A 56-year-old grandmother died after falling into an uncovered steam-filled manhole in Midtown Manhattan, with medical officials ruling that she suffered severe thermal injuries and blunt force trauma in the tragic accident.Officials said Gocaj suffered inhalational thermal injuries and blunt force trauma to her torso after plunging into the steam-filled opening. (X/ @SarahisCensored)According to The Mirror US, Donike Gocaj fell into the exposed maintenance hole late Monday night while parking her SUV near East 52nd Street and Fifth Avenue in New York City.The city medical examiner ruled her death accidental on Wednesday.Severe steam inhalation and burnsOfficials said Gocaj suffered inhalational thermal injuries and blunt force trauma to her torso after plunging into the steam-filled opening.New York City’s underground steam system, known for producing the iconic steam rising from manholes across Manhattan, reportedly carries water at temperatures reaching approximately 456 degrees Fahrenheit.Barbara Butcher, former chief of staff at the city’s medical examiner’s office, explained that inhaling the superheated steam may have caused the most catastrophic injuries.“Perhaps the most damaging injury was the inhalation of steam, which would have damaged the alveoli, the tissue in the lungs, which transports oxygen to the bloodstream,” Butcher said, according to the Irish Star.“When they swell, they can no longer bring in oxygen. The steam would have caused her to have scald burns on her skin, but the real cause of injury would be the inhalation,” she added.Also Read: Dylan Carter cause of death: The Voice star dies at 24 in South CarolinaWitnesses tried to help victimBystanders at the scene reportedly attempted to assist Gocaj before emergency crews arrived.One witness told local media they heard her cry out, “I’m dying,” after she fell into the opening, which appeared filled with boiling water and steam.Witness Carl Wood told the New York Post that the area did not appear to be properly secured before the accident occurred. “The cover was right next to the hole. It was just off the hole,” Wood said. “There were no cones, there were no barricades, there was nothing.”Also Read: Ray Hartman cause of death: Details of St. Louis journalist and US House candidate's accidentAccording to the New York Post, forensic pathologist Lee Ann Grossberg said the injuries Gocaj sustained would likely have caused “a really painful death.”Authorities have not publicly explained why the manhole was left uncovered at the time of the fatal incident.