSS technician called the owner to follow up the case. The owner stated the cat was sent home with a muscle relaxant, but the owner does not remember the name. The medication was making the cat disoriented, so the owner discontinued it after a couple days. The owner also stated the cat is improving and the signs are intermittent, but they are decreasing in severity. The owner further stated the cat jumps around and plays now, she is still in contact with the attending veterinarian, and no new signs developed. Extra label use, pets to be kept away from treated areas until dry.