{ "id": "AIBD-0022", "title": "Apple Watch Blood Oxygen reading leading to diagnosis and treatment of pulmonary embolism", "summary": "Apple Watch Series 7 SpO2 of 88% prompted CT angiography that found pulmonary embolism; anticoagulated and discharged (Japan).", "date_observed": "2022-09-05", "date_basis": "unassessed", "date_precision": "unassessed", "benefit_status": null, "source_collection": null, "source_entry": null, "account": "A case appeared online on 5 September 2022 in QJM (event date not reported). A 50-year-old woman who recently had COVID-19 was referred to the authors' hospital (Oita University, Yufu, Japan) for assessment of dyspnea. Hospital pulse oximetry read 97%, but her Apple Watch Series 7 had shown 88% oxygen saturation in the early morning. Prompted by the watch reading, clinicians did emergent computed tomography (CT) angiography. It showed filling defects in multiple pulmonary artery branches, confirming pulmonary embolism with bilateral deep venous thrombosis (DVT). She was treated with a direct oral anticoagulant, oxygen was stopped on day 6 and she was discharged on day 15. The authors state the watch's low reading led to the diagnosis.", "category": "benefit created", "unexpected": true, "purpose": "The Blood Oxygen app measures oxygen saturation for general wellness and is not intended for medical diagnosis. Detecting a pulmonary embolism was not what it was built to do.", "system": "Apple Watch Blood Oxygen app", "model_version": "Apple Watch Series 7 (event); Series 6 in echo", "developer": "Apple", "deployer": null, "location": "Yufu, Oita Prefecture, Japan", "domain": "Healthcare (emergency and respiratory medicine)", "segment": "Consumer wearables", "benefit_type": "Improved Physical Health", "taxonomy_note": null, "registry_ids": {}, "ratings": [ { "group": "personal", "depth": 3, "reason": "A pulmonary embolism with bilateral DVT was diagnosed and anticoagulated after hospital oximetry had been normal. A life-changing benefit, though the source does not establish that death was imminent." } ], "ai_role": { "status": "assessed", "statement": "The watch's pulse-oximetry algorithm produced the 88% reading on the patient's watch. The letter does not say who reported it to the clinicians and describes no automatic alert. Clinicians chose to perform CT angiography because of that reading and state that it led to the diagnosis." }, "evidence": [ { "kind": "case report", "citation": "Shiota S, Horinouchi Y, Doi E, Miyazaki E (2022). Suspicion of pulmonary embolism after COVID-19 infection raised by a smartwatch. QJM, hcac217 (online 5 Sep 2022; issue 2023).", "title": "Suspicion of pulmonary embolism after COVID-19 infection raised by a smartwatch", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9494381/", "date": "2022-09-05", "written_by": "independent", "quote": "The smartwatch correctly recognized a low SpO2, which led to the diagnosis of PE in our case." }, { "kind": "case report", "citation": "Tulisiak LN, Loesing ME, Ljungberg A, Kaczor EE (2025). Smartwatch Detection of Refractory Hypoxemia in Phenazopyridine-Induced Methemoglobinemia: A Case Report. Journal of Medical Toxicology 21(4):430-433.", "title": "Smartwatch Detection of Refractory Hypoxemia in Phenazopyridine-Induced Methemoglobinemia", "url": "https://europepmc.org/article/PMC/PMC12511463", "date": "2025-08-04", "written_by": "independent", "quote": "The day before presentation, she was walking in the mall when she was notified by her Series 6 Apple Watch© (version 9.6.3) that her oxygen level was low." } ], "replication": { "produced_by": [ "The wearer has an Apple Watch with the Blood Oxygen app and reviews its readings", "A hypoxemic condition produces a persistently low reading at home", "The wearer reports the reading and a clinician acts on it despite normal spot oximetry" ], "must_hold": [ "The reading is not dismissed as artifact", "Confirmatory testing (CT angiography, co-oximetry) is available", "Effective treatment exists for the condition found" ], "echoes": [ { "date": "2025-08-04", "setting": "71-year-old woman, emergency department, USA (authors' institution: University at Buffalo); her watch notified her of low oxygen and read 73–86% over the next 24 hours, but she ignored the alert and sought care only when her family saw blue discoloration of her skin; hospital pulse oximetry itself read 84% and venous methaemoglobin was 19.8% from phenazopyridine; methylene blue, discharged after about 24 hours; the watch readings corroborated the hospital finding rather than bringing her to care, so the index mechanism did not repeat (publication date)", "model_version": "Apple Watch Series 6", "outcome": "did not recur", "source": "Tulisiak et al. (2025). J Med Toxicol 21(4):430-433. https://europepmc.org/article/PMC/PMC12511463" } ] }, "paired_incident": { "database": "AI Incident Database", "identifier": "463", "title": "Apple Devices Mistook Skiing Activities, Dialed False Distress Emergency Calls", "url": "https://incidentdatabase.ai/cite/463", "severity": null, "group": "personal", "basis": "Same device, Apple Watch: a sensor-driven alert that was false (Crash Detection dialed 911 for skiers) mirrors a sensor reading that was true (88% SpO2 prompting CT); harmed were Apple Watch users and dispatchers." }, "headline": "Apple Watch SpO2 of 88% prompts CT that finds pulmonary embolism", "metric": "Apple Watch Series 7 had shown an oxygen saturation of 88% in the early morning", "comparator": null, "later": { "status": "unknown", "date": null, "note": "No development after the 2022 case report was found; the 2025 methemoglobinemia report involved a different patient and mechanism.", "quote": null, "url": null }, "value": null, "developer_country": "United States", "deployer_country": null, "unrated_because": null, "brief_notes": null, "brief": null, "revisions": [ { "date": "2026-10-20", "change": "Record drafted from the cited sources.", "source": null, "editor": "AIBD" }, { "date": "2026-10-20", "change": "Paired with AI Incident Database incident 463 (medium confidence); severity not given by the source.", "source": "https://incidentdatabase.ai/cite/463", "editor": "AIBD" }, { "date": "2026-10-20", "change": "Restored “(version 9.6.3)” to the Tulisiak quote, re-recorded the Tulisiak echo as “did not recur” because the patient ignored the watch alert and hospital oximetry itself read 84%, replaced “Buffalo” and “Oita” with the authors' institutions as the sources state them (University at Buffalo; Oita University, Yufu), dropped the unsupported claim that the patient reported the 88% reading, and changed the kind of event from a specific harm prevented to a benefit created or restored because the source shows a changed diagnostic course rather than an averted specified harm, in line with AIBD-0021 and AIBD-0025.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9494381/ ; https://europepmc.org/article/PMC/PMC12511463", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Accessibility among the six first used.", "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Country of the developer added from the organization's own site or a registry.", "source": "https://en.wikipedia.org/wiki/Apple_Inc.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Prose pass: a rating reason, account, purpose, the replication conditions, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.", "source": null, "editor": "AIBD" } ], "confidence": "studied", "shade": "high", "claim_status": "Independently studied", "claim_basis": "Sources: two independent case reports. The cited evidence includes no finding by a regulator or court.", "profile": { "case_id": "AIBD-0022", "catalog_version": "1.0.0", "source_fingerprint": "37aad5184fa2ebfaedddf37a1f064ea271a76fecfb119919ae17d8d00138ffef", "collection_refs": [ { "collection_id": "aibd", "version": "snapshot-8bf7cfec9cb185aa" }, { "collection_id": "aibd", "version": "2026-10-25" }, { "collection_id": "viator", "version": "2026-10-25" } ], "source_ids": [ "AIBD-0022-source-0001", "AIBD-0022-source-0002" ], "families": { "strategic assessments": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial", "record_ids": [] }, "evaluations": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial", "record_ids": [] }, "monetary observations": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial", "record_ids": [] }, "institutional decisions": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial", "record_ids": [] } }, "fields": { "actors[]": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "developer": "Apple" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "developer" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "actors[].ownership_control": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "ai_contribution": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "ai_role": { "status": "assessed", "statement": "The watch's pulse-oximetry algorithm produced the 88% reading on the patient's watch. The letter does not say who reported it to the clinicians and describes no automatic alert. Clinicians chose to perform CT angiography because of that reading and state that it led to the diagnosis." } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "ai_role" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "ai_relationship": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "category": "benefit created", "ai_role": { "status": "assessed", "statement": "The watch's pulse-oximetry algorithm produced the 88% reading on the patient's watch. The letter does not say who reported it to the clinicians and describes no automatic alert. 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A 50-year-old woman who recently had COVID-19 was referred to the authors' hospital (Oita University, Yufu, Japan) for assessment of dyspnea. Hospital pulse oximetry read 97%, but her Apple Watch Series 7 had shown 88% oxygen saturation in the early morning. Prompted by the watch reading, clinicians did emergent computed tomography (CT) angiography. It showed filling defects in multiple pulmonary artery branches, confirming pulmonary embolism with bilateral deep venous thrombosis (DVT). She was treated with a direct oral anticoagulant, oxygen was stopped on day 6 and she was discharged on day 15. The authors state the watch's low reading led to the diagnosis.", "benefit_type": "Improved Physical Health" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "account", "benefit_type" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "outcomes[].distribution": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].duration": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].id": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].stakeholder_group": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "ratings": [ { "group": "personal", "depth": 3, "reason": "A pulmonary embolism with bilateral DVT was diagnosed and anticoagulated after hospital oximetry had been normal. A life-changing benefit, though the source does not establish that death was imminent." } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "ratings" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "outcomes[].status": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].tradeoffs": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].unexpected": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "unexpected": true, "purpose": "The Blood Oxygen app measures oxygen saturation for general wellness and is not intended for medical diagnosis. Detecting a pulmonary embolism was not what it was built to do." } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "unexpected", "purpose" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "places[]": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "location": "Yufu, Oita Prefecture, Japan", "developer_country": "United States" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "location", "developer_country" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "purpose": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "purpose": "The Blood Oxygen app measures oxygen saturation for general wellness and is not intended for medical diagnosis. Detecting a pulmonary embolism was not what it was built to do." } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "purpose" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "record_dates": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "date_observed": "2022-09-05", "revisions": [ { "date": "2026-10-20", "change": "Record drafted from the cited sources.", "editor": "AIBD" }, { "date": "2026-10-20", "change": "Paired with AI Incident Database incident 463 (medium confidence); severity not given by the source.", "source": "https://incidentdatabase.ai/cite/463", "editor": "AIBD" }, { "date": "2026-10-20", "change": "Restored “(version 9.6.3)” to the Tulisiak quote, re-recorded the Tulisiak echo as “did not recur” because the patient ignored the watch alert and hospital oximetry itself read 84%, replaced “Buffalo” and “Oita” with the authors' institutions as the sources state them (University at Buffalo; Oita University, Yufu), dropped the unsupported claim that the patient reported the 88% reading, and changed the kind of event from a specific harm prevented to a benefit created or restored because the source shows a changed diagnostic course rather than an averted specified harm, in line with AIBD-0021 and AIBD-0025.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9494381/ ; https://europepmc.org/article/PMC/PMC12511463", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Accessibility among the six first used.", "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Country of the developer added from the organization's own site or a registry.", "source": "https://en.wikipedia.org/wiki/Apple_Inc.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Prose pass: a rating reason, account, purpose, the replication conditions, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.", "editor": "AIBD" } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "date_observed", "revisions" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "replication.attempts[]": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "replication": { "produced_by": [ "The wearer has an Apple Watch with the Blood Oxygen app and reviews its readings", "A hypoxemic condition produces a persistently low reading at home", "The wearer reports the reading and a clinician acts on it despite normal spot oximetry" ], "must_hold": [ "The reading is not dismissed as artifact", "Confirmatory testing (CT angiography, co-oximetry) is available", "Effective treatment exists for the condition found" ], "echoes": [ { "date": "2025-08-04", "setting": "71-year-old woman, emergency department, USA (authors' institution: University at Buffalo); her watch notified her of low oxygen and read 73–86% over the next 24 hours, but she ignored the alert and sought care only when her family saw blue discoloration of her skin; hospital pulse oximetry itself read 84% and venous methaemoglobin was 19.8% from phenazopyridine; methylene blue, discharged after about 24 hours; the watch readings corroborated the hospital finding rather than bringing her to care, so the index mechanism did not repeat (publication date)", "model_version": "Apple Watch Series 6", "outcome": "did not recur", "source": "Tulisiak et al. (2025). J Med Toxicol 21(4):430-433. https://europepmc.org/article/PMC/PMC12511463" } ] } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "replication" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "replication.conditions": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "replication": { "produced_by": [ "The wearer has an Apple Watch with the Blood Oxygen app and reviews its readings", "A hypoxemic condition produces a persistently low reading at home", "The wearer reports the reading and a clinician acts on it despite normal spot oximetry" ], "must_hold": [ "The reading is not dismissed as artifact", "Confirmatory testing (CT angiography, co-oximetry) is available", "Effective treatment exists for the condition found" ], "echoes": [ { "date": "2025-08-04", "setting": "71-year-old woman, emergency department, USA (authors' institution: University at Buffalo); her watch notified her of low oxygen and read 73–86% over the next 24 hours, but she ignored the alert and sought care only when her family saw blue discoloration of her skin; hospital pulse oximetry itself read 84% and venous methaemoglobin was 19.8% from phenazopyridine; methylene blue, discharged after about 24 hours; the watch readings corroborated the hospital finding rather than bringing her to care, so the index mechanism did not repeat (publication date)", "model_version": "Apple Watch Series 6", "outcome": "did not recur", "source": "Tulisiak et al. (2025). J Med Toxicol 21(4):430-433. https://europepmc.org/article/PMC/PMC12511463" } ] } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "replication" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "revision_history[]": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "revisions": [ { "date": "2026-10-20", "change": "Record drafted from the cited sources.", "editor": "AIBD" }, { "date": "2026-10-20", "change": "Paired with AI Incident Database incident 463 (medium confidence); severity not given by the source.", "source": "https://incidentdatabase.ai/cite/463", "editor": "AIBD" }, { "date": "2026-10-20", "change": "Restored “(version 9.6.3)” to the Tulisiak quote, re-recorded the Tulisiak echo as “did not recur” because the patient ignored the watch alert and hospital oximetry itself read 84%, replaced “Buffalo” and “Oita” with the authors' institutions as the sources state them (University at Buffalo; Oita University, Yufu), dropped the unsupported claim that the patient reported the 88% reading, and changed the kind of event from a specific harm prevented to a benefit created or restored because the source shows a changed diagnostic course rather than an averted specified harm, in line with AIBD-0021 and AIBD-0025.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9494381/ ; https://europepmc.org/article/PMC/PMC12511463", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Accessibility among the six first used.", "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Country of the developer added from the organization's own site or a registry.", "source": "https://en.wikipedia.org/wiki/Apple_Inc.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Prose pass: a rating reason, account, purpose, the replication conditions, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.", "editor": "AIBD" } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "revisions" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "sector": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "domain": "Healthcare (emergency and respiratory medicine)", "segment": "Consumer wearables" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "domain", "segment" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "sources[].access_version": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "sources[].citation_locator": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "evidence": [ { "kind": "case report", "citation": "Shiota S, Horinouchi Y, Doi E, Miyazaki E (2022). Suspicion of pulmonary embolism after COVID-19 infection raised by a smartwatch. QJM, hcac217 (online 5 Sep 2022; issue 2023).", "title": "Suspicion of pulmonary embolism after COVID-19 infection raised by a smartwatch", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9494381/", "date": "2022-09-05", "written_by": "independent", "quote": "The smartwatch correctly recognized a low SpO2, which led to the diagnosis of PE in our case." }, { "kind": "case report", "citation": "Tulisiak LN, Loesing ME, Ljungberg A, Kaczor EE (2025). Smartwatch Detection of Refractory Hypoxemia in Phenazopyridine-Induced Methemoglobinemia: A Case Report. Journal of Medical Toxicology 21(4):430-433.", "title": "Smartwatch Detection of Refractory Hypoxemia in Phenazopyridine-Induced Methemoglobinemia", "url": "https://europepmc.org/article/PMC/PMC12511463", "date": "2025-08-04", "written_by": "independent", "quote": "The day before presentation, she was walking in the mall when she was notified by her Series 6 Apple Watch© (version 9.6.3) that her oxygen level was low." } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "evidence" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "sources[].id": { "state": "value_present", "value": { "kind": "identifiers", "identifiers": [ "AIBD-0022-source-0001", "AIBD-0022-source-0002" ], "role": "Existing evidence items, in their original order" }, "provenance": { "kind": "curatorial", "basis": "Stable within the fingerprinted record version; no source content or source review has been added.", "record_fields": [], "source_refs": [] }, "review_state": "record_mapped", "coverage": "complete" }, "sources[].language": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "sources[].relationship": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "evidence": [ { "kind": "case report", "citation": "Shiota S, Horinouchi Y, Doi E, Miyazaki E (2022). Suspicion of pulmonary embolism after COVID-19 infection raised by a smartwatch. QJM, hcac217 (online 5 Sep 2022; issue 2023).", "title": "Suspicion of pulmonary embolism after COVID-19 infection raised by a smartwatch", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9494381/", "date": "2022-09-05", "written_by": "independent", "quote": "The smartwatch correctly recognized a low SpO2, which led to the diagnosis of PE in our case." }, { "kind": "case report", "citation": "Tulisiak LN, Loesing ME, Ljungberg A, Kaczor EE (2025). Smartwatch Detection of Refractory Hypoxemia in Phenazopyridine-Induced Methemoglobinemia: A Case Report. Journal of Medical Toxicology 21(4):430-433.", "title": "Smartwatch Detection of Refractory Hypoxemia in Phenazopyridine-Induced Methemoglobinemia", "url": "https://europepmc.org/article/PMC/PMC12511463", "date": "2025-08-04", "written_by": "independent", "quote": "The day before presentation, she was walking in the mall when she was notified by her Series 6 Apple Watch© (version 9.6.3) that her oxygen level was low." } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "evidence" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "sources[].upstream_sources": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "strategic_assessments[]": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial", "family": "strategic assessments" }, "summary": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "summary": "Apple Watch Series 7 SpO2 of 88% prompted CT angiography that found pulmonary embolism; anticoagulated and discharged (Japan).", "account": "A case appeared online on 5 September 2022 in QJM (event date not reported). A 50-year-old woman who recently had COVID-19 was referred to the authors' hospital (Oita University, Yufu, Japan) for assessment of dyspnea. Hospital pulse oximetry read 97%, but her Apple Watch Series 7 had shown 88% oxygen saturation in the early morning. Prompted by the watch reading, clinicians did emergent computed tomography (CT) angiography. It showed filling defects in multiple pulmonary artery branches, confirming pulmonary embolism with bilateral deep venous thrombosis (DVT). She was treated with a direct oral anticoagulant, oxygen was stopped on day 6 and she was discharged on day 15. The authors state the watch's low reading led to the diagnosis." } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "summary", "account" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "systems[].autonomy_permissions": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "systems[].component_role": { "state": "value_present", "value": { "kind": "text", "text": "The watch estimated blood-oxygen saturation from optical measurements." }, "provenance": { "kind": "legacy_record", "basis": "Restated the mechanical task already described in the existing system and AI-role fields. No new source review is claimed.", "record_fields": [ "system", "ai_role" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "systems[].deployment_configuration": { "state": "value_present", "value": { "kind": "text", "text": "The initial event involved an Apple Watch Series 7. A later report involved a Series 6." }, "provenance": { "kind": "legacy_record", "basis": "Separated the model, software, hardware, or operation already described in the existing record. No new source review is claimed.", "record_fields": [ "model_version", "system", "ai_role" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "systems[].inputs_outputs": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "systems[].model_name": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "systems[].model_version": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "model_version": "Apple Watch Series 7 (event); Series 6 in echo" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "model_version" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial", "display": { "answer": "Exact release not established.", "editor_note": "" } }, "systems[].product_name": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "system": "Apple Watch Blood Oxygen app" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "system" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "systems[].provider": { "state": "value_present", "value": { "kind": "structured", "data": { "application_developer": "Apple" } }, "provenance": { "kind": "legacy_record", "basis": "Mapped from the existing case description without a new external source review.", "record_fields": [ "developer" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "taxonomy_crosswalks[]": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "title": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "title": "Apple Watch Blood Oxygen reading leading to diagnosis and treatment of pulmonary embolism", "headline": "Apple Watch SpO2 of 88% prompts CT that finds pulmonary embolism" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "title", "headline" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "version": { "state": "value_present", "value": { "kind": "identifiers", "identifiers": [ "37aad5184fa2ebfaedddf37a1f064ea271a76fecfb119919ae17d8d00138ffef" ], "role": "SHA-256 of normalized original case data" }, "provenance": { "kind": "curatorial", "basis": "Deterministic content version assigned by the local migration.", "record_fields": [], "source_refs": [] }, "review_state": "record_mapped", "coverage": "complete" }, "workflow": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "account": "A case appeared online on 5 September 2022 in QJM (event date not reported). A 50-year-old woman who recently had COVID-19 was referred to the authors' hospital (Oita University, Yufu, Japan) for assessment of dyspnea. Hospital pulse oximetry read 97%, but her Apple Watch Series 7 had shown 88% oxygen saturation in the early morning. Prompted by the watch reading, clinicians did emergent computed tomography (CT) angiography. It showed filling defects in multiple pulmonary artery branches, confirming pulmonary embolism with bilateral deep venous thrombosis (DVT). She was treated with a direct oral anticoagulant, oxygen was stopped on day 6 and she was discharged on day 15. The authors state the watch's low reading led to the diagnosis.", "replication": { "produced_by": [ "The wearer has an Apple Watch with the Blood Oxygen app and reviews its readings", "A hypoxemic condition produces a persistently low reading at home", "The wearer reports the reading and a clinician acts on it despite normal spot oximetry" ], "must_hold": [ "The reading is not dismissed as artifact", "Confirmatory testing (CT angiography, co-oximetry) is available", "Effective treatment exists for the condition found" ], "echoes": [ { "date": "2025-08-04", "setting": "71-year-old woman, emergency department, USA (authors' institution: University at Buffalo); her watch notified her of low oxygen and read 73–86% over the next 24 hours, but she ignored the alert and sought care only when her family saw blue discoloration of her skin; hospital pulse oximetry itself read 84% and venous methaemoglobin was 19.8% from phenazopyridine; methylene blue, discharged after about 24 hours; the watch readings corroborated the hospital finding rather than bringing her to care, so the index mechanism did not repeat (publication date)", "model_version": "Apple Watch Series 6", "outcome": "did not recur", "source": "Tulisiak et al. (2025). J Med Toxicol 21(4):430-433. https://europepmc.org/article/PMC/PMC12511463" } ] } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "account", "replication" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" } }, "summary": { "total": 91, "addressed": 91, "known": 34, "reviewed": 0, "record_mapped": 34, "not_assessed": 57, "complete": false, "by_state": { "value_present": 34, "not_reported": 0, "unresolved": 0, "not_assessed": 57, "not_applicable": 0, "withheld": 0, "source_unavailable": 0 } } } }