Teen Who Died After Spicy ‘One Chip Challenge’ Had Enlarged Heart

A 14-year-old whose family said he had eaten a chip made with two of the hottest peppers in the world died of cardiopulmonary arrest, according to a medical examiner’s report released on Thursday, which noted that he had eaten a spicy substance and had an enlarged heart.

The report found that the teenager, Harris Wolobah of Worcester, Mass., died on Sept. 1 of “cardiopulmonary arrest in the setting of recent ingestion of food substance with high capsaicin concentration in a person with cardiomegaly and myocardial bridging of the left anterior descending coronary artery.”

Capsaicin is the chemical compound found in chili peppers that causes a burning sensation. Cardiomegaly is commonly known as an enlarged heart. And myocardial bridging refers to a coronary artery that passes through a band of heart muscle instead of lying on top of it.

The Massachusetts Office of the Chief Medical Examiner said the manner of death “could not be determined.” Examples of the manner of death in other cases include “natural,” “accident” and “homicide.”

Lois Wolobah, Harris’s mother, declined to comment on the report on Thursday. She has said previously that she believed that the single Paqui brand tortilla chip that her son ate hours before he died jeopardized his health.

The chip, dusted with two very hot peppers, the Carolina Reaper and the Naga Viper, had a label on the box that read, “One Chip Challenge” and carried a warning — “Inside: One Extremely Hot Chip.” It came in a coffin-shaped box that bore an image of a skull with a snake coiled around it.

Marketing materials for the chip dared customers to wait as long as possible after eating the chip before eating or drinking anything, and then to post their reactions on social media.

In an interview in September, Ms. Wolobah said that her son’s school had called to report that he was sick and that she should pick him up. When she arrived, Harris was clutching his stomach in the nurse’s office, she said.

Ms. Wolobah said she took her son home, but after about two hours he passed out and was rushed to a hospital, where he died.

Dr. Juliana Gomez-Arostegui, a pediatric cardiologist at Rady Children’s Hospital in San Diego, Calif., said many factors could have played a role Harris’s death.

She said that myocardial bridges do not generally cause problems except for in a few uncommon cases. She said it is also hard to know if Harris’s heart was enlarged because of attempts to resuscitate him or if it was something he had all along that no one knew about.

But eating the spicy chip, combined with an enlarged heart and a myocardial bridge, “in theory, could be a bad combo if his heart rate got up fast enough from the intense spice and stress of it to him, causing ischemia (lack of oxygen to the heart muscle) that could lead to a fatal tachyarrhythmia,” or ultrafast abnormal heart rhythm, Dr. Gomez-Arostegui wrote in an email.

Paqui chips were made by Amplify Snack Brands, a subsidiary of the Hershey Company.

About a week after Harris’s death, the company said it was pulling the chip from store shelves “out of an abundance of caution” and that it was offering refunds for the product, which was priced at about $9.99 for a single serving.

“We were and remain deeply saddened by the death of Harris Wolobah and extend our condolences to his family and friends,” Paqui said in a statement on Thursday. “Paqui’s One Chip Challenge was intended for adults only, with clear and prominent labeling highlighting that the product was not for children or anyone sensitive to spicy foods or with underlying health conditions.”

After the company said it “saw increased reports of teens and other individuals not heeding these warnings,” it worked with retailers to remove the product from shelves, and “the One Chip Challenge has been discontinued.”