An 86-year-old New Cumberland woman died after she tripped and her medical alert necklace caught on her walker and strangled her. 
 
 Roseann J. DiFrancesco was found dead in her bathroom on Feb. 15, according to the report from the Cumberland County Coroner's Office. Relatives had last spoken to her on Feb. 12. 
 
 She was found after a visiting nurse, unable to summon DiFranceso by knocking on the door, entered her home and found her. It was unclear how long she had been dead. 
 
 Cumberland County Coroner Charles Hall said the lanyard of the medical device, having caught on the walker, caused DiFrancesco's upper torso to be suspended above the floor level, and the resulting pressure on her neck cut off air and blood flow. 
 
 Hall said the lanyard used by DiFrancesco apparently lacked a breakaway feature. But he didn't know whether it was the lanyard that came with the device or a replacement. 
 
 Hall called the death a "freak accident." 
 
 However, there have been injuries and a few deaths associated with such personal alert systems over the years. In 2009, the U.S. Food and Drug Administration issued a warning, saying it was aware of at least six serious injuries or deaths related to one of the popular brands of the device between 1998 and 2009. 
 
 Available from numerous makers, they often involve a pendant with a button the wearer can push to summon medical help in the event of a fall or medical emergency. 
 
 Some have break-away lanyards to prevent choking or injury if the lanyard catches on something or is otherwise pulled. 
 
 However, there has been disagreement over the benefits of breakaway lanyards, with some device makers saying the greater danger is that a lanyard will break and the alert device will be out of reach when needed. 
 
 The FDA said the risks of a non-breakaway lanyards are greatest for people such as those who use wheelchairs, walkers or beds with rails. 
 
 Noting that some alert devices can be worn around the wrist, the FDA advised people to consult a health care provider to determine which type of device is most appropriate. 
 
 The FDA wrote, "These widely used devices provide critical and immediate access to emergency care for those at risk of falls or who may be more likely to need outside assistance. While the number of adverse events reported is small compared to the number of people who use this device, the severity of these events is of concern. It remains important that users, along with their health care providers, assess the options provided by each style of button, and choose the option that best fits their condition." 
 
 Note: This story was edited to remove the slogan of one the companies that manufactures personal alert systems. The Cumberland County Coroner said he didn't know the brand of the device used by Roseann DiFrancesco. ||||| × 86-year-old woman accidentally hangs herself with medical alert necklace 
 
 CUMBERLAND COUNTY, Pa. – An 86-year-old Cumberland County woman is dead after she trips and is accidentally hanged by her medical alert necklace. It happened on February 15. 
 
 County Coroner Charles Hall says Roseann DiFrancesco was found dead in her bathroom by a visiting nurse who entered the home after getting no response after knocking. 
 
 Hall says DiFrancesco was using her walker when she lost her balance and fell. Her medical alert necklace got caught on the handle of the walker. She was left hanging by the necklace which led to her death. 
 
 Her death has been ruled accidental. 
 
 Medical alert devices are quite common. Most are worn suspended by a necklace. Hall says DiFrancesco’s necklace did not have a break away clasp. ||||| A Pennsylvania couple was jailed Wednesday on charges they strapped a mattress to the top of their 2-year-old son's crib to prevent him from crawling out, causing his suffocation death four months ago. 
 
 Justin J. Dwyer, 29, and Courtney Stash, 28, were arraigned on charges that include involuntary manslaughter and aggravated assault for the April 25 death of their son Eoin. 
 
 Police allege the two used bungee cords and heavy bags of ice melt in an effort to keep Eoin from getting out of his crib, but neither Dwyer nor Stash mentioned the ice melt or straps during initial interviews. 
 
 It was a few days after Eoin's death that Stash's 8-year-old son told detectives of the alleged practice, police said. 
 
 The couple's lawyers did not return messages seeking comment. 
 
 A district judge in Lebanon set bail Wednesday at $250,000 each. 
 
 Police said the Eoin was dead by the time emergency crews arrived at family home in Myerstown, summoned after Stash had found Eoin unresponsive and not breathing in his crib, located in the master bedroom. Myerstown is an agricultural area about 83 miles (133 kilometers) northwest of Philadelphia. 
 
 Stash told investigators she found her son that morning "standing/leaning and slumped over a top railing," and took him to the living room where she performed CPR, according to the arrest affidavit. 
 
 Three days later, Stash's 8-year-old told a detective that for about three weeks Stash and Dwyer had been placing a blue mattress over the top of the crib to keep Eoin from crawling out, police said. The 8-year-old also said that more recently they had begun to place what he called "ice bags" on top of that mattress, along with a red cord with hooks on the ends. 
 
 The 8-year-old said Eoin "was eventually able to push the mattress with the 'ice bags' up, so they started using the rope/bungee cord to secure the mattress to the crib," wrote Lebanon County Detective Todd Hirsch. 
 
 During a search of the home, investigators said, they recovered the blue mattress, two 50-pound bags of ice melt driveway salt and a red bungee cord from the master bedroom. Authorities said wear patterns on the crib were consistent with the use of the bungee cord. 
 
 In a follow-up interview in May, the 8-year-old told police that on the morning Eoin died, and before emergency help arrived, Dwyer and Stash talked about how the mattress had trapped Eoin by the neck. 
 
 The forensic pathologist who performed the autopsy said the cause of death was asphyxia due to "entrapment between crib and overlying twin mattress secured by bungee cording." 
 
 Eoin was one of triplets born on Christmas 2014. His two sisters are living with Dwyer's father, while the 8-year-old and another sibling are living with their biological father, said Lebanon County District Attorney Dave Arnold. 
 
 Arnold said Stash has worked as a nursing assistant, and Dwyer as a farm hand. 
 
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 This story has been corrected to show the couple did not tell police about the crib being covered, their 8-year-old son did. ||||| Breaking News Emails Get breaking news alerts and special reports. The news and stories that matter, delivered weekday mornings. 
 
 / Updated By Maggie Fox 
 
 One woman died after she was left on the floor of her hospital room, overdosed by poorly trained staff. 
 
 Others died in ambulances on long journeys to emergency rooms because local facilities were closed for being such a mess. 
 
 Witness after witness at a Senate hearing Wednesday begged the federal government to properly fund the neglected Indian Health Service, and even government officials in charge of the service said they were struggling to get the resources they need. 
 
 "What we’ve found is simply horrifying and unacceptable. In my view, the information provided to this committee and witness first hand can be summed up in one word: malpractice," Wyoming Republican Senator John Barrasso, who chairs the Senate Committee on Indian Affairs. 
 
 “The Centers for Medicare & Medicaid Services — another agency within the Department of Health and Human Services — has confirmed not only that these same problems continue to fester, but that they pose immediate risk to patient safety,” Barrasso added. 
 
 “In fact, they have led to multiple patient deaths.” 
 
 One of those deaths was Debra Free, who died in the Winnebago Hospital in northeastern Nebraska in 2011. 
 
 “Since at least 2007, this IHS facility has been operating with demonstrated deficiencies which should not exist at any hospital in the United States,” Free’s niece, Victoria Kitcheyan, told the committee. 
 
 “I am talking about a facility which employs emergency room nurses who do not know how to administer such basic drugs as dopamine; employees who did not know how to call a Code Blue." 
 
 “I am not talking about unpainted walls or equipment that is outdated,” Kitcheyan, who is treasurer of the Winnebago Tribe of Nebraska, said. 
 
 “I am talking about a facility which employs emergency room nurses who do not know how to administer such basic drugs as dopamine; employees who did not know how to call a Code Blue; an emergency room where defibrillators could not be found or utilized when a human life was at stake; and a facility which has a track record of sending patients home with aspirin and other over-the-counter drugs, only to have them airlifted out from our Reservation in a life threatening state.” 
 
 Free died at age 45 after suffering a heart attack, her obituary noted. 
 
 “According to what our family learned, Debra [Free] was overmedicated and left unsupervised, even though the nursing staff at the Hospital knew that she was dizzy and hallucinating from the drugs and should be watched closely,” Kitcheyan testified. 
 
 “After her death, a nurse at the hospital told my family that Debra had fallen during the night. She said that that nurses from the emergency room had to be called to the inpatient ward to get Debra back into bed because there was inadequate staff and inadequate equipment on the inpatient floor to address that emergency,” she added. 
 
 “While the hospital insisted that they did everything possible to revive her and save her life, we question just how long she remained on the floor and what actually happened. My Aunt Debra Free left behind a nine-year-old daughter and a loving family. She should not have been allowed to die like this.” 
 
 The U.S. has an agreement dating back to 1787 that requires the federal government to provide American Indians with free health care on reservations. 
 
 But the Indian Health Service only has about half of the money it needs, and poor tribes in some of the most remote areas have underfunded facilities and substandard care, critics say. 
 
 “The administration is responsible for providing and delivering health services to American Indians and Alaska Natives across the country. Their federal obligation mandates that they promote health and safe Indian communities while honoring tribal governance. This is not happening,” Barrasso said. 
 
 Some rich tribes that run casinos supplement their medical care, but tribes in the upper Plains states are in remote areas with little opportunity to generate extra income. 
 
 William Bear Shield, a representative of the Sioux Tribe of South Dakota, said they have organized numerous meetings with the Indian Health Service to try to improve matters. 
 
 "This, to me, is a rationing of health care — care that is guaranteed by treaty." 
 
 “We have been voicing our concerns and demanding to be involved. We have been saying that the current situation was going to occur and wanted to prevent it. We went unheard.” Shield told the hearing. He said the IHS closed a local emergency room because it was run so badly, but did not provide an alternative, and at least one tribe member died of a heart attack in an ambulance en route to a facility 70 miles away. 
 
 “The IHS is severely underfunded compared to other federal agencies,” said former Senator Byron Dorgan, chairman of The Center for Native American Youth at The Aspen Institute. 
 
 “You may have heard the phrase ‘Do not get sick after June,’ because if you do, you will not be able to get care. This, to me, is a rationing of health care — care that is guaranteed by treaty. If we start funding IHS at levels commensurate with need, I believe we will solve a lot of the issues revealed in the 2010 report and the ones occurring elsewhere in this country,” Dorgan added. 
 
 Robert McSwain, principal deputy director for the HIS, says the agency is working to solve the problems but said it’s hard to provide services in rural, isolated communities. It’s also hard to recruit and keep staff to work in these communities. “HIS is addressing issues such as recruitment and retention in innovative ways, such as utilizing tele-medicine, including tele-radiology and tele-behavioral health,” he said. 
 
 Mary Wakefield, acting deputy secretary of the Department of Health and Human Services, admitted the service was struggling. 
 
 “We know that more needs to be done to ensure quality health care is provided by IHS,” Wakefield testified. 
 
 She said Mary Smith, who is an enrolled member of the Cherokee Nation, was now deputy director of the HIS and Dorothy Dupree, a member of the Fort Peck Assiniboine Sioux Tribes, was named deputy director for quality health care.
– In what the Cumberland County, Penn., coroner is calling a "freak accident," an 86-year-old woman was strangled to death by a device that was intended to save her life. Roseann J. DiFrancesco apparently tripped and fell, causing her medical alert necklace to become caught on her walker, the Patriot-News reports. The result, says Coroner Charles Hall, was that her upper torso was suspended above the floor, creating pressure on her neck that cut off air and blood flow. Relatives had last spoken to DiFrancesco on Feb. 12. A visiting nurse found the woman dead in her bathroom Feb. 15, when the nurse entered DiFrancesco's home after unsuccessful attempts to summon her by knocking on the door. It is unclear when DiFrancesco died. Her death was ruled an accident, Fox 43 reports. The device (similar to the ones popularized by "I've fallen and I can't get up" commercials) did not have a breakaway lanyard, as some do, per the Patriot-News. The FDA has warned of potential choking with such devices, which typically include a pendant with a button to call for help, saying the agency is aware of at least six serious injuries or deaths related to their use between 1998 and 2009. "Risks are greater for those with mobility limitations or for those who use wheelchairs, walkers, beds with guard rails, or other objects that could entangle with a neck cord," the FDA says in a press release. DiFrancesco, who was retired, had worked for 25 years for the federal government and 18 years for the state, according to an obituary. (A freak accident claimed the life of a pregnant woman in Oregon this week.)