WORKMAN et al v. MENU FOODS LIMITED et al

Filing 13

BRIEF in Opposition re 10 MOTION for Order to Show Cause Why a Protective Order to Supervise or Limit Communications With Absent Class Members Should Not Issue filed by MENU FOODS MIDWEST CORPORATION, MENU FOODS LIMITED, MENU FOODS INC.. (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D)(HANSON, GERARD)

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WORKMAN et al v. MENU FOODS LIMITED et al Doc. 13 Att. 2 Case 1:07-cv-01338-NLH-AMD Document 13-3 Filed 05/15/2007 Page 1 of 9 CRAWFORD & COMPANY DATA COLLECTION FORM RE: MENU FOODS INCOME FUND'S PRODUCT RECALL * Please complete separate form for each pet claimed to have been affected by pet food manufactured by Menu Foods Income Fund. Call ID Number provided by Crawford & Company (if known): I. PET OWNER INFORMATION 1. 2. 3. 4. 5. Name of Pet Owner: _______________________________________________________ Current Address: _________________________________________________________ Telephone Number: _______________________________________________________ Social Security Number: ___________________________________________________ What type of pet does this concern? Cat _____ 6. Are you the owner of the pet? Yes _____ 7. No _____ If no, who owns the pet? __________ Dog _____ Other _____ Are you claiming that your pet has or may develop bodily injury as a result of consuming pet food manufactured by Menu Food Income Fund? Yes _____ No _____ If no, go to Question 15 Dockets.Justia.com Case 1:07-cv-01338-NLH-AMD Document 13-3 Filed 05/15/2007 Page 2 of 9 8. What injuries do you believe your pet has sustained as a result of consuming pet food manufactured by Menu Food Income Fund (Please check all that apply)? _____ Vomiting _____ Lack of appetite _____ Increased thirst _____ Frequent urination and increase in volume _____ Depression / Decrease in interest _____ Ulcers in the mouth _____ Urine-like breath odor _____ Poor hair coat _____ Death _____ Others: ____________________ 9. If your pet has died, please answer the following: a. Date of Death (month/date/year): _________________________________ b. Was a post-mortem exam performed Yes _____ c. No _____ Was the cause of death determined? Yes _____ No _____ If "Yes," what was the cause of death, who determined it and when? Cause of Death Veterinarian Date of Determination 10. When did your pet begin to exhibit the above mentioned symptoms (month/date/year)? ________________________________________________________________________ 11. Have you contacted your veterinarian? Yes _____ No _____ Case 1:07-cv-01338-NLH-AMD Document 13-3 Filed 05/15/2007 Page 3 of 9 12. Has your pet been seen and/or treated by a veterinarian or health care provider subsequent to consuming pet food manufactured by Menu Foods Income Fund? Yes _____ No _____ If "Yes," please list the name, address and telephone of each veterinarian, date of treatment (if any) and diagnosis. Veterinarian Address Telephone Number Date of Treatment Diagnosis 13. What (if any) instructions were given to you by your veterinarian?___________________ ________________________________________________________________________ ________________________________________________________________________ 14. Please list the amount of medical bills and/or expenses your pet has incurred to date (Please itemize, including any burial and/or cremation expenses if applicable). ________ ________________________________________________________________________ ________________________________________________________________________ II. PRODUCT INFORMATION 15. What type of pet food does this claim concern? Cat _____ 16. Dog _____ What is the name of the pet food (product description)? ___________________________ Case 1:07-cv-01338-NLH-AMD Document 13-3 Filed 05/15/2007 Page 4 of 9 17. Cat: What brand is the pet food (Please circle below)? Americas Choice, Preferred Pets Authority Best Choice Companion Compliments Demoulas Market Basket Eukanuba Fine Feline Cat Food Lion Foodtown Giant Companion Hannaford Hill Country Fare Hy-Vee Iams Laura Lynn Li'l Red Loving Meals Meijer's Main Choice Nutriplan Nutro Max Gourmet Classics Nutro Natural Choice Paws Pet Pride Presidents Choice Price Chopper Priority US Save-A-Lot Schnucks Science Diet Feline Savory Cuts Cans Sophistacat Special Kitty Canada Special Kitty US Springfield Prize Sprout Stop & Shop Companion Tops Companion Wegmans Weis Total Pet Western Family US White Rose Winn Dixie Dog: Americas Choice, Preferred Pets Authority Award Best Choice Big Bet Big Red Bloom Wegmans Bruiser Cadillac Companion Demoulas Market Basket Eukanuba Food Lion Giant Companion Great Choice Hannaford Hill Country Fare Hy-VeeIams Laura Lynn Loving Meals Meijers Main Choice Mighty Dog Pouch Mixables Nutriplan Nutro Max Nutro Natural Choice Nutro Ultra Nutro Ol'Roy Canada Ol'Roy US Paws Pet Essentials Pet Pride - Good n Meaty Presidents Choice Price Chopper Priority Canada Priority US Publix Roche Brothers Save-A-Lot Schnucks Shep Dog Springsfield Prize Sprout Stater Brothers Weis Total Pet Western Family US White Rose Winn Dixie Case 1:07-cv-01338-NLH-AMD Document 13-3 Filed 05/15/2007 Page 5 of 9 18. Is the pet food packaged in a can or a pouch? Can: _____ Pouch: _____ 19. 20. 21. What is the size of the can or pouch (in ounces)? ________________________________ Please list the UPC of each can and/or pouch fed to your pet. ______________________ When was the pet food manufactured (The manufacture date can be found on the bottom of the can or the back of the pouch)? __________________________________________ III. PURCHASE INFORMATION 22. Did you purchase the pet food? Yes _____ 23. No _____ If no, who purchased it? _____________ Where was the pet food purchased (Please list store name and address)? ______________ ________________________________________________________________________ 24. 25. When was the pet food purchased (month/date/year)? ____________________________ Do you have a copy of the sales receipt for the pet food? Yes _____ No _____ 26. How many cans and/or pouches of the pet food were purchased? ____________________ Case 1:07-cv-01338-NLH-AMD Document 13-3 Filed 05/15/2007 Page 6 of 9 IV. USE INFORMATION 27. Did you feed the pet food to your pet? Yes _____ 28. 29. No _____ If no, who fed it to your pet?__________ When was the pet food fed to your pet (month/date/year)? _________________________ Was this the first time that your pet had consumed this pet food? Yes _____ No _____ If no, how long had your pet been consuming the pet food (months)? ________ 30. 31. How many cans and/or pouches did your pet consume? ___________________________ Are you currently in possession of the can(s) and/or pouch(es) Yes _____ No _____ If "Yes," preserve all opened and unopened can(s) and/or pouch(es) in question. 32. How many can(s) and/or pouch(es) do you have in your possession? Can(s) _____ 33. Pouch(es) _____ How many of the can(s) and or pouch(es) in your possession are open: Can(s) _____ Pouch(es) _____ 34. How many of the can(s) and or pouch(es) in your possession are unopened: Can(s) _____ Pouch(es) _____ Case 1:07-cv-01338-NLH-AMD Document 13-3 Filed 05/15/2007 Page 7 of 9 35. Are you in possession of any open and/or unused pet food? Yes _____ No _____ If "Yes" preserve all open and/or unused pet food in double-bagged sealable plastic and store in the freezer. 36. Did you return any open and/or unused can(s), pouch(es) and/or pet food to the store? Yes _____ No _____ If "Yes," where and when? ___________________________________________ V. PET MEDICAL INFORMATION 37. 38. 39. 40. Breed of Pet: ____________________________________________________________ Date of birth: ____________________________________________________________ Sex: Male _____ Female _____ Prior to consuming the product, did your pet have any preexisting health conditions? Yes _____ No _____ 41. If "Yes," please specify the type of condition or disease, date of diagnosis, veterinarian by whom diagnosis was made, treatment (if applicable), date of recovery (if applicable). Date of Diagnosis Veterinarian Treatment Date of Recovery Condition/Disease Case 1:07-cv-01338-NLH-AMD Document 13-3 Filed 05/15/2007 Page 8 of 9 42. Prior to consuming the product, was your pet on any medications? Yes _____ No _____ 43. If "Yes," please list medication(s) and date of use. Medication Date of Use 44. Please list the names and addresses of each of your pet's current veterinarian. Name Address 45. Please list the names and addresses of each clinic or healthcare facility that your pet has received treatment in the last ninety (90) days. Address Clinic / Healthcare Facility Case 1:07-cv-01338-NLH-AMD Document 13-3 Filed 05/15/2007 Page 9 of 9 VI. RELEVANT DOCUMENTS Please send all relevant documents and materials, including the following: Any records relating to the purchase of the pet food in question, including but not limited to sales receipts, credit card bills and/or other related invoices. Can(s) and/or pouch(es) of the pet food in question. (Please ensure they are fully cleaned prior to sending to avoid delays at the post office). If there is still product in the can our pouch, please retain the product in a doublesealed bag in your freezer. Do not send cat or dog food in the mail. Records of any veterinarian, clinic and/or other healthcare facility identified in response to this profile form. Please retain a copy of these documents for your own records. Please return this claim form and all relevant documents to: Crawford & Company Menu Foods Recall 133 Weber Street North, Suite 3-514 Waterloo, ON N2J 3G9

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