Yeah that threw me off as well. Had to do a little reading on [Boerhaave Syndrome](http://emedicine.medscape.com/article/171683-overview) to have it make a little more sense. The rupturing is caused by forced vomiting, of which the hot pepper in this case was the catalyst.
Yes. This ultimately killed my grandfather (esophageal rupture). The subsequent infection and inability to eat or breathe is bad. Its also quite possible his esophagus was thin, which can happen due to acid reflux among other causes.
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