The various shareholder families had organized themselves into groups for milk pick-up. When the pickup person arrived at the farm, the Pucketts placed the glass jars into a large cooler with blue ice. Each group of families had a pickup location, such as a front porch, where the cooler was left unattended. Families for each group had a window of 3 to 9 pm to come by and retrieve their milk from the cooler.

Michael Puckett often picked up the empty cooler early the following morning, on the way home from his night job. About two weeks before the incident, he was somewhat unnerved by the presence of a car parked across the street of the pickup house. A driver sat behind the steering wheel. Puckett stalled to see how long the car would remain. Twenty minutes passed, at which time a police car arrived and the driver drove off.

The first Dee Creek shareholder to become sick was a child from a family that picked up milk on Monday from the milking of November 26 or 27, at the pickup house where Michael had noticed the parked car. Soon other children fell ill and several were hospitalized. Health officials quickly confirmed the culprit as a strain of virulent E. coli O157:H7.