In spite of its name containing "Suspicious Looking", this item spawns a pet rather than a boss.
If the worm buff is active and the player dies, a unique tombstone drops.
Trivia
The summoned Pet Worm is a reference to the game series Worms.
There is a hole in the bottom right corner of the apple which is the reason why it is "Suspicious Looking", based on the fact that worms eat apples by tunneling into the fruit.
Quotes
"Boring!" - when standing still too long.
"Bye bye!" - when player dies.
"Grenade!" - when throwing an explosive, such as a Grenade .
"Incoming!" - when an Event or army approaches.
"(Jump)"
"Victory!" - sometimes, when the player kills an enemy.
