CVE-2011-3386 in Paradigm wireless insulin pump
Summary
by MITRE
Unspecified vulnerability in Medtronic Paradigm wireless insulin pump 512, 522, 712, and 722 allows remote attackers to modify the delivery of an insulin bolus dose and cause a denial of service (adverse human health effects) via unspecified vectors involving wireless communications and knowledge of the device s serial number, as demonstrated by Jerome Radcliffe at the Black Hat USA conference in August 2011. NOTE: the vendor has disputed the severity of this issue, saying "we believe the risk of deliberate, malicious, or unauthorized manipulation of medical devices is extremely low... we strongly believe it would be extremely difficult for a third-party to wirelessly tamper with your insulin pump... you would be able to detect tones on the insulin pump that weren t intentionally programmed and could intervene accordingly."
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Analysis
by VulDB Data Team • 08/16/2018
The vulnerability identified as CVE-2011-3386 affects Medtronic Paradigm wireless insulin pumps across multiple models including 512, 522, 712, and 722 series devices. This represents a critical security flaw in medical device cybersecurity that demonstrates the potential for remote manipulation of life-critical medical equipment. The vulnerability specifically relates to wireless communication protocols that allow unauthorized parties to potentially alter insulin delivery parameters without physical access to the device. The flaw exploits the inherent wireless communication capabilities of these medical devices, which were designed to facilitate remote monitoring and adjustment of insulin delivery but inadvertently created attack surfaces for malicious actors.
The technical nature of this vulnerability involves the exploitation of wireless communication channels that are not adequately secured against unauthorized access. Attackers can potentially modify insulin bolus doses and cause denial of service conditions through unspecified vectors that leverage knowledge of the device's serial number. This represents a significant weakness in the device's authentication and authorization mechanisms, as the serial number knowledge alone provides sufficient information to potentially compromise the device's operation. The vulnerability falls under the category of insufficient authentication and inadequate cryptographic protection as outlined in CWE-287 and CWE-327 respectively, highlighting the fundamental security flaws in the device's wireless communication architecture.
The operational impact of this vulnerability extends beyond simple technical disruption to pose serious threats to patient health and safety. When insulin delivery is compromised, patients may receive incorrect dosages that can lead to severe medical emergencies including hypoglycemic or hyperglycemic reactions. The potential for denial of service through this vulnerability means that patients could lose access to critical insulin delivery during times when their medical condition requires consistent treatment. This vulnerability directly impacts the availability and integrity of medical device functionality, which can be fatal for diabetic patients who depend entirely on these devices for their survival. The risk assessment for such vulnerabilities aligns with ATT&CK technique T1499.001 which addresses adversary tactics targeting device availability and integrity in medical environments.
The demonstration of this vulnerability at the Black Hat USA conference in August 2011 by Jerome Radcliffe highlighted the real-world applicability of such attacks against medical devices. This public disclosure raised awareness about the critical security challenges facing connected medical devices and the need for comprehensive security testing of life-critical equipment. The vendor's response dismissing the severity of the issue is problematic as it underestimates the potential for exploitation and the serious consequences of such attacks on patient safety. This vulnerability demonstrates the gap between medical device manufacturers' security assessments and actual security risks, particularly when devices are designed without adequate consideration for wireless security threats. The incident underscores the importance of robust security by design principles in medical device development and the need for continuous security evaluation of connected medical equipment.
The security implications of this vulnerability extend to broader concerns about medical device cybersecurity and the protection of patients using connected medical devices. The vulnerability represents a significant gap in the security architecture of medical devices that could be exploited by malicious actors with sufficient technical knowledge and access to the target device's serial number. This type of attack vector demonstrates how wireless connectivity in medical devices, while beneficial for remote monitoring and management, can create security vulnerabilities that compromise patient safety. The potential for such attacks to go undetected until they cause harm makes these vulnerabilities particularly dangerous and highlights the critical need for comprehensive security testing and monitoring of medical device networks. The incident serves as a foundational example of why medical device security standards must be rigorously enforced and why manufacturers must take security threats seriously in the development lifecycle of connected medical equipment.