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Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2018-0732
2. Registrant Information.
Registrant Reference Number: 170178518
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.
13-OCT-175. Location of incident.
Country: UNITED STATES
Prov / State: GEORGIA
6. Date incident was first observed.
13-OCT-17Product 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. 2724-803-270
Product Name: Adams Flea And Tick Spray For Dogs And Cats
- Active Ingredient(s)
- (S)-METHOPRENE
- Guarantee/concentration .1 %
- ETOFENPROX
- Guarantee/concentration .25 %
- PIPERONYL BUTOXIDE
- Guarantee/concentration .75 %
- (S)-METHOPRENE
7. b) Type of formulation.
Liquid
Application Information
8. Product was applied?
No
9. Application Rate.
10. Site pesticide was applied to (select all that apply).
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 Shorthair
4. Number of animals affected
1
5. Sex
Male
6. Age (provide a range if necessary )
14.0
7. Weight (provide a range if necessary )
16.0
lbs
8. Route(s) of exposure
Oral
9. What was the length of exposure?
>15 min <=2 hrs / >15 min <=2 h
10. Time between exposure and onset of symptoms
<=30 min / <=30 min
11. List all symptoms
System
- Nervous and Muscular Systems
- Symptom - Recumbent
- Specify - Lateral Recumbency
- General
- Symptom - Vocalizing
- Nervous and Muscular Systems
- Symptom - Unresponsive
- General
- Symptom - Death
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?
Accidental ingestion/Ingestion accident.
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
On October 13, 2017 the cat developed symptoms and the owner suspects that the cat ingested some of the product as the cat was found near the punctured bottle. Shortly after finding the cat, the owner contacted the Animal Product Safety Service (APSS) whose veterinarian stated that etofenprox is in the pyrethroid family and is safe to use on cats as a topical agent to treat fleas. The APSS veterinarian also stated that it does not result in tremors or seizure activity that can be seen from other pyrethroids, since it is structurally different. The APSS veterinarian further stated that some animals will hypersalivate just from the odor of the product. Finally, the APSS veterinarian stated that the signs are not consistent with licking up some of the product after a spill. The APSS assistant recommended the owner take the animal to a veterinarian and have the veterinarian call for information.
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 not considered to be related to causing the clinical situation. The owner's mother stated that the cat passed away on the way to the clinic. The owner's mother stated that they did not want to do a necropsy.
