Understanding the Cybersecurity Threat Landscape of Connected Infusion Devices

Takeaways

• Cyber risks to IoMT-connected infusion pumps are prevalent and can directly endanger patient safety through dosage manipulation or data breaches.
• Mitigation demands layered protection—firmware integrity, network segmentation, authentication, and lifecycle governance.
• Human and operational safeguards—trained staff, asset tracking, and decommissioning protocols—must complement technical controls for comprehensive defense.

What Are IoMT-Connected Infusion Devices?

Infusion pumps deliver controlled amounts of fluids, nutrients, or medication directly into a patient’s body. These devices now often connect to hospital networks through Wi-Fi, Bluetooth, or Ethernet to improve monitoring and efficiency. This networked capability places them firmly in the category of Internet of Medical Things (IoMT) devices. Their connectivity allows integration with electronic health records and remote patient management platforms. However, this convenience creates a range of new cybersecurity vulnerabilities that did not exist in standalone equipment. Understanding their function is essential for assessing the scope of security risks.

Why Infusion Devices Are High-Value Cyber Targets

Infusion devices control the flow of life-saving medications, making them highly sensitive assets in any healthcare setting. Their connection to a hospital’s IT infrastructure opens doors for attackers aiming to compromise critical care. These pumps often store and transmit Protected Health Information (PHI), including dosage plans and patient identifiers. Cybercriminals may exploit these devices not just to steal data, but to disrupt treatment or conduct ransomware attacks. Because tampering with dosages can directly impact patient outcomes, attackers view them as high-leverage targets for extortion. Healthcare professionals must therefore treat them as both clinical and cybersecurity priorities.

Common Vulnerability Types Found in Infusion Devices

The table below outlines common cybersecurity vulnerabilities affecting infusion pumps, categorized by source and technical weakness. Understanding these risks helps clarify why layered security strategies are essential in healthcare environments.

Vulnerability Category	Description	Real-World Example	Potential Risk
Device-Level	Legacy firmware, hardcoded credentials, no patch management.	Hospira LifeCare PCA with hardcoded passwords.	Unauthorized firmware changes, unsafe dose programming.
Network Communication	Unencrypted data transmission, insecure protocols like Telnet or FTP.	McAfee demo of B. Braun Infusomat exploit via network access.	Remote manipulation of dosage without alerts.
Authentication & Access	Default login credentials, lack of multi-factor authentication.	Hospira Symbiq permitted access with no password change.	Full device access for internal or external threats.
Data Security	Sensitive data sent in clear text, weak encryption standards.	Various pumps transmitting PHI over unsecured networks.	HIPAA violations, data theft, compliance penalties.
Operational Oversight	Lack of asset tracking, clinician training, or cross-department collaboration.	Secondary market pumps retaining hospital credentials.	Hospital breach through decommissioned device reuse.

Device-Level Vulnerabilities

Many infusion devices run on legacy operating systems that manufacturers no longer support with security patches. Their outdated firmware often contains hardcoded credentials or default settings that attackers can easily exploit. In some cases, physical access to the device enables firmware overrides or hardware tampering. Some devices cannot receive over-the-air updates, forcing hospitals to rely on manual updates that often get delayed. This combination of aging software and hardware limitations creates a fertile ground for cyberattacks.

Network & Communication Weaknesses

Most infusion pumps lack adequate network segmentation, allowing attackers to move laterally across hospital systems. They often use insecure protocols such as Telnet or outdated versions of FTP for data exchange. Communication traffic may remain unencrypted, making it easy for attackers to intercept and manipulate real-time data. Pumps without MAC address filtering or dynamic host configuration pose additional risks within hospital networks. These vulnerabilities compromise not only the device but also the larger IT ecosystem surrounding it.

Authentication & Access Control Flaws

Several documented exploits involve infusion devices that permit access without any form of user authentication. In some models, the default login credentials remain unchanged even after deployment. Administrative interfaces sometimes lack multi-factor authentication, allowing unauthorized users to reprogram dosage settings. Access control policies, if they exist, are often inconsistently applied across devices. This lack of robust verification increases the risk of external tampering or internal misuse.

Data Security and Privacy Gaps

Some infusion pumps transmit sensitive data such as dosage parameters and patient identifiers in clear text. Without encryption, these transmissions become vulnerable to man-in-the-middle attacks. In certain cases, the update mechanisms themselves lack cryptographic integrity checks. Attackers can exploit these weaknesses to inject malicious code or extract sensitive patient data. These data security gaps violate HIPAA standards and place hospitals at legal and financial risk.

Organizational and Operational Missteps

Even when the technology is sound, human error can open cybersecurity backdoors. Hospitals sometimes fail to track the lifecycle status of infusion devices across multiple departments. Staff may overlook outdated firmware or ignore manufacturer advisories. Limited coordination between IT and biomedical teams further complicates vulnerability management. In many settings, clinical personnel receive little to no training on cybersecurity best practices. These gaps in organizational behavior often serve as the final link in a successful attack chain (source).

Real-World Case Studies That Changed the Conversation

McAfee’s B. Braun Infusomat Hack

In a controlled test, researchers demonstrated that B. Braun’s Infusomat Space pump could be hacked remotely. They successfully altered the medication flow rate without setting off system alarms. This incident showed that attackers could bypass safeguards without needing direct device access. The test used existing network protocols and software vulnerabilities to manipulate the pump. This case triggered significant industry discussion (source).

Hospira’s Vulnerable Pump Models

Hospira’s Symbiq and LifeCare PCA pumps exhibited multiple security flaws, including the use of hardcoded passwords. Security researchers uncovered that attackers could access the pumps remotely and alter their firmware. In response, the FDA issued advisories urging healthcare providers to stop using these models. The vulnerabilities persisted across multiple firmware versions, emphasizing the need for secure-by-design principles. This case illustrated the dangers of long product lifecycles (source).

Urgent/11 Vulnerability Across Embedded Devices

Researchers discovered that many IoMT devices shared outdated network stack code known as IPnet. This flaw, called Urgent/11, affected infusion pumps and other critical care equipment. The vulnerability allowed attackers to take full control over targeted devices without user interaction. Since these embedded systems lack regular update cycles, patching the flaw proved especially difficult. Urgent/11 highlighted the systemic risk of shared software components (source).

Improper Decommissioning and Secondary Market Exposure

Researchers found that retired infusion pumps sold on secondary markets still contained active configurations. These included hospital network credentials, dosage logs, and patient IDs. Anyone purchasing the devices could use them to infiltrate hospital systems or extract sensitive data. This case underscores the importance of secure decommissioning procedures and asset lifecycle governance. The risk extends beyond hospital walls and into supply chain and disposal practices.

Network-Level Attacks and Ransomware Fallout

WannaCry ransomware disabled critical services across healthcare systems globally in 2017. Although not targeted at infusion pumps, the attack demonstrated how vulnerable hospital networks can disrupt device functionality. Many pumps rely on shared IT infrastructure, making them collateral victims of broader cyberattacks. Scenario-based studies now show that ransomware could corrupt pump configurations or block telemetry. These events show that infusion pump security depends as much on network integrity as on device-level controls (source).

Regulatory and Compliance Frameworks

The FDA requires manufacturers to include cybersecurity controls in premarket submissions and postmarket surveillance. Its guidance recommends that infusion devices support encrypted communication, access control, and update mechanisms. NIST SP 1800-8 provides actionable steps for segmenting networks and verifying device authenticity. Standards from IEC 80001 and AAMI TIR57 encourage risk management and security testing throughout the product lifecycle. Hospitals that follow these guidelines can reduce exposure and increase compliance with HIPAA and HITECH requirements. At HealthE1 Mobile Medical Services, our team implements these standards proactively in both home and mobile IV care settings.

Defense in Depth: Security Strategies That Actually Work

Technical Controls

Secure infusion pumps must support digitally signed firmware and encrypted updates. Hospitals should isolate these devices on dedicated VLANs with firewall rules to block external traffic. Devices must enforce user authentication before allowing configuration changes. Intrusion detection systems can monitor traffic for signs of unauthorized access attempts. These technical layers must work together to limit entry points and contain breaches.

Organizational Safeguards

Clinical engineering teams must coordinate with IT to maintain updated asset inventories. Periodic audits can help track firmware versions, device usage patterns, and known vulnerabilities. Hospitals should enforce cybersecurity policies across all departments involved with device maintenance. Training modules can help staff recognize indicators of compromise or abnormal behavior. At HealthE1 Mobile Medical Services, we conduct these risk assessments quarterly to stay ahead of emerging threats.

Lifecycle Security

Hospitals must define formal procedures for decommissioning infusion devices, including secure data wipes and disposal. Legacy models should be replaced once manufacturers cease security support. Procurement teams should demand security documentation from vendors before purchase. Regular penetration tests help validate the continued resilience of older devices in active use. Lifecycle management ensures long-term device security, not just initial safety compliance.

3 Practical Tips to Strengthen Infusion Pump Security

• Hospitals should isolate infusion devices on their own network segment, separate from general IT infrastructure.
• Staff must disable all default credentials and implement password rotation for administrative accounts.
• Clinicians and support personnel should learn to recognize unusual alerts or errors as potential signs of tampering. Prompt reporting of anomalies enables faster response and containment.

Hospitals that act on these simple measures improve safety without requiring large-scale infrastructure changes.

The Human Factor in Device Security

Healthcare providers often underestimate the role of human behavior in cybersecurity. Staff may unknowingly connect unsecured devices to critical networks or overlook basic patch alerts. Clinical workflows may prioritize speed over proper shutdown and re-authentication procedures. Attackers exploit these human lapses as much as technical flaws. In high-pressure environments, providing staff with IV-based stress management solutions can help reduce cognitive overload and improve clinical vigilance.

FAQ – Addressing Common Questions About Infusion Pump Cybersecurity

What kinds of infusion pumps are most vulnerable to cyberattacks?

Pumps running on outdated firmware or unsupported operating systems are especially prone to exploitation. Models without regular patch schedules or remote management features pose additional risks. Devices that use default credentials or lack access controls remain easy targets for attackers. Hospital-wide deployment of these models increases the attack surface across the network. Manufacturers that do not disclose security practices often contribute to long-term exposure.

Can attackers actually change dosage remotely?

Yes, researchers have demonstrated remote manipulation of dosage parameters in several case studies. The McAfee-B. Braun experiment showed how network-based vulnerabilities can override dose limits. Attackers can exploit remote interfaces or weak protocols to send malicious commands. These actions can bypass alarms and go undetected during normal workflows. Hospitals must implement network segmentation and intrusion monitoring to prevent such attacks.

Are home-infusion pumps at similar risk as hospital systems?

Home infusion pumps often connect via Wi-Fi or mobile hotspots, exposing them to different risks than hospital devices. These connections usually lack enterprise-grade firewalls or segmentation. If the pump lacks encryption or authentication, attackers could intercept transmissions. Users at home may also neglect firmware updates or ignore device alerts. HealthE1 Mobile Medical Services mitigates these risks by pre-configuring secure communication protocols and offering remote monitoring.

What is being done to secure legacy infusion devices still in use?

Many hospitals audit legacy devices to assess their remaining security life. Some replace unsupported models with newer alternatives that meet current standards. Others use network-level controls like segmentation and firewalls to isolate older pumps. Regulatory bodies now require vendors to disclose vulnerabilities and provide patches. Hospitals must decide whether to upgrade, isolate, or retire each legacy device based on risk tolerance.

Looking Ahead: Securing the Future of IoMT Therapy Delivery

Medical device manufacturers now prioritize secure-by-design principles in new infusion systems. These include embedded encryption, multifactor access, and anomaly detection powered by machine learning. Hospitals are adopting AI to analyze pump telemetry for signs of tampering or malfunction. Policy changes may soon require mandatory vulnerability disclosures from manufacturers to improve transparency. As cybersecurity threats grow, connected therapy delivery will evolve to meet them head-on, blending innovation with safety.

Medical review: Reviewed by Gary A. Webb MD MS FAAFP, Medical Director at HealthE1 Mobile Medical Services on September 5, 2025. Fact-checked against government and academic sources; see in-text citations. This page follows our Medical Review & Sourcing Policy and undergoes updates at least every six months. Last updated September 5, 2025.