TY - CHAP A1 - Puschner, Endres A1 - Saatjohann, Christoph A1 - Willing, Markus A1 - Dresen, Christian A1 - Köbe, Julia A1 - Rath, Benjamin A1 - Paar, Christof A1 - Eckardt, Lars A1 - Haverkamp, Uwe A1 - Schinzel, Sebastian T1 - Listen to Your Heart: Evaluation of the Cardiologic Ecosystem T2 - ARES 2021: The 16th International Conference on Availability, Reliability and Security N2 - Modern implantable cardiologic devices communicate via radio frequency techniques and nearby gateways to a backend server on the internet. Those implanted devices, gateways, and servers form an ecosystem of proprietary hardware and protocols that process sensitive medical data and is often vital for patients’ health. This paper analyzes the security of this Ecosystem, from technical gateway aspects, via the programmer, to configure the implanted device, up to the processing of personal medical data from large cardiological device producers. Based on a real-world attacker model, we evaluated different devices and found several severe vulnerabilities. Furthermore, we could purchase a fully functional programmer for implantable cardiological devices, allowing us to re-program such devices or even induce electric shocks on untampered implanted devices. Additionally, we sent several Art. 15 and Art. 20 GDPR inquiries to manufacturers of implantable cardiologic devices, revealing non-conforming processes and a lack of awareness about patients’ rights and companies’ obligations. This, and the fact that many vulnerabilities are still to be found after many vulnerability disclosures in recent years, present a worrying security state of the whole ecosystem. Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:hbz:836-opus-139012 ER - TY - JOUR A1 - Brinkmann, Marcus A1 - Dresen, Christian A1 - Merget, Robert A1 - Poddebniak, Damian A1 - Müller, Jens A1 - Somorovsky, Juraj A1 - Schwenk, Jörg A1 - Schinzel, Sebastian T1 - ALPACA: Application Layer Protocol Confusion - Analyzing and Mitigating Cracks in TLS Authentication JF - 30th USENIX Security Symposium Y1 - 2021 UR - https://www.usenix.org/conference/usenixsecurity21/presentation/brinkmann ER - TY - JOUR A1 - Gierling, Markus A1 - Saatjohann, Christoph A1 - Dresen, Christian A1 - Köbe, Julia A1 - Rath, Benjamin A1 - Eckardt, Lars A1 - Schinzel, Sebastian T1 - Reviewing Cyber Security Research of Implantable Medical Rhythm Devices regarding Patients’ Risk JF - 86. Jahrestagung und Herztage 2020 der DGK N2 - Introduction: The recent publication of several critical cyber security issues in cardiac implantable devices and the resulting press coverage upsets affected users and their trust in medical device producers. Reviewing the published security vulnerabilities regarding networked medical devices, it raises the question, if the reporting media, the responsible security researchers, and the producers handle security vulnerabilities appropriately. Are the media reports of security vulnerabilities in medical devices meaningful in a way that patients can assess their respective risk for an attack via the security vulnerability? The collaboration between IT-security experts and clinicians aims at reviewing published security vulnerabilities of rhythm devices, and evaluate overall patients risks. Methodology: We performed a literature review on security vulnerabilities in implantable medical devices with a focus on cardiac devices. We analyzed (Fig. 1) the (1) requirements for an attacker and the (2) technical feasibility and clustered them in three different scenarios: The first scenario requires that the attacker physically approaches a victim with a programming device. The second scenario requires proximity to the victim, e.g., within a few meters. The third and strongest attacker scenario is a remote attack that doesn’t require any physical proximity to the victim. We then compare the attacker scenarios and (3) the overall patients’ risks with the press coverage (overhyped, adequate, underhyped). (4) The resulting overall patients’ risk was rated by clinicians (security vulnerability of patients’ data, dangerous programming possible). Results: Out of the three analyzed incidents, we found one to be underhyped, one to be overhyped, and one was appropriate compared to the medial coverage (Fig. 2). The most occurring technical issues were based on the absence of basic security primitives. The patient damage for all of the analyzed incidents was fatal in the worst-case scenario. Further, the patient damage and the overall patient risks are disjunct due to the missing capability of performing large scale attacks. Conclusion: The resulting overall patients’ risks may not adequately reflect the patient damage in the considered cases. Often, the overall patient risk is not as severe as the necessary attacker capabilities are high and it would require strongly motivated attackers to perform the attack. Therefore, most of the reviewed cases are considered with a smaller overall patient risk than implied by press reports. Reviewing the ongoing IT-Security trends regarding implantable medical devices shows an increasing focus on researching in the field of medical device security. Therefore, further findings in the near future are to be expected. To deal with this fact in a responsible way, proper proactive knowledge management is mandatory. We recommend medical staff to critically reflect reports in mass media due to possible sensationalism. Therefore, we propose a joint approach in combining the technical expertise of cyber security experts with clinical aspects of medical experts, to ensure a solid understanding of a newly published vulnerability. The combination of both communities promises to result in better predictions for patients’ risks from security vulnerabilities in implanted cardiac devices. KW - Cyber Security KW - Cardiac Implantable Devices Y1 - 2020 U6 - https://doi.org/10.1007/s00392-020-01621-0 VL - Band 109, Supplement 1, April 2020 SP - 1 EP - 2 ER - TY - CHAP A1 - Dresen, Christian A1 - Ising, Fabian A1 - Poddebniak, Damian A1 - Kappert, Tobias A1 - Holz, Thorsten A1 - Schinzel, Sebastian ED - Zhou, Jianying T1 - CORSICA: Cross-Origin Web Service Identification T2 - The 15th ACM ASIA Conference on Computer and Communications Security N2 - Vulnerabilities in private networks are difficult to detect for attackers outside of the network. While there are known methods for port scanning internal hosts that work by luring unwitting internal users to an external web page that hosts malicious JavaScript code, no such method for detailed and precise service identification is known. The reason is that the Same Origin Policy (SOP) prevents access to HTTP responses of other origins by default. We perform a structured analysis of loopholes in the SOP that can be used to identify web applications across network boundaries. For this, we analyze HTML5, CSS, and JavaScript features of standard-compliant web browsers that may leak sensitive information about cross-origin content. The results reveal several novel techniques, including leaking JavaScript function names or styles of cross-origin requests that are available in all common browsers. We implement and test these techniques in a tool called CORSICA. It can successfully identify 31 of 42 (74%) of web services running on different IoT devices as well as the version numbers of the four most widely used content management systems WordPress, Drupal, Joomla, and TYPO3. CORSICA can also determine the patch level on average down to three versions (WordPress), six versions (Drupal), two versions (Joomla), and four versions (TYPO3) with only ten requests on average. Furthermore, CORSICA is able to identify 48 WordPress plugins containing 65 vulnerabilities. Finally, we analyze mitigation strategies and show that the proposed but not yet implemented strategies Cross-Origin Resource Policy (CORP)} and Sec-Metadata would prevent our identification techniques. Y1 - 2020 UR - https://asiaccs2020.cs.nthu.edu.tw/program/ ER - TY - JOUR A1 - Willing, Markus A1 - Ebbers, Simon A1 - Dresen, Christian A1 - Czolbe, Marc A1 - Saatjohann, Christoph A1 - Schinzel, Sebastian T1 - Simulating the overload of medical processes due to system failures during a cyberattack JF - BMC Medical Informatics and Decision Making N2 - Today’s medical IT is more and more connected and network or IT system outages may impact the quality of patient treatment. IT outages from cyberattacks are particularly worrisome if attackers focus on those medical IT devices that are critical for medical processes. However, medical processes are primarily documented for the hospital employees and not for analyzing the criticality of any given human or medical IT resource. This paper presents a generic model for realistic, patient-focused simulation of medical processes. The model allows the simulation of cyber incidents, focusing on device outages or overload situations like mass casualty incidents. Furthermore, we present a proof-of-concept tool that implements the described model, enabling end-users to simulate their processes. The tool offers the ability to run with low detailed data for overview purposes and highly detailed data for fine-grained simulation results. We perform different scenario simulations for a sample hospital, including the acute phase of a ransomware attack, negative performance impacts due to the implementation of cybersecurity measures, and emergency plans for mass casualty incidents. In each scenario, the respective simulation resulted in a quantitative statement of how these scenarios affect overall process performance and show possible key factors supporting decision-making. We use real-world data from a German trauma room to optimize and evaluate the process simulation. Y1 - 2025 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:hbz:836-opus-190188 UR - https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-025-02988-8 VL - 25 ER -