In May, 2012, Buncombe County health officials and the North Carolina Department of Agriculture & Consumer Services linked Salmonella Paratyphi B outbreak to unpasteurized tempeh produced by Smiling Hara Tempeh. Officials determined the source of the outbreak to be imported starter culture that was used as an ingredient in the tempeh and was provided by Tempeh Online (also known as Indonesianfoodmart.com), a Rockville, Maryland company. Since the announcement of the outbreak, at least 88 people have been confirmed part of the Salmonella paratyphi B outbreak, and Tempeh Online has shut down its websites.

According to a complaint filed in North Carolina District Court in Asheville (#1:12-cv-152), Mary Ann Hurtado, a Jacksonville, Florida resident, was on vacation with her husband in Asheville when she consumed contaminated tempeh on March 19. Approximately 48 hours later, she began experiencing abdominal cramps. Her symptoms quickly escalated, and by March 23 included uncontrollable shaking, headache, vomiting, diarrhea, and worsening cramps. Despite her illness, Mrs. Hurtado, a registered nurse, returned to Jacksonville the next day where she continued to attempt self-care at home. By March 25, however, she could barely walk and was rushed to the emergency room where she was eventually admitted to the hospital for three days of treatment. A stool sample secured after her admission would be sent to health officials for testing. Though still ailing from symptoms, she attempted to return to work on March 30. On April 2, Mrs. Hurtado was informed by Duval County Health in Florida of her positive test for Salmonella paratyphi B and directed to cease all patient contact at her place of work.