CVE-2019-6538 in MyCareLink Monitor
Summary
by MITRE
The Conexus telemetry protocol utilized within Medtronic MyCareLink Monitor versions 24950 and 24952, CareLink Monitor version 2490C, CareLink 2090 Programmer, Amplia CRT-D, Claria CRT-D, Compia CRT-D, Concerto CRT-D, Concerto II CRT-D, Consulta CRT-D, Evera ICD, Maximo II CRT-D and ICD, Mirro ICD, Nayamed ND ICD, Primo ICD, Protecta ICD and CRT-D, Secura ICD, Virtuoso ICD, Virtuoso II ICD, Visia AF ICD, and Viva CRT-D does not implement authentication or authorization. An attacker with adjacent short-range access to an affected product, in situations where the product?s radio is turned on, can inject, replay, modify, and/or intercept data within the telemetry communication. This communication protocol provides the ability to read and write memory values to affected implanted cardiac devices; therefore, an attacker could exploit this communication protocol to change memory in the implanted cardiac device.
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Analysis
by VulDB Data Team • 05/22/2025
The vulnerability described in CVE-2019-6538 represents a critical security flaw in the Conexus telemetry protocol implemented by Medtronic across numerous cardiac implantable electronic devices. This protocol serves as the communication interface between medical devices and healthcare providers, enabling remote monitoring and programming of life-saving implants. The absence of proper authentication and authorization mechanisms creates a fundamental security gap that directly threatens patient safety and device integrity. The affected devices include various models of cardiac resynchronization therapy defibrillators and implantable cardioverter defibrillators, spanning multiple product lines including Amplia, Claria, Compia, Concerto, Consulta, Maximo II, Mirro, Nayamed ND, Primo, Protecta, Secura, Virtuoso, Visia AF, and Viva series.
The technical implementation flaw stems from the protocol's failure to establish secure communication channels between the medical device and external programmers or monitors. This vulnerability operates at the network layer of the device communication stack, specifically targeting the short-range wireless telemetry functionality that enables healthcare providers to access device memory and configuration parameters. The Conexus protocol lacks cryptographic authentication mechanisms that would normally verify the identity of communicating parties and ensure data integrity. As a result, an attacker positioned in close proximity to an affected device can exploit this weakness to perform man-in-the-middle attacks, injecting malicious commands or modifying legitimate data transmissions. The protocol's design does not implement message authentication codes or digital signatures, leaving communication channels completely exposed to unauthorized manipulation.
The operational impact of this vulnerability extends beyond simple data interception, as it provides attackers with the capability to directly modify critical device memory values. This represents a severe threat to patient safety since cardiac devices maintain sensitive configuration parameters that control device behavior, including therapy delivery timing, sensitivity thresholds, and anti-tachycardia pacing settings. An attacker could potentially disable life-saving therapies, alter device sensitivity to detect arrhythmias, or even program the device to deliver inappropriate shocks. The vulnerability affects devices in active use, meaning that patients currently implanted with these devices face ongoing risk while the device's radio is powered on. The attack vector requires only adjacent short-range access, making it particularly concerning given that these devices are implanted within patients' bodies and could be compromised in various real-world scenarios including medical facility visits, airport security screening, or even casual proximity to unauthorized individuals.
This vulnerability aligns with CWE-312 (Cleartext Storage of Sensitive Information) and CWE-310 (Cryptographic Issues) categories, representing a fundamental failure in implementing proper cryptographic controls for medical device communications. From an attack perspective, this vulnerability maps to several ATT&CK techniques including T1046 (Network Service Scanning) for initial discovery, T1566 (Phishing) for potential social engineering to gain proximity access, and T1059 (Command and Scripting Interpreter) for executing malicious commands once access is achieved. The attack surface is particularly concerning given that these devices operate continuously within patients' bodies, making any compromise potentially life-threatening. Healthcare organizations and patients must consider this vulnerability as a critical risk requiring immediate attention, as it fundamentally undermines the security model of medical device telemetry communications and represents a serious breach of the principle of least privilege in medical device security.
Mitigation strategies for this vulnerability should include immediate implementation of physical security measures to prevent unauthorized access to devices, enhanced monitoring of device communications, and coordination with Medtronic for potential firmware updates or device replacement programs. Healthcare providers must implement strict access controls for device programming environments and consider the development of secure communication protocols for future medical device implementations. The vulnerability underscores the critical need for robust security-by-design principles in medical device development, particularly for devices that operate in close proximity to patients and handle life-critical data. Organizations should also consider implementing additional layers of security including device authentication, encrypted communications, and regular security assessments of medical device networks to prevent similar vulnerabilities from emerging in other critical systems.