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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2016-7624

2. Registrant Information.

Registrant Reference Number: ProPharma Group case:# 1-45872234

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.

10-OCT-16

5. Location of incident.

Country: UNITED STATES

Prov / State: ILLINOIS

6. Date incident was first observed.

Unknown

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. 2596-79

Product Name: HARTZ ULTRA GUARD FLEA & TICK POWDER FOR DOGS

  • Active Ingredient(s)
    • TETRACHLORVINPHOS
      • Guarantee/concentration 3.3 %

7. b) Type of formulation.

Dust

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).

1-45872234- The reporter used a non-company flea and tick product "Pet Guard Shampoo" of unknown active ingredient(s), and a non-company flea and tick spray "Sergeants flea and tick spray" of unknown active ingredient(s) on the dog.

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 Shorthair

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

0.06

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • General
    • Symptom - Death
  • Gastrointestinal System
    • Symptom - Anorexia
  • Nervous and Muscular Systems
    • Symptom - Muscle weakness

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?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

16. How was the animal exposed?

Other / Autre

specify Contact with the product that was applied to a dog.

17. Provide any additional details about the incident

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

1-45872234 - The reporter, a pet owner, indicated her cat was exposed to an insecticidal powder containing the active ingredient tetrachlorvinphos. Approximately five days before the day of initial contact with the registrant, the reporter applied the product to her dog, as well as using the non-company shampoo and spray on the dog. Some of the powder spilled on the floor and the reporters three-week-old, male, domestic shorthair kitten of unknown weight walked through the powder. The next day the kitten was not nursing and was weak. The reporter took the kitten to a veterinarian where he died. The reporter was advised to clean up any of the remaining powder. The kitten might have died from an overdose of the product as he was too young and the product was intended to be used for dogs. 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

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

2

5. Sex

Male

6. Age (provide a range if necessary )

0.06

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • General
    • Symptom - Death

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

Died

16. How was the animal exposed?

Other / Autre

specify Contact with the product that was applied to a dog.

17. Provide any additional details about the incident

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

1-45872234 - The reporter, a pet owner, indicated her cats were exposed to an insecticidal powder containing the active ingredient tetrachlorvinphos. Approximately five days before the day of initial contact with the registrant, the reporter applied the product to her dog, as well as using the non-company shampoo and spray on the dog. Some of the powder spilled on the floor and the reporters two three-week-old, male, domestic shorthair kittens of unknown weight walked through the powder. The kittens were found dead the next day. The reporter was advised to clean up any of the remaining powder. The kittens might have died from an overdose of the product as they were too young and the product was intended to be used for dogs. 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

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

1

5. Sex

Female

6. Age (provide a range if necessary )

0.06

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Skin

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • General
    • Symptom - Death
  • Nervous and Muscular Systems
    • Symptom - Muscle weakness
  • Gastrointestinal System
    • Symptom - Anorexia
  • Skin
    • Symptom - Pale mucous membrane colour

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

Died

16. How was the animal exposed?

Other / Autre

specify Contact with the product that was applied to a dog.

17. Provide any additional details about the incident

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

1-45872234 - The reporter, a pet owner, indicated her cat was exposed to an insecticidal powder containing the active ingredient tetrachlorvinphos. Approximately five days before the day of initial contact with the registrant, the reporter applied the product to her dog, as well as using the non-company shampoo and spray on the dog. Some of the powder spilled on the floor and the reporters three-week-old, female, domestic shorthair kitten of unknown weight walked through the powder. The next day the kitten was not nursing, was weak, and her tongue, skin and nose were very pale. The reporter was advised to clean up any of the remaining powder and get the kitten immediate medical attention. On follow-up call one day later, the reporter indicated the kitten had died before she could get veterinary attention. A necropsy was discussed, but the reporter declined. The kitten might have died from an overdose of the product as she was too young and the product was intended to be used for dogs. 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