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Hospital Equipment Infected With Conficker
nandemoari writes "Recently, the Conficker/Downadup worm infected several hundred machines and critical medical equipment in an undisclosed number of US hospitals.
The attacks were not widespread; however, Marcus Sachs, director of the SANS Internet Storm Center, told CNET News that it raises the awareness of what we would do if there were millions of computers infected in hospitals or in critical infrastructure locations.
It's not clear how the devices (including heart monitors, MRI machines and PCs) got infected. Infected computers were running Windows NT and Windows 2000 in a local area network (LAN) that wasn't supposed to be Internet accessible, but the LAN was connected to one with direct Internet access.
A patch was released by Microsoft last October that fixes the problem, but the computers infected were reportedly too old to be patched."
I guess that's the other meaning of "Nosocomial infection"...
So if a patient dies due to a (computer) virus and the virus writer gets caught can he be charged with manslaughter or something?
Negative moral value of force outweighs the positive value of good intentions.
Newer isn't always better.
All versions of Windows (and Linux) are way too complex to ever be 100% bug-free. They should be running DOS.
For a life-critical system they probably shouldn't be running ANY version of Windows. But once you get past that issue, if you have tested it sufficiently to permit people's lives to depend on it, retesting it to the same standards on first Win2000 and then XP is a non-trivial effort, and might not even be possible without massive changes. So you would be sorely tempted to leave it alone. Presumably, since it's the same code, it doesn't need any more "features" or performance. So porting it provides no value.
A better question is whether or not it's a good idea to have the damn thing hooked up to the internet so it could *get* Conficker in the first place! Well, actually, that's not a question, since its obvious...
Brett
In the medical industry, making even the smallest changes is often difficult. (I've heard stories of companies continuing to release medical software based on WinNT, and they will probably continue to do it.) When it comes to making changes to software (and hardware), there are lots of regulatory hurdles you need to meet. (The more "life-critical" a device is, the more stringent the regulations are) Obviously, it makes sense, because you don't want to go to the hospital today and find a Windows 7 Beta powered device responsible for your safety.
Also, many hospitals refuse to upgrade existing equipment to something newer. If it works, and it gets the clinicians the data they need to help the patient, then they don't want to take the risk of updating software/hardware.
Doh!
Why risk having security vulnerabilities on a tried and tested mission-critical system? They should have gone with Linux or BSD from the start and had virtually guaranteed upgrade compatibility from that point on, with plenty of commercial support options.
Sam ty sig.
Medical equipment has a very long lifespan. Many devices for measurement and monitoring are used for 10 to 20 years before replacement. The general policy is "if it works, don't fix it and, more important, do not touch it".
The real problem is that most suppliers of equipment are reluctant to support any type of patches. Many of the suppliers explicitly state that the machines may not be changed in any way (and that includes patching the OS) or you will lose all guarantee and support.
I can totally understand why these systems were still running NT or 2000. If it ain't broke, don't fix it, right?
But if it ain't supported anymore, and it's completely closed-source, you literally CAN'T get fixes for vulnerabilities discovered later on. At least with an OSS product, you'd be able to hire a developer to fix the specific vulnerability on the existing system.
Don't you wish your girlfriend was a geek like me?
1) Vendors of these devices almost across the board disallow local IT admins to put any windows patches on the machines
- this is due to FDA requirements for approval, and the vendor is "covering" themselves
- also, they usually have a list of "qualified updates" that is usually MONTHS behind MS's patch cycle (not surprising given the sheer number and speed of holes that are found)
- usually the vendors claim that THEY will apply patches regularly, in practice, they almost NEVER do
2) Vendors typically disallow these machines to be on the active directory
- this is because they can't stand troubleshooting/supporting issues in their software due to GPO's being pushed down, software management software, etc etc
3) To everyone screaming how idiotic it is that medical devices have Windows on them: you may be a geek, but have clearly never worked in a real enterprise environment. Windows is embedded on so many devices in the world (medical and otherwise) that you would never even know existed. Why? Because it's widely supported, has huge hardware support, and is surprisingly OPEN to developers to hack it into whatever they need it to be. And windows programmers are a dime a dozen.
4) To everyone screaming how idiotic it is that medical devices are connected to the internet getting infected - Do you even know how Conficker spreads? It spreads quite easily across a LAN, attaching to Windows file shares. See MS08-067 for more info. Many of these devices are on a LAN with no DNS (although plenty are on the 'net). Why? Again, because vendors insist that they be connected so they can VPN in and support them (often using LogMeIn, Webex etc).
THE MAGIC WORDS ARE SQUEAMISH OSSIFRAGE
Suddenly I have this horrible urge to write a virus called "Swine Flu" that only attacks medical systems..
It's not like they can just upgrade the computer. The computer is running software that goes with specialized equipment. They'd have to upgrade everything if they upgraded anything and with that you could easily be talking millions of dollars. That might not be really needed as the machine should run just as well as it did with they bought it if it hasn't broke. If it's a smaller hospital, they might not have the budget to replace non-broken machines that still preform within needed specs, especially in this economic climate. Add in that some of these machines need to be FDA tested and are only supported by the manufactuer and that makes it even more expensive and harder to upgrade. Then, on many of these machines, the users might not even know they're running on NT4 as the software they run takes up the entire screen and they never actually interact with Windows at all.
I work in healthcare and I'm not surprised at all. Within the last year we just got rid of a Win95 system that was still talking over Novell networking, our Vax system, and a bunch of Sun Sparq stations. We still have plenty of Win2k and probably some WinNT4 around. We also have one of the most advanced set ups in the country, but legacy systems still exist for lots of reasons. First off, if it still works, management is not likely to want to get rid of it unless you make a good case for a good ROI. They're all old and aren't used to replacing major hospital systems that aren't broke especially if the new system doesn't offer any advantages. Budgets are always a problem because if the department isn't bringing in enough money to warrant new equipment, they might not get it. Then there are the vendors. perhaps GE, Fuji, or Cerner are happy with their old system or wants to sell you lots of stuff you don't want or need to replace one bit that is still running on old server tech just fine, so you effectively can't upgrade even if you wanted to.
This SPAM was brought to you by a heart monitor!
http://www.beanleafpress.com
"Hi it says I need to upgrade my RAM, what is that?"... "RAM is a part of your computer, if you have more of it, you can expect it to run faster... tell me what your computer is running and I'll see if I can help you out."... "Uh, right now the computer is running Bob's heart and lungs for him."
For that matter, why is it running a general-purpose OS like Windows?
Ease of development, particularly UI support for rich user interaction and feedback.
Most medical systems I've worked on have two OS's: a relatively hard realtime system that's really close to the hardware, and a second system (Linux or Windows) that's close to the user. For some applications the general purpose OS is used as a soft realtime system and talks to all the hardware via USB or a framegrabber. Only very simple systems are pure embedded these days.
Given the complexity of computing that some of these machines do this makes perfect sense: an embedded, realtime OS is just not what you want to be dealing with when trying to develop richly representational software. Think imaging systems and computer-assisted surgery systems, which often have a lot of analysis and image processing built in, including heavy user interaction, in realtime, in the OR.
Intra-op ultrasound is routine in cardiac surgery (and yes, sometimes systems hang and have to be rebooted while the patient is on the table with their heart stopped...) Intra-op fluoroscopy is routine in some procedures as well, particularly in ortho.
The problem is that people have come to expect features that can't be easily delivered without a general purpose OS, and the issues that come with that are pretty much invisible to anyone who would be likely to scream about it, including the FDA. Users get used to periodic failures and work around them, just like desktop users do.
Blasphemy is a human right. Blasphemophobia kills.
So, we have Conficker infecting hospitals now. And meanwhile, after Conficker's payload goes live, there's a massive outbreak of swine flu. And conficker spreads spam... spam is a pork product... COINCIDENCE?!
No kidding!!! What do you say at this point?
what part of 10 year old equipment didn't you understand? What part of Win NT and win 2K makes you think the hardware can even run anything newer?
At that time your looking at Red Hat 5. think about it. linux wasn't ready back then for mission critical stuff.
At best they could have gone with OS/2 warp.
i thought once I was found, but it was only a dream.
Medical equipment has a very long lifespan. Many devices for measurement and monitoring are used for 10 to 20 years before replacement. The general policy is "if it works, don't fix it and, more important, do not touch it". The real problem is that most suppliers of equipment are reluctant to support any type of patches. Many of the suppliers explicitly state that the machines may not be changed in any way (and that includes patching the OS) or you will lose all guarantee and support.
Doesn't Microsoft itself say (perhaps in the EULA disclaimer) that its operating systems were not intended to be used in this sort of mission-critical capacity? That could of course have a very narrow definition, something along the lines of "don't ever use it to operate that iron lung but maybe use it so the receptionist can run MS Office" but if that were the case, then this would be a mere nuisance and not such a real problem. That is, in that case there'd be nothing special about the fact that the affected institution happened to be a hospital beyond the fact that it sounds bad. Because of that, I really get the impression that they were using the wrong tool for the job.
It is a miracle that curiosity survives formal education. - Einstein
The biggest issue here is that Medical Equipment has to be run through an FDA Validation process. If you make changes to the system, you have to revalidate, and Validation takes months and $100K's. So the vendors leave them as-is.
What's frustrating is that these systems need to be on a LAN, since they need to report their results to other clinical systems. So these small islands need to be linked other islands, and eventually, someone screws up and links an island with an Internet connection . . . .
The question here is this: did the sub-human wankers who created this ever consider this possibility? Now that it's happened, do you think they give a shit? Is there a chance that someone is saying, "Gee, maybe this wasn't such a good idea..." right about now?
If the support contract doesn't include tested and managed security updates, it's not really support is it?
Sam ty sig.
As I unfortunately found out yesterday, one of the more common ways the virus spreads is through removable drives. If autorun is enabled for removable devices (which it is by default, and no MS basher responses please), Windows will load autorun.inf straight away, infecting you.
A work colleague brought over a USB stick with some music on it, which I happily acquired, along with Conficker. For some retarded reason the resident shield was disabled. After we received an email about it, I noticed this and re-enabled it. I didn't realise I had the virus until this guy came over again with some more music and the AV software exploded in my face with a nice "warning conficker detected and removed" message. Of course that meant "removed from the USB stick" and not "removed from the PC".
Virus scans would no longer run, and I couldn't access most conficker-removal-related websites unless I went through a proxy. Incredibly, the Microsoft Malicious Software Removal tool worked a treat. After using that, rebooting, and disabling autorun in the registry, it's gone.
I blame partly myself for not disabling autorun (security lockdown on these work PCs is ridiculous; I would have had to ask an admin to do it), and for whoever disabled my bloody resident shield.
I hinted to our admin that I wanted Debian instead, but that didn't go down well. :)
tl;dr version: Conficker is bad, mmkay.
Homonyms are fun!
You're driving your car, but they're riding their bikes there.
Indeed, I work for an OEM on the imaging (X-Ray) side of the house. My system(s) do get patched regularly. The users are given specific instruction not to "Surf the web".
These systems are usually on a network segment dedicated strictly to imaging yet somehow I manage to find all fashon of virus (Most recently Conficker) games and saved email attachments on the Desktop.
The FDA is very strict about how these systems are to be upgraded and serviced but patching is a non issue.
My company has a simple solution to the virus issue though, If the network admin allows the cluster to get infected, we will gladly remove the infection, for a price.
If I have only had a penny for every time I have heard "It's not my network, check your equipment"
The above post is accurate about the car analogy.
From my own experience, auto-manufacturers took it a step further and only made PARTS of the car with built in obsolescence. Then they buried that part under 30 other ones. That way they get the repair cost MUCH higher. A simple $10 part can cost you (at the dealership, of course) $1000 to get to and replace, the Ford Ranger/Explorer clutch slave cylinder INSIDE the transmission bellhousing...$30 part, $500 job, being a good example (most manufacturers put it on the outside). It also discourages the "shade-tree mechanics" from doing their own work.
But what you say is mostly correct. The REAL problem is that they've been at it so long, people think that a car that only lasts 5-6 years is NORMAL. They've been conditioned to it. People will not know what to do with a car that lasts 25 years, nor be happy with it. Its all about "new", or so we are told by the auto companies.
All that being said, the OP isn't being overly cynical, in my opinion. That shit happens ALL the time, and I see no reason it shouldn't in the IT field.
Because the network admin should have the laboratory equipment firewalled off with a "deny all" preceded and followed by comment lines that read " # DANGER -- MEDICAL EQUIPMENT ON THIS SEGMENT -- If you permit so much as one stinking port to pass through this firewall, I will hunt you down and leave nothing behind for the doctors to patch together."
There is no excuse on the planet for letting health care equipment see the cloud. If data has to enter or leave, it should pass through a bastion host. If the requirements are that the equipment really has to reach the internet, the requirements are faulty.
John
I have to agree. You think a car maker gives a crap about the cost of a repair job down the line? I know several engineers personally that work in the auto industry. Their priorities go something like this:
1. Meet bare minimum, required by law emissions, safety, and quality standards.
2. Be as cheap to make as possible
3. Be as cheap to assemble as possible
4. Require the minimum retooling for factories making it.
5. Require minimum retraining for workers assembling it.
6. When it fails (and it will) make sure it doesn't make the car catch on fire, or slam on the gas, or lose the ability to brake, or otherwise hurt/maim/kill the driver (lawsuits cost money).
7. Make it implement some sort buzzword marketing tech that doesn't do much but sells cars.
8. Make it implement some tech that actually improves the car in a way that sells more cars.
9. Make it look cool.
10. Be durable enough to last past the warranty in 99% of vehicles, and not blatantly defective enough to force a recall/inspire a class action lawsuit.
11. Be servicable.
Notice thats a long list of conflicting goals, and how easy it is to service is on the bottom. Few people even look at the (estimated) total cost of ownership of a car, much less personally inspect how easy it looks to surface. And since systemic, hard to service problems tend to show up 5 years down the line, when the engineers responsible have long ago moved on to other projects, and that particular model has already been replaced anyways, noone really cares.
The idea that some sort of sneaky conspiracy of planned obsolescence is going on is bogus. The reality is the engineers and designers have different priorities. Replacement parts are often expensive because the machines required to make them are expensive, and they want to retool them to make something else as soon as possible, so they often make a bunch of extras and shove them in a warehouse somewhere. If those run out, and they have to make more, it means they have to spend a ton of money to make another run of them.
When people are buying cars, they want the latest and greatest. A car made using the tried and tested tech from 10 years ago would last longer, and be more reliable, but would offer less performance,comfort, and safety for pretty much the same price or more.
Shouldn't they be using OpenBSD, then?
Then the hospitals all complain because the in-house IT generally only understand MS, so they will have to pay for even the simplistic things.
I work for a medical software company and we had a program that ran on Linux only for a long time. We eventually ported it to Windows because the majority of the support calls required an on site visit since no one in IT support was willing and/or able to touch a Linux box. Several times I went to sites and the only problem would be that the hard disk was full and they simply needed to delete some old/unneeded data.