The commission upheld a previous ruling by a US judge who ruled in favour of a company called Masimo who came up with the idea for a light-based pulse oximetry technology or blood oxygen tracking.
Apple appears to have thought it was such a good idea it would "invent it" itself and then lock down the case with legal quibbles.
While ITC's latest ruling confirms Apple's infringement and can potentially stop the company from bringing Apple Watches to the US, it will not come into effect immediately. The decision now faces a Presidential review and could be followed by inevitable appeals by Apple.
"Masimo has wrongly attempted to use the ITC to keep a potentially lifesaving product from millions of U.S. consumers while making way for their own watch that copies Apple," an Apple spokesperson told Reuters.
"While today's decision has no immediate impact on sales of Apple Watch, we believe it should be reversed, and will continue our efforts to appeal."
The Biden administration will have 60 days to veto the import ban on Apple Watches which is something that US Presidents have rarely vetoed bans in the past.
Masimo's complaint alleged that the Apple Watch 6, the first one to feature blood oxygen tracking, violated its patent.
Masimo has accused Apple of entering discussions with it for a potential partnership, including a potential acquisition, in 2013, only to steal Masimo's idea and poach some of Masimo's engineers to implement it.
Masimo CEO Joe Kiani said the ITC's ruling "sends a powerful message that even the world's largest company is not above the law."
We will see what he thinks after Apple takes the case to the Supreme Court as it will probably do so.