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Over 1,400 Vulnerabilities Found In Automated Medical Supply System

An anonymous reader writes: Security researchers have discovered 1,418 vulnerabilities in CareFusion's Pyxis SupplyStation system -- automated cabinets used to dispense medical supplies -- that are still being used in the healthcare and public health sectors in the US and around the world. The vulnerabilities can be exploited remotely by attackers with low skills, and exploits that target these vulnerabilities are publicly available. Things already seem to be getting out hand.

16 of 85 comments (clear)

  1. No surprise by marcansoft · · Score: 4, Insightful

    Medical and healthcare companies consistently seem to have *no idea* whatsoever about security, and *no idea* that they actually need to hire someone who knows security.

    Anything with a computer in it needs to take into account security. If you're putting code into your product and don't know security and aren't hiring someone who does, you're doing it wrong. Medical devices, cars, even Bluetooth toilets. If it communicates with the outside world or is exposed to users who aren't authorized full control over the device, it needs security. If you don't do it, your product is a ticking time bomb waiting for a researcher, if you're lucky, or a malicious attacker, if you aren't, to notice the lack of security. This will keep happening until everyone gets the message.

    1. Re:No surprise by tripleevenfall · · Score: 2

      At one time that was the case, but things are changing. These organizations have become well aware of what breaches can cost them from news related to the legal ramifications, and that's what finally gets people motivated to beef up security... the dollars at risk.

      The problem is exacerbated by the shoestring budgets that health care orgs run on these days, due to declining reimbursement, an increase in government as payor reimbursement models (but I repeat myself), and ever-increasing levels of unreimbursed care mean that money (and thus, the will) to refresh hardware and legacy systems is not there - particularly when clinical staff will say these older systems "are working just fine".

      Things are changing, but government efforts to massively increase the volume of care being given while simultaneously driving down reimbursement does not help security to become better.

    2. Re:No surprise by Anonymous Coward · · Score: 3, Interesting

      As someone who has worked on FDA approved medical devices, while the development processes can be a hassle to work with, ultimately they aren't the cause of poor security. What is the cause is that noone is willing to pay for it because a more secure product doesn't cause more checkboxes on the spec sheet to be filled out.

    3. Re:No surprise by SecurityGuy · · Score: 2

      Not government, it's the false belief that security is sufficiently handled by following a process. It's not enough to check the boxes if the boxes are wrong.

  2. End of Life systems prone to New Attacks= by bigdady92 · · Score: 4, Insightful

    No Shit sherlock.

    Windows XP and Windows 2003 systems are prone to all sorts of horrible security flaws. Reading the Fucking Article I see that the newer, non EOL, equipment isn't prone to any of these problems.

    I wonder how many vulnerabilities are in older Cisco routers that haven't been patched since 2007?

    --
    Wheel of Time: Book by Book and Sumview (summary review) Bigdady92 style: http://bigdady92.blogspot.com/
    1. Re:End of Life systems prone to New Attacks= by aaarrrgggh · · Score: 3, Insightful

      The bulk attacks that are likely enabled by XP/2003 I would agree with you on. However, they are representative of many other problems with brand new Pyxis units from what I hear. The unspoken word seems to be that it is still less vulnerable than the traditional human-centric supply systems. The typical solution is defense in depth, with a key-code door lock to the room and a camera in the room-- so things can be tracked by belt and suspenders in a failure/attack.

    2. Re: End of Life systems prone to New Attacks= by Anonymous Coward · · Score: 3, Informative

      These things sit in the hallways on every floor in my hospital.

    3. Re: End of Life systems prone to New Attacks= by demonlapin · · Score: 2

      That's not exactly the best design. There are a lot of ways around the problem - you put them in nurses' stations where the likelihood of someone observing an intruder is very high, you put cameras on the area, you limit accounts from being able to dispense meds when outside their proper work area, you put them on a separate network. I'm an anesthesiologist. If I need to get into a drug dispensing machine I need to get into it right the hell now, but my login only works in the operating rooms and the obstetric suite. It's a bit silly (if I wanted to divert drugs, I could do so easily, as I go through enough that taking 10% of the total would be more than enough to supply anything less than a hardcore habit), but it does exist.

      I'm not saying this isn't a problem, but until we have perfect computer security, you're going to have to have the other methods as well. Even very good security doesn't save you much (if any) money.

  3. This should surprise no one by ranton · · Score: 2

    I worked at a competitor of Pyxis who created similar automated drug dispensing cabinets, and the market research at the time was that they all were pretty insecure. When I left my company they were dealing with a defect where anyone with a screwdriver could bypass the locking mechanism of our newest model (meant for the area where the schedule 2 drugs were kept).

    At the time (almost 10 years ago) these devices were meant to help with inventory management, not to be ultra-secure safes. Anyone with even moderate training using these devices could steal drugs if they wanted. Most thieves were caught only because of the sheer volume of drugs they stole over months or even years.

    --
    -- All that is necessary for the triumph of evil is that good men do nothing. -- Edmund Burke
    1. Re:This should surprise no one by tnk1 · · Score: 3, Interesting

      I think that's the major issue with medical IT and computing in general. The products are designed to do something, and security is an afterthought. That's made worse because many of the products were designed a long time ago and not updated for various reasons, including a long regulatory approval process to get them to market.

      So you have a supply cabinet that was designed to help with inventory, but now we expect it to be a safe. And the network infrastructure that probably grew ad hoc in the hospitals was just meant to enable interconnection and security only became an eventual concern as attacker capabilities grew. Because the product cycle is so long for medical purposes, they don't react in a timely way to anything, especially something that is not the primary concern of the equipment that is being deployed. So now you have this issue.

      I don't think this is a permanent problem for hospitals, but there will be some sacrificial lambs before the process changes. Once those cases are over, there will be more money put into security at those places.

      Unfortunately, it's just another thing that is likely to raise the cost of medical care because they will continue to be bad at it, but now they'll be trying to compensate for their incompetence by overpaying for security products and services.

  4. War Story on Medical System Security by Salgak1 · · Score: 4, Interesting

    . . . . year or two back, my oldest daughter entered a program to learn the "EPIC" medical records system. Now, admittedly, we're a geekhaus, my daughters were doing computers at age 5, and my youngest managed to hack the oldest by examining her browser cache at age 8.

    But she came back from the first day or two of training, shaking HER head. Not only was there no folder security, but, at least as configured there, every user was an admin.. Each of which could mess with another's files and account settings.

    Worse still, they were being trained at the site where the system was being hosted for production. No physical security. No backup power: in fact, zero redundancy whatsoever. And data backup ? "What's that ?"

    She wrote up a 2-page summary of problems SHE saw (and her training was in Medical Administration, although she DID learn Security from me. . .). She sends it to the POC at the Hospital the system was in the process of being installed for. . . .and the EPIC people dropped her from the course.

    There's a cherry on the top of this Sundae of Fail: she was eventually hired by the Hospital as, surprisingly enough, a Ward Medical Admin. And the IT Department comes to HER for help and suggestions. . . .

    1. Re:War Story on Medical System Security by dmr001 · · Score: 2

      Epic is a big suite of applications that run on top of a big iron server - typically Unix (ours is AIX, I think). There's fine-grained user permissions in the application itself. End users do not have shell access or filesystem access or MUMPS prompt access, and everything has an audit trail. A select group of IT nerds get access to a text-based system running as a (Unix) application (with audit trails), and, at least at our organization, next to no one gets MUMPS prompt access or shell access. We have hot swappable servers located on opposing coasts of North America. I can't speak to the implementation at your daughter's site.

      There may be examples out of there of hackers breaking into Epic; I'm not aware of any. Since our implementation was modeled after Epic's recommendations my impression is they've got their heads screwed on straight, security-wise.

  5. Re:epic MUMPS by Salgak1 · · Score: 2

    No clue. . . but as MUMPS is now 50 years old, it's entirely possible that it was built without multi-user systems in mind. Looking at the basic description in Wikipedia, and perusing the Annotated MUMPS standard, I don't even see provisions for accounts, much less security. . .

  6. I'd be proud by JustAnotherOldGuy · · Score: 2

    I don't know about you, but I'd be proud as hell if I'd managed to write an application that had 1400+ vulnerabilities.

    It must have taken a lot of work and testing to make sure it was that porous and vulnerable. I mean, just think of all the work involved in taking out all of the bounds checking, sanity tests, input validation, error checking, etc etc.

    IF ($INPUT){
          GRANT FULL ADMIN SUPERUSER ACCESS OMG;
    }ELSE{
          GRANT FULL ADMIN SUPERUSER ACCESS OMG;
    }

    --
    Just cruising through this digital world at 33 1/3 rpm...
  7. "Professionals Know Best" Syndrome by jasnw · · Score: 2

    I've seen this problem in many organizations run by people who consider themselves to be in a "profession" like doctors, lawyers, and to a varied extent anyone with a non-computer PhD. The attitude seems to be that "I am smart, so I can figure this out without paying someone who knows what they're doing, and I'll do a better and less expensive job." This applies to many aspects of running an organization, with IT and finance/budget being two very egregious areas. I've seen many a small R&D company fail because its principle owners/operators try to do the finance/budget side after the company has become larger than a couple of people, and lots of computer security issues in companies where this "we can do it all" attitude holds sway. They can't quite see that people pay them for their expertise, so why should they balk at paying other people for expertise they don't themselves have. I've been expecting a security meltdown at hospitals and medical facilities ever since the big money pushed in a few years ago by the Government to drag medical IT into at least the last decade of the 20th century. This will be quite the roller-coaster ride.

    1. Re:"Professionals Know Best" Syndrome by Kevin+by+the+Beach · · Score: 2

      Good Point... I helped a Lawyer friend upgrade his systems. He didn't want an in-house IT person, so I strongly recommended the cloud based solution. One of his practice partners had too much regulated and sensitive data to move to the cloud (I warned them about the common practice of cloud vendors with their contracts which absolve the cloud vendor of nearly all accountability...) That contract had so many red lines by the time they were done it was funny.