CVE-2018-18564 in Accu-Chek Inform II
Summary
by MITRE
An issue was discovered in Roche Accu-Chek Inform II Instrument before 03.06.00 (Serial number below 14000) and 04.x before 04.03.00 (Serial Number above 14000), CoaguChek Pro II before 04.03.00, and cobas h 232 before 04.00.04 (Serial number above KQ0400000 or KS0400000). Improper access control allows attackers in the adjacent network to change the instrument configuration.
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Analysis
by VulDB Data Team • 04/14/2020
This vulnerability represents a critical access control flaw in medical diagnostic equipment manufactured by Roche Diagnostics, specifically affecting several models of blood glucose monitoring instruments and coagulation analyzers. The issue stems from insufficient authentication mechanisms and weak authorization checks within the network communication protocols of these devices, creating a pathway for unauthorized network actors to manipulate critical system configurations. The vulnerability affects multiple generations of medical devices including the Accu-Chek Inform II series, CoaguChek Pro II, and cobas h 232 analyzers, with specific version ranges indicating the scope of affected firmware implementations. The improper access control design allows attackers positioned within the same network segment to execute configuration changes without proper credentials or authorization, fundamentally compromising the integrity of medical testing equipment.
The technical exploitation of this vulnerability occurs through network-based attacks targeting the communication protocols used by these medical devices. Attackers can manipulate device settings, potentially altering calibration parameters, test configurations, or operational parameters that directly impact patient care outcomes. This flaw specifically affects devices operating within the same adjacent network, meaning that network proximity alone is sufficient for exploitation, without requiring physical access or sophisticated attack vectors. The vulnerability creates a persistent risk where unauthorized modifications can persist until manual intervention occurs, potentially leading to incorrect test results or device malfunctions that could compromise patient safety. The affected firmware versions indicate that this issue was present across multiple software releases, suggesting a systemic design flaw rather than a single instance of poor coding practice.
The operational impact of this vulnerability extends beyond simple configuration changes to encompass potential patient safety risks and regulatory compliance issues. Medical devices that provide critical diagnostic information must maintain configuration integrity to ensure accurate results and proper device operation. When attackers can modify these parameters, they create opportunities for false readings, incorrect diagnoses, or device failures that could delay critical medical decisions. The vulnerability also raises concerns about the security posture of healthcare facilities, as it demonstrates that network segmentation alone is insufficient to protect critical medical equipment from adjacent network attackers. Healthcare organizations may face regulatory scrutiny and compliance violations under standards such as hipaa and medical device regulations when such vulnerabilities exist in their deployed equipment. The risk is particularly concerning in hospital environments where multiple devices communicate over shared networks and where unauthorized access could potentially affect multiple patients across different care units.
Mitigation strategies for this vulnerability must address both immediate remediation and long-term security improvements. Organizations should prioritize updating affected devices to the latest firmware versions provided by Roche Diagnostics, ensuring that all devices within their network are patched according to manufacturer recommendations. Network segmentation and access control measures should be enhanced to limit communication between medical devices and other network segments, implementing stricter firewall rules and network access controls. Regular vulnerability assessments and security audits should be conducted to identify similar access control weaknesses in other medical devices within the healthcare environment. The implementation of network monitoring solutions can help detect unauthorized configuration changes and alert security teams to potential exploitation attempts. Additionally, healthcare organizations should establish robust device management policies that include regular firmware updates, secure configuration baselines, and incident response procedures specifically tailored to medical device security incidents. This vulnerability highlights the importance of addressing security in medical device lifecycle management and the need for continuous monitoring of device security post-deployment.