The Food and Drug Administration is continuing to investigate an outbreak of complaints about illnesses associated with Daily Harvest brand frozen crumbles and has named specific problems consumers have had.

As of Oct. 21, the number of complaints was 393, with at least 133 patients having required hospitalization, according to an updat from the FDA posted on Oct. 25.

The FDA reported that problems described by patients in the outbreak include gastrointestinal illness and liver, bile duct, and/or gallbladder illnesses. The most recent illness onset was Sept. 4. there is still concern that some consumers may have unused portions of the product in their freezers.

As many as 25 patients have had to have their gallbladders removed after becoming ill following consumption of the implicated product. 

Earlier this year Daily Harvest reported having received more than 400 complaints from customers. The company recalled its frozen Lentil & Leek Crumbles on June 17 and asked consumers to check their freezers for the product. 

“Although the response to this incident is no longer being handled by FDA’s Coordinated Outbreak Response & evaluation (CORE) Network, FDA’s research, and investigation to evaluate which components of this product may have caused these illnesses is ongoing and more information will be provided as it becomes available,” according to the FDA’s update.

Daily Harvest has stopped selling the product and has said that one possible cause of the illnesses that is being investigated is the tara flour that was used in it. No other Daily Harvest products are made with tara flour, according to the company. Tara flour and other tara products are made from the seeds of a plant native to Peru.

The product was sold through online sales and in two retail locations: the Daily Harvest store in Chicago, IL, and a “pop-up” store in Los Angeles, CA.

Known sick people live in Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Michigan, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, and Wisconsin.

Anyone who has eaten or handled Daily Harvest Lentil & Leek Crumbles and developed any of the following symptoms should contact their doctors: yellowing of the skin and eyes (jaundice), dark urine, itching with no rash, gastrointestinal illness, nausea, fatigue, body aches, severe abdominal pain and/or fever. Healthcare providers should report these illnesses to their health departments.