CVE-2011-5160 in OpenEMR
Summary
by MITRE
Cross-site scripting (XSS) vulnerability in setup.php in OpenEMR 4 allows remote attackers to inject arbitrary web script or HTML via the site parameter.
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Analysis
by VulDB Data Team • 12/29/2024
The CVE-2011-5160 vulnerability represents a critical cross-site scripting flaw in the OpenEMR 4 healthcare management system that exposes organizations to significant security risks. This vulnerability specifically affects the setup.php file, which serves as the initial configuration interface for the medical records system. The flaw arises from inadequate input validation and sanitization mechanisms that fail to properly filter user-supplied data before processing. Attackers can exploit this weakness by manipulating the site parameter during the setup process, allowing them to inject malicious web scripts or HTML content that executes in the context of other users' browsers.
The technical implementation of this vulnerability stems from the application's failure to properly escape or validate user input before incorporating it into dynamic web content. When the setup.php script processes the site parameter without adequate sanitization, it creates an environment where malicious actors can inject script code that gets executed when other users access the affected page. This type of vulnerability falls under CWE-79 which specifically addresses cross-site scripting flaws in web applications, and represents a classic example of how insufficient input validation can lead to severe security consequences. The vulnerability is particularly dangerous because it occurs during the setup phase of the application, potentially allowing attackers to compromise the system before it is fully operational.
The operational impact of CVE-2011-5160 extends far beyond simple data theft or defacement. Healthcare organizations using OpenEMR 4 are at risk of having their systems compromised through persistent XSS attacks that can lead to unauthorized access to patient records, data exfiltration, and potential system takeover. Attackers could inject malicious scripts that redirect users to phishing sites, steal session cookies, or execute commands on behalf of authenticated users. This vulnerability directly violates the principle of least privilege and can enable attackers to establish persistent backdoors within healthcare networks. The attack surface is particularly concerning given that healthcare systems often contain sensitive personal health information that is subject to strict regulatory compliance requirements such as HIPAA, making successful exploitation potentially catastrophic for both patients and organizations.
Mitigation strategies for this vulnerability should include immediate implementation of input validation and output encoding mechanisms within the setup.php script. Organizations should ensure that all user-supplied parameters are properly sanitized and validated before being processed or displayed in web pages. The recommended approach involves implementing strict parameter validation that rejects any input containing potentially dangerous characters or script tags. Additionally, organizations should consider implementing Content Security Policy (CSP) headers to prevent unauthorized script execution, and deploy web application firewalls to monitor and filter suspicious requests. The remediation process should also include comprehensive code review and security testing to identify similar vulnerabilities in other parts of the application. According to ATT&CK framework, this vulnerability maps to T1059.007 which covers scripting through web shells, and T1566 which encompasses social engineering tactics. Regular security updates and patch management procedures should be implemented to prevent similar vulnerabilities from being introduced in future versions of the software. Organizations should also conduct regular security awareness training for administrators to recognize potential exploitation attempts and maintain detailed audit logs to track any suspicious activities related to the setup process.