A Class Action against Apple claims that the Apple Watch Blood Oxygen app incorporates biases & defects against persons of darker skin
Alex Morales has begun a class action against Apple in the Southern District of New York claiming that the Apple Watch incorporates biases and defects of pulse oximetry with respect to persons of darker skin tones.
The complaint before the court reads in-part: " Apple, Inc. (“Defendant”) manufactures, markets, and sells the Apple Watch, purporting to measure the oxygen level of a wearer’s blood directly from their wrist (“Product”).
The interest in blood oxygen levels extends began at least two hundred years ago hot air balloon flyers and mountain climbers needed to ensure survival.
Later, these groups included astronauts, pilots and divers.
The early devices, were used in a person’s ear, used light-based technology or spectrophotometry to measure oxygen levels.
In the 1970s, a fingertip oximeter was invented that was easier to use than its predecessors.
For decades, there have been reports that such devices were significantly less accurate in measuring blood oxygen levels based on skin color.
The “real world significance” of this bias lay unaddressed until the middle of the Coronavirus pandemic, which converged with a greater awareness of structural racism which exists in many aspects of society.
Researchers confirmed the clinical significance of racial bias of pulse oximetry using records of patients taken during and before the pandemic.
The conclusion was that “reliance on pulse oximetry to triage patients and adjust supplemental oxygen levels may place Black patients at increased risk for hypoxemia.”
Since health care recommendations are based on readings of their blood oxygen levels, white patients are more able to obtain care than those with darker skin when faced with equally low blood oxygenation.
While traditional fingertip pulse oximeters are capable of measuring blood oxygen levels and heart rate, wrist-worn devices like the Product determine heart rate, as blood oxygen measurements from the wrist are believed inaccurate.
Algorithms designed for fingertip sensing are inappropriate when based on wrist measurements, and can lead to over 90% of readings being unusable.
Though one recent study concluded the Product was able to detect reduced blood oxygen saturation in comparison to medical-grade pulse oximeters this fails to recognize the failings of pulse oximetry in general with respect to persons of color.
As a result of the false and misleading representations, the Product is sold at a premium price, approximately no less than $400, excluding tax and sales.
The Product was manufactured, identified, marketed, and sold by Defendant and expressly and impliedly warranted to Plaintiff that it did not incorporate biases and defects of pulse oximetry with respect to persons of darker skin tone.
For more details, read Apple's full complaint filed with the court in the full SCRIBD document below, courteous of Patently Apple.
Alex Morales v Apple by Jack Purcher on Scribd
For interest sake, a study published in October 2022 concluded that "Apple Watch Series 6 can reliably detect states of reduced blood oxygen saturation with SpO2 below 90% when compared to a medical-grade pulse oximeter. The technology used in this smartwatch is sufficiently advanced for the indicative measurement of SpO2 outside the clinic."
Whether Apple specifically tested their blood oxygen app for people of color, especially darker tones of skin, is unknown at this time.