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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: 2011-5620

2. Renseignements concernant le titulaire.

Numéro de référence du titulaire d'homologation: PROSAR Case # 1-27588180

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.

02-OCT-11

5. Lieu de l'incident.

Pays: UNITED STATES

État: TENNESSEE

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

01-OCT-11

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. 2596-147

Nom du produit: UltraGuard One Spot Flea Egg Larvae Treatment for Cats Kittens

  • Matière active
    • (S)-METHOPRENE
      • Garantie/concentration 2.9 %

7. b) Type de formulation.

Liquide

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.)

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?

Inconnu

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)

1.5

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

  • Systèmes nerveux et musculaire
    • Symptôme - Crise
    • Symptôme - Autre
    • Specify - 'Brain hemorrhage
  • General
    • Symptôme - Mort
  • Oeil
    • Symptôme - Autre
    • Specify - blood in eyes

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

1-27588180- The reporter, a pet owner, indicated her animal had been exposed to an insecticide containing the active ingredient methoprene. The reporter indicated she had applied the product to her three cats 4pm the day prior to her initial contact with the registrant. On her initial contact she was unable to identify the product she had used and there was some ambivalence about active ingredients. The reporter indicated all three animals developed signs by 10:30pm the evening of application. Her one and one half year female domestic shorthair (Subform III, #1) developed seizures and died later the same evening. The animal received no treatment prior to its death but he caller reported the animals remains had been taken to (name) Agriculture Center? for a necropsy. The owner was advised of registrant supported necropsy through the University of (name) Veterinary Diagnostic Laboratory. She refused the offer. The pet owner indicated her eight year female domestic short hair cat (Subform III #2) also developed seizures and dermal color alteration at the site of application. The animal was taken to the veterinarian where it was given a bath with a non insecticidal shampoo and Benadryl (unknown route). The animal remained at the veterinarian for observation. The pet owner indicated her eight year male cat (Subform III, #3) developed seizures and lethargy. The animal remained at home but was similarly given a bath with a non insecticidal shampoo and oral Benadryl. The pet owner was advised use of similarly labeled products as directed on the label would not be expected to elicit the signs or the outcome seen. Occasionally pet owners will apply canine flea and tick drops to their cats and elicit this type of signs. The pet owner denied this. The pet owner was advised cats that cohabitate with dogs to which flea and tick products are applied will sometimes become exposed to the canine product and elicit signs of this type. The caller indicated she had dogs but denied this was possible. The pet owner was advised to continue to work with her veterinarian. The pet owner spontaneously called back two weeks later and verified the product used as a methoprene only product. She indicated she was told her deceased cat had a brain hemorrhage by a veterinarian because it had blood in its eyes. Both additional animals had returned home and fully recovered. The pet owner was advised neither the active ingredient nor the finished product would be expected to elicit the signs or outcome seen. It is likely something else was affecting the health of her animals. No further information is available.


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:

Femme

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

8

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

  • Systèmes nerveux et musculaire
    • Symptôme - Crise

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.

Oui

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

Oui

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

Inconnu

15. Issue de l'incident

Fully Recovered / Complètement rétabli

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

1-27588180- The reporter, a pet owner, indicated her animal had been exposed to an insecticide containing the active ingredient methoprene. The reporter indicated she had applied the product to her three cats 4pm the day prior to her initial contact with the registrant. On her initial contact she was unable to identify the product she had used and there was some ambivalence about active ingredients. The reporter indicated all three animals developed signs by 10:30pm the evening of application. Her one and one half year female domestic shorthair (Subform III, #1) developed seizures and died later the same evening. The animal received no treatment prior to its death but he caller reported the animals remains had been taken to (name) Agriculture Center? for a necropsy. The owner was advised of registrant supported necropsy through the University of (name) Veterinary Diagnostic Laboratory. She refused the offer. The pet owner indicated her eight year female domestic short hair cat (Subform III #2) also developed seizures and dermal color alteration at the site of application. The animal was taken to the veterinarian where it was given a bath with a non insecticidal shampoo and Benadryl (unknown route). The animal remained at the veterinarian for observation. The pet owner indicated her eight year male cat (Subform III, #3) developed seizures and lethargy. The animal remained at home but was similarly given a bath with a non insecticidal shampoo and oral Benadryl. The pet owner was advised use of similarly labeled products as directed on the label would not be expected to elicit the signs or the outcome seen. Occasionally pet owners will apply canine flea and tick drops to their cats and elicit this type of signs. The pet owner denied this. The pet owner was advised cats that cohabitate with dogs to which flea and tick products are applied will sometimes become exposed to the canine product and elicit signs of this type. The caller indicated she had dogs but denied this was possible. The pet owner was advised to continue to work with her veterinarian. The pet owner spontaneously called back two weeks later and verified the product used as a methoprene only product. She indicated she was told her deceased cat had a brain hemorrhage by a veterinarian because it had blood in its eyes. Both additional animals had returned home and fully recovered. The pet owner was advised neither the active ingredient nor the finished product would be expected to elicit the signs or outcome seen. It is likely something else was affecting the health of her animals. No further information is available.


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:

Homme

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

8

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

  • Systèmes nerveux et musculaire
    • Symptôme - Crise
  • General
    • Symptôme - Lethargie

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.

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

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

1-27588180- The reporter, a pet owner, indicated her animal had been exposed to an insecticide containing the active ingredient methoprene. The reporter indicated she had applied the product to her three cats 4pm the day prior to her initial contact with the registrant. On her initial contact she was unable to identify the product she had used and there was some ambivalence about active ingredients. The reporter indicated all three animals developed signs by 10:30pm the evening of application. Her one and one half year female domestic shorthair (Subform III, #1) developed seizures and died later the same evening. The animal received no treatment prior to its death but he caller reported the animals remains had been taken to (name) Agriculture Center? for a necropsy. The owner was advised of registrant supported necropsy through the University of (name) Veterinary Diagnostic Laboratory. She refused the offer. The pet owner indicated her eight year female domestic short hair cat (Subform III #2) also developed seizures and dermal color alteration at the site of application. The animal was taken to the veterinarian where it was given a bath with a non insecticidal shampoo and Benadryl (unknown route). The animal remained at the veterinarian for observation. The pet owner indicated her eight year male cat (Subform III, #3) developed seizures and lethargy. The animal remained at home but was similarly given a bath with a non insecticidal shampoo and oral Benadryl. The pet owner was advised use of similarly labeled products as directed on the label would not be expected to elicit the signs or the outcome seen. Occasionally pet owners will apply canine flea and tick drops to their cats and elicit this type of signs. The pet owner denied this. The pet owner was advised cats that cohabitate with dogs to which flea and tick products are applied will sometimes become exposed to the canine product and elicit signs of this type. The caller indicated she had dogs but denied this was possible. The pet owner was advised to continue to work with her veterinarian. The pet owner spontaneously called back two weeks later and verified the product used as a methoprene only product. She indicated she was told her deceased cat had a brain hemorrhage by a veterinarian because it had blood in its eyes. Both additional animals had returned home and fully recovered. The pet owner was advised neither the active ingredient nor the finished product would be expected to elicit the signs or outcome seen. It is likely something else was affecting the health of her animals. No further information is available.


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