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: 2021-0394

2. Registrant Information.

Registrant Reference Number: 2020-US-039831

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.

05-NOV-20

5. Location of incident.

Country: UNITED STATES

Prov / State: GEORGIA

6. Date incident was first observed.

01-NOV-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.       PMRA Submission No.       EPA Registration No. 2596-125

Product Name: Hartz UltraGuard Flea and Tick Spray for Dogs 16oz

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

7. b) Type of formulation.

Liquid

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).

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?

Yes

Subform III: Domestic Animal Incident Report

1. Source of Report

Animal's Owner

2. Type of animal affected

Dog / Chien

3. Breed

Pit Bull

4. Number of animals affected

1

5. Sex

Female

6. Age (provide a range if necessary )

0.67

7. Weight (provide a range if necessary )

28

lbs

8. Route(s) of exposure

Skin

9. What was the length of exposure?

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

10. Time between exposure and onset of symptoms

>8 hrs <=24 hrs / > 8 h < = 24 h

11. List all symptoms

System

  • General
    • Symptom - Lethargy
  • Gastrointestinal System
    • Symptom - Anorexia
  • General
    • Symptom - Adipsia
    • Symptom - Death

12. How long did the symptoms last?

Persisted until death

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

Yes

14. a) Was the animal hospitalized?

No

14. b) How long was the animal hospitalized?

15. Outcome of the incident

Died

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 31-Oct-2020, an 8 month old, 28 pound, intact, female, Pit Bull dog, in unknown condition, with concomitant medical condition of fleas, was administered an unknown amount of Hartz UltraGuard Flea and Tick Spray for Dogs 16oz (Tetrachlorvinphos) via the topical route by the animal owner. On 01-Nov-2020, the dog exhibited lethargy, anorexia, and adipsia. On 02-Nov-2020, the dog was evaluated by a veterinarian. Diagnostics performed were bloodwork, x-rays, parasite screening, and a parvovirus test. The parasite screening and parvovirus test were both reportedly negative. Results of blood work and x-rays were not provided. The dog was administered an unknown amount of vitamin B12, an unknown amount of maropitant citrate (anti-emetic), and an unknown amount of fluids all via an unknown route by the veterinarian. The dog was then discharged to the owner for monitoring at home. On 03-Nov-2020, the dog died at home. No necropsy was performed. No further information was received.


To be determined by Registrant

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

Death

19. Provide supplemental information here

Assessment: Tetrachlorvinphos is an organophosphate insecticide that has a wide safety margin in dogs following topical use. If this product were ingested, mild GI upset may occur. Severe signs persisting until death are not expected. Results of all diagnostics were not provided by the pet owner and direct discussion with the treating veterinarian did not occur. Without more information, the cause of death remains unknown. Other causes including GI foreign body obstruction, infectious diseases, severe flea anemia, unknown trauma, and other unknown exposures should be considered in the death of a young dog. 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.