# ICS Medical Advisory (ICSMA-19-297-01)
## Philips IntelliSpace Perinatal
Original release date: October 24, 2019
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### Legal Notice
All information products included in [https://us-cert.gov/ics](/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://www.us-
cert.gov/tlp/](/tlp/).
* * *
## 1\. EXECUTIVE SUMMARY
* **CVSS v3 6.1**
* **ATTENTION:** Low skill level to exploit
* **Vendor:** Philips
* **Equipment:** IntelliSpace Perinatal
* **Vulnerability:** Exposure of Resource to Wrong Sphere
## 2\. RISK EVALUATION
Successful exploitation of this vulnerability may allow an attacker
unauthorized access to system resources, including access to execute software
or to view/update files, directories, or system configuration. This could
impact confidentiality and integrity of the system and application. If a user
has opted to install the Document Export (DOX) function on the application
server, information at risk of exposure may also include protected health
information (PHI).
## 3\. TECHNICAL DETAILS
### 3.1 AFFECTED PRODUCTS
The following versions of IntelliSpace Perinatal, an obstetrics information
management system, are affected:
* IntelliSpace Perinatal Versions K and prior
### 3.2 VULNERABILITY OVERVIEW
#### 3.2.1 [EXPOSURE OF RESOURCE TO WRONG SPHERE
CWE-668](https://cwe.mitre.org/data/definitions/668.html)
A vulnerability within the IntelliSpace Perinatal application environment
could enable an unauthorized attacker with physical access to a locked
application screen, or an authorized remote desktop session host application
user to break-out from the containment of the application and access
unauthorized resources from the Windows operating system as the limited-access
Windows user. Due to potential Windows vulnerabilities, it may be possible for
additional attack methods to be used to escalate privileges on the operating
system.
[CVE-2019-13546](http://web.nvd.nist.gov/view/vuln/detail?vulnId=CVE-2019-13546)
has been assigned to this vulnerability. A CVSS v3 base score of 6.1 has been
assigned; the CVSS vector string is
([AV:L/AC:L/PR:L/UI:N/S:U/C:H/I:L/A:N](https://www.first.org/cvss/calculator/3.0#CVSS:3.0/AV:L/AC:L/PR:L/UI:N/S:U/C:H/I:L/A:N)).
### 3.3 BACKGROUND
* **CRITICAL INFRASTRUCTURE SECTORS:** Healthcare and Public Health
* **COUNTRIES/AREAS DEPLOYED:** Worldwide
* **COMPANY HEADQUARTERS LOCATION:** Netherlands
### 3.4 RESEARCHER
Brian Landrum of Coalfire LABS reported this vulnerability to Philips.
## 4\. MITIGATIONS
Philips has identified the following guidance and controlling risk
mitigations:
* Users should operate all deployed and supported Philips IntelliSpace Perinatal products within Philips authorized specifications, including Philips approved software, software configuration, system services, and security configuration. Reference the Philips Site Preparation and IT Specification Guide, which is available on [Philips InCenter](http://incenter.medical.philips.com/Default.aspx?alias=incenter.medical.philips.com/pmspublic).
* During installation, the Philips provided System Check Tool must be run to properly configure the system as per the installation guide. The latest version of the System Check Tool is available for download from [Philips InCenter](http://incenter.medical.philips.com/Default.aspx?alias=incenter.medical.philips.com/pmspublic).
* The IntelliSpace Perinatal System Check Tool prepares the Windows firewall and opens required ports automatically as per the installation guide, but users should also configure local and network firewalls to prevent unauthorized access to network resources.
* For IntelliSpace Perinatal applications running continuously/unattended or in remote desktop mode, the logged in Windows user must run with restricted privileges. The Windows user logon should never be granted administrator rights, and permissions to the file system should not be changed.
* Locking or logging out of the application does not automatically lock Windows. Users should always lock Windows when not actively using the application. Closing the application when in remote desktop session mode will logoff the active Windows session.
* For all IntelliSpace Perinatal applications running on PCs with a wall mounted display, ensure there is no public access by making only the display available and physically locking the machine. When this is not possible, ensure there are no publicly accessible input devices available.
* Install the IntelliSpace Perinatal application on a dedicated server with no unnecessary services or drivers installed.
* It is not recommended to run the Document Export (DOX) functionality on the IntelliSpace Perinatal application server. Where DOX is required, only allow logon of Windows users who are allowed to access patient data and lock the Windows session when not in use.
* Install the database on a dedicated server. All other IntelliSpace Perinatal functionality (remote desktop session hosting, application client) should not be installed or used on the database server.
* As documented in the Philips Site Preparation and IT Specification Guide, it is recommended for the user to prevent the start of Task Manager for non-administrators.
* Philips also recommends users implement a comprehensive, multi-layered strategy to protect their systems from internal and external security threats, including restricting physical access to only authorized personnel, thus reducing the risk of physical access compromise by an unauthorized user.
Philips will update IntelliSpace Perinatal documentation to provide clear
guidance on the above mitigations. This documentation is available to users on
[Philips
InCenter](http://incenter.medical.philips.com/Default.aspx?alias=incenter.medical.philips.com/pmspublic).
Philips will be further assessing options for remediation in the next minor
product update, which is planned for the end of 2020.
Users with questions about their specific IntelliSpace Perinatal product
should contact a Philips service support team.
The Philips advisory is available at the following URL:
[http://www.philips.com/productsecurity](https://www.usa.philips.com/healthcare/about/customer-
support/product-security)
CISA recommends users take defensive measures to minimize the risk of
exploitation of this vulnerability. Specifically, users should:
* Restrict physical system access to authorized personnel only and follow a least privilege approach.
* Apply defense-in-depth strategies.
* Disable unnecessary accounts and services.
Where additional information is needed, follow this [link to existing
cybersecurity in medical device guidance issued by the
FDA](https://www.fda.gov/MedicalDevices/DigitalHealth/ucm373213.htm).
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](https://www.us-cert.gov/ics/recommended-practices) on the ICS
webpage on [us-cert.gov](https://www.us-cert.gov/ics). Several recommended
practices are available for reading and download, including [Improving
Industrial Control Systems Cybersecurity with Defense-in-Depth
Strategies](https://www.us-
cert.gov/sites/default/files/recommended_practices/NCCIC_ICS-
CERT_Defense_in_Depth_2016_S508C.pdf).
Additional mitigation guidance and recommended practices are publicly
available on the [ICS webpage on us-cert.gov](https://www.us-cert.gov/ics) in
the Technical Information Paper, [ICS-TIP-12-146-01B--Targeted Cyber Intrusion
Detection and Mitigation Strategies](https://www.us-cert.gov/ics/tips/ICS-
TIP-12-146-01B).
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.
No known public exploits specifically target this vulnerability. This
vulnerability is not exploitable remotely.
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