The number of cases of liver damage connected to use of a dietary supplement has climbed to 32 in Hawaii as state and federal officials continue their investigation into the cause.

The state Department of Health today said one of the two new cases is on Kauai, but no information was given on the origin of the second.

Health officials are looking into whether the new cases are linked to the product OxyELITE Pro, which the state has ordered removed from store shelves across the state. 

Of the cases under investigation, 24 patients reported using OxyELITE Pro. “No other supplement or medication has been identified in common among more than two patients,” health department spokeswoman Janice Okubo said.

Stores are prohibited from selling, shipping or discarding the product, Okubo said. 

Inspectors are visiting stores statewide today to ensure shelves are cleared of the dietary supplement.

Violators will face fines ranging from $500 to $10,000. Possible criminal penalties may also be imposed for those who fail to comply.

The health department said the cases date as far back as May, ranging from hepatitis, acute liver inflammation and liver failure. The damage has led to two liver transplants and one death.

Sonnette Marras, 48, of Maui, died Oct 4 after taking the dietary supplement for several weeks to lose weight she had gained from her last pregnancy. Marras, a construction laborer for Local 368 of the Laborer’s Union, had seven children ranging from 1 to 26.