Lawsuit Says Apple’s ‘Complete Control’ Over Apple Watch Heart Monitoring Is ‘Putting Users’ Lives in Danger’

Apple Watch Series 4 Heart ECG App Credit: Fabio Mota / Shutterstock
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A U.S. federal judge has ruled that Apple will have to face a claim that its alleged illegal monopoly on heart rate monitoring apps for the Apple Watch put the lives of users of third-party apps in danger.

In May 2021, an antitrust lawsuit was filed against Apple by AliveCor, the company behind KardiaBand. In its complaint, AliveCor maintained that Apple had not only harmed its business but also negatively impacted its customers by making deliberate changes in watchOS as “behind-the-scenes acts of sabotage” to specifically render its SmartRhythm app inoperable.

AliveCor’s KardiaBand was the first Apple Watch accessory to be cleared by the FDA, providing a way for Apple Watch users to take ECG readings nearly a year before Apple added a similar feature to the Apple Watch Series 4.

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Before that, AliveCor claims, the Apple Watch was nothing more than “a high-tech fashion accessory,” that Apple viewed “primarily as a way for luxury and high-end watch purchasers to dress up their wrist with an extension of their smartphone.”

In its complaint, AliveCor describes itself as “an innovator that helped change that perception, first for the public and then for Apple.” The suit claims that it was its founder, Dr. Dave Albert, who was one of the first to realize that “smartwatches […] were the perfect device to monitor one’s heart for potentially life-threatening conditions.”

KardiaBand was developed as a direct result of this, along with a pair of companion apps: Kardia to pull in readings from the KardiaBand, and SmartRhythm to monitor a user’s heart rate and alert them to irregularities that might warrant recording an ECG.

The AliveCor complaint notes that it was “open with Apple about its intentions” and that the Apple Watch maker not only cooperated in approving the apps but also “advertised AliveCor’s innovations in order to sell more Apple Watches.”

However, AliveCor believes that during this time, Apple was working on copying its ideas to bring its own ECG solution to the Apple Watch and even made a pre-announcement of this technology intended to take the wind out of AliveCor’s sails.

What AliveCor did not know is that Apple had finally realized heart health analysis was incredibly valuable to (and desired by) smartwatch users, and thus had been working in the background to copy AliveCor’s ideas—including both the ability to record an ECG on the Apple Watch, as well as to provide a separate app for heartrate analysis. Apple apparently decided that it needed to try to undercut AliveCor’s success and, the same day AliveCor told Apple that it planned to announce its FDA clearance, Apple “pre-announced” a heart initiative for the Apple Watch. AliveCor court filing

Apple’s alleged attempt to “steal AliveCor’s thunder” supposedly backfired, since Apple’s “demonstrated commitment to heart health on the Apple Watch” actually led to “an increase in AliveCor’s sales and public brand awareness,” — at least initially.

Hence, the suit claims, Apple looked for other ways to push AliveCor out of the market for health monitoring apps. This included sudden claims that SmartRhythm “violated various unwritten App Store guidelines” and then “literally rewriting the rules” to give it a reason to try to block SmartRhythm from the App Store.

But, as it has done multiple times over the years in other markets, Apple decided that it would not accept competition on the merits. Almost immediately after AliveCor started selling KardiaBand and its apps, Apple began a concentrated campaign to corner the market for heartrate analysis on the Apple Watch, because the value of controlling such critical health data (with the accompanying ability to exploit it) was apparently too much of a temptation for Apple.AliveCor court filing

The court filing alleges that as a result of AliveCor’s “tenacity” in continually updating SmartRhythm to keep it “in compliance with Apple’s new and ever-changing guidelines,” the company instead “resorted to behind-the-scenes acts of sabotage,” with undocumented updates to watchOS that seemed to be specifically designed to “suddenly render SmartRhythm inoperable.”

This tactic occurred with unfortunate regularity throughout the first half and late summer of 2018, and AliveCor was forced each time to drop everything to update its app so that its customers (who relied on SmartRhythm for medical purposes) were not left without its lifesaving monitoring for too long.AliveCor court filing

This was followed by the debut of the Apple Watch Series 4 with its built-in ECG app and heart rate analysis app similar to SmartRhythm. AliveCor concedes that it was perfectly fair and reasonable for Apple to adopt this feature — or at least it would have been if Apple had played fair. However, AliveCor insists that’s not what happened.

Had that been the extent of Apple’s actions, the market would have dictated who won or lost. Apple’s app came standard on the Watch, which gave it an advantage, but AliveCor’s SmartRhythm app was simply better at identifying worrisome heart-related health events, a quality difference industry participants clearly recognized.AliveCor court filing

Instead, the suit claims, Apple exploited its control over the watchOS heart rate algorithm. With watchOS 5, Apple released an update to its algorithms that seemed purposely designed to “prevent third parties from identifying irregular heartrate situations,” effectively rendering all competing heart rate analysis apps useless.

AliveCor adds that Apple was so determined to push the competition out of the market that it “insidiously” added the same update to older Apple Watch models, which “negated the reason they purchased KardiaBands and AliveCor’s other apps,” endangering their lives in the process.

In short, to gain an unfair competitive edge, Apple put countless AliveCor users’ lives in danger.AliveCor court filing

AliveCor claims that Apple “devastated” the competition and now “commands 100% share of heartrate analysis apps on watchOS devices,” which works out to over 70% of the market for “U.S. ECG-capable wearable devices.” AliveCor “was forced to remove” SmartRhythm from the App Store as it no longer worked reliably. It alleges that other companies offering similar apps either followed suit or updated their apps to limit them to basic heart rate tracking rather than complete analysis.

Apple Must Answer to AliveCor’s Allegations

In a decision this week, U.S. District Judge Jeffrey White ruled that AliveCor’s lawsuit will be able to proceed, according to Reuters.

Judge White said in his ruling that AliveCor’s allegations “plausibly establish that Apple’s conduct was anticompetitive,” although it will still need to prove that to a jury.

Asking to have the lawsuit dismissed, Apple’s lawyers had maintained that it was an “uncontroversial proposition that product improvement by itself” did not violate federal antitrust laws.

While Judge White ruled that AliveCor’s claim of Apple’s illegal monopoly over the U.S. market for heart rate monitoring apps had merit, he dismissed the company’s separate claim that Apple maintained an unlawful monopoly over ECG-capable smartwatches. However, Judge White ruled that AliveCor had no legal standing to make such a claim, as its KardiaBand wristband “complements but does not compete” in that market.

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