Health Canada
Symbol of the Government of Canada
Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2020-3366

2. Registrant Information.

Registrant Reference Number: ProPharma Group case#: 1-60456150

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.

12-MAR-20

5. Location of incident.

Country: CANADA

Prov / State: SASKATCHEWAN

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. 30167      PMRA Submission No.       EPA Registration No. Unknown

Product Name: RAMIK BARS KILLS RATS AND MICE

  • Active Ingredient(s)
    • DIPHACINONE (PRESENT IN FREE FORM OR AS SODIUM SALT)

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: Res. - Out Home / Rés - à l'ext.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

Mixed

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

10.5

7. Weight (provide a range if necessary )

18.92

lbs

8. Route(s) of exposure

Unknown

9. What was the length of exposure?

Unknown / Inconnu

10. Time between exposure and onset of symptoms

Unknown / Inconnu

11. List all symptoms

System

  • Blood
    • Symptom - Anemia
  • General
    • Symptom - Lethargy
  • Gastrointestinal System
    • Symptom - Loss of appetite
  • Renal System
    • Symptom - Blood in urine

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?

Unknown

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Unknown/Inconnu

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

1-60456150 - 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 2-3 weeks before the day of initial contact, the reporter stated an exterminator placed the product in his yard. Approximately nine days before the day of initial contact with the registrant, the reporter stated his 10.5-year-old, 18.92-pound, female, mixed dog developed lethargy and a decreased appetite and was diagnosed with anemia by a veterinarian, but an exposure to the product was not witnessed. The reporter was advised to continue to work with their veterinarian as the symptoms could be related to a toxic ingestion of the product. On follow-up call four days later, the reporter indicated the dog had been placed on the antidote to the pesticide but had developed blood in the urine. The reporter was advised to continue to work with their veterinarian. No additional information is available.


To be determined by Registrant

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

Moderate

19. Provide supplemental information here