Nouvelle déclaration d'incident
No de la demande: 2019-1209
Numéro de référence du titulaire d'homologation: 2342265
Nom du titulaire (nom légal complet, aucune abbréviation): McLaughlin Gormley King Company
Adresse: 8810 Tenth Ave North
Ville: Minneapolis
État: MN
Pays: USA
Code postal /Zip: 55427-4319
Incident chez un animal domestique
Pays: UNITED STATES
État: NEW JERSEY
ARLA No d'homologation ARLA No de la demande d'homologation EPA No d'homologation. 1021-2685-73470
Nom du produit: Rid Home Lice, Bedbug and Dust Mite Spray
Oui
Inconnu
Site: Res. - In Home / Rés. - à l'int. maison
Propriétaire de l'animal
Other / Autre
préciser Exotic
Hamster
1
Femme
1.50
Inconnu
Inconnu
<=15 min / <=15 min
>3 days <=1 wk / >3 jours <=1 sem
Système
Persisted until death
Non
Non
Inconnu
Mort
Other / Autre
préciser Defined point of exposure not evident or witnessed. Exposure based on speculation.
(p.ex. description des symptômes tels que la fréquence et la gravité
11/15/2018 Caller applied product on mattresses and a sofa in her home on 11/3/2018. She had three hamsters in cages in the hallway while the product was used in a room and the doors were closed. Caller found one hamster laterally recumbent and breathing shallow on 11/7/2018, and the hamster died the next day. Another hamster died on 11/14/2018, and seemed asymptomatic the day prior. Upon returning home today, she found the third hamster with her right eye proptosed. She also noticed the hamster was having an increase of fecal material yesterday. 11/16/2018 Attempted call back to the original caller. A message was left requesting follow up information. 11/19/2018 Attempted call back to the original caller. A message was left requesting follow up information.
Mort
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 can not 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.
Propriétaire de l'animal
Other / Autre
préciser Exotic
Hamster
1
Femme
1.50
Inconnu
Inconnu
<=15 min / <=15 min
>1 wk <=1 mo / > 1 sem < = 1 mois
Système
Persisted until death
Non
Non
Inconnu
Mort
Other / Autre
préciser Defined point of exposure not evident or witnessed. Exposure based on speculation.
(p.ex. description des symptômes tels que la fréquence et la gravité
11/15/2018 Caller applied product on mattresses and a sofa in her home on 11/3/2018. She had three hamsters in cages in the hallway while the product was used in a room and the doors were closed. Caller found one hamster laterally recumbent and breathing shallow on 11/7/2018, and the hamster died the next day. Another hamster died on 11/14/2018, and seemed asymptomatic the day prior. Upon returning home today, she found the third hamster with her right eye proptosed. She also noticed the hamster was having an increase of fecal material yesterday. 11/16/2018 Attempted call back to the original caller. A message was left requesting follow up information. 11/19/2018 Attempted call back to the original caller. A message was left requesting follow up information.
Mort
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 can not 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.
Propriétaire de l'animal
Other / Autre
préciser Exotic
Hamster
1
Femme
Inconnu
Inconnu
Inconnu
<=15 min / <=15 min
>1 wk <=1 mo / > 1 sem < = 1 mois
Système
Unknown / Inconnu
Inconnu
Non
Inconnu
Unknown/Inconnu
Other / Autre
préciser Defined point of exposure not evident or witnessed. Exposure based on speculation.
(p.ex. description des symptômes tels que la fréquence et la gravité
11/15/2018 Caller applied product on mattresses and a sofa in her home on 11/3/2018. She had three hamsters in cages in the hallway while the product was used in a room and the doors were closed. Caller found one hamster laterally recumbent and breathing shallow on 11/7/2018, and the hamster died the next day. Another hamster died on 11/14/2018, and seemed asymptomatic the day prior. Upon returning home today, she found the third hamster with her right eye proptosed. She also noticed the hamster was having an increase of fecal material yesterday. 11/16/2018 Attempted call back to the original caller. A message was left requesting follow up information. 11/19/2018 Attempted call back to the original caller. A message was left requesting follow up information.
Mineure
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 can not 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.