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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2017-1007

2. Registrant Information.

Registrant Reference Number: 1931438

Registrant Name (Full Legal Name no abbreviations): S.C. Johnson and Son, Limited

Address: 1 Webster Street

City: Brantford

Prov / State: ON

Country: Canada

Postal Code: N3T 5R1

3. Select the appropriate subform(s) for the incident.

Domestic Animal

4. Date registrant was first informed of the incident.

25-OCT-16

5. Location of incident.

Country: UNITED STATES

Prov / State: MISSOURI

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. 4822-229

Product Name: Raid Flea Killer Plus Fogger

  • Active Ingredient(s)
    • (S)-METHOPRENE
    • N-OCTYL BICYCLOHEPTENE DICARBOXIMIDE
      • Guarantee/concentration 1.67 %
    • PIPERONYL BUTOXIDE
      • Guarantee/concentration 1 %
    • PYRETHRINS
      • Guarantee/concentration .5 %

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: Res. - In Home / Rés. - à l'int. maison

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 Short Hair

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

.25

7. Weight (provide a range if necessary )

5

lbs

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

  • Gastrointestinal System
    • Symptom - Anorexia
  • General
    • Symptom - Death
    • Symptom - Lethargy
  • Gastrointestinal System
    • Symptom - Vomiting

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?

Contact treat.area/Contact surf. traitée

17. Provide any additional details about the incident

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

10/25/2016 Caller states that approximately one month ago she set off 1 fogger from a 3 pack in one room of her home where a stray kitten had been housed. She applied the other 2 cans at one week intervals to the same room. Caller states that she removed the cat from the room, closed off the room, and applied tape to the doors to seal the room up during each use. She, her family, and the cat did not leave the home. Caller states that after the last fogger application she also sprayed the carpet with another product. Caller also states that a few weeks before the first fogger application she washed the kitten with a flea shampoo and that the day of the first fogger application she washed the kitten in dish soap. She states that she did not return the cat to the room at all until 2 days after the 3rd fogger application. Caller reports she opened the windows and aired the treated room out before returning the cat to the room. Caller states that 2 to 3 days after returning the kitten to the room it became lethargic, anorexic, and began vomiting. The kitten passed away at home 4 to 5 hours after the symptoms were first noticed. No veterinary advice or evaluation was sought.


To be determined by Registrant

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

Death

19. Provide supplemental information here

The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified in the telephone interviews. The product use history is vague and lacks any description of a known or defined point of direct exposure to this product. Even had casual or incidental contact with this pesticide occurred, such serious illness resulting in fatality would be unexpected and is biologically implausible. Finally, the differential diagnosis for the sudden onset of acute illness and death in a 3 month old kitten would include multiple potential etiologies and this animal was never properly evaluated and treated by a DVM nor was a necropsy performed to determine a possible cause of death. Note that his product is not registered in Canada.