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An 86-year-old woman is dead after she fell and was strangled to death by her medical alert necklace, according to KTLA sister station WPMT in York, Pennsylvania.

Roseann DiFrancesco of New Cumberland was found dead on Feb. 15, according to Cumberland County Coroner Charles Hall. A visiting nurse entered the home after knocking and getting no response.

Hall says DiFrancesco was using her walker when she lost her balance and fell. The woman’s medical alert necklace got caught on the handle of the walker, strangling her to death.

The coroner called the death a “freak accident,” PennLive.com reported.

Hall says DiFrancesco’s necklace did not have a breakaway clasp.

Her death has been ruled accidental.

The U.S. Food and Drug Administration issued a warning about such medical alert devices in 2009, according to PennLive.

Personal emergency response buttons worn around the neck can pose a choking hazard if they do not break away, the FDA said. Patients should check with their doctors about which kind of device to use, including the possibility of one worn on the wrist, the agency said.

The FDA said six serious injuries or deaths had been attributed to the Philips Lifeline Personal Help Button between 1998 and 2009.

“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,” the FDA stated. “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.”