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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2016-3168

2. Registrant Information.

Registrant Reference Number: ProPharma Group case#: 1-44117672

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.

14-MAY-16

5. Location of incident.

Country: UNITED STATES

Prov / State: TEXAS

6. Date incident was first observed.

13-MAY-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. 2596-147

Product Name: HARTZ ULTRA ONESPOT GUARD FLEA EGG & FLEA LARVAE TREATMENT FOR CATS

  • Active Ingredient(s)
    • (S)-METHOPRENE
      • Guarantee/concentration 2.9 %

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).

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 Longhair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

1.5

7. Weight (provide a range if necessary )

6

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

  • Gastrointestinal System
    • Symptom - Vomiting
  • General
    • Symptom - Lethargy
  • Nervous and Muscular Systems
    • Symptom - Difficulty walking
  • Renal System
    • Symptom - Other
    • Specify - "something wrong with his kidneys"
  • General
    • Symptom - Death

12. How long did the symptoms last?

Persisted until death

13. Was medical treatment provided? Provide details in question 17.

Yes

14. a) Was the animal hospitalized?

Yes

14. b) How long was the animal hospitalized?

3

Day(s) / Jour(s)

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

1-44117672 - The reporter, a pet owner, indicated his cat was exposed to an insecticidal spot-on product containing the active ingredient (S)-methoprene. The reporter applied the product to his 18-month-old, 6-pound, male, domestic longhair cat two days before initial contact with the registrant. The cat tried to lick the product off immediately after application. One day before contact with the registrant, the cat became lethargic and vomited. On the day of contact with the registrant, the reporter was advised that ingesting small quantities of this product are unlikely to result in significant problems but if enough is ingested minor GI upset may result, and if the symptoms persisted or worsened to contact a veterinarian. On follow-up three days after initial contact, the reporter indicated his cat developed an inability to walk and was taken to the veterinarian who found "something wrong with his kidneys." The cat died at the veterinarian three days after initial contact. A necropsy was recommended to determine an underlying cause for the cats symptoms but the reporter declined. No additional information is available.


To be determined by Registrant

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

Death

19. Provide supplemental information here