An attack on a single IV infusion pump or digital smart pen can be leveraged to a widespread breach that exposes patient records, according to a Spirent SecurityLabs researcher.
Saurabh Harit, managing consultant with Spirent, will present his findings on flaws in IV infusion pumps and digital smart pens at Black Hat Europe this week.
"Perpetuators can use this patient information to file false insurance claims as well as to buy medical equipment and drugs using a fake ID. These products are then easily sold on the black market," Harit says. "What makes medical data more lucrative than the financial data is the low and slow detection rate of the fraud itself. While a credit card fraud can be detected and blocked in a matter of minutes these days, medical data fraud can go undetected for months, if not more."
Harit has notified the affected IV infusion pump and digital smart pen vendors of the vulnerabilities, which have patched the flaws, Harit says he will not reveal the names of the companies or their devices.
Smart Pen Problems
"By far the most surprising thing we came across in our research was the amount of patient information that was available with the digital smart pen," Harit says. "We felt even if we breached it, we would not get a lot of information off of it because the healthcare organization said they did not store patient information on the device."
Doctors use digital smart pens to prescribe medications for patients and that information is then digitally transmitted to pharmacies with the patient's name, address, phone number, health records, and other medical information.
But after reverse-engineering the digital smart pen, Harit found a cache of information. First he peered into the device's underlying operating system by simply connecting a monitor to the device through a serial interface.
Then, by exploiting network protocols, he obtained low-privilege access to the device. After exploiting its software and services to bypass the device's security checks and lock-down mode, he was able to gain administrative access.
Once the on-device encryption was broken, Harit gained access to sensitive configurations for the healthcare institution’s backend servers, where a treasure trove of patient medical records and other sensitive data could be found for a number of doctors and medical facilities tied to that healthcare institution that had used the digital smart pens.
"I thought this server was not connected to the Internet, but it was," Harit says.
Fixing the vulnerability in the digital smart pen was easy, though, because it's a new product and designed with security in mind, Harit says, noting that the pens can be updated remotely.
Harit's research also explored the security of an IV infusion pump, a growing target when it comes to IoT medical device attacks and one that can be lethal given that it delivers fluids, medication, and nutrients to patients.
Harit discovered that a simple $7 hardware device could interface with the IV infusion pump, read its configuration data, and understand which access point it was seeking to connect to. As a result, he established a fake access point, connected with the IV pump, and then collected sensitive medical data on an individual that included a master drug list and quantity of drugs to be taken.
"If you have 200 of the same pumps in a hospital, an attacker could write a malware script and launch it onto the hospital network and modify the attack to search for all the pumps and attack them," he says.
The IV pump requires the creation, test, and remote deployment of a patch to fix the vulnerability, Harit says.
An attacker would need to gain physical access to the IV pump or digital smart pen to compromise them, Harit says.
He adds that task is not difficult, given the relative ease in walking into a poorly staffed hospital room or medical clinic room. Digital smart pens are small, so they are also easy to pocket, he notes.
Meanwhile, healthcare organizations that suffer a data breach typically learn about a breach from a third party, such as an insurance company, end user, a security monitoring entity, or law enforcement, Harit says.
"In most cases, the breach goes undetected for months and even years."
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