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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2017-2693

2. Registrant Information.

Registrant Reference Number: 170049502

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.

29-MAR-17

5. Location of incident.

Country: UNITED STATES

Prov / State: TEXAS

6. Date incident was first observed.

29-MAR-17

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. 2724-777-270

Product Name: Adams Carpet Powder With Linalool and Nylar

  • Active Ingredient(s)
    • PIPERONYL BUTOXIDE
      • Guarantee/concentration .5 %
    • PYRETHRINS
      • Guarantee/concentration .075 %
    • PYRIPROXYFEN
      • Guarantee/concentration .02 %

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).

On March 29, 2017 the owner's child inappropriately covered the cat in the powder.

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

Medical Professional

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 )

0.67

7. Weight (provide a range if necessary )

3.7

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

>2 hrs <=8 hrs / >2 h <=8 h

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • Nervous and Muscular Systems
    • Symptom - Recumbent
    • Symptom - Disorientation
  • Skin
    • Symptom - Other
    • Specify - Substance on Hair Coat
  • Nervous and Muscular Systems
    • Symptom - Fasciculations
  • General
    • Symptom - Hypothermia
  • Cardiovascular System
    • Symptom - Cardiac arrest
  • Nervous and Muscular Systems
    • Symptom - Other
    • Specify - Mental Dullness
  • Blood
    • Symptom - Hyperglycemia
  • Renal System
    • Symptom - Other
    • Specify - Low Creatinine
  • Blood
    • Symptom - Hypoproteinemia
    • Symptom - Hypoalbuminemia
  • 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?

Unknown

15. Outcome of the incident

Died

16. How was the animal exposed?

Other / Autre

specify Child applied product to the cat

17. Provide any additional details about the incident

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

On March 29 2017, shortly after the cat was covered in the product, the owner found the cat laterally recumbent and disoriented. The owner took the cat to an emergency veterinarian who bathed the cat with a liquid dish washing detergent (LDWD), placed an intravenous catheter (IV), ran fluids and warmed the cat and gave 80 milligrams (mg) of Robaxin (methocarbamol) intravenously. Within a few hours, the cat was standing and was discharged from the hospital. However ten minutes later, the owner brought the cat back to clinic in cardiopulmonary arrest. The veterinarian performed cardiopulmonary resuscitation (CPR) The APSS veterinarian stated that the risk for this product exposure was dermal irritation, depression, mild respiratory irritation from the powder, gastrointestinal (GI) upset if powder was groomed off of the coat, and potentially tremors. The APSS veterinarian further stated that they would not expect the severe clinical picture that was seen with this cat from the product. The APSS veterinarian advised to look for the underlying conditions to explain the cat's poor body condition and the severe response to the powder.


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 March 30 2017, the emergency veterinarian called to update the case. The cat was unresponsive to naloxone, taken off the ventilator, didn't start breathing on her own again, and passed away. A necropsy was not offered as the product was used off label.