CVE-2024-50589 is a vulnerability identified in the HASOMED Elefant medical software product, specifically affecting versions prior to 24.04.00. The root cause is a missing authentication mechanism (CWE-306) on a critical function exposed via the Fast Healthcare Interoperability Resources (FHIR) API. This API is designed to facilitate access to electronic health records (EHR) but, due to the lack of authentication, allows any attacker with local network access to query and retrieve sensitive patient data without any credentials or user interaction. The vulnerability is classified with a CVSS 3.1 score of 7.5 (high severity), indicating a high impact on confidentiality, no impact on integrity or availability, and an attack vector that is network-based with low complexity and no privileges required. The scope is unchanged, meaning the vulnerability affects only the Elefant system itself. Although no exploits have been reported in the wild, the exposure of sensitive health data could have serious privacy and regulatory consequences. The vulnerability highlights a critical security design flaw in the Elefant product's API, which should enforce strict authentication and authorization controls to protect patient data. Given the sensitive nature of healthcare information and the increasing reliance on digital health records, this vulnerability represents a significant risk to healthcare providers using the affected versions of Elefant.

For European organizations, especially healthcare providers using HASOMED Elefant, this vulnerability could lead to unauthorized disclosure of sensitive patient health information, violating GDPR and other data protection regulations. The exposure of EHR data can result in loss of patient privacy, reputational damage, legal penalties, and potential harm to patients if data is misused. Since the attack requires only local network access, any compromise or insider threat within the healthcare network could exploit this vulnerability. This elevates the risk in environments where network segmentation or access controls are weak. The confidentiality breach could undermine trust in healthcare providers and disrupt clinical operations if data integrity concerns arise from subsequent attacks. The lack of authentication on the FHIR API also suggests potential for automated data harvesting if an attacker gains network foothold. Overall, the impact is primarily on confidentiality but with significant regulatory and operational consequences for European healthcare entities.

1. Immediately upgrade HASOMED Elefant to version 24.04.00 or later once available, as this will contain the necessary authentication fixes. 2. Until patching is possible, restrict network access to the FHIR API by implementing strict network segmentation and firewall rules to limit access only to trusted systems and personnel. 3. Deploy network monitoring and intrusion detection systems to identify unusual or unauthorized API queries indicative of exploitation attempts. 4. Enforce strong internal access controls and limit local network access to the Elefant system to essential users only. 5. Conduct regular audits of API access logs to detect anomalous activity. 6. Educate staff about the risks of insider threats and the importance of network security hygiene. 7. Coordinate with HASOMED support for any available interim security advisories or workarounds. 8. Review and enhance overall FHIR API security posture, including implementing authentication and authorization mechanisms if custom integrations are used. 9. Prepare incident response plans specific to potential data breaches involving EHR data.