CVE-2018-5446 identifies a security vulnerability in the Medtronic 2090 CareLink Programmer, a medical device programmer used to configure and manage implantable cardiac devices. The vulnerability is classified under CWE-257, which pertains to the use of hard-coded or recoverable passwords. Specifically, the device uses a per-product username and password that are stored in a recoverable format. This means that the credentials are not securely hashed or encrypted, allowing an attacker with access to the device or its software to extract these credentials and potentially gain unauthorized access. The CVSS v3.1 base score is 4.9 (medium severity), with the vector indicating that the attack requires physical proximity (AV:P - physical access), high attack complexity (AC:H), no privileges required (PR:N), and no user interaction (UI:N). The scope is changed (S:C), and the impact is high on confidentiality (C:H), but no impact on integrity (I:N) or availability (A:N). This vulnerability does not have known exploits in the wild. The lack of patch links suggests that no official patch has been released or publicly documented. The vulnerability could allow an attacker with physical access to the device to extract credentials, potentially enabling unauthorized configuration or data access. Given the critical nature of the device in managing cardiac implants, unauthorized access could lead to privacy violations or misuse of device settings, although direct patient harm from this vulnerability alone is not indicated.

For European organizations, particularly healthcare providers and hospitals using Medtronic 2090 CareLink Programmers, this vulnerability poses a risk to patient data confidentiality and device management security. Unauthorized access to the programmer could lead to exposure of sensitive patient information or unauthorized changes to device configurations, potentially undermining patient trust and violating GDPR regulations concerning data protection. While the vulnerability requires physical access and has high attack complexity, insider threats or attackers with physical proximity could exploit it. The impact on device integrity and availability is not indicated, reducing the risk of direct patient harm from device malfunction due to this vulnerability. However, the confidentiality breach alone is significant in the healthcare context. European healthcare institutions must consider this vulnerability in their risk assessments, especially in environments where physical security controls may be insufficient.

1. Enforce strict physical security controls around Medtronic 2090 CareLink Programmers to prevent unauthorized physical access. 2. Implement role-based access controls and monitor access logs to detect any unauthorized usage. 3. Where possible, isolate the programmers from network access to reduce remote attack vectors. 4. Engage with Medtronic for any available firmware updates or patches addressing this vulnerability, or request guidance on secure credential management. 5. Use device-level encryption or secure storage mechanisms if supported to protect stored credentials. 6. Train staff on the importance of securing medical devices and recognizing potential tampering. 7. Conduct regular audits of device configurations and access to detect anomalies. 8. Consider additional compensating controls such as tamper-evident seals or surveillance in areas where the programmers are used or stored.