Burns, Crash Injury Ruled Joint Causes of Hospital Fire Death : Tragedy: Burns alone could not have killed woman engulfed by flames on operating table, coroner’s spokesman says. She was brought to UCLA for surgery with massive heart and liver damage.

A 26-year-old woman who died after flames engulfed her on an operating table at UCLA Medical Center was killed by a combination of the fire and internal injuries that she suffered earlier in an automobile accident, a coroner’s spokesman said Wednesday.

The burns were “significant enough to cause her death,� said coroner’s spokesman Scott Carrier. But Carrier said the burns alone could not have caused the death Monday of Angela Hernandez without the massive heart and liver injuries that had brought her to the hospital for exploratory surgery.

Carrier said he could not speculate as to whether Hernandez would have survived the operation if the fire had not occurred.

Hernandez, an Echo Park resident, was admitted to UCLA Medical Center early Sunday in critical condition after her stalled car was rammed by another vehicle. She and four others had been riding in the vehicle, a 1976 Toyota, when it stalled near Pacific Coast Highway in Santa Monica.

Hernandez got out of the car and was standing in front of it when another vehicle struck the parked Toyota and pushed it into her. Doctors at UCLA Medical Center were in the midst of exploratory surgery when the fire erupted, a UCLA spokeswoman said.

Meanwhile, Los Angeles and State Fire Marshal investigators said that their probe into the cause of the fire is focusing on four elements--the hospital’s operating procedures, the drapery cloths that covered Hernandez, oxygen used during the surgery and a surgical device called a cauterizing tool.

The tool, common in operating rooms since the 1920s, uses an electric current to emit constant sparks to sear shut blood vessels. In an oxygen-rich operating room, the sparks can easily ignite materials not normally flammable, investigators said.

A cauterizer caused the death two years ago of a 19-day-old infant at Cedars-Sinai Medical Center in a similar operating room fire. The child, identified only as Baby de Jesus, was covered with gauze which was ignited by a spark from the tool. A lawsuit has been filed against the hospital, a Cedars-Sinai spokesman said.

Determining the cause of the fire is more complex than investigators anticipated, said Los Angeles Fire Department spokesman Ed Reed. A report is not expected until early next week, he said.

But the investigation could result in recommendations for improved safety procedures at University of California medical facilities statewide.

“We’re looking into procedures that might constitute a fire hazard,� Reed said.

The National Fire Protection Assn. in Boston also has expressed interest in learning more about the accident, Reed said. The association sets electrical and fire regulations nationwide, he said.