WASHINGTON — How could hundreds of bags of intravenous saline solution meant for training health care workers have been given to real patients?

That is the question health authorities were scrambling to answer this week after Wallcur, a San Diego-based company, recalled different-size bags of its saline solution and distilled water on Jan. 7.

As of Thursday, 17 patients had fallen ill and one person — a hospice patient — had died after being given the solution, health officials said, though they could not say conclusively whether the saline solution was the cause. Patients in seven states reported symptoms, including chills, fever, tremors and headaches.

The company said it began shipping the saline, in bags labeled “for clinical simulation,” on May 22, 2014. It said the products were not intended for people or animals because they were not sterile.