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Sécurité des produits de consommation

Déclaration d'incident

Sous-formulaire I: Renseignements généraux

1.Type de rapport.

Nouvelle déclaration d'incident

No de la demande: 2009-4706

2. Renseignements concernant le titulaire.

Numéro de référence du titulaire d'homologation: Prosar 1-20203622

Nom du titulaire (nom légal complet, aucune abbréviation): The Hartz Mountain Corporation

Adresse: 400 Plaza Drive

Ville: Secaucus

État: New Jersey

Pays: USA

Code postal /Zip: 07094-3688

3.Choisir le (les) sous-formulaire(s) correspondant à l'incident.

Incident chez un animal domestique

4. Date à laquelle le titulaire d'homologation a été informé pour la première fois de l'incident.

24-SEP-09

5. Lieu de l'incident.

Pays: UNITED STATES

État: KANSAS

6. Date de la première observation de l'incident.

21-SEP-09

Description du produit

7. a) Donner le nom de la matière active et, si disponibles, le numéro d'homologation et le nom du produit (incluant tous les mélanges). Si le produit n'est pas homologué, donner le numéro de la demande d'homologation.

Matière(s) active(s)

ARLA No d'homologation       ARLA No de la demande d'homologation       EPA No d'homologation. 2596-78

Nom du produit: UltraGuard Flea/Tick Powder for Cats 4 oz

  • Matière active
    • TETRACHLORVINPHOS
      • Garantie/concentration 3.3 %

7. b) Type de formulation.

Poudre

Renseignments sur l'application

8. Est-ce que le produit a été appliqué?

Oui

9. Dose d'application.

Inconnu

10. Site d'application (choisir tout ce qui s'applique).

Site: Animal / Usage sur un animal domestique

11. Donner tout renseignement additionnel concernant l'application (comment le produit a été appliqué, la quantité utilisée, la superficie de la zone traitée, etc.)

The product was applied to 5 cats between 09/21/2009 and 09/24/2009. All 5 cats were also bathed with an unknown company shampoo just prior to product application. NOTE: This product is not labeled for use in conjunction with other pesticide containing products.

À être déterminé par le titulaire

12. Selon vous, le produit a-t-il été utilisé en conformité avec le mode d'emploi de L'étiquette?

Non

Sous-formulaire III : Animal domestique

1. Source de la déclaration

Propriétaire de l'animal

2.Type d'animal touché

Cat / Chat

3. Race

Unknown breed

4. Nombre d'animaux touchés

1

5. Sexe:

Homme

6. Âge (fournir un ordre de grandeur si nécessaire)

1

7. Poids (fournir un ordre de grandeur si nécessaire)

Inconnu

8. Voie(s) d'exposition:

Cutanée

9. Durée de l'exposition?

Unknown / Inconnu

10. Temps écoulé entre l'exposition et l'apparition des symptômes

Unknown / Inconnu

11. Énumérer tous les symptômes

Système

  • General
    • Symptôme - Lethargie
  • Système gastro-intestinal
    • Symptôme - Anorexie
  • General
    • Symptôme - Mort

12. Quelle a été la durée des symptômes?

Persisted until death

13. Des soins médicaux ont-ils été prodigués? Donner les détails à la question 17.

Non

14. a) Est-ce que l'animal a-t-il été hospitalisé?

Non

14. b) Combien de temps l'animal était-il hospitalisé?

15. Issue de l'incident

Mort

16. De quelle manière l'animal a-t-il été exposé?

Treatment / Traitement

17. Donnez tout détail additionnel au sujet de l'incident

(p.ex. description des symptômes tels que la fréquence et la gravité

1-20203622: A reporter (cat owner) called on 09/24/2009 to report the exposure of his 5 cats to a flea and tick powder containing the active ingredient Tetrachlorvinphos. According to the reporter, the product was applied to 3 cats on 09/21/2009, 1 cat on 09/22/2009, and 1 cat on 09/24/2009 following bathing the cats with a non-specific company flea and tick shampoo. At an unspecified time on the day of product application on 09/21/2009, Cat #1 (1st Subform III)developed lethargy and anorexia. He died the same day the signs developed. Cat #2 (1st Subform III) was also treated with the products on 09/21/2009 and developed hair loss, difficulty walking, and lethargy. The cat was euthanized on 09/22/2009. Cat #3 (3rd Subform III) was treated with the products on 09/21/2009 and began vocalizing 5 hours following product application. Cat #3 was found dead outside on 09/24/2009. Cat #4 (4th Subform III) was treated with the products on 09/22/2009 and developed lethargy, difficulty walking, and vocalization. On 09/24/2009, Cat #5 (5th Subform III) was bathed in the shampoo and "went limp". Cat #5 was then treated with the powder, and developed lethargy and panting. The reporter gave her an unspecified antibiotic left over from a previous issue and water from a dropper. At the time of the report, Cat #5's signs were improving. The reporter was advised to bathe Cat #4 and Cat #5 with hand dish soap and have them evaluated by a veterinarian. Organophosphate testing was discussed as was necropsy for the deceased cats. On follow up on 09/25/2009, the reporter stated that he bathed Cat #5 on 09/24/2009, but that her rear limbs became weak and she was vocalizing during the bath. Cat #4 had not been bathed at the time of the follow up. The reporter indicated that Cat #4 was also having some problems with his rear limbs. The reporter was encouraged to take his cats to the veterinarian for evaluation and appropriate testing. Several attempts at follow up were unsuccessful. No further information was obtained. NOTE: This product is not labeled to be used in conjunction with other pesticide-containing products.


À être déterminé par le titulaire

Classification selon la gravité (s'il y a plus d'une catégorie possible, veuillez choisir la plus grave)

Mort

19. Donner des renseignements additionnels ici

Sous-formulaire III : Animal domestique

1. Source de la déclaration

Propriétaire de l'animal

2.Type d'animal touché

Cat / Chat

3. Race

Mixed Breed

4. Nombre d'animaux touchés

1

5. Sexe:

Homme

6. Âge (fournir un ordre de grandeur si nécessaire)

4

7. Poids (fournir un ordre de grandeur si nécessaire)

Inconnu

8. Voie(s) d'exposition:

Cutanée

9. Durée de l'exposition?

Unknown / Inconnu

10. Temps écoulé entre l'exposition et l'apparition des symptômes

Unknown / Inconnu

11. Énumérer tous les symptômes

Système

  • Peau
    • Symptôme - Perte de cheveux
  • Systèmes nerveux et musculaire
    • Symptôme - Difficulté de marcher
  • General
    • Symptôme - Lethargie

12. Quelle a été la durée des symptômes?

Persisted until death

13. Des soins médicaux ont-ils été prodigués? Donner les détails à la question 17.

Non

14. a) Est-ce que l'animal a-t-il été hospitalisé?

Non

14. b) Combien de temps l'animal était-il hospitalisé?

15. Issue de l'incident

Euthanised / Euthanasie

16. De quelle manière l'animal a-t-il été exposé?

Treatment / Traitement

17. Donnez tout détail additionnel au sujet de l'incident

(p.ex. description des symptômes tels que la fréquence et la gravité

1-20203622: A reporter (cat owner) called on 09/24/2009 to report the exposure of his 5 cats to a flea and tick powder containing the active ingredient Tetrachlorvinphos. According to the reporter, the product was applied to 3 cats on 09/21/2009, 1 cat on 09/22/2009, and 1 cat on 09/24/2009 following bathing the cats with a non-specific company flea and tick shampoo. At an unspecified time on the day of product application on 09/21/2009, Cat #1 (1st Subform III)developed lethargy and anorexia. He died the same day the signs developed. Cat #2 (1st Subform III) was also treated with the products on 09/21/2009 and developed hair loss, difficulty walking, and lethargy. The cat was euthanized on 09/22/2009. Cat #3 (3rd Subform III) was treated with the products on 09/21/2009 and began vocalizing 5 hours following product application. Cat #3 was found dead outside on 09/24/2009. Cat #4 (4th Subform III) was treated with the products on 09/22/2009 and developed lethargy, difficulty walking, and vocalization. On 09/24/2009, Cat #5 (5th Subform III) was bathed in the shampoo and "went limp". Cat #5 was then treated with the powder, and developed lethargy and panting. The reporter gave her an unspecified antibiotic left over from a previous issue and water from a dropper. At the time of the report, Cat #5's signs were improving. The reporter was advised to bathe Cat #4 and Cat #5 with hand dish soap and have them evaluated by a veterinarian. Organophosphate testing was discussed as was necropsy for the deceased cats. On follow up on 09/25/2009, the reporter stated that he bathed Cat #5 on 09/24/2009, but that her rear limbs became weak and she was vocalizing during the bath. Cat #4 had not been bathed at the time of the follow up. The reporter indicated that Cat #4 was also having some problems with his rear limbs. The reporter was encouraged to take his cats to the veterinarian for evaluation and appropriate testing. Several attempts at follow up were unsuccessful. No further information was obtained. NOTE: This product is not labeled to be used in conjunction with other pesticide-containing products.


À être déterminé par le titulaire

Classification selon la gravité (s'il y a plus d'une catégorie possible, veuillez choisir la plus grave)

Mort

19. Donner des renseignements additionnels ici

Sous-formulaire III : Animal domestique

1. Source de la déclaration

Propriétaire de l'animal

2.Type d'animal touché

Cat / Chat

3. Race

Unknown breed

4. Nombre d'animaux touchés

1

5. Sexe:

Femme

6. Âge (fournir un ordre de grandeur si nécessaire)

1

7. Poids (fournir un ordre de grandeur si nécessaire)

Inconnu

8. Voie(s) d'exposition:

Cutanée

9. Durée de l'exposition?

Unknown / Inconnu

10. Temps écoulé entre l'exposition et l'apparition des symptômes

>2 hrs <=8 hrs / > 2 h < = 8 h

11. Énumérer tous les symptômes

Système

  • General
    • Symptôme - Vocalisation
    • Symptôme - Mort

12. Quelle a été la durée des symptômes?

Persisted until death

13. Des soins médicaux ont-ils été prodigués? Donner les détails à la question 17.

Non

14. a) Est-ce que l'animal a-t-il été hospitalisé?

Non

14. b) Combien de temps l'animal était-il hospitalisé?

15. Issue de l'incident

Mort

16. De quelle manière l'animal a-t-il été exposé?

Treatment / Traitement

17. Donnez tout détail additionnel au sujet de l'incident

(p.ex. description des symptômes tels que la fréquence et la gravité

1-20203622: A reporter (cat owner) called on 09/24/2009 to report the exposure of his 5 cats to a flea and tick powder containing the active ingredient Tetrachlorvinphos. According to the reporter, the product was applied to 3 cats on 09/21/2009, 1 cat on 09/22/2009, and 1 cat on 09/24/2009 following bathing the cats with a non-specific company flea and tick shampoo. At an unspecified time on the day of product application on 09/21/2009, Cat #1 (1st Subform III)developed lethargy and anorexia. He died the same day the signs developed. Cat #2 (1st Subform III) was also treated with the products on 09/21/2009 and developed hair loss, difficulty walking, and lethargy. The cat was euthanized on 09/22/2009. Cat #3 (3rd Subform III) was treated with the products on 09/21/2009 and began vocalizing 5 hours following product application. Cat #3 was found dead outside on 09/24/2009. Cat #4 (4th Subform III) was treated with the products on 09/22/2009 and developed lethargy, difficulty walking, and vocalization. On 09/24/2009, Cat #5 (5th Subform III) was bathed in the shampoo and "went limp". Cat #5 was then treated with the powder, and developed lethargy and panting. The reporter gave her an unspecified antibiotic left over from a previous issue and water from a dropper. At the time of the report, Cat #5's signs were improving. The reporter was advised to bathe Cat #4 and Cat #5 with hand dish soap and have them evaluated by a veterinarian. Organophosphate testing was discussed as was necropsy for the deceased cats. On follow up on 09/25/2009, the reporter stated that he bathed Cat #5 on 09/24/2009, but that her rear limbs became weak and she was vocalizing during the bath. Cat #4 had not been bathed at the time of the follow up. The reporter indicated that Cat #4 was also having some problems with his rear limbs. The reporter was encouraged to take his cats to the veterinarian for evaluation and appropriate testing. Several attempts at follow up were unsuccessful. No further information was obtained. NOTE: This product is not labeled to be used in conjunction with other pesticide-containing products.


À être déterminé par le titulaire

Classification selon la gravité (s'il y a plus d'une catégorie possible, veuillez choisir la plus grave)

Mort

19. Donner des renseignements additionnels ici

Sous-formulaire III : Animal domestique

1. Source de la déclaration

Propriétaire de l'animal

2.Type d'animal touché

Cat / Chat

3. Race

Domestic Shorthair

4. Nombre d'animaux touchés

1

5. Sexe:

Homme

6. Âge (fournir un ordre de grandeur si nécessaire)

9

7. Poids (fournir un ordre de grandeur si nécessaire)

20

lbs

8. Voie(s) d'exposition:

Cutanée

9. Durée de l'exposition?

Unknown / Inconnu

10. Temps écoulé entre l'exposition et l'apparition des symptômes

Unknown / Inconnu

11. Énumérer tous les symptômes

Système

  • General
    • Symptôme - Vocalisation
  • Systèmes nerveux et musculaire
    • Symptôme - Difficulté de marcher
  • General
    • Symptôme - Lethargie
    • Symptôme - Faiblesse
    • Specify - Problems with hind limbs

12. Quelle a été la durée des symptômes?

Unknown / Inconnu

13. Des soins médicaux ont-ils été prodigués? Donner les détails à la question 17.

Inconnu

14. a) Est-ce que l'animal a-t-il été hospitalisé?

Inconnu

14. b) Combien de temps l'animal était-il hospitalisé?

15. Issue de l'incident

Unknown/Inconnu

16. De quelle manière l'animal a-t-il été exposé?

Treatment / Traitement

17. Donnez tout détail additionnel au sujet de l'incident

(p.ex. description des symptômes tels que la fréquence et la gravité

1-20203622: A reporter (cat owner) called on 09/24/2009 to report the exposure of his 5 cats to a flea and tick powder containing the active ingredient Tetrachlorvinphos. According to the reporter, the product was applied to 3 cats on 09/21/2009, 1 cat on 09/22/2009, and 1 cat on 09/24/2009 following bathing the cats with a non-specific company flea and tick shampoo. At an unspecified time on the day of product application on 09/21/2009, Cat #1 (1st Subform III)developed lethargy and anorexia. He died the same day the signs developed. Cat #2 (1st Subform III) was also treated with the products on 09/21/2009 and developed hair loss, difficulty walking, and lethargy. The cat was euthanized on 09/22/2009. Cat #3 (3rd Subform III) was treated with the products on 09/21/2009 and began vocalizing 5 hours following product application. Cat #3 was found dead outside on 09/24/2009. Cat #4 (4th Subform III) was treated with the products on 09/22/2009 and developed lethargy, difficulty walking, and vocalization. On 09/24/2009, Cat #5 (5th Subform III) was bathed in the shampoo and "went limp". Cat #5 was then treated with the powder, and developed lethargy and panting. The reporter gave her an unspecified antibiotic left over from a previous issue and water from a dropper. At the time of the report, Cat #5's signs were improving. The reporter was advised to bathe Cat #4 and Cat #5 with hand dish soap and have them evaluated by a veterinarian. Organophosphate testing was discussed as was necropsy for the deceased cats. On follow up on 09/25/2009, the reporter stated that he bathed Cat #5 on 09/24/2009, but that her rear limbs became weak and she was vocalizing during the bath. Cat #4 had not been bathed at the time of the follow up. The reporter indicated that Cat #4 was also having some problems with his rear limbs. The reporter was encouraged to take his cats to the veterinarian for evaluation and appropriate testing. Several attempts at follow up were unsuccessful. No further information was obtained. NOTE: This product is not labeled to be used in conjunction with other pesticide-containing products.


À être déterminé par le titulaire

Classification selon la gravité (s'il y a plus d'une catégorie possible, veuillez choisir la plus grave)

Modérée

19. Donner des renseignements additionnels ici

Sous-formulaire III : Animal domestique

1. Source de la déclaration

Propriétaire de l'animal

2.Type d'animal touché

Cat / Chat

3. Race

Domestic Shorthair

4. Nombre d'animaux touchés

1

5. Sexe:

Femme

6. Âge (fournir un ordre de grandeur si nécessaire)

3

7. Poids (fournir un ordre de grandeur si nécessaire)

Inconnu

8. Voie(s) d'exposition:

Cutanée

9. Durée de l'exposition?

Unknown / Inconnu

10. Temps écoulé entre l'exposition et l'apparition des symptômes

<=30 min / <=30 min

11. Énumérer tous les symptômes

Système

  • Systèmes nerveux et musculaire
    • Symptôme - Autre
    • Specify - "Went limp"
  • Système respiratoire
    • Symptôme - Halètement
  • General
    • Symptôme - Lethargie
  • Systèmes nerveux et musculaire
    • Symptôme - Faiblesse musculaire
  • General
    • Symptôme - Vocalisation

12. Quelle a été la durée des symptômes?

Unknown / Inconnu

13. Des soins médicaux ont-ils été prodigués? Donner les détails à la question 17.

Inconnu

14. a) Est-ce que l'animal a-t-il été hospitalisé?

Inconnu

14. b) Combien de temps l'animal était-il hospitalisé?

15. Issue de l'incident

Unknown/Inconnu

16. De quelle manière l'animal a-t-il été exposé?

Treatment / Traitement

17. Donnez tout détail additionnel au sujet de l'incident

(p.ex. description des symptômes tels que la fréquence et la gravité

1-20203622: A reporter (cat owner) called on 09/24/2009 to report the exposure of his 5 cats to a flea and tick powder containing the active ingredient Tetrachlorvinphos. According to the reporter, the product was applied to 3 cats on 09/21/2009, 1 cat on 09/22/2009, and 1 cat on 09/24/2009 following bathing the cats with a non-specific company flea and tick shampoo. At an unspecified time on the day of product application on 09/21/2009, Cat #1 (1st Subform III)developed lethargy and anorexia. He died the same day the signs developed. Cat #2 (1st Subform III) was also treated with the products on 09/21/2009 and developed hair loss, difficulty walking, and lethargy. The cat was euthanized on 09/22/2009. Cat #3 (3rd Subform III) was treated with the products on 09/21/2009 and began vocalizing 5 hours following product application. Cat #3 was found dead outside on 09/24/2009. Cat #4 (4th Subform III) was treated with the products on 09/22/2009 and developed lethargy, difficulty walking, and vocalization. On 09/24/2009, Cat #5 (5th Subform III) was bathed in the shampoo and "went limp". Cat #5 was then treated with the powder, and developed lethargy and panting. The reporter gave her an unspecified antibiotic left over from a previous issue and water from a dropper. At the time of the report, Cat #5's signs were improving. The reporter was advised to bathe Cat #4 and Cat #5 with hand dish soap and have them evaluated by a veterinarian. Organophosphate testing was discussed as was necropsy for the deceased cats. On follow up on 09/25/2009, the reporter stated that he bathed Cat #5 on 09/24/2009, but that her rear limbs became weak and she was vocalizing during the bath. Cat #4 had not been bathed at the time of the follow up. The reporter indicated that Cat #4 was also having some problems with his rear limbs. The reporter was encouraged to take his cats to the veterinarian for evaluation and appropriate testing. Several attempts at follow up were unsuccessful. No further information was obtained. NOTE: This product is not labeled to be used in conjunction with other pesticide-containing products.


À être déterminé par le titulaire

Classification selon la gravité (s'il y a plus d'une catégorie possible, veuillez choisir la plus grave)

Modérée

19. Donner des renseignements additionnels ici