[HN Gopher] Medtronic's MiniMed 600 insulin pumps potentially at...
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       Medtronic's MiniMed 600 insulin pumps potentially at risk of
       compromise
        
       Author : woliveirajr
       Score  : 64 points
       Date   : 2022-09-30 16:29 UTC (6 hours ago)
        
 (HTM) web link (www.medtronicdiabetes.com)
 (TXT) w3m dump (www.medtronicdiabetes.com)
        
       | code_duck wrote:
       | Hmm, MedTronic already had at least one recall on this series of
       | pumps:
       | 
       | https://diatribe.org/medtronic-provides-update-recall-thousa...
       | 
       | Tandem recently released updated firmware and mobile app for
       | their t:slim X2 pumps which includes a function to deliver
       | insulin from the mobile app. To me, this seems like a dangerous
       | idea, given that people can die from an insulin overdose. I'm
       | perfectly happy keeping the function solely on the physical
       | device. My wariness has not been shared by the majority (or even
       | a small fraction) I've discussed this with online - pump users
       | generally desire this convenience and are not at all concerned
       | about potential security implications.
        
         | jwoglom wrote:
         | While I'm not a certified security professional, I have looked
         | pretty closely at Tandem's mobile pairing and remote bolus
         | implementation and it seems to have been designed in the right
         | way. After initializing a Bluetooth connection, the phone and
         | pump complete a handshake wherein a 16 character alphanumeric
         | key appears on the pump screen and you need to enter it on your
         | phone, which then uses it as a shared HMAC symmetric key.
         | Status information and responses then occur in cleartext once
         | authenticated, while bolus operations require messages to be
         | signed with the initial key.
         | 
         | That being said, on the chance that there is a security flaw
         | here I'm willing to eat my words...
        
           | qmarchi wrote:
           | Would be cool if you contributed to xDrip!
           | 
           | My partner uses a Tandem pump, and is annoyed that she can't
           | actually use most of the features of the Tandem app because
           | she uses an unapproved (Pixel 6 Pro) device.
        
             | jwoglom wrote:
             | Take a look at https://github.com/jwoglom/pumpx2, I'm
             | working with the AndroidAPS folks currently to make it more
             | broadly available. xDrip integration would happen via AAPS.
        
           | code_duck wrote:
           | My concern is that the phone could be compromised. Having a
           | phone hacked would be bad enough without giving the attacker
           | the option to easily hospitalize/kill you.
        
       | dsaavy wrote:
       | There was an entire data set released that had all the medical
       | device injuries and malfunctions listed. Pretty interesting to
       | dive into considering it wasn't previously public.
       | 
       | Article mentioning the previously non-public database:
       | https://khn.org/news/hidden-fda-database-medical-device-inju...
       | 
       | FDA database that was eventually released:
       | https://www.fda.gov/medical-devices/mandatory-reporting-requ...
       | 
       | As a Type 1 diabetic, insulin pumps are a game changer for the
       | entire population that needs to use them. But I think it's
       | understated the risks that come with the devices. In my opinion
       | the benefits outweigh the risks but that is still something you
       | should be able to determine on your own as a user.
       | 
       | Side note: One of the things I see a lot of diabetics miss with
       | insulin pumps is how changes in altitude and air pressure can
       | cause unintended delivery of insulin if you have air bubbles in
       | the cartridge. For those who travel with insulin pumps, make sure
       | to disconnect during changes in altitude (take-off and landing).
        
       | WaitWaitWha wrote:
       | > ... CareLink(tm) USB device that communicate wirelessly. ...
       | 
       | > ... For unauthorized access to occur, a nearby person other
       | than you or your care partner would need to gain access to your
       | pump at the same time that the pump is being paired with other
       | system components. _This cannot be done over the internet._ ...
       | 
       | >4. Disconnect the USB device from your computer when you're not
       | using it to download pump data. 5. DO NOT confirm remote
       | connection requests or any other remote action on the pump screen
       | unless it is initiated by you or your care partner. 6. DO NOT
       | share your pump's or devices' serial numbers with anyone other
       | than your healthcare provider, distributors, and Medtronic.
       | 
       | Hmm... You have a wireless dongle connected to a PC that appears
       | to rely at least in part on the serial number as authZ/N, and can
       | provide fully remote communications over the Internet and
       | manipulation of the terminal device. But... " _This cannot be
       | done over the internet_ "? Seems to be at the time of pairing,
       | but can the pairing be initiated & accepted remotely?
        
         | idealmedtech wrote:
         | Welcome to cyber security in medicine! Stay a while!
        
       | [deleted]
        
       | Group_B wrote:
       | To be fair the earlier Medtronic pumps were also insecure, but it
       | allowed for reverse engineers to get into them and create one of
       | the first closed loop systems.
        
         | cperciva wrote:
         | Indeed. I'm using such a closed loop right now, and old
         | Medtronic pumps routinely sell for $500-1000 to people who want
         | to use them to loop.
        
       | terminalcommand wrote:
       | This makes me mad as a minimed user. I can't even get data out of
       | my pump (a 754) because minimed does not sell the reader in my
       | country. The 600 models are the top-off the line models that cost
       | $$$.
       | 
       | Medtronic shouldn't be able to get away with just saying, turn
       | off remote bolusing to be secure. I hope they get a class-action
       | suit.
       | 
       | Background: Medtronic is a money-hungry company. I've been using
       | their insulin pumps for 15 years. Over the years the quality of
       | their infusion sets dropped, they no longer provide a cap (the
       | thing you put on to close the catheter before you shower) with
       | each infusion set, rather than they put only one cap in a 10x
       | bag. The infusion sets started to fail after 2 days (the default
       | timespan is 3 days), whereas it used to last 4-5 days before.
        
         | TimBurman wrote:
         | There are some Contour Next Link (non-2.4 version) listed on
         | Ebay and other sites. Unless Medtronic locks the meter to one
         | user account, maybe you could then pair it and get the data
         | out, if they will ship to your country.
         | 
         | Here in Canada, the infusion sets Mio 30, Mio Advance, Sure T
         | and Mio that I have used all came with a cap in each set. They
         | also charge the government C$26 each, but still that cap cannot
         | be worth more than a few cents, so it is a strange way to save
         | money.
         | 
         | The sets have been failing early for me as well at the rate of
         | about 1 in 10. I started with the Mio Advance and my nurse said
         | to call Medtronic and report the failures. Medtronic sent a box
         | of 10 Mio Advance plus boxes of 10 Mio and 10 Sure T (metal) to
         | try for free. The Sure T failed less than the Mio Advance and
         | Mio, but I just had one fail the first day so am trying the Mio
         | 30 which goes in at an angle but uses plastic.
        
       | rbarnes01 wrote:
       | Not surprised that QA is a problem with them. They don't even
       | realize that one of their contract manufacturers isn't registered
       | with the FDA.
        
       | jmptable wrote:
       | It's very interesting to see an in-the-wild example of a security
       | flaw in the wireless pairing of a class C medical device (i.e. a
       | device that can severely injure or kill). Would love to see
       | technical details about the specific flaw here.
       | 
       | Just spending a few minutes searching around I found this
       | interesting reverse engineering work on the Contour Next Link 2.4
       | USB dongle: https://github.com/szpaku80/reverse-engineering-
       | contour-next...
       | 
       | It looks like it's implementing 802.15.4 (the basis for ZigBee
       | among other protocols).
       | 
       | The user manual for the Contour Next Link 2.4 device
       | (https://www.medtronicdiabetes.com/sites/default/files/librar...)
       | shows that pairing can be initiated by the USB dongle and
       | succeeds if the user confirms the request on the device. A serial
       | number is displayed but that appears to be under the control of
       | the hypothetical attacker. So the user must know to reject an
       | unexpected request even if it has the right serial number, or the
       | attacker will gain control of their pump and can issue a remote
       | bolus command.
       | 
       | This example doesn't have to do with Bluetooth but there's an
       | interesting connection there because most BLE pairing methods
       | have been shown to be insecure to sniffing attacks. That imposes
       | constraints on how medical devices that need Bluetooth
       | connectivity are designed, because it may force a device to have
       | a screen for showing a pairing code when it otherwise would not
       | need one.
        
         | HeyLaughingBoy wrote:
         | The FDA released a Draft of the new Cybersecurity Guidance
         | document back in April and there was speculation that this
         | draft was going to become active (an actual regulation) by the
         | end of the year. I wonder if this news is going to speed that
         | up in any way.
        
           | ska wrote:
           | FDA is probably more concerned about getting it right[1],
           | than faster.
           | 
           | [1] this is not a comment on how likely that is
        
       | AnthonBerg wrote:
       | From experience, Medtronic's software is obviously low-quality.
       | Obviously bad and unnecessarily bad.
        
         | morcheeba wrote:
         | Medtronic buys a lot of companies and rebrands their products
         | under their name. Software quality is going to vary a lot,
         | because it comes from a wide variety of sources.
        
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       (page generated 2022-09-30 23:00 UTC)