Apple Watch racial bias lawsuit dismissed with prejudice

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in Apple Watch

An attempted class-action lawsuit claiming the Apple Watch blood oxygen sensor is racially biased against dark skin tones was dismissed with prejudice on Monday.




In December 2022, a proposed class action lawsuit was filed by Alex Morales after buying an Apple Watch, one that made claims that the device was "less accurate in measuring blood oxygen levels based on skin color," and that therefore there was a "racial bias."

On Monday, U.S. District Judge Jed Rakoff in Manhattan dismissed the class action with prejudice, reports Reuters, which effectively means the lawsuit cannot be attempted again. Reasoning for the dismissal will be issued by the court by August 31.

The original lawsuit leaned on the decades of reports that blood oxygen sensors like those employed by the Apple Watch were sensitive to skin tones. The suit also pointed to claims by researchers that "confirmed the clinical significance of racial bias of pulse oximetry using records of patients taken during and before the pandemic."

It was therefore reasoned in the suit that "reliance on pulse oximetry to triage patients and adjust supplemental oxygen levels may place Black patients at increased risk for hypoxemia."

In an amendment filed in May, the suit added citations for reports of similar pulse oximetry devices over the last few decades, which said the sensors were "significantly less accurate" for measuring non-white people's pulses.

Morales added that the impact of the bias wasn't addressed until the "greater awareness of structural racism" in society was raised during the pandemic.

The suit also made accusations of breaches of express warranty, fraud, and unjust enrichment, claiming violations of New York General Business Law and State Consumer Fraud Acts.

Apple argued that Morales didn't make allegations supporting the fraud claim, nor did he demonstrate that he was exposed to misleading information before his Apple Watch purchase.

Apple is well aware of complaints relating to the Apple Watch's heart sensor performance when it comes to pigments in the skin, confirming it to be a problem in May 2015 for people who got black wrist tattoos.

Read on AppleInsider

Comments

  • Reply 1 of 15
    I wouldn’t rely on the Apple Watch if you have a condition that needs oxygen monitoring. You’re better off buying a portable pulse oximeter and going to your doctor’s office and comparing its accuracy to your doctors WIRED meter that connects to a portable unit the nurses use. 
    Some offices use the same battery operated ones that can be inaccurate. 
    This along with blood sugar are readings you can’t get wrong because the consequences can be fatal. 
    mayfly
  • Reply 2 of 15
    mayflymayfly Posts: 385member
    I wouldn’t rely on the Apple Watch if you have a condition that needs oxygen monitoring. You’re better off buying a portable pulse oximeter and going to your doctor’s office and comparing its accuracy to your doctors WIRED meter that connects to a portable unit the nurses use. 
    Some offices use the same battery operated ones that can be inaccurate. 
    This along with blood sugar are readings you can’t get wrong because the consequences can be fatal. 
    I'd certainly rely on it. Of course if you get an alert that your O2 is low, see a doctor. But I've tested the watch against those things they put on my finger every time I go to a doctor's office. It's always within 1%, usually dead on. Even at my pulmonologist's office. That's accurate enough to feel confident that I'll get an alerrt if it drops too low. And face it, no one is going to walk around with a pulse oximeter on their finger all the time.
    bonobobSpitbathwatto_cobraJinTechBart Y
  • Reply 3 of 15
    igorskyigorsky Posts: 757member
    I wouldn’t rely on the Apple Watch if you have a condition that needs oxygen monitoring. You’re better off buying a portable pulse oximeter and going to your doctor’s office and comparing its accuracy to your doctors WIRED meter that connects to a portable unit the nurses use. 
    Some offices use the same battery operated ones that can be inaccurate. 
    This along with blood sugar are readings you can’t get wrong because the consequences can be fatal. 
    You’re more comfortable using a $10 pulse oximeter from Amazon that was probably made in the same factory that makes 1,000 other unrelated products?  Good luck to you. 
    Spitbathwatto_cobraJinTechBart Y
  • Reply 4 of 15
    rob53rob53 Posts: 3,253member
    If I remember correctly, trying to use a pulse oximeter on people with tattoos on their fingers or wrist also gave wrong readings. These devices use light so anything restricting the light will cause potentially wrong readings. I could see people with very fair skin also getting higher readings than “average” pigmented skin. Calling it a racial bias is incorrect since African Americans have skin pigmentation from very light to very dark. If they wan to use pigmentation color that’s fine. Maybe Apple could find a way to measure skin pigmentation and adjust either the intensity of the Watch light or the results to come up with a cluster result but I doubt the units hospitals and doctors offices have this capability. They’re looking for a range not a specific value.  

    Don’t know what’s going on today but I just got a reading of 100%. I’m usually in the high 90’s. I have gotten my summer tan so maybe that makes a difference. 
    watto_cobra
  • Reply 5 of 15
    igorsky said:
    I wouldn’t rely on the Apple Watch if you have a condition that needs oxygen monitoring. You’re better off buying a portable pulse oximeter and going to your doctor’s office and comparing its accuracy to your doctors WIRED meter that connects to a portable unit the nurses use. 
    Some offices use the same battery operated ones that can be inaccurate. 
    This along with blood sugar are readings you can’t get wrong because the consequences can be fatal. 
    You’re more comfortable using a $10 pulse oximeter from Amazon that was probably made in the same factory that makes 1,000 other unrelated products?  Good luck to you. 
    Versus the $10 pulse oximeter that gets put into an over priced watch?
    williamlondon
  • Reply 6 of 15
    kmkmdkmkmd Posts: 2member
    You’re more comfortable using a $10 pulse oximeter from Amazon that was probably made in the same factory that makes 1,000 other unrelated products?  Good luck to you. 
    I don't know much about the specific allegations surrounding the watch and the suit. However, finger pulse oximeters sample the blood through the fingernail and underlying skin -- which is pigment free (unless you use fingernail polish). Therefore, fingertip pulse oximeters are not influenced by skin pigmentation.

    ronnbonobobwilliamhwatto_cobra
  • Reply 7 of 15
    This lawsuit is called false duality.
    Calvin_Hobbes
  • Reply 8 of 15
    rob53 said:
    If I remember correctly, trying to use a pulse oximeter on people with tattoos on their fingers or wrist also gave wrong readings. These devices use light so anything restricting the light will cause potentially wrong readings. I could see people with very fair skin also getting higher readings than “average” pigmented skin. Calling it a racial bias is incorrect since African Americans have skin pigmentation from very light to very dark. If they wan to use pigmentation color that’s fine. Maybe Apple could find a way to measure skin pigmentation and adjust either the intensity of the Watch light or the results to come up with a cluster result but I doubt the units hospitals and doctors offices have this capability. They’re looking for a range not a specific value.  

    Don’t know what’s going on today but I just got a reading of 100%. I’m usually in the high 90’s. I have gotten my summer tan so maybe that makes a difference. 
    After wearing Apple Watch for many months, the skin that the watch covers is less dark. How will Apple adjust for this? 
  • Reply 9 of 15
    JinTechJinTech Posts: 1,024member
    igorsky said:
    I wouldn’t rely on the Apple Watch if you have a condition that needs oxygen monitoring. You’re better off buying a portable pulse oximeter and going to your doctor’s office and comparing its accuracy to your doctors WIRED meter that connects to a portable unit the nurses use. 
    Some offices use the same battery operated ones that can be inaccurate. 
    This along with blood sugar are readings you can’t get wrong because the consequences can be fatal. 
    You’re more comfortable using a $10 pulse oximeter from Amazon that was probably made in the same factory that makes 1,000 other unrelated products?  Good luck to you. 
    Versus the $10 pulse oximeter that gets put into an over priced watch?
    The difference is, Apple buys them in quantities of millions so they are able to get them for $10. I am pretty sure they are quality sensors. Apple is not going to put garbage in its products.
    Bart Yronn
  • Reply 10 of 15
    davidwdavidw Posts: 2,053member
    kmkmd said:
    You’re more comfortable using a $10 pulse oximeter from Amazon that was probably made in the same factory that makes 1,000 other unrelated products?  Good luck to you. 
    I don't know much about the specific allegations surrounding the watch and the suit. However, finger pulse oximeters sample the blood through the fingernail and underlying skin -- which is pigment free (unless you use fingernail polish). Therefore, fingertip pulse oximeters are not influenced by skin pigmentation.


    That is false. It's been known since the development of the pulse oximeters (over twenty years ago) that their accuracy of are affected by a persons skin pigmentation. Even the clinical ones used by doctors.




    ronnmuthuk_vanalingamMplsP
  • Reply 11 of 15
    AppleZuluAppleZulu Posts: 2,011member
    rob53 said:
    If I remember correctly, trying to use a pulse oximeter on people with tattoos on their fingers or wrist also gave wrong readings. These devices use light so anything restricting the light will cause potentially wrong readings. I could see people with very fair skin also getting higher readings than “average” pigmented skin. Calling it a racial bias is incorrect since African Americans have skin pigmentation from very light to very dark. If they wan to use pigmentation color that’s fine. Maybe Apple could find a way to measure skin pigmentation and adjust either the intensity of the Watch light or the results to come up with a cluster result but I doubt the units hospitals and doctors offices have this capability. They’re looking for a range not a specific value.  

    Don’t know what’s going on today but I just got a reading of 100%. I’m usually in the high 90’s. I have gotten my summer tan so maybe that makes a difference. 
    Tattoos and natural melanin skin pigmentation are not the same thing.

    The article says the reason the suit was dismissed is not yet available. The rest of the article paints a picture of a suit filed on the basis of other pulse oximeter devices, rather than specifically the performance of the Apple Watch. One might imagine this would significantly weaken any claims, if it's not the primary reason for the dismissal. Seems a bit much to sue a company based on the performance of other companies' devices.
  • Reply 12 of 15
    payecopayeco Posts: 581member
    Why wife’s cousin (cousin-in-law?) is pale as a ghost but he has full sleeve tattoos and none of the sensors on the watch work for him. 
  • Reply 13 of 15
    MplsPMplsP Posts: 3,931member
    davidw said:
    kmkmd said:
    You’re more comfortable using a $10 pulse oximeter from Amazon that was probably made in the same factory that makes 1,000 other unrelated products?  Good luck to you. 
    I don't know much about the specific allegations surrounding the watch and the suit. However, finger pulse oximeters sample the blood through the fingernail and underlying skin -- which is pigment free (unless you use fingernail polish). Therefore, fingertip pulse oximeters are not influenced by skin pigmentation.


    That is false. It's been known since the development of the pulse oximeters (over twenty years ago) that their accuracy of are affected by a persons skin pigmentation. Even the clinical ones used by doctors.




    exactly - the Apple Watch uses the same basic technology and suffers the same limitations.
  • Reply 14 of 15
    AppleZuluAppleZulu Posts: 2,011member
    payeco said:
    Why wife’s cousin (cousin-in-law?) is pale as a ghost but he has full sleeve tattoos and none of the sensors on the watch work for him. 
    That’s what happens when you decide to allow someone to use a needle to permanently insert opaque material into your skin. 
  • Reply 15 of 15
    The average Joe has no idea what the values mean or how they relate to underlying oxygenation anyway. Watch based pulse oximetry was never designed to monitor health conditions and this is the problem with giving the general public a device that needs a good understanding of pathophysiology and the limitations of the device in order to utilise correctly. Have a quick read of the discussion around the Oxyhaemaglobin Dissociation Curve. This doesn't even touch the surface of the knowledge required to operate and interpret the results from a pulse oximeter accurately - https://en.wikipedia.org/wiki/Oxygen%E2%80%93hemoglobin_dissociation_curve

    I've had robust discussions online with people arguing that a Garmin Fenix is inaccurate because it was reading 96% (it's either wrong or I have an illness), well that depends, but it's well within normal ranges. I get to play with some pretty fancy, expensive and calibrated pulse oximeters and my Garmin matched those devices at a single point in time under ideal conditions.

    Would I use a Watch Pulse-Oximeter to look for illness? NOPE.
    Would I use a cheap pulse oximeter from the pharmacy? NOPE! These are also not calibrated and have much worse resolution than FDA (or equivalent) certified/ calibrated devices. The medical world uses Masimo Pulse Oximetry for a reason....both of the below devices - the Corpuls 3 and the Lifepak 15 also use Masimo plus oximetery, and the vast majority of other medical grade combined-divices use Masimo as the provider for pulse oximetry.

    Masimo have their Rainbow SET technology which is significantly better than competing technology on pigmented skin, low oxygen states, low blood perfusion states, critically unwell patients, those with high or low heart rates, dysrhythmias, low temperatures etc, etc. The difference is, their fingertip version similar to what you can buy in the pharmacy is approx $600. Just because they look the same, doesn't mean they work the same or output quality data.

    "But my $10 fingertip pulse oximeter works just fine" - Much like a broken clock can be right twice a day. The average Joe has no idea if the reading is right or not...just that they like what it says, or they don't. We live in an interesting world where people think their feelings override quantifiable data.

    Studies: https://www.masimo.com/evidence/pulse-oximetry/set/




    Seeing as though we're discussing the Apple Watch specifically, a simple google search can answer the question: https://www.apple.com/healthcare/docs/site/Blood_Oxygen_app_on_Apple_Watch_October_2022.pdf




    edited August 2023
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