CVE-2024-50588 is a critical security vulnerability affecting HASOMED Elefant versions earlier than 24.03.03. The root cause is the use of default, well-known credentials that allow unauthenticated attackers with local network access to remotely connect as database administrators (DBA) to the Firebird database backend. This database stores highly sensitive information, including patient medical records and user login credentials. The vulnerability stems from CWE-1393 (Use of Default Password) and CWE-419 (Use After Free or similar memory corruption leading to arbitrary file write). By exploiting this flaw, attackers can not only exfiltrate confidential data but also write or overwrite arbitrary files on the server filesystem with the privileges of the Firebird database service, which runs under the powerful NT AUTHORITY\SYSTEM account on Windows systems. This level of access effectively grants full control over the affected server, enabling persistent compromise, data manipulation, or ransomware deployment. The vulnerability requires no authentication or user interaction and can be exploited remotely over the local network, making it highly accessible to insider threats or attackers who have breached perimeter defenses. Although no public exploits have been reported yet, the CVSS 3.1 base score of 9.8 reflects the critical severity due to the combination of high impact on confidentiality, integrity, and availability, and low attack complexity. The vulnerability was published on November 8, 2024, and affects a widely used medical office software product, increasing the urgency for remediation.

For European organizations, particularly healthcare providers using HASOMED Elefant, this vulnerability poses a severe risk to patient privacy and regulatory compliance under GDPR. Unauthorized access to patient data can lead to significant legal penalties, reputational damage, and loss of patient trust. The ability to overwrite arbitrary files with SYSTEM privileges can result in complete system compromise, enabling attackers to deploy ransomware, disrupt medical services, or manipulate medical records, potentially endangering patient safety. Given the critical nature of healthcare infrastructure and the sensitivity of medical data, exploitation could have cascading effects on healthcare delivery and data integrity. The local network access requirement means that attackers could be insiders or external actors who have gained foothold within the network, emphasizing the need for strong internal network segmentation and monitoring. The impact extends beyond confidentiality to integrity and availability, making this a comprehensive threat to affected organizations.

Immediate mitigation involves upgrading HASOMED Elefant to version 24.03.03 or later where the default password issue is resolved. Until patching is possible, organizations should change default credentials on the Firebird database to strong, unique passwords and restrict network access to the database server strictly to authorized personnel and systems. Implement network segmentation to isolate medical office systems from general corporate and guest networks. Employ strict monitoring and logging of database access and file system changes to detect suspicious activity early. Use host-based intrusion detection systems (HIDS) to identify unauthorized file modifications. Additionally, enforce the principle of least privilege on all service accounts and consider running the Firebird service with reduced privileges if feasible. Conduct regular security audits and penetration tests focusing on internal network threats. Finally, ensure robust backup and recovery procedures are in place to restore systems in case of compromise.