Can “Internet-of-Body” Thwart Cyber Attacks on Implanted Medical Devices?

Medtronic discloses medical device vulnerabilities, while Purdue University scientists propose countermeasure to block attacks

3 min read
Photograph of two Medtronic devices.
Photo: Medtronic

The U.S. Department of Homeland Security last week warned that numerous medical devices made by Medtronic are vulnerable to cyber attack. The vulnerabilities affect 17 of the company’s implantable cardiac device models and the external equipment used to communicate with them. 

A Medtronic spokesperson told IEEE Spectrum that the company voluntarily disclosed the vulnerabilities to the Department of Homeland Security (DHS), and that “no cyberattack, privacy breach, or patient harm has been observed or associated with these issues.”

At risk are certain models of heart-regulating devices: implantable cardiac resynchronization therapy/defibrillators (CRT-Ds) and implantable cardioverter defibrillators (ICDs). CRT-Ds send electrical impulses to the lower chambers of the heart to help them beat together in a more synchronized pattern. ICDs deliver electrical impulses to correct fast heart rhythms. External computers program the devices and retrieve information.

Such devices emit radio frequency signals that can be detected up to several meters from the body. A malicious individual nearby could conceivably hack into the signal to jam it, alter it, or snoop on it, according to the Feds’ warning.

Signals that are unencrypted, as was the case with Medtronic’s devices, make intentional interception easy, says Shreyas Sen, an electrical and computer engineer at Purdue University. “It would be like sitting in a room listening to someone speaking in plain language,” he says.

For more than a decade researchers have repeatedly warned that medical devices could be turned into murder weapons. Scientists have demonstrated in written reports and live, at conferences, how to hack into an insulin pump, or a pacemaker, or even an entire hospital network.

Medtronic is one of several companies over the last few years to publicly disclose weaknesses in the cybersecurity of its medical devices. Smiths Medical in 2017 disclosed, through DHS, that its wireless drug pump, typically used in hospitals, could be hacked remotely. The U.S. Food and Drug Administration (FDA) the same year notified the public of vulnerabilities in St. Jude Medical’s implantable cardiac devices, including pacemakers, defibrillators and resynchronization devices. An attacker could crash a breathing therapy machine made by BMC Medical and 3B Medical, DHS warned in 2017.

DHS’s Cybersecurity and Infrastructure Security Agency (CISA) started tracking medical device vulnerabilities in 2013. The agency issued only seven advisories over the first five years, a CISA spokesperson told IEEE Spectrum. That number jumped to 16 in fiscal year 2017 and nearly twice that many—29—in fiscal 2018, the spokesperson said. The U.S. Federal Drug Administration and DHS in October announced a framework to coordinate their response to medical device cybersecurity threats.

No known attack on a life-supporting medical device has actually occurred, makers of such machines often point out. And encrypting the signals on these devices should provide reasonable protection. But Sen, at Purdue, says encryption isn’t enough. “The physical signals are available, and we are not good with using passwords,” he says.

To thwart would-be attackers, Sen and his colleagues have designed a countermeasure: a device worn around the wrist that uses a particular low-frequency range to confine within the human body all of the communication signals coming from a medical device.

The signals create what’s known as an electro-quasistatic field using the body’s conductive properties. Signals from a pacemaker can travel from head to toe, but they won’t leave the skin. “Unless someone is physically touching you, they don’t get the signals,” Sen says.

Sen and his colleagues call it electro-quasistatic human body communication, and described it earlier this month in the journal Scientific Reports. In the study, Sen’s prototype successfully confined to the body signals from a wearable device. The researchers have not yet tested their prototype on people with an implanted medical device.

Bonus: signals in the electro-quasistatic range use a fraction of the energy of traditional Bluetooth communication.

Medtronic, for its part, is developing a series of software updates to better secure the wireless communication affected by the issues described in the advisory, according to a Medtronic spokesperson. The first update is scheduled for later in 2019, subject to regulatory approvals. Medtronic and the FDA recommend that patients and physicians continue to use the devices.

A version of this post appears in the May 2019 print issue as “Thwarting Cyberattacks on Medical Implants.”

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This CAD Program Can Design New Organisms

Genetic engineers have a powerful new tool to write and edit DNA code

11 min read
A photo showing machinery in a lab

Foundries such as the Edinburgh Genome Foundry assemble fragments of synthetic DNA and send them to labs for testing in cells.

Edinburgh Genome Foundry, University of Edinburgh

In the next decade, medical science may finally advance cures for some of the most complex diseases that plague humanity. Many diseases are caused by mutations in the human genome, which can either be inherited from our parents (such as in cystic fibrosis), or acquired during life, such as most types of cancer. For some of these conditions, medical researchers have identified the exact mutations that lead to disease; but in many more, they're still seeking answers. And without understanding the cause of a problem, it's pretty tough to find a cure.

We believe that a key enabling technology in this quest is a computer-aided design (CAD) program for genome editing, which our organization is launching this week at the Genome Project-write (GP-write) conference.

With this CAD program, medical researchers will be able to quickly design hundreds of different genomes with any combination of mutations and send the genetic code to a company that manufactures strings of DNA. Those fragments of synthesized DNA can then be sent to a foundry for assembly, and finally to a lab where the designed genomes can be tested in cells. Based on how the cells grow, researchers can use the CAD program to iterate with a new batch of redesigned genomes, sharing data for collaborative efforts. Enabling fast redesign of thousands of variants can only be achieved through automation; at that scale, researchers just might identify the combinations of mutations that are causing genetic diseases. This is the first critical R&D step toward finding cures.

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