Kansas City, Mo. ? The Jackson County medical examiner’s office has confirmed that heat exposure was a factor in two summer deaths, city officials announced Friday.

The deaths bring the total heat-related fatalities in Kansas City to four, with the Jackson County medical examiner still investigating three others.

One of the deaths announced Friday was that of a 19-month-old girl who was left in a car, the city said. The girl, whose name was not released, died at a hospital in late July. A criminal investigation is ongoing, the city said.

The other death involved a 92-year-old woman who was found in her residence with no fan or running air conditioning on a blistering hot August day, the city said. The woman, Hazel Pratt, had a history of cardiovascular disease, the city said.