Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2018-4307

2. Registrant Information.

Registrant Reference Number: 2018CK037

Registrant Name (Full Legal Name no abbreviations): Bayer inc

Address: 2920 Matheson Blvd

City: Mississaugua

Prov / State: ON

Country: Canada

Postal Code: L4W 5R6

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

Domestic Animal

4. Date registrant was first informed of the incident.

17-MAY-18

5. Location of incident.

Country: CANADA

Prov / State: SASKATCHEWAN

6. Date incident was first observed.

17-MAY-18

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)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. Unknown

Product Name: K9advantixII pipette size unknown

• Active Ingredient(s)
  • IMIDACLOPRID
  • PERMETHRIN
  • PYRIPROXYFEN

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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).

On May 14th, an unknown dose of K9 Advantix II was applied to a dog of unknown signalment.

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

Unknown

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

Unknown

7. Weight (provide a range if necessary )

Unknown

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

>24 hrs <=3 days / >24 h <=3 jours

11. List all symptoms

System

• Nervous and Muscular Systems
  • Symptom - Muscle tremors

12. How long did the symptoms last?

Unknown / Inconnu

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

Unknown/Inconnu

16. How was the animal exposed?

Other / Autre

specify possibility of the cat licking a treated dog

17. Provide any additional details about the incident

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

On May 14th, an unknown dose of K9 Advantix II was applied to a dog of unknown signalment. On May 17th, an indoor cat of unknown signalment was examined by a veterinarian for tremors. The cat was treated with diazepam, fluids, methocarbamol. Permethrin toxicity was a differential diagnosis for the clinical signs. Further information is currently unavailable. The veterinarian was not calling to report a K9 Advantix II reaction specifically but rather to inquire as to the possibility of the cat licking a treated dog to cause the clinical signs. The cat had not been seen to lick the treated dog.

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To be determined by Registrant

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

Moderate

19. Provide supplemental information here

A - Probable Secondary contact with treated dog. Reported sign is consistent with intoxication after contact with permethrin in cats. Considering consistent time to onset, a product involvement is deemed to be probable.