A Westchester grandmother who fell into an open manhole in Midtown Manhattan died from scald burns, steam inhalation injuries, and blunt force trauma, according to the city’s medical examiner.

The shocking death of 56-year-old Donike Gocaj was ruled an accident, officials said Wednesday.

Gocaj had parked her SUV along East 52nd Street near Fifth Avenue around 11:20 p.m. Monday when she plunged into an uncovered Con Edison utility hole.

Authorities said she fell about 10 feet.

The medical examiner found that Gocaj suffered severe scald burns, inhalational thermal injuries, and blunt force trauma to her torso. Those injuries caused her death.

Experts said the findings are consistent with someone falling into the extremely hot steam and water often found inside New York City manholes.

Barbara Butcher, former chief of staff at the city’s medical examiner’s office, said the steam inhalation may have been the most devastating injury.

“Perhaps the most damaging injury was the inhalation of steam,” Butcher said, explaining that the heat could damage the lung tissue that helps move oxygen into the bloodstream.

She said the steam would have burned Gocaj’s skin, but the damage to her lungs may have been even more deadly.

Forensic pathologist Lee Ann Grossberg also described the injuries as especially horrific.

“That would have been a really painful death,” she said.

A witness said Gocaj, a devoted mother and grandmother from Briarcliff Manor, screamed “I’m dying” as bystanders desperately tried to help her before first responders arrived.

The witness said the utility hole appeared to be filled with boiling water and steam.

Con Edison workers were later seen at the scene investigating the manhole.

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