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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2019-6278

2. Registrant Information.

Registrant Reference Number: 2019-US-016460

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.


5. Location of incident.


Prov / State: MAINE

6. Date incident was first observed.


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.


PMRA Registration No.       PMRA Submission No.       EPA Registration No. 2596-126

Product Name: Hartz UltraGuard Flea and Tick Spray for Cats

  • Active Ingredient(s)
      • Guarantee/concentration 1.08 %

7. b) Type of formulation.

Other (specify)


Application Information

8. Product was applied?


9. Application Rate.


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).

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?


Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Cat / Chat

3. Breed

Domestic Longhair

4. Number of animals affected


5. Sex


6. Age (provide a range if necessary )


7. Weight (provide a range if necessary )



8. Route(s) of exposure


9. What was the length of exposure?

>3 days <=1 wk / >3 jours <=1 sem

10. Time between exposure and onset of symptoms

>3 days <=1 wk / >3 jours <=1 sem

11. List all symptoms


  • General
    • Symptom - Vocalizing
    • Symptom -
    • Specify - Limp
    • Symptom - Death

12. How long did the symptoms last?

Persisted until death

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


14. a) Was the animal hospitalized?


14. b) How long was the animal hospitalized?

15. Outcome of the incident


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

On 10-Jul-2019 the pet owner applied Hartz UltraGuard Flea and Tick Spray for Cats (Tetrachlorvinphos) to each of her four cats for the first time to treat a flea infestation. On 14-Jul-2019 one cat rolled in some dirt in the basement of the home. The owner reported she did not know of anything in the basement that would be toxic. The owner bathed the cat using liquid dish soap within a few hours. The cat vocalized during the bath, which was not unusual, but sounded different than normal. While drying the cat with a towel, it became limp and then died within an hour. The owner attempted CPR but was unsuccessful. No necropsy was performed and the cat was buried. The three other cats in the home remained asymptomatic and were not bathed.

To be determined by Registrant

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


19. Provide supplemental information here

Assessment: This product has a wide margin of safety in cats when used per label directions. Even if ingested from the fur following use, only mild oral irritation or gastrointestinal upset resulting in drooling or vomiting would be expected. Signs did not occur in this case until four days after product use and after the cat rolled in dirt in the basement. It is unknown what else the cat may have been exposed to in the basement. Also, three other cats in the home remained asymptomatic following product use, adding to the unlikeliness that the product was the cause of the catżżżżżżs signs in this case. 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 cannot 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.