CVE-2022-32537 is a medium-severity vulnerability (CVSS 4.8) identified in the Medtronic Minimed 600 Series Insulin Pumps, specifically affecting models 620G, 630G, 640G, and 670G. The vulnerability is classified under CWE-693, which relates to protection mechanisms that are insufficient or incorrectly implemented. This flaw allows an unauthorized attacker in close wireless proximity to the patient and device to potentially learn details about the communication protocol used during the pairing process between the insulin pump and its system components. The pairing process is critical as it establishes secure communication channels between the pump and associated devices such as continuous glucose monitors or remote controllers. By gaining insight into the protocol, an attacker could theoretically attempt to interfere with or manipulate the communication, potentially compromising the integrity of commands sent to the pump. However, exploitation requires advanced technical knowledge and physical proximity to the patient, as the attack vector is limited to wireless signals during the pairing phase. Notably, the vulnerability does not impact confidentiality (no direct data leakage), nor availability (the pump’s operation is not disrupted), but it does threaten integrity since unauthorized manipulation of the communication protocol could alter insulin delivery commands. There is no user interaction required beyond the pairing process, and a low level of privileges is assumed since the attacker is unauthorized but must be physically near the device. No known exploits are reported in the wild, and Medtronic has issued a security bulletin with guidance, although no specific patches are currently linked. The vulnerability’s attack complexity is high due to the technical expertise and proximity needed, limiting widespread exploitation but posing a risk to individual patients if targeted.

For European organizations, particularly healthcare providers and medical device distributors, this vulnerability presents a patient safety risk and potential liability issue. If exploited, it could lead to unauthorized manipulation of insulin delivery, risking patient health through incorrect dosing. This could undermine trust in medical device security and complicate regulatory compliance under the EU Medical Device Regulation (MDR) and GDPR if patient safety or data integrity is compromised. Hospitals and clinics using affected Medtronic pumps must be aware of the risk during device pairing, especially in environments where unauthorized individuals could be physically close to patients. The impact is primarily on patient safety and device integrity rather than data confidentiality or system availability. Given the specialized nature of the attack, widespread disruption is unlikely, but targeted attacks on high-risk patients or critical care settings could have severe consequences. Additionally, healthcare providers may face increased operational burdens to monitor and secure device pairing processes, and manufacturers may be pressured to accelerate firmware updates or device replacements.

1. Strictly control physical access to patients during the pairing process to prevent unauthorized wireless proximity attacks. 2. Implement pairing procedures in secure, controlled environments such as hospital rooms with restricted access or private patient areas. 3. Educate healthcare staff and patients on the importance of limiting nearby wireless devices during pairing and recognizing suspicious activity. 4. Monitor for unusual device behavior post-pairing that could indicate protocol manipulation attempts. 5. Coordinate with Medtronic to apply any forthcoming firmware updates or patches as soon as they become available. 6. Consider deploying additional wireless signal monitoring tools in clinical settings to detect unauthorized pairing attempts or anomalous wireless activity near patients. 7. Maintain detailed logs of pairing events and device interactions to support forensic analysis if exploitation is suspected. 8. Engage with regulatory bodies to ensure compliance with updated security standards and reporting obligations related to this vulnerability. 9. For organizations managing large fleets of these devices, implement asset management and periodic security assessments focused on wireless communication security.