Operating System:

[Win]

Published:

09 September 2019

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             AUSCERT External Security Bulletin Redistribution

                               ESB-2019.3404
                    Advisory (icsma-19-248-01) BD Pyxis
                             9 September 2019

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        AusCERT Security Bulletin Summary
        ---------------------------------

Product:           Becton, Dickinson and Company Pyxis
Publisher:         ICS-CERT
Operating System:  Windows
Impact/Access:     Unauthorised Access -- Existing Account
Resolution:        Mitigation
CVE Names:         CVE-2019-13517  

Original Bulletin: 
   https://www.us-cert.gov/ics/advisories/icsma-19-248-01

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ICS Medical Advisory (ICSMA-19-248-01)

BD Pyxis

Original release date: September 05, 2019

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1. EXECUTIVE SUMMARY

  o CVSS v3 7.6
  o ATTENTION: Exploitable remotely/low skill level to exploit
  o Vendor: Becton, Dickinson and Company (BD)
  o Equipment: Pyxis
  o Vulnerability: Session Fixation

2. RISK EVALUATION

Successful exploitation of this vulnerability could allow the Active Directory
(AD) credentials of a previously authenticated user to gain access to the
device. This could result in an attacker having the same level of privilege
previously granted to a user prior to account expiration, and could allow
access to patient data and medications. For exploitation to occur, products
must be actively using AD for login and be connected to the hospital domain.
Users who do not use AD are not impacted by this vulnerability.

3. TECHNICAL DETAILS

3.1 AFFECTED PRODUCTS

The following versions of BD Pyxis, a medication management platform, are
affected:

  o Pyxis ES Versions 1.3.4 through to 1.6.1
  o Pyxis Enterprise Server, with Windows Server Versions 4.4 through 4.12

3.2 VULNERABILITY OVERVIEW

3.2.1 SESSION FIXATION CWE-384

A vulnerability has been identified where existing access privileges are not
restricted in coordination with the expiration of access based on active
directory user account changes when the device is joined to an AD domain.

CVE-2019-13517 has been assigned to this vulnerability. A CVSS v3 base score of
7.6 has been calculated; the CVSS vector string is ( AV:A/AC:L/PR:L/UI:N/S:U/
C:H/I:H/A:L ).

3.3 BACKGROUND

  o CRITICAL INFRASTRUCTURE SECTORS: Healthcare and Public Health
  o COUNTRIES/AREAS DEPLOYED: Worldwide
  o COMPANY HEADQUARTERS LOCATION: United States

3.4 RESEARCHER

BD reported this vulnerability to CISA.

4. MITIGATIONS

BD notes that connecting medication dispensing cabinets to a hospital domain is
an uncommon configuration and is not recommended by BD. BD also notes this
vulnerability has been remediated in the latest release of Version 1.6.1.1, and
recommends the following mitigations and compensating controls in order to
reduce risk associated with this vulnerability:

  o Remove expired users from the relevant AD role that grants access to the
    Pyxis ES system.
  o Pyxis ES systems are not recommended to be placed on the hospital domain.
  o As a best practice, users should not rely on expiration dates to remove
    users from their hospitals' AD system.

CISA recommends users take defensive measures to minimize the risk of
exploitation of this vulnerability. Specifically, users should:

  o Minimize network exposure for all medical devices and/or systems.
  o Locate medical devices behind firewalls and isolate them where possible.
  o Restrict system access to authorized personnel only and follow a least
    privilege approach.
  o Apply defense-in-depth strategies.
  o Disable any unnecessary accounts, protocols and services.
  o Where additional information is needed, refer to existing cybersecurity in
    medical device guidance issued by the FDA at the following location: https:
    //www.fda.gov/medical-devices/digital-health/cybersecurity

CISA reminds organizations to perform proper impact analysis and risk
assessment prior to deploying defensive measures.

CISA also provides a section for control systems security recommended practices
on the ICS webpage on us-cert.gov . Several recommended practices are available
for reading and download, including Improving Industrial Control Systems
Cybersecurity with Defense-in-Depth Strategies .

Additional mitigation guidance and recommended practices are publicly available
on the ICS webpage on us-cert.gov in the Technical Information Paper,
ICS-TIP-12-146-01B--Targeted Cyber Intrusion Detection and Mitigation
Strategies .

Organizations observing any suspected malicious activity should follow their
established internal procedures and report their findings to CISA for tracking
and correlation against other incidents.

CISA also recommends users take the following measures to protect themselves
from social engineering attacks:

  o Do not click web links or open unsolicited attachments in email messages.
  o Refer to Recognizing and Avoiding Email Scams for more information on
    avoiding email scams.
  o Refer to Avoiding Social Engineering and Phishing Attacks for more
    information on social engineering attacks.

No known public exploits specifically target this vulnerability.

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