Frozen shakes served at hospitals and nursing homes are being recalled after they were linked to a deadly outbreak of listeria, the U.S. Food and Drug Administration said. The agency said in an update Monday that 12 people have died.

The frozen shakes were served at hospitals and long-term care facilities, sickening 38 people and resulting in 11 deaths in 21 states, according to the FDA.

Frozen shakes distributed in long-term facilities around the United States have been recalled due to potential listeria contamination. Lyons Magnus announced Feb. 22 that it had issued a recall for 4 oz. Lyons ReadyCare and Sysco Imperial Frozen Supplemental Shakes, which were manufactured by Prairie Farms Dairy, Inc.