Not secure - lost three times
The bracelet is high quality but it fatally flawed as a medical id. By definition, a piece that serves as a medical alert will be subjected to 24/7 utilization under all types of condition The clasp broke and I lost it twice (fortunately found). After the second time I asked for a safety to be put on. A secondary chain was installed but the bracelet still slipped off after the clasp failed a third time. Unfortunately, I have not found it, so it must be replaced. I wish I could order a another James Avery piece, but it is just too much money given the high likelihood the clasp will fail again. Also, if you decide to proceed with an order, ask for extra deep engraving. My name and medical condition was so lightly etched it was difficult to read. Again, the opposite of what you want in a medical emergency. James Avery makes beautiful jewelry, but this is a working piece and needs to be designed with the core function as the priority which means durability, security, and visibility.
I bought one of these bracelets, clasp broke almost immediately. This was replaced at James Avery, no cost. Apparently the clasp broke again, lost bracelet. The fastening clasp is of poor quality. Too much money spent to loose the bracelet!