CVE-2018-14781 in MMT 508
Summary
by MITRE
Medtronic MMT 508 MiniMed insulin pump, 522 / MMT - 722 Paradigm REAL-TIME, 523 / MMT - 723 Paradigm Revel, 523K / MMT - 723K Paradigm Revel, and 551 / MMT - 751 MiniMed 530G The models identified above, when paired with a remote controller and having the "easy bolus" and "remote bolus" options enabled (non-default), are vulnerable to a capture-replay attack. An attacker can capture the wireless transmissions between the remote controller and the pump and replay them to cause an insulin (bolus) delivery.
If you want to get the best quality for vulnerability data then you always have to consider VulDB.
Analysis
by VulDB Data Team • 05/22/2025
The CVE-2018-14781 vulnerability affects several Medtronic insulin pump models including the MiniMed 508, 522, 523, 523K, 551, 530G, 722, 723, and 723K devices. These medical devices are critical for diabetes management, with the affected models utilizing wireless communication protocols to facilitate remote control functions. The vulnerability specifically targets the wireless communication channel between the remote controller and the insulin pump, creating a significant security risk for patients who rely on these life-saving devices. The issue manifests when the "easy bolus" and "remote bolus" features are enabled, which represents a non-default configuration that increases the attack surface. This vulnerability falls under the CWE-310 cryptographic weakness category, specifically addressing weaknesses in cryptographic protocols and implementation flaws in wireless communication systems. The attack vector involves passive monitoring of wireless transmissions followed by active replay of captured data packets, representing a classic capture-replay attack pattern that aligns with techniques documented in the MITRE ATT&CK framework under the T1059.001 command and control categories.
The technical flaw stems from inadequate authentication mechanisms and lack of proper message integrity verification within the wireless communication protocol. When users enable the remote bolus functionality, the system transmits commands containing insulin dosage information without sufficient cryptographic protection or sequence number validation. This allows an attacker within radio range to intercept these transmissions and replay them at a later time to execute unauthorized insulin deliveries. The vulnerability represents a fundamental failure in implementing secure communication protocols for medical devices, where the wireless protocol lacks proper encryption, authentication, and replay protection mechanisms. The affected devices operate in a closed-loop environment where the remote controller communicates with the pump through proprietary wireless protocols, but these protocols do not implement adequate security measures to prevent unauthorized command injection. This weakness creates a scenario where an attacker with basic radio equipment and minimal technical knowledge can potentially cause life-threatening situations by manipulating insulin delivery amounts.
The operational impact of this vulnerability extends beyond simple unauthorized command execution to pose serious patient safety risks. An attacker could potentially deliver incorrect insulin dosages, leading to severe hypoglycemic or hyperglycemic events that could result in immediate health complications or even death. The vulnerability affects patients who are already managing critical health conditions and rely on automated insulin delivery systems for their daily survival. The risk is particularly concerning because the attack can be executed remotely without physical access to the device, making it difficult for patients to detect or prevent unauthorized access. Healthcare providers and patients must consider the implications of this vulnerability in clinical settings where multiple devices may be operating in close proximity, potentially creating opportunities for attackers to capture transmissions from multiple devices. The vulnerability also impacts the broader medical device security landscape by demonstrating how wireless communication in critical medical systems can be compromised without proper security implementation. This represents a significant concern for the medical device industry and regulatory bodies responsible for ensuring patient safety in connected healthcare environments.
Mitigation strategies for CVE-2018-14781 should focus on both immediate operational measures and long-term security improvements. Users should disable the "easy bolus" and "remote bolus" features when not actively required, as these represent the primary attack vectors for this vulnerability. Medical device manufacturers should implement proper cryptographic protocols including message authentication codes and sequence number validation to prevent replay attacks. The affected devices should be updated with firmware patches that address the communication protocol weaknesses, though this may require coordination with healthcare providers and regulatory approvals. Healthcare facilities should implement physical security measures to limit unauthorized access to areas where these devices operate, including monitoring for unusual radio frequency activity. The vulnerability highlights the importance of secure design principles in medical devices and the need for comprehensive security testing during the development lifecycle. Organizations should also consider implementing network segmentation and monitoring solutions to detect anomalous communication patterns that might indicate attempted exploitation of this vulnerability. Regular security assessments of connected medical devices should be conducted to identify similar weaknesses in other systems that may pose comparable risks to patient safety and device integrity.