This is a legitimately dangerous move, as if the victim's head is too close to the ground at the beginning of the move, he will actually land on his head and severely injure his neck. The idea is to have it so that the victim's head ends up a few inches from the ground, but close enough so that the executor's legs obscure that fact to everyone watching.

Stone Cold Steve Austin was, in fact, severely injured as a result of a botched piledriver at the hands of Owen Hart at SummerSlam '97. Austin's head was too low, and he landed straight onto his head and, as one might expect, suffered severe neck damage. Austin indeed was paralyzed for about a minute after the move, but luckily recovered some feeling in his arms and legs as Hart was heckling the fans to buy Austin some time. It took him several months to recover fully from the incident.

In The Rock's autobiography, he also details an incident that occurred while he was in primary school, wherein one of his classmates was prodding him about wrestling being fake. In response, The Rock placed the kid in a piledriver, messed it up, and ended up hurting the kid pretty badly.

So, like they say, do not try this at home!