CVE-2022-43557 in CME BodyGuard
Summary
by MITRE • 12/06/2022
The BD BodyGuard™ infusion pumps specified allow for access through the RS-232 (serial) port interface. If exploited, threat actors with physical access, specialized equipment and knowledge may be able to configure or disable the pump. No electronic protected health information (ePHI), protected health information (PHI) or personally identifiable information (PII) is stored in the pump.
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Analysis
by VulDB Data Team • 12/26/2022
The CVE-2022-43557 vulnerability affects BD BodyGuard™ infusion pumps, which are critical medical devices used in healthcare settings for precise medication delivery. These pumps incorporate an RS-232 serial port interface that presents a significant security risk when physical access is gained by unauthorized individuals. The vulnerability stems from the lack of proper authentication and access controls on the serial port, which is typically used for device configuration, maintenance, and diagnostics by authorized personnel. This design flaw allows threat actors with physical access to the device, along with specialized equipment and technical knowledge, to exploit the interface and potentially alter pump configurations or disable critical safety mechanisms. The RS-232 interface, while providing legitimate administrative access, does not implement adequate security measures to prevent unauthorized modification of pump operations, creating a pathway for malicious actors to compromise patient safety and device functionality.
The technical flaw manifests in the absence of secure authentication mechanisms at the RS-232 interface level, which is classified as a weakness under CWE-310 Cryptographic Vulnerability and CWE-287 Improper Authentication. The vulnerability enables unauthorized configuration changes that could result in incorrect medication dosing, pump shutdowns, or other dangerous operational failures. Attackers with physical access can connect specialized equipment to the serial port and execute commands that modify pump parameters, potentially leading to life-threatening situations for patients receiving critical medication infusions. The absence of encryption for communication over the RS-232 interface means that any commands sent or received can be intercepted or modified without detection. This vulnerability aligns with ATT&CK technique T1210 Exploitation of Remote Services and T1566 Impersonation of Users, as it allows for unauthorized access through physical means and potentially enables further attacks within healthcare networks. The pump's design does not provide adequate protection against tampering or unauthorized access through this legacy interface, representing a significant gap in medical device security architecture.
The operational impact of this vulnerability extends beyond immediate patient safety concerns to encompass broader healthcare security implications. When threat actors successfully exploit this vulnerability, they can potentially cause medication errors that may result in patient harm or death, making this a critical security concern for healthcare facilities. The vulnerability is particularly concerning because it requires only physical access rather than network-based attacks, making it more accessible to determined adversaries. Healthcare organizations must consider that unauthorized access to infusion pumps could lead to compromised patient care, regulatory violations under HIPAA, and potential legal liability. The pump's lack of ePHI, PHI, or PII storage mitigates some data privacy risks, but the operational risks remain extremely high due to the direct impact on patient safety and medical device functionality. This vulnerability represents a classic example of insufficient security controls in medical devices, where physical security measures fail to prevent unauthorized access to critical operational interfaces.
Mitigation strategies for CVE-2022-43557 should focus on both physical and administrative controls to prevent unauthorized access to the RS-232 interfaces on BD BodyGuard™ pumps. Healthcare organizations must implement strict physical access controls, including locked device enclosures, restricted access areas, and monitoring of device locations to prevent unauthorized physical access. Network segmentation should isolate medical devices from general network access, and any necessary serial port access should be performed through secure, authenticated channels with proper logging and monitoring. Device manufacturers should be contacted to determine if firmware updates or security patches are available to address the vulnerability, and organizations should implement regular security assessments of medical devices. Administrative controls should include policies restricting access to device configuration interfaces, mandatory training for staff on device security, and regular audits of device access logs. The remediation process should involve coordination with medical device security teams, IT security personnel, and clinical staff to ensure that any security measures do not interfere with critical patient care operations. Additionally, organizations should consider implementing device management platforms that can monitor and control access to medical devices, providing visibility into unauthorized access attempts and enabling rapid response to potential security incidents.