Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2020-1035
2. Registrant Information.
Registrant Reference Number: 32749
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.
04-APR-20
5. Location of incident.
Country: CANADA
Prov / State: ONTARIO
6. Date incident was first observed.
04-APR-20
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. 27582
PMRA Submission No.
EPA Registration No.
Product Name: advantage II large dog
- Active Ingredient(s)
- IMIDACLOPRID
- PYRIPROXYFEN
7. b) Type of formulation.
Application Information
8. Product was applied?
Yes
9. Application Rate.
2.5
Units: mL
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 03-Apr-2020, a 7 year old, 14 pound, neutered, female, Domestic Shorthair feline, in unknown condition, with no known concomitant medical conditions, was administered a partial tube of Advantage II Large Dog (Imidacloprid-Pyriproxyfen) topically by the owner. During application, after a portion of the dose was administered, the cat exhibited a behavioral disorder NOS (ran off) and resolved in approximately 5 minutes, so the remainder of the dose was applied.
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
Animal's Owner
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 )
7
7. Weight (provide a range if necessary )
6.36
kg
8. Route(s) of exposure
Skin
9. What was the length of exposure?
>8 hrs <= 24 hrs / >8 h <= 24 h
10. Time between exposure and onset of symptoms
>8 hrs <=24 hrs / > 8 h < = 24 h
11. List all symptoms
System
- Skin
- Symptom - Erythema
- Symptom - Hair loss
- Nervous and Muscular Systems
- General
- Symptom - Abnormal behaviour
12. How long did the symptoms last?
Unknown / Inconnu
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
Unknown/Inconnu
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 04-Apr-2020, the cat exhibited application site erythema, application site alopecia, agitation, a behavioral disorder NOS (distant), mydriasis and panting. The cat was fed tuna juice and food by the owner and the agitation improved. The cat was not examined by a veterinarian and the clinical signs continued.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Minor
19. Provide supplemental information here