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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2016-3102

2. Registrant Information.

Registrant Reference Number: 160022924

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.

17-FEB-16

5. Location of incident.

Country: UNITED STATES

Prov / State: LOUISIANA

6. Date incident was first observed.

14-FEB-16

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. 1021-2684-89459

Product Name: Adams Flea And Tick Dip For Dogs And Cats

  • Active Ingredient(s)
    • PIPERONYL BUTOXIDE
      • Guarantee/concentration 3 %
    • PYRETHRINS
      • Guarantee/concentration .3 %

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

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

On February 12, 2016 the owner's husband mixed 4 ounces of the product with 4-5 gallons of water before dipping the kitten.

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

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Domestic Mediumhair

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

0.375

7. Weight (provide a range if necessary )

3.0

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>24 hrs <=3 days / >24 h <=3 jours

11. List all symptoms

System

  • General
    • Symptom - Lethargy
  • Gastrointestinal System
    • Symptom - Anorexia
  • General
    • Symptom - Adipsia
  • Nervous and Muscular Systems
    • Symptom - Seizure
  • General
    • Symptom - Vocalizing
    • Symptom - Death

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

On February 14, 2016 the kitten developed symptoms. On February 17, 2016 the owner contacted the Animal Product Safety Service (APSS). The APSS veterinarian stated products labeled for cats generally have low concentrations of pyrethroids. The APSS veterinarian also stated if the product is groomed off and ingested, can see taste reaction (hypersalivation, nausea) and these signs are usually self-limiting. The APSS veterinarian finally stated severe systemic gastrointestinal (GI) signs are not expected. The APSS veterinarian recommended taking the kitten to the veterinarian, bathing the kitten (keep warm following bath), providing water and food, and calling back with questions.


To be determined by Registrant

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

Death

19. Provide supplemental information here

The APSS veterinarian stated that the substance was considered to have a doubtful likelihood of causing the clinical situation. On February 24, 2016 the owner called the APSS with an update. The owner stated she was unable to take the kitten to the veterinarian due to financial restrictions, but she did bathe the kitten and offer food and water; the kitten drank, but would not eat. The owner also stated that on February 21, 2016 the kitten had a seizure (neurological episode- legs became stiff) and she vocalized and died right after. The owner finally stated that the kitten's body had been buried, so the APSS technician stated a necropsy was not available. The APSS veterinarian briefly spoke with the owner. The owner was certain that the product caused her kitten to die a week after use. The APSS veterinarian advised her the signs have been noted and the record would be sent to the company and the EPA. The APSS veterinarian explained although cats can be sensitive to the ingredients, death is not expected.