Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2016-0108
2. Registrant Information.
Registrant Reference Number: 150135871
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.
02-OCT-15
5. Location of incident.
Country: CANADA
Prov / State: NOVA SCOTIA
6. Date incident was first observed.
30-SEP-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. 28382
PMRA Submission No.
EPA Registration No.
Product Name: Zodiac Dual Action Flea And Tick Spray For Cats And Kittens
- Active Ingredient(s)
- (S)-METHOPRENE
- N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
- 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 September 30, 2015 the owner applied the product onto 3 kittens.
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 Shorthair
4. Number of animals affected
3
5. Sex
Male
Female
6. Age (provide a range if necessary )
0.25
7. Weight (provide a range if necessary )
1.0
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
<=30 min / <=30 min
11. List all symptoms
System
- Nervous and Muscular Systems
12. How long did the symptoms last?
>8 hrs <=24 hrs / > 8 h < = 24 h
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
Fully Recovered / Complètement rétabli
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 September 30, 2015 the owner noticed the kittens developed symptoms, so she bathed them. On October 1, 2015 the symptoms all resolved and the kittens fully recovered. On October 2, 2015 the owner contacted the Animal Product Safety Service (APSS) to inquire about using another flea product she purchased from the veterinarian (who recommended waiting 2 weeks before applying). The APSS veterinarian stated the risk is for a taste reaction and serious signs are not expected with this exposure. The APSS technician stated no treatment was necessary, recommended calling back with questions, and recommended waiting at least one week before applying the flea product obtained from the veterinarian.
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.