A burger laced with the one of the world's hottest pepper has ripped a hole in a man's esophagus, as reported recently in a case study published the Journal of Emergency Medicine. The American who was not named in the study ate the burger topped with a "ghost pepper puree" as part of an eating contest.

Washington Post said ghost pepper's heat is measured at one million units on the Scoville scale, a system for measuring the spiciness of different substances. Because it is extremely hot, as in more than twice as hot as a habanero, it is only eaten by daredevils in an eating challenge just like the one participated by the 47-year-old man.

So how did this happen? While the ghost pepper did not directly put a hole on the man's esophagus, retching and vomiting after he consumed the hot pepper resulted to it.

"The patient was intubated and taken immediately to the operating room, where he was noted to have a 2.5-cm tear in the distal esophagus, with a mediastinal fluid collection including food debris, as well as a left-sided pneumothorax," the study done by doctors at the University of California-San Francisco and Alameda County Medical Center/Highland Hospital in Oakland read.

CBS notes that medical diagnosis was called Boerhaave syndrome, or spontaneous esophageal rupture, which the authors describe as a "rare condition encountered by emergency physicians, with a high mortality rate."

"When patients die from a ruptured esophagus, the cause of death is likely a rapid and fatal infection," said lead study author Dr. Ann Arens, who was aphysician in the department of emergency medicine at the University of California, San Francisco at the time of the man's case in the summer of 2015 told Live Science.

Meanwhile, TIME said the world's hottest pepper is called the Carolina Reaper with 1.5 million units on the Scoville scale.