Smokey Bear, the famous icon of forest fire prevention, tells us that it takes three essential elements to start a fire: oxygen, heat, and fuel.

Pure oxygen, like the kind that pumped through the patient’s lungs and out through burst bullae, is extremely combustible.

During surgery, the doctors used a common tool called an electrocautery pen, an electronic device that generates high heat using an electrical current and is used to cauterize small wounds to quickly stop bleeding.

Fuel, the third ingredient, came in the form of dry surgical packs. These simple items are dry pieces of gauze that surgeons use to either absorb bodily fluids or hold tissues out of the way during surgery.