A spicy chip challenge left one child dead and several others hospitalized. Here's why the chip is so dangerous

TikTok has often been a breeding ground for food challenges, in which the platform’s users share videos of them eating, for example, only red foods or extremely caloric meals. Some challenges, however, have proven more dangerous than others. 

Recently, a teen boy died after trying the Paqui One Chip Challenge, which involves eating a single, extremely spicy chip without consuming water or other food afterward for as long as possible. The chip—which comes packaged in a coffin-shaped container—is made by Paqui, a subsidiary of The Hershey Company.^[]

The Associated Press (AP) reported that Harris Wolobah, a 10th-grader, died on September 1 after eating the chip. Police were called to the family home, where they found Wolobah “‘unresponsive and not breathing.’” He was transported to a hospital, where he was pronounced dead. An autopsy, which will likely take weeks, has yet to determine Wolobah’s cause of death, but the family says that the One Chip Challenge is responsible. 

Paqui has since asked retailers, including Amazon, to refrain from selling the chip, which costs about $10.^[] 

The company’s website also shares instructions for eating the chip: “Please read product warning. Cool down by drinking milk or eating ice cream. Consult a physician, if necessary.” The website also says that the One Chip Challenge is intended for adults only and is not for anyone with underlying health conditions. It is unclear whether this disclaimer was displayed on Paqui’s website before or as a result of Wolobah’s death. 

While Paqui says that it does not have an official Scoville rating—a scale that measures pepper pungency values—for the chip, the Carolina Reaper pepper clocks in around 1.7 million Scoville Heat Units (SHU), while the Naga Viper pepper reaches approximately 1.4 million SHU. For reference, the highest Scoville unit is 16 million SHU.^[][] 

The AP also reported that a 10-year-old Florida girl was suspended last week after bringing one of the chips to school, resulting in six other children requiring medical attention after coming into contact with the chip. Adults have also reported experiencing stomach cramps and diarrhea after eating the chip. 

One 56-year-old spicy food enthusiast, Roger Trier, said he tried the chip and thinks minors shouldn’t be allowed to participate in challenges like the One Chip Challenge. “‘Most people you see on social media – with any challenges – don’t understand the consequences,” he told AP. 

The Paqui challenge isn’t the first to capitalize on extreme spice (a spicy gum TikTok challenge previously sent young kids to the ER).  

Why are spicy foods potentially risky?

Kelly Johnson-Arbor, MD, FACEP, FUHM, FACMT, a medical toxicology physician based in Washington, DC, tells MDLinx that chili peppers like the Carolina Reaper contain capsaicin, a naturally occurring compound used in pepper and bear spray. Capsaicin, she says, can cause short-term mouth and throat irritation but can also lead to persistent vomiting or chest pain. “If untreated, those symptoms may result in esophageal rupture or a heart attack, both of which could potentially be fatal,” she says.

In fact, one healthy young male experienced severe chest pain and extensive inferior myocardial infarction after taking “slimming” cayenne pepper pills, according to the International Journal of Emergency Medicine.^[]

The authors of the article report that capsaicin “is associated with cardiotoxicity, including coronary vasospasm, supraventricular tachycardia, and acute atrial fibrillation….Coronary vasospasm and acute myocardial infarction (AMI) associated with the use of topical capsaicin patches to relieve back pain have been reported recently.” 

Another case report in the Journal of Emergency Medicine shares the experience of a 47-year-old who presented to the ER with severe abdominal and chest pain and vomiting after eating ghost peppers during a contest: “A subsequent chest x-ray study showed evidence of a left-sided pleural effusion and patchy infiltrates. A computed tomography scan of the abdomen and pelvis showed pneumomediastinum with air around the distal esophagus, suggestive of a spontaneous esophageal perforation and a left-sided pneumothorax,” the authors write. The patient was found, during surgery, to have a 2.5 cm tear in the distal esophagus, along with pneumothorax.^[] 

The authors warn of spontaneous esophageal rupture, or Boerhaave syndrome, a rare condition with a high mortality rate that can be misinterpreted as discomfort after a large spicy meal. 

Despite these rare case reports, most people can enjoy spicy food safely, says Ken Perry, MD, FACEP, an emergency physician in Charleston, SC, and member of the executive board of the State Chapter of the College of Emergency Physicians. “Our bodies can handle capsaicin well, although some of us obviously are more comfortable with heat than others,” he says.

Dr. Perry also says these challenges need very obvious risk warnings. “Although other people may be able to ingest spicy chips, spoonfuls of cinnamon, or even water without a problem, the risk is still inherent in the extreme aspect of the challenge,” he says. 

Dr. Johnson-Arbor stresses that MDs should educate their younger patients about the dangers of these TikTok food challenges. 

“Many social media trends, including the One Chip Challenge, appeal to teenagers and young adults whose brains are still developing and who may not have adequate insight or knowledge about the potential dangers of these trends,” she says. “Physicians should advise patients to engage in social media trends and challenges with caution; avoid social media challenges that involve medications; and remain vigilant about the limitations associated with social media content, [which may omit] unpleasant parts of a trend— like vomiting or coughing that occurs after eating spicy foods—to make the challenge seem more enticing and pleasant.”