The first fatality in a nationwide outbreak of E. coli linked to bagged spinach that has sickened at least 50 people has been reported in Wisconsin. There have been 11 confirmed cases of E. coli in Milwaukee County, but only four have been linked to the national outbreak of E. coli O157:H7.

Among the Wisconsin cases, 12 people remain in the hospital. Four of those have been diagnosed with hemolytic uremic syndrome, a condition that can lead to serious kidney damage and death.

Roundy’s Supermarkets Inc. said it is voluntarily removing all prepackaged fresh spinach and packaged salads containing fresh spinach. The recall will affect all Roundy’s stores, including Pick ‘n Save, Copps and Metro Market in Wisconsin and Rainbow in Minnesota, even though Minnesota has not reported any outbreak-related illnesses.

Bill Marler of the Seattle-based law firm Marler Clark said he is representing four cases of victims of the latest outbreak, including a Milwaukee family whose two children were hospitalized with the syndrome. In that case, a 6-year-old boy was released from the hospital Thursday. His sister remains hospitalized.