ok so to make it short,Tainted Cain bag make items depending from what pickup you get right?
So when you get a bone heart,it will pull items from the secret room,and I found out it bug with your cause you have an item in itempool.xml that don't exist in item.xml, "Greed's Torso"
So when picking a bone heart with the bag and getting 8 pickup,the game will instant crash because of that,so i removed it from the pool of itempool.xml and it work now,no more crash with bone heart in the bag.
If you look at deliverance they had the same problem and we fixed it yesterday in the discord,hope it help