CVE-2024-1863 identifies a critical SQL Injection vulnerability (CWE-89) in Sante PACS Server version 3.3.3. The vulnerability resides in the token endpoint, which listens on port 3000 and processes HTTP requests containing a token parameter. The server fails to properly sanitize or neutralize special characters in this parameter before incorporating it into SQL queries. This improper input validation allows an unauthenticated remote attacker to inject arbitrary SQL commands, leading to remote code execution within the context of the NETWORK SERVICE account. The vulnerability was reported by ZDI (ZDI-CAN-21539) and has a CVSS v3.0 base score of 9.8, indicating critical severity with network attack vector, no required privileges or user interaction, and full impact on confidentiality, integrity, and availability. The vulnerability enables attackers to compromise the PACS server, potentially accessing or manipulating sensitive medical imaging data, disrupting services, or using the server as a foothold for further network intrusion. No official patches or mitigations are listed yet, increasing the urgency for defensive measures. The vulnerability affects a widely used healthcare imaging server product, which is integral to medical workflows, making exploitation highly impactful.

The impact of CVE-2024-1863 is severe for organizations using Sante PACS Server, particularly healthcare providers and medical facilities. Exploitation allows attackers to execute arbitrary code remotely without authentication, potentially leading to full system compromise. This can result in unauthorized access to sensitive patient imaging data, alteration or deletion of medical records, disruption of critical healthcare services, and potential lateral movement within the network. Given the NETWORK SERVICE context of execution, attackers may escalate privileges or deploy ransomware and other malware. The breach of confidentiality and integrity of medical data can have serious regulatory and reputational consequences. Additionally, availability impacts could disrupt diagnostic workflows, delaying patient care. The vulnerability's ease of exploitation and critical severity make it a high-risk threat that could be leveraged by cybercriminals or nation-state actors targeting healthcare infrastructure.

1. Immediate mitigation involves isolating the affected Sante PACS Server from untrusted networks and restricting access to port 3000 to trusted internal hosts only. 2. Implement Web Application Firewall (WAF) rules to detect and block SQL injection patterns targeting the token parameter. 3. Monitor network traffic and server logs for unusual or suspicious requests to the token endpoint. 4. Employ network segmentation to limit the server’s access to sensitive backend systems and reduce lateral movement risk. 5. If possible, disable or restrict the token endpoint functionality until a vendor patch is available. 6. Engage with Sante support to obtain official patches or updates addressing this vulnerability. 7. Conduct a thorough security audit of the PACS server environment to identify any signs of compromise. 8. Educate IT and security teams about this vulnerability to ensure rapid response and incident handling. 9. Consider deploying application-layer input validation and parameterized queries in custom integrations or proxies as an additional safeguard. 10. Maintain up-to-date backups of critical data to enable recovery in case of exploitation.