SF ghost-pepper burger yields 1-inch esophagus tear

They’re more than twice as hot as habaneros. They make jalapeños taste like a walk in the park. And if you’re unlucky, they can cause severe bodily harm.

A 47-year-old man engaged in a daredevil eating contest in San Francisco found out the hard way just how hot a ghost pepper can be when he munched into a burger topped with a puree made out of the legendary chile.

The result? A 1-inch-wide tear in his esophagus and a 23-day stay at UCSF Medical Center.

The ordeal, while rare, was documented by UCSF physicians in a case study published recently in the Journal of Emergency Medicine that highlights the potential danger of extreme eating. The doctors said the man, who was not identified, survived despite violently and repeatedly retching and vomiting.

Photo: Doug Cannell/Getty Images The ghost pepper, also known as naga jolokia or bhut jolokia,...

On the Scoville scale — a heat index designed to measure the levels of capsaicin in peppers that make them so spicy — ghost peppers weigh in at 1 million units, or super-hot territory.

A jalapeño by comparison clocks in between 5,000 and 8,000 Scoville units, while the world’s hottest pepper, a cross-breeding feat of spicy engineering, measures about 1.5 million.

Chili peppers are shown at the Houston Hot Sauce Festival. Chili peppers are shown at the Houston Hot Sauce Festival. Photo: Courtesy Photo, Houston Hot Sauce Festival Photo: Courtesy Photo, Houston Hot Sauce Festival Image 1 of / 15 Caption Close SF ghost-pepper burger yields 1-inch esophagus tear 1 / 15 Back to Gallery

The restaurant where the hospitalized man got sick was also left unnamed by UCSF, but the contest was part of a trend of people consuming hotter and hotter substances in an effort to outdo one another.

“Is it just boredom?” asked Dr. Craig Smollin, co-author of the study. “Is it just this culture of, ‘I can one-up you?’ Or sort of like a schoolyard culture? I honestly don’t know. I don’t see the attractiveness of being able to say you accomplished this.”

People brave or foolish enough to chew and swallow the super-hot peppers are featured in food-dare YouTube videos. They typically scream or cry, mouths held hostage by the fiery pepper that can scald the tongue for a half-hour — or do worse.

The man in San Francisco chugged six glasses of water after chomping down on the pepper-laced burger, to no avail. That’s when the vomiting started, and soon there was a 911 call followed by complaints of excruciating stomach pain.

Smollin, consulted in the case for his expertise with the California Poison Control System, described the episode as an outlier.

“There’s a lot of people out there who are ingesting ghost peppers and who have been OK, who have been fine,” Smollin said. “But there is a possibility, yeah, you could have a reaction and have a bad complication like this.”

The ghost pepper itself — which is spicy but not acidic — couldn’t alone have caused the one-inch tear in the man’s esophagus, Smollin said. It was the bouts of vomiting caused by the pepper’s irritation.

The man was released from the hospital 23 days later with a gastric tube, UCSF said, after undergoing extensive surgery to repair his throat.

Jasmine Robinson, a manager at San Francisco’s Hot Licks, a chain that specializes in spicy products, said she’d be “surprised” if the man wasn’t required to sign a waiver for the challenge.

Those seeking to purchase the hottest sauces in her store require such a waiver releasing the chain from liability, she said.

“If you have too much or you use it improperly, or if your body just has a harmful reaction to it, then we don’t want to be held responsible,” Robinson said.

Dave Hirschkop, who set out to make the spiciest sauce in the world when he founded San Francisco’s Dave’s Gourmet, said the question when it comes to heat has become: “How far does it go?”

That’s why his hotter bottles now come prescribed with a label urging the customer to use “one drop at a time.”

“At some point, there is a chance that some bizarre set of circumstances will happen and someone will get hurt even worse,” Hirschkop said. “Or die.”

Michael Bodley is a San Francisco Chronicle staff writer. Email: mbodley@sfchronicle.com Twitter: @michael_bodley