Apple crippled watchOS to corner heart-tracking market, doctors say

A quartet of heart doctors are trying to resuscitate health-monitoring tech outfit AliveCor's antitrust lawsuit regarding the Apple Watch, by arguing changes made to the iMaker's gadget "resulted in a loss of access to a potentially life-saving product." The physicians argue in their amicus brief [PDF] filed this week with the …

[HuBo]

Lowered expectations

The single point measurement provided by a watch can't produce the EKG-style detailed data needed to correctly identify (and diagnose) arrhythmia. Biomedical engineers will tell you that at least three points are needed for this (Einthoven's triangle for electrocardiography). The watch is likely ok for heart rate and oximetry, but anything beyond that is wishful thinking (and related hallucinations) in my experience. It's not about the OS or an app, but about biology and physics.

[diodesign]

Hmmm...

FWIW to clear up any confusion: AliveCor's Apple smartwatch app used the continuous heart-rate data from the Watch to identify potential signs of danger, and would tell the wearer they should take a test with proper ECG equipment to be sure (for the reasons you give).

And AliveCor primarily sold FDA-approved ECG monitoring devices, including an FDA-approved Watch wristband that did just that. So it's not like AliveCor was trying to do full ECG with just the Watch's built-in senor. Without the continuous feed, it couldn't even properly warn wearers of potential danger, and had to pull its app, hence the antitrust suit, or so it says.

The watchOS changes, as far as AliveCor is concerned, caused the biz to offer less to the market.

C.

[HuBo]

Re: Hmmm...

Thanks for the clear-up (makes better sense to me now)!

[Cliffwilliams44]

Re: Hmmm...

But so what?!

So they sold a product that connected to the iWatch and enhanced heart monitoring. Apple changes they watch making this accessory no longer functional. There is nothing in the anti-trust laws that states this is against the law! All this anti-trust nonsense is getting out of hand. It's apples product, they can do with it as they please. They are under no obligation to make sure that it continues to function with any accessory no matter what it is. If they change the band connector so that all previous bands cannot be used, is that an anti-trust violation?

This is just laziness on the part of business. Don't create a better product, just sue then the company you've been parasiting off of changes something.

[sarusa]

So basically...

'Apple changed their stuff and that killed our product.' Well, that happens all the time, across the industry.

I don't know if they're right about the new stuff being worse, hard to say when they're all in the pocket of the company filing the suit. Even if they're right (could be!), Apple has no requirement to give them exactly what they want to make their product work. Companies make their products crappier all the time - just look at Google Search and Windows 11. And there are plenty of heart monitoring devices out there (including their own), so the monopoly thing doesn't really fly.

[SundogUK]

Re: So basically...

Yeah. If there was a contract between Apple and AliveCor to maintain functionality in the watchOS they would have a point but I cannot see any way Apple is obliged to maintain ALL functionality in an OS for all time because a third party app writer might need it.

[Martin an gof]

Re: So basically...

I would have thought that taking functionality away from third party apps was only anti-competitive if that functionality was still available to Apple apps. The article is mute on that subject - is the original "full feed" still available, but only to Apple's own monitoring app?

M.

[that one in the corner]

Re: So basically...

> is the original "full feed" still available, but only to Apple's own monitoring app?

There is an argument to be made that that is the case: from TFA, that feed is now going into Apple's own processing, that Neural Net, HRNN (and presumably from that into IRN). Those are clearly doing a lot of processing for Apple, in service of its own app, and under Apple's control; anything built on top will just be a variant GUI and underneath will be 99% of "Apple's heart app".

So the Apple app effectively has the full feed, as Apple is the one who can update its app by updating the HRNN. But of course that isn't a monopoly on the data, anyone can get the output from HRNN and - only replicate Apple's app's functionality perfectly.

But many (most? all?) non-trivial apps are shipped as a (pile of) libraries with just a simple exe to glue them together; just documenting the API to a couple of them does not change the fact that they are nothing more than the guts of this specific app from Apple.

But this line of argument is probably going to be contentious in this comment section, good luck getting it past a judge with Apple lawyer's arguing that just having a variant GUI is clearly enough to say you have an app that competes against Apple's.

[Missing Semicolon]

Re: So basically...

Is it not possible that the monopoly argument is that Apple are trying to eliminate competition in the heart monitoring space? This may be an enshittification move - if a company is making money out of an Apple feature, Apple regard that as revenue that Apple should be accruing.

[martinusher]

Its just business

According to my cardiologist a simple, inexpensive tool like a hand held EKG is a cheap and cheerful Go/NoGo tester for abnormal heart conditions. Like other domestic health meters its useful but its not some kind of magic lifesaving devices, just something that will tell you that you need to get checked out. This can save everyone a lot of time and money but its important not to over estimate their usefulness. The problem with health devices is that by and large they're either super-cheap or they have to be upsold as premium devices that give you extra confidence in their readings. This can be both very profitable for the supplier and very misleading for the user.

[Justthefacts]

Re: Its just business

But one exactly *shouldn’t* treat them as a Go/No device. They don’t give you any actionable information. Either you have valid risk-factors, in which case the test should be done properly using an actual ECG, rather than waste your time with that crap. Or, you don’t have valid risk factors, in which case the chance of false positive is extremely high (incorrectly alarming the “worried well”); and the chance of false negative is also extremely high (reassures incorrectly, delaying when you get a warning symptom checked out, then when you finally do “can’t blame the smartwatch, it was obviously very low-level, it’s just one of those things”).

These apps should be banned by regulatory, as fraudulent medical devices. As should all the so-called health apps.

[MadocOwain]

They sued Apple for infringing on patents in v4, then when Apple changed the features in v5, presumably to avoid the infringement, they are suing Apple because they're not using their patented feature any longer and their add-on watch band won't work? Am I parsing this correctly?

[Falmari]

@MadocOwain "Am I parsing this correctly?"

I don't think you are. Because the band worked in the 3 WatchOS before the first of the versions they claim infringe.

AliveCor's add-on KardiaBand added ECG capabilities to Apple WatchOS 1–3. Apple introduced their own heart-monitoring hardware with WatchOS 4 which AliveCor claims infringes their patents in that and all later WatchOS versions. The 2023 ITC case was when WatchOS was at version 8.

AliveCor's antitrust lawsuit the doctors are trying to resuscitate claims that Apple eliminates competing heartrate analysis apps by exploiting its control of the platform. Such as changing app store rules or changing how things work (HRPO to HRNN) to stop apps working.