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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2020-3357

2. Registrant Information.

Registrant Reference Number: ProPharma Group case#: 1-58806918

Registrant Name (Full Legal Name no abbreviations): Neogen Corporation

Address: 620 Lesher Place

City: Lansing

Prov / State: Michigan

Country: USA

Postal Code: 48912

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

Domestic Animal

4. Date registrant was first informed of the incident.

01-NOV-19

5. Location of incident.

Country: UNITED STATES

Prov / State: TENNESSEE

6. Date incident was first observed.

Unknown

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. 61282-48

Product Name: RAMIK GREEN BAIT PACK KILLS RATS & MICE FISH FLAVORED WEATHER-RESISTAN

  • Active Ingredient(s)
    • DIPHACINONE (PRESENT IN FREE FORM OR AS SODIUM SALT)
      • Guarantee/concentration .005 %

7. b) Type of formulation.

Bait

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

10. Site pesticide was applied to (select all that apply).

Site: Res. - In Home / Rés. - à l'int. maison

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

Dog / Chien

3. Breed

Miniature Pinscher

4. Number of animals affected

1

5. Sex

Male

6. Age (provide a range if necessary )

20

7. Weight (provide a range if necessary )

8

lbs

8. Route(s) of exposure

Oral

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • General
    • Symptom - Death
  • Gastrointestinal System
    • Symptom - Vomiting
    • Symptom - Anorexia
  • General
    • Symptom - Lethargy
  • Nervous and Muscular Systems
    • Symptom - Difficulty getting up
  • Gastrointestinal System
    • Symptom - Diarrhea

12. How long did the symptoms last?

Persisted until death

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

Unknown

14. a) Was the animal hospitalized?

Unknown

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

1-58806918 - The reporter, a pet owner, indicates an exposure to a pesticide containing the active ingredient diphacinone (present in free form or as sodium salt). Approximately 4-5 days before the day of initial contact with the registrant, the reporter stated his 20-year-old, 8-pound, male, Miniature Pinscher dog might have ingested an unknown amount of the product but an exposure was not witnessed. Approximately 2-3 days before the day of initial contact, the dog developed vomiting, diarrhea, lethargy, anorexia, and had a difficult time getting up, and the symptoms persisted throughout the time of initial contact. The reporter was advised to seek immediate veterinary evaluation of the dog as the symptoms might be related to product ingestion. On follow-up call three days later, the reporter indicated the dog had died one day after the day of initial contact. It is unknown if the caller sought veterinary care for the dog. No additional information is available.


To be determined by Registrant

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

Death

19. Provide supplemental information here