Schinzel, Sebastian
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Reviewing Cyber Security Research of Implantable Medical Rhythm Devices regarding Patients’ Risk
(2020)
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.
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.
The Portable Document Format, better known as PDF, is one of themost widely used document formats worldwide, and in order to en-sure information confidentiality, this file format supports documentencryption. In this paper, we analyze PDF encryption and showtwo novel techniques for breaking the confidentiality of encrypteddocuments. First, we abuse the PDF feature ofpartially encrypteddocuments to wrap the encrypted part of the document withinattacker-controlled content and therefore, exfiltrate the plaintextonce the document is opened by a legitimate user. Second, we abusea flaw in the PDF encryption specification to arbitrarily manipulateencrypted content. The only requirement is that a single block ofknown plaintext is needed, and we show that this is fulfilled bydesign. Our attacks allow the recovery of the entire plaintext of en-crypted documents by using exfiltration channels which are basedon standard compliant PDF properties.We evaluated our attacks on 27 widely used PDF viewers andfound all of them to be vulnerable. We responsibly disclosed thevulnerabilities and supported the vendors in fixing the issue
We show practical attacks against OpenPGP and S/MIMEencryption and digital signatures in the context of email. Instead of tar-geting the underlying cryptographic primitives, our attacks abuse legiti-mate features of the MIME standard and HTML, as supported by emailclients, to deceive the user regarding the actual message content. Wedemonstrate how the attacker can unknowingly abuse the user as a de-cryption oracle by replying to an unsuspicious looking email. Using thistechnique, the plaintext of hundreds of encrypted emails can be leakedat once. Furthermore, we show how users could be tricked into signingarbitrary text by replying to emails containing CSS conditional rules.An evaluation shows that "out of" OpenPGP-capable email clients,as well as "out of" clients supporting S/MIME, are vulnerable to atleast one attack. We provide different countermeasures and discuss theiradvantages and disadvantages.
OpenPGP and S/MIME are the two major standards to en-crypt and digitally sign emails. Digital signatures are sup-posed to guarantee authenticity and integrity of messages. Inthis work we show practical forgery attacks against variousimplementations of OpenPGP and S/MIME email signatureverification in five attack classes: (1) We analyze edge casesin S/MIME’s container format. (2) We exploit in-band sig-naling in the GnuPG API, the most widely used OpenPGPimplementation. (3) We apply MIME wrapping attacks thatabuse the email clients’ handling of partially signed mes-sages. (4) We analyze weaknesses in the binding of signedmessages to the sender identity. (5) We systematically testemail clients for UI redressing attacks.Our attacks allow the spoofing of digital signatures for ar-bitrary messages in 14 out of 20 tested OpenPGP-capableemail clients and 15 out of 22 email clients supportingS/MIME signatures. While the attacks do not target the un-derlying cryptographic primitives of digital signatures, theyraise concerns about the actual security of OpenPGP andS/MIME email applications. Finally, we propose mitigationstrategies to counter these attacks.
Cache Attacks on Intel SGX
(2017)