CVE-2019-5091 in LEADTOOLS
Summary
by MITRE
An exploitable denial-of-service vulnerability exists in the Dicom-packet parsing functionality of LEADTOOLS libltdic.so version 20.0.2019.3.15. A specially crafted packet can cause an infinite loop, resulting in a denial of service. An attacker can send a packet to trigger this vulnerability.
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Analysis
by VulDB Data Team • 03/10/2024
The vulnerability identified as CVE-2019-5091 represents a critical denial-of-service weakness within the LEADTOOLS libltdic.so library version 20.0.2019.3.15. This library serves as a foundational component for medical imaging applications, particularly those handling DICOM (Digital Imaging and Communications in Medicine) protocol data. The DICOM standard governs the storage, exchange, and transmission of medical imaging information, making this vulnerability particularly concerning for healthcare systems and medical device manufacturers that rely on LEADTOOLS for their imaging software solutions. The flaw manifests specifically within the packet parsing functionality, which is responsible for interpreting and processing incoming DICOM data streams from various sources including medical devices, PACS systems, and imaging workstations.
The technical implementation of this vulnerability stems from inadequate input validation within the DICOM packet processing logic. When a specially crafted packet is received by the vulnerable library, the parsing routine enters an infinite loop condition that consumes excessive system resources and prevents the application from processing legitimate requests. This occurs because the packet structure contains malformed or recursive elements that the parser cannot properly handle, causing it to repeatedly execute the same processing steps without making forward progress. The vulnerability is classified under CWE-835, which specifically addresses infinite loops in software, and represents a classic example of how malformed input can lead to resource exhaustion attacks. The infinite loop mechanism typically involves recursive data structures or circular references within the DICOM packet that cause the parser to continuously iterate through the same data segments without proper termination conditions.
The operational impact of CVE-2019-5091 extends beyond simple service disruption to potentially compromise entire medical imaging workflows. In healthcare environments, this vulnerability could lead to critical system outages where radiology departments lose access to imaging data, diagnostic systems become unresponsive, and medical workflows are severely disrupted. The attack surface is particularly broad since DICOM packets can originate from numerous sources including PACS servers, medical imaging devices, and networked diagnostic equipment. Attackers can exploit this vulnerability by simply sending a maliciously constructed DICOM packet to any system running the vulnerable LEADTOOLS library, making the attack vector extremely accessible and difficult to defend against through network segmentation alone. This type of vulnerability aligns with ATT&CK technique T1499.001, which covers network denial of service attacks, and demonstrates how seemingly benign protocol parsing functions can become attack vectors when proper input validation is absent.
Mitigation strategies for CVE-2019-5091 require immediate attention from system administrators and security teams responsible for medical imaging infrastructure. The primary solution involves upgrading to a patched version of the LEADTOOLS library where the parsing logic has been corrected to properly handle malformed DICOM packets and prevent infinite loop conditions. Organizations should implement network monitoring solutions to detect unusual traffic patterns that might indicate exploitation attempts, including monitoring for repeated malformed DICOM packet transmissions. Additionally, implementing input validation at network boundaries and using intrusion detection systems specifically configured to identify DICOM protocol anomalies can provide additional layers of defense. The vulnerability also highlights the importance of regular security assessments for medical imaging systems and adherence to industry standards such as those established by the National Institute of Standards and Technology for healthcare cybersecurity. Organizations should also consider implementing application-level firewalls or proxy services that can filter DICOM traffic before it reaches vulnerable applications, providing an additional protective barrier against exploitation attempts.