Automated Healthcare System Holes

Wednesday, March 30, 2016 @ 12:03 PM gHale


CareFusion provided compensating measures to help reduce the risk of exploitation for third-party software vulnerabilities in end-of-life versions of its Pyxis SupplyStation system, according to a report on ICS-CERT.

Independent researchers Billy Rios and Mike Ahmadi in collaboration with CareFusion discovered the vulnerabilities. They obtained the Pyxis SupplyStation through a third-party that resells decommissioned systems from healthcare systems, and the vulnerabilities ended up discovered using an automated software composition analysis tool. Because the affected versions are at end‑of-life, CareFusion will not issue a patch for the remotely exploitable vulnerabilities.

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Exploits that target these vulnerabilities are known to be publicly available.

The following Pyxis SupplyStation system software versions suffer from the issue:
• Pyxis SupplyStation system, Version 8.0 Server 2003/XP
• Pyxis SupplyStation system, Version 8.1.3 Server 2003/XP
• Pyxis SupplyStation system, Version 9.0 Server 2003/XP
• Pyxis SupplyStation system, Version 9.1 Server 2003/XP
• Pyxis SupplyStation system, Version 9.2 Server 2003/XP
• Pyxis SupplyStation system, Version 9.3 Server 2003/XP

CareFusion said Version 9.3, Version 9.4, and Version 10.0 of the Pyxis SupplyStation systems that operate on Server 2008/Server 2012/Windows 7 do not contain the reported vulnerabilities.

Exploitation of these vulnerabilities may allow a remote attacker to compromise the Pyxis SupplyStation system. The SupplyStation system maintains critical functionality and provides access to supplies in “fail-safe mode” in the event that the cabinet is rendered inoperable. Manual keys can end up used to access the cabinet if it is inoperable.

CareFusion is a subsidiary of Becton, Dickinson and Company (BD), which is a U.S.-based company that maintains offices in multiple countries around the world.

The affected products, Pyxis SupplyStation systems, are automated supply cabinets used to dispense medical supplies that can document usage in real-time.

The Pyxis SupplyStation systems include automated devices that may end up deployed using a variety of functional configurations. The Pyxis SupplyStation systems have an architecture that typically includes a network of units, or workstations, located in various patient care areas throughout a facility and managed by the Pyxis SupplyCenter server, which links to the facility’s existing information systems.

CareFusion products see action across the healthcare and public health sector.

Version 8.1.3 of the Pyxis SupplyStation system, last updated around April 2010, ended up tested and researchers found it contained 1,418 vulnerabilities present in 7 different third-party vendor software packages, spread across 86 different files. The breakdown of the 1,418 vulnerabilities by CVSS score is as follows:
• 715 vulnerabilities had a CVSS base score of 7.0-10.0
• 606 vulnerabilities had a CVSS base score of 4.0-6.9
• 97 vulnerabilities had a CVSS base score of 0-3.9

Third-party software components for these legacy versions of the Pyxis SupplyStation are:
• BMC Appsight 5.7
• SAP Crystal Reports 8.5
• Flexera Software Installshield
• Microsoft Windows XP
• Sybase SQL Anywhere 9
• Symantec Antivirus 9
• Symantec pcAnywhere 10.5

An attacker with low skill would be able to exploit many of these vulnerabilities.

CareFusion confirmed the identified vulnerabilities are present in the Pyxis SupplyStation systems that operate on Server 2003/Windows XP, which are at end-of-life, and no longer supported. As a result of the identified vulnerabilities, CareFusion has started reissuing targeted customer communications, advising customers of end-of-life versions with an upgrade path. For customers not pursuing the remediation path of upgrading devices, CareFusion has provided compensating measures to help reduce the risk of exploitation. CareFusion recommends customers using older versions of the Pyxis SupplyStation system that operate on these legacy operating systems should apply the following compensating measures.

Specifically, users should:
• Isolate affected products from the Internet and untrusted systems; however, if additional connectivity is required, use a VPN solution.
• When remote access is required, use secure methods, such as Virtual Private Networks (VPNs), recognizing that VPNs may have vulnerabilities and should be updated to the most current version available. Also recognize that VPN is only as secure as the connected devices.
• Monitor and log all network traffic attempting to reach the affected products for suspicious activity.
• Close all unused ports on affected products.
• Locate medical devices and remote devices behind firewalls, and isolate them from the business network.
• Work with a local team to ensure all Microsoft patching and ESET virus definitions are up to date. A Security Module for automated WSUS patching and virus definition management is provided to all accounts. SupplyStations Version 8 and Version 9 have been upgraded to ESET.
• If pcAnywhere is used and has not been upgraded to Version 12.5 Service Pack 4, contact CareFusion’s Customer Support to schedule an upgrade or to have it removed. Click here for contact information for CareFusion’s Customer Support.