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The tragic death of a Massachusetts teenager who collapsed after eating an extremely spicy tortilla chip last year may prompt both doctors and food manufacturers to take a closer look at the ingredient that provides the punch — capsaicin.

Harris Wolobah died in September at age 14 from cardiopulmonary arrest “in the setting of recent ingestion of food substance with high capsaicin concentration,” according to a statement released Thursday by Elaine Driscoll, a spokesperson for the Massachusetts Executive Office of Public Safety and Security.

He had consumed a chip manufactured by Paqui that was packed with the chili pepper extract and marketed as the “One Chip Challenge.”

Paqui pulled the chips, which came individually wrapped and in a coffin-shaped container with a skull on the front, from shelves after Wolobah’s death.

“I think this case is going to force us to pause and look more closely at capsaicin and its effects,” said Dr. Stuart Berger, head of cardiology at Lurie Children’s Heart Center in Chicago.

Wolobah had an enlarged heart and a congenital heart defect, Driscoll confirmed, after The Associated Press reported that the issue was described in the teen’s autopsy report.

It is not known whether the family was aware of the health issue before the teen’s death. Wolobah’s parents did not immediately respond to a request for comment.

There’s not a lot of research on how capsaicin, which fuels the spicy flavor in various hot sauces and other foods, affects children, Berger said. But Wolobah’s death could change that.

Berger said he has heard reports of people who used capsaicin-based products to lose weight showing up at emergency rooms with chest pain and, in some cases, myocardial ischemia, a condition in which blood flow to the heart is reduced.

“Having said all of the above, it is very hard to know what the effect could be on children or adolescents with underlying heart disease,” Berger said.

Ed Currie, who markets a line of hot sauces through this South Carolina-based PuckerButt Pepper Co., said “there’s a lot more attention” now on capsaicin in his industry, as well.

Wolobah’s death could change the way very spicy foods like the Paqui chips are marketed, according to Angeli Gianchandani, a practitioner in residence at the University of New Haven’s business college.

She noted that the Paqui chips promised “vengeful pleasure of intense heat and pain.”

“This type of messaging would warrant some type of labeling that is for ‘adults’ and not be consumed by young children or anyone sensitive to spicy foods or risk of allergies or any underlying health conditions.”

“The warning label in this case is a no-brainer,” she said.

After the news of Wolobah’s death, a spokesperson for Paqui said the challenge was, indeed, intended only for adults but that the company had “seen an increase in teen usage of the product.”

“We care about all of our consumers and have made the decision to remove the product from shelves,” the statement said.

A Paqui One Chip Challenge chip
A Paqui One Chip Challenge chip in Boston on Sept. 8, 2023.Steve LeBlanc / AP

In an interview with the CBS affiliate in Boston on Thursday, Wolobah’s mother, Lois Wolobah, said she’s “feeling the pain of Sept. 1 all over again.”

Last year, she told NBC Boston about that day: Her son went to the school nurse with a stomach ache after he’d eaten the chip, then passed out at home that afternoon. He was pronounced dead at the hospital later that day, she said.

The chip that Wolobah ate was seasoned with two of the hottest peppers in the world: the Carolina Reaper and the Naga Viper.

The spiciness of chili peppers is measured on the Scoville scale, which calculates the heat units in a given pepper. Naga Viper peppers score around 1.4 million Scoville heat units, and Carolina Reapers score around 1.7 million. By contrast, a typical jalapeño rates at 8,500 Scoville heat units.

Currie helped crossbreed and grow the Carolina Reaper. It packs more punch than most pepper sprays that police use to subdue people, he said.

“We don’t market our products to children at all,” Currie said. “And I also think challenges like these are stupid. I eat super spicy stuff on a daily basis so my body is acclimated to it. Also, my doctor has cleared me to make sure I don’t have any underlying conditions.”

“I think, as an industry, we need to inform people of what they’re getting into,” he added. “To me, that’s common sense.”

Until Wolobah’s death, Paqui marketed their chips by daring customers to eat a chip and post pictures of their tongues on social media after they turned blue — then wait for as long as possible to relieve the burning sensations with water or milk or some other cooling liquid.

“Only the bravest will be able to prove they faced the Reaper when they show off their blue tongue,” Paqui’s former senior brand manager, Brandon Kieffer, said in a 2022 news release.

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