In a 4 quart Dutch oven cook sausage, onion and garlic in hot oil over medium high heat until sausage is lightly browned and onion is tender.
Add broth and water to Dutch Oven; bring to boiling. Add pasta; cook for 3 minutes, stirring frequently. Add spinach and pepper; cook about 1 min more or until spinach wilts. Stir in cream. Serve immediately.