Fall. 'Pop.' Air bag. A Montco start-up is out to prevent hip fractures with a high-tech belt

Zane McKinney's business card says he's a product specialist. It should also say "stuntman."

He's taken 30 to 40 falls so far for the Montgomery County start-up ActiveProtective Technologies Inc. They were hard falls, intended to deploy an air bag contained in the 2½-inch-high belt McKinney wore, the contoured cushion designed to prevent serious injury to his hips once inflated.

For people way older than McKinney, who is 33, success can mean the difference between life and death.

"Our vision as a company is to make hip fractures a preventable condition because it's the most devastating injury," said Drew Lakatos, ActiveProtective's cofounder and chief executive. He cited a 25 percent mortality rate for elderly fall victims within one year of a hip fracture, usually from complications from immobility, such as pneumonia. "We're protecting your hip because breaking the hip kills you."

Since its founding in late 2012, ActiveProtective has raised $10.6 million for research and development, secured several patents, and launched two pilot programs: at a senior-care facility in Northern California and with one of the largest U.S. post-acute-care providers, Genesis HealthCare, based in Kennett Square.

The belt is equipped with WiFi and Bluetooth to relay fall alerts to caregivers by text or email, and contains motion-sensing technology to assess when a serious hip-impacting fall is imminent so that the air bag is deployed in time — less than 0.3 seconds from the start of a fall. It is expected to be on the market for use in supervised-care communities later this year, and in private homes after that.

Pricing is pending results of a market-research study. U.S. market potential for such fall protection is $7 billion, Lakatos said. Air-bag belts are in development throughout the world, primarily by Hip-Hope Technologies of Israel, Helite of France, and Wolk Co. of the Netherlands.

"The dawn of wearable air bags is upon us," Lakatos said during a recent demonstration at ActiveProtective's headquarters in Fort Washington.

McKinney rose from a chair with the aid of a cane, turned, and dropped to the carpet, taking a direct hit to his right hip. Before his 5-foot-6, 140-pound frame landed, the quiet was broken by a sound resembling a balloon popping. Then an automotive-grade air bag made of showerproof fabric burst from his belt. The 2-inch-thick air bag expanded to the shape of a baseball mitt over each hip, with a piece across McKinney's lower back that resembled a fanny pack.

Physically fit and wearing padding on his arms, McKinney came through uninjured. ActiveProtective is not guaranteeing that its belt users will endure a fall completely unscathed. For instance, the air bags can't prevent whiplash or a broken elbow, Lakatos said — emphasizing that the priority at this, his third start-up, is to prevent an often life-threatening injury.

Inspiration first came at a 2006 Christmas party at St. Mary Medical Center in Langhorne, where Lakatos' wife, a trauma physician assistant, was on call and had to respond to the emergency department for an 80-year-old woman who had fallen down stairs at home, hit her head, and broke a hip. The patient did not survive. Later at the party, Lakatos said he was told by Dr. Robert Buckman, a trauma surgeon, an ActiveProtective cofounder and inventor of its smart belt technology, that many of his cases were elderly men and women dying from falls.

That, and Lakatos' grandfather, Andy, who was showing signs of imbalance, planted a seed in the serial entrepreneur's problem-solving mind.

Six years later, the technology Lakatos had in mind was mature enough that he quit a corporate job to devote himself full time to fund-raising for ActiveProtective. By January 2014, funding amounted to $600,000. In 2015, a TED talk helped raise an additional $2.4 million, followed by $2.6 million in 2016, and $5 million more in 2017.

By then, product development and pilots were underway. And Lakatos' grandfather had died.

"He got up from the breakfast table, kind of stumbled backward, fell, broke his hip, and he died 11 days later," said Lakatos, 47, of Allentown. "When I started this company, he said he needed a device, and when he was dying in the hospital he said: 'Get this done. My friends need this thing.' "

About three months later, an ActiveProtective board member's father died after fracturing his hip in a hospital fall.

"The stats around the outcomes of a hip fracture in an older adult are bleak, at best, and they haven't changed in the last three-plus decades," said Wamis Singhatat, vice president of product development at the company of eight employees.

Research is plentiful about the effectiveness of cushioning the hip, which is why padded shorts have been on the market as a protection against hip fractures for about 20 years, Lakatos said.

"They're incredibly effective. The problem is no one wants to wear them because you're asking folks that have trouble putting on their socks to now put on a compression garment and then sit on big heavy plastic pads," he said. "Caregivers simply can't support them. If someone needs to go to the bathroom 15 times a day and they need help each time to do it, it's just really a solution that doesn't work."

ActiveProtective's objective was to come up with protection people would actually wear. Technology was key.

Weighing just two pounds, the belt contains computer processors, WiFi and Bluetooth antennas, a variety of sensors, and a rechargeable battery, along with an air bag and a cold-gas inflator (vs. the heat-induced explosion used in automobile air bags). Motion sensors provide insight into how the belt's wearer is walking and if the steps being taken are indicating an imminent fall. The data feed a patented algorithm developed over years that is able to distinguish between a serious hip-impact fall and, say, a collapse into a couch that would not require air-bag protection.

To open and close the plastic buckle requires just a 45-degree twist, modeled on the weak "crab claw grip" of an 85-year-old woman with severe arthritis.

The pilot programs have revealed an unanticipated benefit of the belt: confidence-building.

Fear of falling "can be debilitating and can result in less mobility, less walking, less strength, which all increase both the risk of falls and risk of injury with a fall," Jeanine Maguire wrote in an email. Trained as a physical therapist, she is also senior director of clinical operations, skin integrity, and wound management for Genesis, which has about 25 patients or residents participating in an ActiveProtective trial, Maguire said. One belt has deployed with no injury, she said.

While the belt could be more "fashionable," Maguire marveled at "the complexity of a technology that can deploy so fast for a specific type of movement. It's amazing."

Yet, she cautioned against placing too much faith in it.

"It is important to keep in mind that there is no one solution or quick fix to prevent falls and falls with injury," Maguire said.