Apple Watch sensor has racial bias, claims new lawsuit

Posted:
in General Discussion edited December 2022
A new class action lawsuit against Apple alleges that the Apple Watch blood oxygen sensor is racially biased against people with dark skin tones.

Blood oxygen sensor
Blood oxygen sensor


Plaintiff Alex Morales says he purchased an Apple Watch between 2020 and 2021. He says that he was aware that the device has pulse oximetry features, and believed it did this without regard to skin tone.

"For decades, there have been reports that such devices were significantly less accurate in measuring blood oxygen levels based on skin color," the lawsuit alleges. "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."

The lawsuit also claims that researchers "confirmed the clinical significance of racial bias of pulse oximetry using records of patients taken during and before the pandemic."

As a result, "reliance on pulse oximetry to triage patients and adjust supplemental oxygen levels may place Black patients at increased risk for hypoxemia."

Morales filed the lawsuit on December 24 on behalf of all New York consumers who bought an Apple Watch during the statutes of limitations. He also sued on behalf of residents in Alaska, Arkansas, Idaho, Iowa, Mississippi, North Carolina, North Dakota, Utah, and Wyoming under those states' consumer fraud laws.

The lawsuit also accuses Apple of breaches of express warranty, fraud, and unjust enrichment, claiming violations of New York General Business Law and State Consumer Fraud Acts.

Apple Watch skin awareness

Apple has not commented on the lawsuit, however in October 2022 it published a white paper that included details about skin tone and the bloody oxygen app. The paper also specifies that the company had tested the app on "many hundreds of participants... [ranging] from ages 19 to 40... split evenly by biological sex, and covering a wide range of skin tones."

"Subject pools included a wide range of skin types and tones to ensure that the sensor platform can accommodate the full range of users and maintain accuracy," says the white paper. "At the wavelengths that Apple Watch uses, melanin is a strong light absorber -- particularly in the green and red part of the spectrum -- potentially making PPG measurements more difficult in users with darker skin tones."

"To account for this," it continues, "the Apple Watch sensing platform senses the amount of detected light signals, and it automatically adjusts the LED current (and hence the light output), photodiode gain (sensitivity to light), and sampling rate to ensure adequate signal resolution across the range of human skin tones."

Previous issues

The 2022 lawsuit isn't the only complaint the Apple Watch has faced with regard to skin. Back in 2015, users complained that black wrist tattoos interfered with the device's heart sensor.

Apple confirmed the issue in May 2015. "Permanent or temporary changes to your skin, such as some tattoos, can also impact heart rate sensor performance, read an updated support page. "The ink, pattern, and saturation of some tattoos can block light from the sensor, making it difficult to get reliable readings."

Those issues happened before the addition of the blood oxygen sensor, which Apple added to the product line with the Apple Watch Series 6 in 2020.

Apple Sued Over Racial Bias in Heart Rate Monitoring by Mike Wuerthele on Scribd

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Updated December 29, 2022, 11:40 ET added additional context.

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Comments

  • Reply 1 of 59
    MacProMacPro Posts: 19,776member
    I can't see what Apple could do?  If they improved the sensitivity wouldn't that just make measurements better for light skins too, thus maintaining the differential?  It's physics not bias. 
    Alreschastarof80llamawatto_cobraqwerty52elijahgcoolfactoriOS_Guy80pulseimagesradarthekat
  • Reply 2 of 59
    maestro64maestro64 Posts: 5,043member
    This lawsuit isn’t about what Apple did it was about what happen in NYC and how people of color were treated during Covid. As it was stated O2 skin sensor are less accurate or completely wrong the darker the skin becomes. If medical professionals did not know this that is their fault not the device you have to know the limitations of your tools. But I’m this country you can sue for any reason.
    starof80llamawatto_cobraqwerty52elijahgiOS_Guy80ravnorodomtwokatmewanantksundaram
  • Reply 3 of 59
    Seriously?
    edited December 2022 llamawatto_cobraqwerty52dewmebaconstang
  • Reply 4 of 59
    zimmiezimmie Posts: 651member
    MacPro said:
    I can't see what Apple could do?  If they improved the sensitivity wouldn't that just make measurements better for light skins too, thus maintaining the differential?  It's physics not bias. 
    Not necessarily. All pulse oximeters use a measurement correction curve to convert from the amount of reflected light to an oxygenation percentage. That curve needs to change based on skin tone and possibly other characteristics we don’t even know about today (since only recently did a million people start carrying an oximeter around with them everywhere). Correcting the curve for darker skin would make readings for lighter skin less accurate, so it would need to be adjustable.
    watto_cobrafreeassociate2anonymousemainyehcravnorodomtwokatmewlogic2.6
  • Reply 5 of 59
    Welcome to America! Where you can be sued for farting in public..
    9secondkox2coolfactorravnorodom
  • Reply 6 of 59
  • Reply 7 of 59
    Tech limitations aren’t inherent racial bias. Some hot takes on these things are unbelievable. 

    Feels like the country has regressed in terms of everything on earth getting turned into victimization, outrage, and excuses for bad behavior - and apparently, frivolous lawsuits. 

    This is a known tech limitation. That’s it. 

    Can’t wait to see the heart attack and stroke lawsuits once Apple finally figured out blood pressure monitoring in a watch. 
    edited December 2022 elijahgdutchlordcoolfactorentropysSylasbeowulfschmidt
  • Reply 8 of 59
    zimmie said:
    MacPro said:
    I can't see what Apple could do?  If they improved the sensitivity wouldn't that just make measurements better for light skins too, thus maintaining the differential?  It's physics not bias. 
    Not necessarily. All pulse oximeters use a measurement correction curve to convert from the amount of reflected light to an oxygenation percentage. That curve needs to change based on skin tone and possibly other characteristics we don’t even know about today (since only recently did a million people start carrying an oximeter around with them everywhere). Correcting the curve for darker skin would make readings for lighter skin less accurate, so it would need to be adjustable.
    There should be a calibration setting. 
    WhiskeyAPPLEciderchiaravnorodomgatorguy
  • Reply 9 of 59
    MacPro said:
    I can't see what Apple could do?  If they improved the sensitivity wouldn't that just make measurements better for light skins too, thus maintaining the differential?  It's physics not bias. 
    I don’t know what wavelength of light they use for these but there probably is a range in the non visible spectrum that could be used where skin tone would be irrelevant.
  • Reply 10 of 59
    XedXed Posts: 2,676member
    It's a technological issue, not a racial bias. "It's been known for decades that skin pigmentation and melanin can affect a pulse oximeter's ability to accurately measure oxygen saturation."

    That quoted text isn't from me and this isn't only an issue with Apple's sensor tech, but every IR-based 
    pulse oximeter technology.

    https://hms.harvard.edu/news/skin-tone-pulse-oximetry

    While I hope we find a solution works the same regardless of pigmentation (which can be tattoos) or melanin having a frivolous lawsuit that doesn't care about the longstanding issues with the technology doesn't help that.
    coolfactorradarthekat
  • Reply 11 of 59
    I will sue Apple, because I am not able to fly as a bird, when having my Apple Watch on my wrist.
  • Reply 12 of 59
    lkrupplkrupp Posts: 10,557member
    What if the technology just isn’t capable? People with tattoos on their arms/wrists are bitching about this too. How long till they sue?
    edited December 2022 9secondkox2coolfactorexgeniustrainerradarthekatalgrdewme
  • Reply 13 of 59
    MacPro said:
    I can't see what Apple could do?  If they improved the sensitivity wouldn't that just make measurements better for light skins too, thus maintaining the differential?  It's physics not bias. 
    I don’t know what wavelength of light they use for these but there probably is a range in the non visible spectrum that could be used where skin tone would be irrelevant.
    Pulse oximetry depends on the differential absorbance of 2 (or more) different frequencies of IR light in the blood, specifically the oxygenated and deoxygenated haemoglobin. You can pick 2 IR wavelengths where the absorbance curves of oxi and de-oxi cross each other (typically pick one <700nm and one >800nm. Acquire relative intensity (changes in time) of both these wavelengths and you can fit them to a curve using something called the modified Beer-Lambert law to get an estimated change in blood oxygenation. You have to pick wavelengths that are on the right spots on the curve as well as what wavelengths of LED are actually available and affordable (only a new nm difference can mean a $1 LED or a $100LED due to the material in the LED that emits the light). This is not an easy problem to solve, other than blasting more light in, but you then run into concerns over heating the skin (absorbing IR light means conversion into heat) as well as power consumption and safety (too intense and you run the risk of eye damage if some fool stares into the back of the watch with the LEDs on. Not an easy fix.
    anonymouseradarthekatravnorodomh4y3sbeowulfschmidtMacocalypse
  • Reply 14 of 59
    hexclockhexclock Posts: 1,272member
    Just more race hustling. What a joke. This case should be tossed with prejudice. 
    radarthekat9secondkox2OliveTheDogbaconstang
  • Reply 15 of 59
    Craziness to the next level. 
    coolfactorradarthekat9secondkox2ravnorodom
  • Reply 16 of 59
    cpsrocpsro Posts: 3,212member
    Physics is racially biased. I suggest the Watch be returned for a refund and another one not purchased until physical reality changes its tune.
    edited December 2022 radarthekat9secondkox2
  • Reply 17 of 59
    dutchlord said:
    Craziness to the next level. 

    Yup, we live in a crazy world of victimization, to the next level. Can't help but think they are just trying to be opportunistic by filing a lawsuit against a company that is bound by the limits of PHYSICS!
    radarthekat9secondkox2entropysalgrdutchlord
  • Reply 18 of 59
    XedXed Posts: 2,676member
    dutchlord said:
    Craziness to the next level. 

    Yup, we live in a crazy world of victimization, to the next level. Can't help but think they are just trying to be opportunistic by filing a lawsuit against a company that is bound by the limits of PHYSICS!
    While this is unfortunately directed at Apple there is a longstanding bias in the regulations themselves as they do not require diversity in medical device evaluation. This means that a company can choose subjects for medical testing that will tilt the numbers to favor a better result. If anything the regulations need to be changed to allow for a more complete and accurate testing for a population.

    https://fas.org/blogs/sciencepolicy/an-overdue-fix-racial-bias-and-pulse-oximeters/

    This isn't a new issue, either. This has been around as long as the Apple Watch (in regards to Apple) and since this tech first came about since the 1980s.

    https://thegrio.com/2015/05/01/apple-watch-dark-skin/
    ronn9secondkox2MplsPmuthuk_vanalingamlogic2.6
  • Reply 19 of 59
    MacProMacPro Posts: 19,776member
    zimmie said:
    MacPro said:
    I can't see what Apple could do?  If they improved the sensitivity wouldn't that just make measurements better for light skins too, thus maintaining the differential?  It's physics not bias. 
    Not necessarily. All pulse oximeters use a measurement correction curve to convert from the amount of reflected light to an oxygenation percentage. That curve needs to change based on skin tone and possibly other characteristics we don’t even know about today (since only recently did a million people start carrying an oximeter around with them everywhere). Correcting the curve for darker skin would make readings for lighter skin less accurate, so it would need to be adjustable.
    That sounds not only doable, but automatable.
  • Reply 20 of 59
    Welp, looks like the racists (”it doesn't effect me so it can’t be racism”) are out in force.

    They key here is that even though the limits of oximeters are known, Apple went ahead and introduced the feature regardless of how it would impact users’ experience. No disclaimers. No apparent skin tone detection. No on Watch warning or dialogue allowing you to adjust for skin tone. And do on. It’s marketed, engineered, and now defended as working for the default skin color assumption... i.e light-skinned people. It’s not a leap to assume that has there been more people with darker skin tones involved in the decision making, this would have been flagged as a bug or a non-starter. So yes, this is the sort of structural or chain of casual racism that you can encounter.

    The separate case regarding medical treatment outcomes will likely be the more serious and far-reaching. The medical industry has a history of these types of errors in judgment. We’ll have to wait and see how well the device makers trained people, what disclaimers are in training literature, research papers and the like, as well as how well hospitals and other organizations trained their staffs.

    I’ll remind everyone that if the shoe were on the other foot, and light skinned people’s lives had been endangered by a fault in the device or training, this would be a major shitfest in general, in the news cycle for weeks, and likely the target of very public and swift government reaction.

    Also, anyone trotting out “frivolous lawsuit” — have a care. That term has been weaponized to question the legitimacy of valid the legal rights of black and brown Americans for decades. Do some research before you use that as a point of argument.

    There’s also a bunch of folks that mixing up the two cases. The case for medical treatment is being referred to as supporting evidence that Apple management and engineers should or would have known about the technology’s limitations as currently designed.

    For anyone interested in well researched institutional racism, how casually it’s applied, and what cumulative effect it continues to have on generations of Americans, I highly recommend The Color of Law by Richard Rothstein. It’s an excellent example of legal and historical analysis being applied to understand American legal history, and how it’s been used to create and defend racial hierarchies.

    Please think twice before responding to me in anything less than a civil and respectful way. If all you’re going to do is trot out manufactured talking points and threats to society, don’t bother. You’ve had quite enough air-time already. I won’t engage trolls.

    For anyone with a good-faith question or argument, I’ll do my best to respond, given my limited time and energy. (And also limited patience. Educate yourselves, people. If it were an engineering issue, you’d go look up info in technical and science resources — not Faux News and it’s ilk. Do the same here. Read a book, even if you disagree with it. Or ask me for a link or several.)
    ronnanonymousebageljoeyiOS_Guy80chia9secondkox2muthuk_vanalingamlogic2.6beowulfschmidt
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