CVE-2021-40374 in OpenEyes
Summary
by MITRE • 04/06/2022
A stored cross-site scripting (XSS) vulnerability was identified in Apperta Foundation OpenEyes 3.5.1. Updating a patient's details allows remote attackers to inject arbitrary web script or HTML via the Address1 parameter. This JavaScript then executes when the patient profile is loaded, which could be used in a XSS attack.
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Analysis
by VulDB Data Team • 04/08/2022
The stored cross-site scripting vulnerability CVE-2021-40374 resides within the Apperta Foundation OpenEyes 3.5.1 medical imaging platform, representing a critical security flaw that undermines patient data integrity and system confidentiality. This vulnerability specifically targets the patient management functionality where user-supplied input is not adequately sanitized or validated before being stored in the database and subsequently rendered in web pages. The flaw manifests when an attacker manipulates the Address1 parameter during patient profile updates, allowing malicious JavaScript code injection that persists in the system's database. The vulnerability stems from insufficient input validation and output encoding mechanisms within the application's data handling pipeline, creating an environment where attacker-controlled content can be seamlessly integrated into legitimate user interfaces. This represents a classic stored XSS scenario where the malicious payload is stored server-side and executed whenever authorized users access the affected patient records, making it particularly dangerous in healthcare environments where sensitive patient information is constantly accessed by multiple authorized personnel.
The technical exploitation of this vulnerability follows a well-established XSS attack pattern that aligns with CWE-79, which defines the weakness of cross-site scripting in web applications. Attackers can craft malicious payloads that leverage the Address1 parameter to inject JavaScript code, which then executes within the context of other users' browsers when they view patient profiles. The vulnerability's impact extends beyond simple data theft as it can enable session hijacking, credential theft, and the potential for privilege escalation within the healthcare system. The attack vector is particularly concerning because it requires minimal user interaction beyond the initial patient update process, and the malicious code executes automatically when legitimate users access patient records, creating an environment where attacks can remain undetected for extended periods. The stored nature of this vulnerability means that the malicious code persists indefinitely until manually removed from the database, making it a persistent threat that can affect multiple users over time.
The operational impact of CVE-2021-40374 in healthcare environments is severe and multifaceted, potentially compromising patient privacy, data integrity, and system availability. In medical settings where OpenEyes is deployed, this vulnerability could enable attackers to access sensitive patient medical records, personal health information, and confidential treatment details. The attack could facilitate unauthorized access to patient histories, diagnostic results, and treatment plans, violating healthcare privacy regulations such as HIPAA and GDPR. Furthermore, the vulnerability could be exploited to redirect users to malicious sites, steal authentication tokens, or inject malware that could spread throughout the healthcare network. The attack's stealth nature makes it particularly dangerous as it operates without user awareness, potentially allowing attackers to establish persistent access to the system. Healthcare organizations using this vulnerable version face significant compliance risks and potential legal ramifications, as the vulnerability creates an attack surface that could lead to data breaches and unauthorized access to critical medical information.
Mitigation strategies for CVE-2021-40374 must address both immediate remediation and long-term security improvements to prevent similar vulnerabilities in healthcare applications. The primary recommendation involves applying the vendor-provided security patch or upgrade to OpenEyes 3.5.1 to address the input validation and output encoding deficiencies. Organizations should implement comprehensive input sanitization mechanisms that validate and sanitize all user-supplied data before storage, particularly focusing on the Address1 parameter and similar fields within patient management interfaces. The implementation of Content Security Policy (CSP) headers can provide additional protection layers by restricting script execution and preventing unauthorized code injection. Regular security testing including automated vulnerability scanning and manual penetration testing should be conducted to identify and remediate similar weaknesses in healthcare applications. Organizations should also implement proper output encoding for all dynamic content rendered in web interfaces, ensuring that special characters are properly escaped to prevent script execution. The vulnerability underscores the importance of secure coding practices in healthcare applications and the necessity of adhering to security standards such as OWASP Top Ten and NIST cybersecurity guidelines for protecting sensitive medical data in digital health environments.