{
  "document": {
    "acknowledgments": [
      {
        "organization": "Medtronic",
        "summary": "reporting this vulnerability to CISA"
      }
    ],
    "category": "csaf_security_advisory",
    "csaf_version": "2.0",
    "distribution": {
      "text": "Disclosure is not limited",
      "tlp": {
        "label": "WHITE",
        "url": "https://us-cert.cisa.gov/tlp/"
      }
    },
    "lang": "en-US",
    "notes": [
      {
        "category": "general",
        "text": "This CSAF advisory was extracted from unstructured data and may contain inaccuracies. If you notice any errors, please reach out to the designated contact at CISA CSAF: central@cisa.dhs.gov",
        "title": "CISA Disclaimer"
      },
      {
        "category": "legal_disclaimer",
        "text": "All information products included in https://us-cert.cisa.gov/ics are provided \"as is\" for informational purposes only. The Department of Homeland Security (DHS) does not provide any warranties of any kind regarding any information contained within. DHS does not endorse any commercial product or service, referenced in this product or otherwise. Further dissemination of this product is governed by the Traffic Light Protocol (TLP) marking in the header. For more information about TLP, see https://us-cert.cisa.gov/tlp/.",
        "title": "Legal Notice"
      },
      {
        "category": "summary",
        "text": "Successful exploitation of this vulnerability could result in remote code execution or a denial-of-service condition impacting a healthcare delivery organization\u0027s Paceart Optima system.",
        "title": "Risk evaluation"
      },
      {
        "category": "other",
        "text": "Healthcare and Public Health",
        "title": "Critical infrastructure sectors"
      },
      {
        "category": "other",
        "text": "Worldwide",
        "title": "Countries/areas deployed"
      },
      {
        "category": "other",
        "text": "Ireland",
        "title": "Company headquarters location"
      },
      {
        "category": "general",
        "text": "CISA recommends users take defensive measures to minimize the risk of exploitation of this (these) vulnerability(ies), such as:",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "Minimize network exposure for all control system devices and/or systems, ensuring they are not accessible from the internet.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "Locate control system networks and remote devices behind firewalls and isolating them from business networks.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "When remote access is required, use more secure methods, such as Virtual Private Networks (VPNs), recognizing VPNs may have vulnerabilities and should be updated to the most current version available. Also recognize VPN is only as secure as the connected devices.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "CISA reminds organizations to perform proper impact analysis and risk assessment prior to deploying defensive measures.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "CISA also provides a section for control systems security recommended practices on the ICS webpage on cisa.gov/ics. Several CISA products detailing cyber defense best practices are available for reading and download, including Improving Industrial Control Systems Cybersecurity with Defense-in-Depth Strategies.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "CISA encourages organizations to implement recommended cybersecurity strategies for proactive defense of ICS assets.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "Additional mitigation guidance and recommended practices are publicly available on the ICS webpage at cisa.gov/ics in the technical information paper, ICS-TIP-12-146-01B--Targeted Cyber Intrusion Detection and Mitigation Strategies.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "Organizations observing suspected malicious activity should follow established internal procedures and report findings to CISA for tracking and correlation against other incidents.",
        "title": "Recommended Practices"
      },
      {
        "category": "general",
        "text": "No known public exploits specifically target this vulnerability.",
        "title": "Recommended Practices"
      }
    ],
    "publisher": {
      "category": "coordinator",
      "contact_details": "Email: CISAservicedesk@cisa.dhs.gov;\n Toll Free: 1-888-282-0870",
      "name": "CISA",
      "namespace": "https://www.cisa.gov/"
    },
    "references": [
      {
        "category": "self",
        "summary": "ICS Advisory ICSMA-23-180-01 JSON",
        "url": "https://raw.githubusercontent.com/cisagov/CSAF/develop/csaf_files/OT/white/2023/icsma-23-180-01.json"
      },
      {
        "category": "self",
        "summary": "ICSA Advisory ICSMA-23-180-01 - Web Version",
        "url": "https://www.cisa.gov/news-events/ics-medical-advisories/icsma-23-180-01"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/uscert/ics/alerts/ICS-ALERT-10-301-01"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/resources-tools/resources/ics-recommended-practices"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/sites/default/files/publications/Cybersecurity_Best_Practices_for_Industrial_Control_Systems.pdf"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/topics/industrial-control-systems"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://us-cert.cisa.gov/sites/default/files/recommended_practices/NCCIC_ICS-CERT_Defense_in_Depth_2016_S508C.pdf"
      },
      {
        "category": "external",
        "summary": "Recommended Practices",
        "url": "https://www.cisa.gov/uscert/ics/tips/ICS-TIP-12-146-01B"
      }
    ],
    "title": "Medtronic Paceart Optima System",
    "tracking": {
      "current_release_date": "2023-06-29T06:00:00.000000Z",
      "generator": {
        "engine": {
          "name": "CISA CSAF Generator",
          "version": "1.0.0"
        }
      },
      "id": "ICSMA-23-180-01",
      "initial_release_date": "2023-06-29T06:00:00.000000Z",
      "revision_history": [
        {
          "date": "2023-06-29T06:00:00.000000Z",
          "legacy_version": "Initial",
          "number": "1",
          "summary": "Initial Publication"
        }
      ],
      "status": "final",
      "version": "1"
    }
  },
  "product_tree": {
    "branches": [
      {
        "branches": [
          {
            "branches": [
              {
                "category": "product_version_range",
                "name": "\u003c= 1.11",
                "product": {
                  "name": "Paceart Optima: \u003c= 1.11",
                  "product_id": "CSAFPID-0001"
                }
              }
            ],
            "category": "product_name",
            "name": "Paceart Optima"
          }
        ],
        "category": "vendor",
        "name": "Medtronic"
      }
    ]
  },
  "vulnerabilities": [
    {
      "cve": "CVE-2023-31222",
      "cwe": {
        "id": "CWE-502",
        "name": "Deserialization of Untrusted Data"
      },
      "notes": [
        {
          "category": "summary",
          "text": "If a healthcare delivery organization has enabled the optional Paceart Messaging Service in the Paceart Optima system, an unauthorized user could exploit this vulnerability to perform remote code execution and/or denial-of-service (DoS) attacks by sending specially crafted messages to the Paceart Optima system. Remote code execution could result in the deletion, theft, or modification of Paceart Optima system\u0027s cardiac device data, or use of the Paceart Optima system for further network penetration. A DoS attack could cause the Paceart Optima system to slow or be unresponsive.",
          "title": "Vulnerability Summary"
        }
      ],
      "product_status": {
        "known_affected": [
          "CSAFPID-0001"
        ]
      },
      "references": [
        {
          "category": "external",
          "summary": "web.nvd.nist.gov",
          "url": "http://web.nvd.nist.gov/view/vuln/detail?vulnId=CVE-2023-31222"
        },
        {
          "category": "external",
          "summary": "www.first.org",
          "url": "https://www.first.org/cvss/calculator/3.0#CVSS:3.0/AV:N/AC:L/PR:N/UI:N/S:U/C:H/I:H/A:H"
        }
      ],
      "remediations": [
        {
          "category": "vendor_fix",
          "details": "Medtronic recommends updating the Paceart Optima system to v1.12. Contact Medtronic to schedule the update. (mailto:dl.paceartupdate@medtronic.com)",
          "product_ids": [
            "CSAFPID-0001"
          ]
        },
        {
          "category": "mitigation",
          "details": "Medtronic has provided some immediate mitigations that users can apply to mitigate the risk. If running a combined Application and Integration Server, contact Medtronic Paceart Optima System technical support for immediate mitigation actions. For all other configurations, Medtronic recommends the following steps:",
          "product_ids": [
            "CSAFPID-0001"
          ]
        },
        {
          "category": "mitigation",
          "details": "Manually disable the Paceart Messaging Service on the Application Server. 1.    Open the \"Windows Services\" application. 2.    Find the \u0027Paceart Messaging Service.\u0027 3.    Right-click the \"Paceart Messaging Service\" and select \"Properties.\" 4.    Select \"Stop\" to stop running the service and change the startup type to \"Disabled.\" 5.    Select \"Apply.\"",
          "product_ids": [
            "CSAFPID-0001"
          ]
        },
        {
          "category": "mitigation",
          "details": "Manually disable message queuing on the Application Server. 1.    Open server manager. 2.    Select \"Add roles and features.\" 3.    Select \"Start the Remove Roles and Features Wizard.\" 4.    Before you begin-next. 5.    Server selection-next. 6.    Server roles-next. 7.    Features section-take action. Select the black box next to Message Queuing. 8.    When the window pops up select the \"Remove Features\" button. 9.    Select \"next.\" 10.    Confirmation-select \"Remove.\"",
          "product_ids": [
            "CSAFPID-0001"
          ]
        },
        {
          "category": "mitigation",
          "details": "As long as the Paceart Messaging Service remains disabled, the vulnerability will remain mitigated.",
          "product_ids": [
            "CSAFPID-0001"
          ]
        },
        {
          "category": "mitigation",
          "details": "Please refer to Medtronic\u0027s security bulletin for more information.",
          "product_ids": [
            "CSAFPID-0001"
          ],
          "url": "https://www.medtronic.com/xg-en/product-security/security-bulletins/paceart-optima-system.html"
        }
      ],
      "scores": [
        {
          "cvss_v3": {
            "baseScore": 9.8,
            "baseSeverity": "CRITICAL",
            "vectorString": "CVSS:3.0/AV:N/AC:L/PR:N/UI:N/S:U/C:H/I:H/A:H",
            "version": "3.0"
          },
          "products": [
            "CSAFPID-0001"
          ]
        }
      ]
    }
  ]
}