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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2017-0067

2. Registrant Information.

Registrant Reference Number: ProPharma Group case: # 1-46305197

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.

18-NOV-16

5. Location of incident.

Country: CANADA

Prov / State: QUEBEC

6. Date incident was first observed.

11-NOV-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. 26133      PMRA Submission No.       EPA Registration No.

Product Name: HARTZ ULTRAGUARD RID FLEA & TICK SHAMPOO FOR DOGS

  • Active Ingredient(s)
    • 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).

1-46305197 - The product is designed for use on dogs only, but in this case was applied to a cat.

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

Unknown

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

10

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

  • Respiratory System
    • Symptom - Dyspnea
  • General
    • Symptom - Death

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

14. a) Was the animal hospitalized?

Unknown

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

1-46305197 - The reporter, a pet owner, indicated her cat was exposed to an insecticidal shampoo containing the active ingredients N-octyl bicycloheptene dicarboximide and piperonyl butoxide. On an unknown number of days before the dayof initial contact with the registrant, the reporter used the product on her 10-year-old, male cat of unknown breed and weight. The reporter stated she had used the product on the cat twice before with no problems. At an unknown number of days after use, the cat developed respiratory difficulties. The reporter was unable to define what these difficulties were, and and it is unclear if the reporter sought veterinary care for the cat. The cat died seven days before the day of initial contact with the registrant. The reporter was advised that the use of canine flea and tick products containing pyrethroid active ingredients on cats can cause severe problems. It is unclear if the reporters cats problems were related to the improper use of the product. No follow-up was attempted. 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