CVE-2015-3459 – Hospira Lifecare PCA Infusion Pump

https://web.nvd.nist.gov/view/vuln/detail?vulnId=CVE-2015-3459

by aburan28 • 11 years ago

152 82 11 years ago

web.nvd.nist.gov

mherdeg• 11 years ago

I wonder how long it's going to be before we see state-level actors exploit these kinds of security holes.

To be sure, there are already a lot of ways to incapacitate or hurt someone. But abusing software bugs in a person's medical devices might be a less traceable way to disrupt their activity.

TheLoneWolfling10• 11 years ago

Why bother with medical devices? Just lock on their driver-side brakes when they're on the highway. Bonus: car accidents are common enough that it'd be unlikely to be noticed.

higherpurpose• 11 years ago

Malicious hackers are going to have so much "fun" with always-connected self-driving cars that get OTA updates that can "upgrade" their engines, or breaks, etc.

Also I imagine CIA would largely be made redundant as the NSA can just take over the assassinations from there.

flashman2• 11 years ago

You'll have to be more subtle than that. A crash investigator is going to notice asymmetric skid patterns and brake disc damage.

duaneb• 11 years ago

I wonder how long it's going to be before we see state-level actors exploit these kinds of security holes.

Sounds like a political nightmare for little gain. I would be more worried about ransom-oriented terrorists.

jMyles• 11 years ago

state-level actors
ransom-oriented terrorists

Sadly, INTERSECT on these groups yields a non-trivial set of results.

xooxies• 11 years ago

This is completely unacceptable. There really should be more pentesting of medical gear and industrial control systems in general.

blueintegral• 11 years ago

It's surprising that the FDA doesn't require that as part of their certification procedure.

asuffield• 11 years ago

I can think of many words to describe my reaction to this, but "surprise" is not one of them. I have never seen a regulatory body impose any meaningful security testing. Even supposedly "secure" standards are often self-certified, not tested.

TheLoneWolfling10• 11 years ago

I'd argue that the very fact that it's physically possible to hack these sort of devices is a huge red flag.

There shouldn't be pentesting, because there shouldn't be anything to pentest.

Something like a medical device, you keep the outside communication part airgapped from anything that could cause harm. If that means you have to duplicate things, then it means you have to duplicate things.

moyix• 11 years ago

Implantable devices typically have to have a wireless interface of some sort. The alternative is to put a physical port on someone's body, which is a great way to cause infections.

mkehrt2• 11 years ago

Things like pacemakers often have radio interfaces, because the alternative is to cut someone open.

fabulist4• 11 years ago

There shouldn't be pentesting, because there shouldn't be anything to pentest.

At the face this seems like the right approach, but you end up with security-through-obscurity protecting (yet another) critical system. If you don't hire pentesters, how can you be sure there is no way to maliciously interact with the device? Because you didn't intend for there to be? Its a good thing vulnerabilities are never unintentional right?

Its also not very resilient to a change in the software's requirements; maybe its okay for a pacemaker not to have a password when you need to open up a patient's chest to connect to it. Maybe those extra microseconds you save mean less blood loss and pain for the patient undergoing surgery, an undeniable win. But this operation turns out to be expensive (by every conceivable measure), so the next model ships with bluetooth, now we have a problem.

spydum• 11 years ago

the problem here is the medical community (especially hospitals) are increasingly pressured to increase productivity to offset cost increases. one way is to automate some of the dreary stuff like monitoring of medical devices in a hospital ward. if youve been in a relatively modern hospital lately, youll find they have wall mounted dashboards which can monitor all the vitals and devices for patients without the nurse needing to walk around and check rooms. this lets them respond to changes as they come up, as opposed to needing to wait till they make their rounds to the room.

this sort of thing needs a network. I'm not familiar, but I thought in the US, HIPPA covered some of this stuff.. not sure how stringent it is, or if it covers scenarios like this.. perhaps it doesnt at all (I am thinking like PCI, where certain data must be encrypted, etc).

rodgerd• 11 years ago

Related: Karen Sandler's LC2012 keynote, which discusses the challenges of finding anything out about life-sustaining medical technology: https://www.youtube.com/watch?v=5XDTQLa3NjE

ars2• 11 years ago

If you take that too far you end up with medical gear that is so locked down the owner can not make any changes themself, but must ask for permission to make any changes.

MaulingMonkey2• 11 years ago

I was under the impression that medical devices were already locked down like that due to e.g. FDA regulations. Not having security either seems like a "worst of both worlds" situation.

Zikes• 11 years ago

Not that this isn't a nasty security hole, but I should hope that this sort of equipment is firewalled at least.

michaelt• 11 years ago

"Hope", yes. But if there are products with unencrypted no-auth telnet, I'm not sure we can assume everyone is following industry-standard best practices :)

achillean• 11 years ago

Glucose meters and pumps similar to this one have already been found on Shodan :-/ The majority aren't directly on the Internet but it happens. There has actually been an increase in the number of hospitals that are showing up online.

ceejayoz2• 11 years ago

Not that this isn't a nasty security hole, but I should hope that this sort of equipment is firewalled at least.

Won't do you much good if an attacker makes an open Wifi point with the same SSID as the hospital's network.

hueving3• 11 years ago

Won't do you much good if an attacker makes an open Wifi point with the same SSID as the hospital's network.

For that to work the hospital's SSID would have to be open as well. And if that were the case, faking the SSID would be a complete waste of time because you could just connect to it yourself.

teuobk• 11 years ago

Here's the bad news: after spending a decade working in the medical device industry, I can say that security is not always a high priority in medical device designs.

I don't think the situation is likely to get better until the FDA starts requiring security audits as a condition of approval -- and for 510(k)s too, not just for PMAs.

wyldfire• 11 years ago

I can say that security is not always a high priority in medical device designs.

Agreed. But it's because generally it's not (yet?) a problem.

dlnovell• 11 years ago

I worked for Hospira last year on the Plum A+ and 360 infusion pumps but not the PCA. I'm a little surprised such a blatant security hole wasn't caught, considering the magnitude of the regulatory environment we worked under. I'd never worked in that kind of environment before, and I left shortly after a successfully defended audit of our software development and tracking process and systems. (Although how successful is the development and tracking process if a year later this "bug" comes out?) My guess is that because we were beaten over the head day in and day out focusing on "if this software delivers the wrong medication the patient is probably going to die", and "if you make a mistake in the development process and in change tracking we can lose the ability to make these devices" that the idea of defending against malicious intent was de-emphasized/overlooked.

lifeisstillgood2• 11 years ago

This is most likely the problem - the number of cases where patients die from drug delivery mistakes is probably in thousands if not tens of thousands. The cases where someone deliberately administers a dose, via a machine are likely to be zero (because I have not heard of them)

So any cost benefit or risk analysis is going to worry about the drug.

voidlogic5• 11 years ago

Question unrelated to the stupidity of supporting telnet as protocol on these devices- Did you guys use formal verification techniques? http://en.wikipedia.org/wiki/Formal_verification

voidlogic5• 11 years ago

If some one would explain the down-voting to me, I'd love to understand... honestly

1. My question was unrelated to the poor decision the OPs former employer made to use telnet.

2. Formal verification the the gold standard in correctness often used for can't fail things like missiles and satellites.

jwiley• 11 years ago

Formal verification would not help if the formal or informal design specs called for unauthenticated telnet. It would prove that the entire stack was bullet-proof against memory violations and mathematically pure, and that it would with 100% certainty allow untrusted users to access administrative functions.

Nitramp• 11 years ago

If you require certification of software by some standard, companies will build software that passes the certification standard.

But in my experience, the assumption that a security, quality, or whatever certification process correlates with actually secure, high quality, etc software does not have a lot backing it.

There's a big difference between dotting the i's and crossing the t's according to ISO-9001, and actually caring about software quality, and it seems like the standards make it harder to actually care and actually focus on delivering a good product.

mryan• 11 years ago

It sounds similar to the idea of teachers "teaching to the test", as opposed to providing an all round education and critical thinking ability.

lifeisstillgood2• 11 years ago

tl;dr - drug pump has no authentication on telnet port

This is the brochure page for this family of products (http://www.hospira.com/en/products_and_services/infusion_pum...) and the one that stands out a mile is

- Robust wireless capabilities enable remote drug library updates

the product itself (let's assume it's top notch medical hardware, I am afraid I cannot comment usefully) works fine, and has been battle tested and built by veterans. But the second they add network access they are hit by a double whammy ... Actually I have rewritten this three times, and really I can find no excuse for this. Selling to moronic sysadmins - "hey easy to use web front end with passwords or even client certs). I can only assume the argument runs like this

- if we make it hard to do X over the network, and X does not happen, chances of someone dying are y%. If we bollox security, then X is sooo easy to do, and we just save y% of lives.

Now that is "tragedy of the commons" in sheeps clothing, but I can see it may be the only excuse you have

vesinisa• 11 years ago

It's essentially a device for automatic delivery of pain killers when the patient presses a button. Why on earth would such device even require network connectivity? They advertise "wireless capabilities for remote drug library update". But "wireless capability" is a whole new engineering domain, and the manufacturer seems to have failed to even begin to address it properly.

ryanmarsh• 11 years ago

Just because you cannot envision a particular use case does not mean that it is not a valuable one. Fist off a large hospital will have drugs that are "formulary", meaning drugs doctors are allowed to prescribe and the in-house pharmacy fill. These lists need to be updated, imagine you have thousands of these pumps on premises. Now imagine you also have to do inventory management. Now imagine you have these pumps wired in with your nurse calling system (for when infusion is complete or the device is empty).

Edit: usually you pick the drug from a list on the interface when programming it. I'm not familiar with this pump but I've used many like it.

forgottenpass• 11 years ago

Why on earth would such device even require network connectivity?

Convenience features sell. It looks like these devices might just push down delivery limits over the network, but the connectivity of medical devices is in the process of exploding. The market forces for software in general don't magically not apply to medical software/devices.

Of all the software out there that sends telemetry back to base, medical devices are probably one of the easiest to justify and least morally dubious types of user monitoring around.

moe• 11 years ago

Was anyone else reminded of that 'Homeland' episode?

smutticus• 11 years ago

Is anyone else dissatisfied with the amount of information we get in many sec bug reports? Almost everytime I read a CVE or other vulnerability I find myself with more questions than answers. There's so little information given.

Is telnet on by default? Is this device normally plugged into a network, for how long? How common is this device? Has it been on the market for long?

Without this kind of information it's very difficult to assess risk, or otherwise form an opinion.

adt2bt• 11 years ago

On the other hand, for potentially significant security holes, answering those questions would make attacking the devices easy. I imagine more detail will come out in a postmortem once the affected devices are updated. I may be overly optimistic, though..

dyngnosis2• 11 years ago

I've got a full advisory written up. It is unclear if the vendor will patching the device. When I get that cleared up I'll have a full advisory for everyone. In the meantime if you need something answered urgently you can contact me directly.

flashman2• 11 years ago

Hopefully not a literal post mortem.

dyngnosis2• 11 years ago

Telnet is on by default. It is a busybox shell. This device is normally connected to a network via wifi. There is an additional Ethernet port on the back. It is safe to say every patient using one of these has physical access. The wireless encryption keys are stored in plain text.

totallynotcool• 11 years ago

I don't think we have any of our equipment in the OR networked other than commo devices; phones, video, et. al. I do know of some dental tools that use bluetooth to sync drills with a nurses cell so they can change the settings for the docs but 'hacking' that wouldn't lead to any unrecoverable harm... unless, of course, you could turn the drill on via blue tooth

NamTaf• 11 years ago

"Robust wireless capabilities enable remote drug library updates" [1]

What do they mean by 'robust'? You can rely on it to be there whenever you want to hack someone to death?

[1] http://www.hospira.com/en/products_and_services/infusion_pum...

abecedarius• 11 years ago

I mentally translate 'robust' to 'fancy' -- the dictionary meaning I grew up with being so rarely used correctly now.

zurn3• 11 years ago

So is the procurement process in medical organizations so feeble that nobody notices these, or is there such widespread apathy about this state of affairs that it all gets ignored, or is there some kind of culture of secrecy that results in even these life threatening cases to be kept quiet between the hospital and the equipment salesman?

sspiff• 11 years ago

I was thinking this is bad, but this thing is running a 2.4 kernel, so it's probably just a wired ethernet port on the back of the device. Limited but dangerous potential here.

Nope, it's a thousands times worse. This devices has WiFi. You don't even need to plug a cable in the back.

I can't find how the wireless is configured in their manual[1], but they clearly mention Wireless LAN.

[1] http://www.meql.com/Manuals/Abbott-Hospira-PCA-III-Mednet-Us...

theskyisfalling• 11 years ago

Of all the bad things that can happen to a patient connected to an infusion pump, being hacked is way way down the list.

CVE-2015-3459 – Hospira Lifecare PCA Infusion Pump

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