CVE-2012-0992 in OpenEMR
Summary
by MITRE
interface/fax/fax_dispatch.php in OpenEMR 4.1.0 allows remote authenticated users to execute arbitrary commands via shell metacharacters in the file parameter.
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Analysis
by VulDB Data Team • 02/03/2025
The vulnerability identified as CVE-2012-0992 resides within the OpenEMR 4.1.0 medical records management system, specifically in the fax_dispatch.php file located in the interface/fax directory. This represents a critical command injection flaw that enables remote authenticated attackers to execute arbitrary system commands through maliciously crafted input. The vulnerability stems from insufficient input validation and sanitization within the file parameter handling mechanism, allowing attackers to inject shell metacharacters that get processed by the underlying system shell.
This security flaw operates at the intersection of multiple cybersecurity domains, particularly aligning with CWE-77 which describes improper neutralization of special elements used in a command inside a software platform. The vulnerability manifests when authenticated users submit crafted payloads containing shell metacharacters such as semicolons, ampersands, or backticks into the file parameter. These characters are then interpreted by the system shell, enabling attackers to execute arbitrary commands with the privileges of the web application user. The attack vector is particularly dangerous because it requires only authentication, which can be obtained through various means including credential theft or social engineering.
The operational impact of this vulnerability is severe and multifaceted across healthcare environments. An attacker who gains authenticated access to an OpenEMR system can escalate their privileges to execute system-level commands, potentially leading to full system compromise. This includes the ability to install malware, exfiltrate sensitive patient data, modify medical records, or establish persistent backdoors within the healthcare network. The attack can result in significant data breaches affecting Protected Health Information (PHI) as defined under HIPAA regulations, potentially exposing thousands of patient records and violating healthcare privacy standards. Additionally, the compromised system may serve as a foothold for lateral movement within the hospital network, targeting other connected systems such as electronic health record databases, medical devices, or administrative servers.
Organizations should implement multiple layers of defense to mitigate this vulnerability, beginning with immediate patching of affected OpenEMR installations to version 4.1.1 or later where the issue has been resolved. Input validation and sanitization should be strengthened throughout the application to prevent any shell metacharacter injection attempts, implementing proper escaping mechanisms for all user-supplied inputs before processing. Network segmentation and access controls should be enforced to limit the scope of potential exploitation, ensuring that only authorized personnel have access to fax-related functionalities. The principle of least privilege should be applied to web application accounts, restricting their system-level capabilities to prevent command execution. Security monitoring should be enhanced to detect unusual command execution patterns, and regular vulnerability assessments should be conducted to identify similar injection vulnerabilities in other healthcare applications. The ATT&CK framework categorizes this as a command injection technique under T1059, emphasizing the need for proper input validation and output encoding to prevent malicious command execution in web applications.