FDA Releases New Cybersecurity Guidelines For Medical Devices (theverge.com)
An anonymous reader quotes a report from The Verge: The U.S. Food and Drug Administration released its recommendations for how medical device manufacturers should maintain the security of internet-connected devices, even after they've entered hospitals, patient homes, or patient bodies. Unsecured devices can allow hackers to tamper with how much medication is delivered by the device -- with potentially deadly results. First issued in draft form last January, this guidance is more than a year in the making. The 30-page document (PDF) encourages manufacturers to monitor their medical devices and associated software for bugs, and patch any problems that occur. But the recommendations are not legally enforceable -- so they're largely without teeth. The FDA issued an earlier set of recommendations in October 2014 (PDF), which recommended ways for manufacturers to build cybersecurity protections into medical devices as they're being designed and developed. Today's guidance focuses on how to maintain medical device cybersecurity after devices have left the factory. The guidelines lay out steps for recognizing and addressing ongoing vulnerabilities. And they recommend that manufacturers join together in an Information Sharing and Analysis Organization (ISAO) to share details about security risks and responses as they occur. Most patches and updates intended to address security vulnerabilities will be considered routine enhancements, which means manufacturers don't have to alert the FDA every time they issue one. That is, unless someone dies or is seriously harmed because of a bug -- then the manufacturer needs to report it. Dangerous bugs identified before they harm or kill anyone won't have to be reported to the FDA as long as the manufacturer tells customers and device users about the bug within 30 days, fixes it within 60 days, and shares information about the vulnerability with an ISAO.
not!
What about makeing os updates happen? and letting the local IT staff lock down there network and not be forced to have some things wide open to the outside vendor.
But the recommendations are not legally enforceable -- so they're largely without teeth
My authoritah !!
Its not enough to just be reactive about computer security. This still means that sophisticated attackers can hoard security vulnerabilities and develop advanced tools that find vulnerabilities the moment they are introduced. Instead, you should already design the system in a way that frustrates attacks and hopefully prevents some attacks entirely. A good talk about this:
https://www.youtube.com/watch?...
Slides:
http://outflux.net/slides/2016...
. . . but an ongoing process, and this does not appear to recognize that. Especially with medical device certification: make a change, and generally the entire system must be re-certified.
So if a flaw is found in $libfoo, and fixed, FIRST the med companies need to know about it (not sure they even LOOK. . . ), and THEN update. And yet all too many Medical systems I've seen are still running Windows XP. . . How do you remediate something that's out of support ???
Is this the same federal government that still hasn't released full security guidelines for Hippa? And how much older is the Hippa issue?
BlackBerry may have conceded the mobile handset business but they own the automotive market. (Both Android Auto and CarPlay run as plug-in modules for BlackBerry's QNX Car OS) And for the last four years they have been quietly buying up medical electronic companies left and right and integrating them into QNX.
"A person is smart. People are dumb, panicky dangerous animals and you know it." - K
But the recommendations are not legally enforceable
Sure it is. Once a manufacturer is sued for negligence, the plaintiff can point out any failures to follow the FDA recommendations. It is a "soft" argument.
The FDA's guidlines are not enforcable. So the hospitals will care a lot more about anything in the manufacturers' EULAs that let them disclaim liability.
A lot of medical equipment, especially large scanners, are controlled by a PC. The embedded OS may be something real time, but the control PC almost always runs Windows. It does higher level functions like visualization, printing, etc. Since these devices are large capitol investments, they're kept for many years. Most doctor's offices don't have the technical skills to upgrade them. Even large hospitals can't maintain the expertise on every single device. Even if they did, they don't dare, because the manufacturer will try to disclaim any liability if the software installed on the PC has been altered in any way. Most places won't even allow IT to install virus scanners.
The equipment vendors have a financial incentive not to change their platform. It requires repeating quality assurance tests for liability, and creates a moving target for their developers. They also have an incentive to forbid local changes, because it gives them an excuse to disclaim responsibility in court.
In my opinion, all of these diagnostic systems should be air-gapped from the hospital intranet. Data should be shuttled in and out of them on removable hard drives. There should be an intermediate system that virus scans them before connecting them to either side. It would be a huge pain, but far less so than the ransomware.
FDA guides are based on their interpretation of existing regulations. Device companies are free to not follow the guides, but they must be able to demonstrate that their internal systems are equal to or better than the guides. If the FDA finds they have not followed the guides or their internal systems are "inadequate", then the FDA cites the regulations and finds the company to not be in compliance.
Where there is a lack of teeth is in FDA's lack of legal enforcement power. They must go through the Justice Department to take legal action. So most violations are corrected by giving the company 30 (or 60 or 90) days to remedy the violations. Unless the someone actually gets hurt, or the FDA believes the company is truly a threat to patient safety. Then the FDA will work with Justice to get warrants and take the company to court. And the device regulations explicitly hold management to be responsible. And the CEO is the "responsible head". So any court action will name the CEO as a defendant.
I see several posts that amount to "These guidelines are too vague." Understand how regulations work, and that they are a trade-off: governments are not going to give a specific detailed list of how to address, for example, security concerns in software and hardware. They will not say "All passwords must be length X" or "Passwords must be stored using PBKDF2 hashes with N number of rounds" or "All secure access doors must use a lock with at least 15 tumblers in it." While such guidelines would make liability a lot simpler, they would need to constantly change and no one could ever agree to them.
Instead, the regulations say things like "Use industry-standard best practices when securing patient data." Now that sounds completely obvious to any professional, but understand that security breaches happen most often because these kinds of obvious things are missed!
They then expect the industry to take those high-level requirements and use a bit of self-regulation to determine what exactly the regulations mean. And that naturally changes over time, which is the intent. For example, the industry has decided that this means web sites should follow the OWASP top 10. They seem to have coalesced on using only FIPS-compliant algorithms. And there is agreement that protected health information (PHI) must be encrypted "in transit and at rest." But take that last one for example: does that mean that PHI must be encrypted when transiting across the internet, or across PCs within a LAN, or within devices in an embedded machine, or across chips on a board? That might depend. As technology changes, so will the expectations for what is secure. And without a bunch of congress-people having to argue over it and pass a new law.
Ultimately, companies that want to be in compliance must to prove that they thought about these things and made sensible decisions. Yeah, it sucks that this is vague, but there really is no perfect regulatory solution here. That work is delegated to other agencies and the industry itself.
There is no bulletproof protection, there is only a probability of failure you are willing to accept. When the consequences of failure are severe (somebody could die / you're a teen in a world that outlaws abortion) then you damn well use multiple layers of defense but you'll never be 100% safe if you're doing anything fun.
A security tool is never ignored for being not bulletproof. You would only choose not to use it if the protection it adds is disproportionate to its cost. These days ASLR is inexpensive relative to the protection it adds so you'd be silly not to include it.
after making sure that the recommendations are useful the Regulators need to "suggest" that the insurance companies can use not following the guidelines would be a jolly way to give an out for the insurance companies (and depending on the scope lawyers love the words "Gross Negligence")
so you don't include decent crypto in your CLOUD ENABLED drug pump or you have a backdoor in your Social Net Enabled Heart (with matching lack of safe default settings)
NO CLAIM FOR YOU and hope that the next of kin does not have good lawyers because your malpractice insurance just got cancelled.
(personally i think the CxOs of those companies need to go down on Murder charges)
And why?
It costs money to think of the problem, it costs even more money to evaluate any risks, it costs still more money to think about fixing them, and it's downright expensive to actually implement any fixes.
Incorporating cyber-security risk management will be part of the development process as soon as people are willing to pay for it. Which they aren't, because they can't see it so they can't even check it's there. Plus, it's probably a lot cheaper to just settle with any victims out of court than to bust a gut trying to turn medical devices into electronic fortresses. So don't count on the market to fix anything.
This seems a typical case where "self-regulation" is dead on arrival and only statutory safety requirements will get results. But that's not happening because of politics. Conservative politics to be precise. Pussyfooting about where industry regulations are concerned is the reason we're seeing such a lot of unsafe devices.
Expect that to continue for the next 4 years. Until and unless someone can whip up a juuuge scare story about ISIS sabotaging medical devices in the US. Oh wait ... what will happen then is that they'll shut down the Internet within half a mile of any hospital and start a fresh bombing campaign wherever. Ok, that won't work.
Perhaps if some reality star is killed through a hacked medical device? Or a photogenic child?