A 2006 E. coli O157:H7 outbreak linked to bagged spinach sickened 204 people, hospitalized 104, caused 31 cases of hemolytic-uremic syndrome (HUS), and resulted in three deaths across 26 states and Canada. This led to the formation of the Leafy Greens Marketing Agreement (LGMA) in California and Arizona, establishing stringent food safety practices for leafy greens.