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Cardiac Implantable Medical Devices forensics: Postmortem analysis of lethal attacks scenarios
Affiliation:1. Communication Networks and Security Research Lab, University of Carthage, School of Communication Engineering (SUP''Com), El Ghazala Technopark, Ariana 2083, Tunisia;2. Department of Forensic Medicine of Charles Nicolle, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia;1. The Affiliated Institute of ETRI, 1559, Yuseong-daero, Yuseong-gu, Daejeon 34044, Republic of Korea;2. Department of Computer Science and CERIAS, Purdue University, West Lafayette, IN 47907, USA;3. School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA;1. Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia;2. Department of Clinical Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia;3. Center for Health Outcomes & PharmacoEconomic Research, University of Arizona, Tucson, Arizona;4. Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia;5. Department of Pharmacy Practice, King Abdulaziz University Faculty of Pharmacy, Jeddah, Saudi Arabia;6. Banner—University Medicine Endocrinology and Diabetes Clinic, Tucson, Arizona;7. Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, College of Medicine, Tucson, Arizona;8. Department of Pharmacy Practice & Science, College of Pharmacy, The University of Arizona, Tucson, Arizona;1. Cardiology and Cardiac Pacing Unit, Douala General Hospital, P.O Box 4856 Douala, Cameroon;2. Clinical Research Education Networking & Consultancy (CRENC), Douala, Cameroon;3. Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon;4. Cardiology and Medical Centre, Yaounde, Cameroon;5. Faculty of Medicine and Phramaceutical Sciences, University of Douala, Douala, Cameroon;6. Douala Cardiovascular Centre, Douala, Cameroon;7. Deido District Hospital, Douala, Cameroon;8. Shisong Cardiac Centre, Kumbo, Cameroon;9. Buea Regional Hospital, Buea, Cameroon;10. Intensive Care Unit, Douala General Hospital, Douala, Cameroon;11. Guidelines Advisory Network, Paris, France;12. Service of internal medicine and cardiology, Bafoussam regional hospital, Bafoussam, Cameroon;1. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark;2. Department of Public Health, Section of General Practice, Aarhus University, Denmark;3. Department of Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark;4. Department of Internal Medicine, Herning Regional Hospital, Denmark;5. Department of Internal Medicine, Viborg Regional Hospital, Denmark;6. Department of Internal Medicine, Randers Regional Hospital, Denmark;7. Department of Internal Medicine, Horsens Regional Hospital, Denmark;8. Department of Internal Medicine, Holstebro Regional Hospital, Denmark;9. Diagnostic Center, Silkeborg Regional Hospital, Denmark;10. Danish Diabetes Academy, Odense, Denmark
Abstract:Cardiac Implantable Medical devices (IMD) are increasingly being used by patients to benefit from their therapeutic and life-saving functions. These medical devices are surgically implanted into patient's bodies and wirelessly configured by prescribing physicians and healthcare professionals using external programmers. However, these devices are threatened by a set of lethal attacks, due to the use of vulnerable wireless communication and security protocols, and the lack of security protection mechanisms deployed on IMDs.In this paper, we propose a digital investigation system for the postmortem analysis of lethal attack scenarios on cardiac IMDs. After developing a set of techniques allowing the secure storage of digital evidence logs which track the executed sensitive events, we implement an in-depth security solution allowing the protection of cardiac IMDs. An inference system integrating a library of medical rules is proposed to automatically infer potential medical scenarios that caused the patient's death, or that created heart-related emergency situations (through the occurrence of ventricular tachycardia for example). A Model Checking based formal technique to reconstruct potential technical attack scenarios on a cardiac IMD, starting from the collected evidence, is also proposed. The results obtained by the two proposed reasoning techniques (i.e., the inference system and the Model Checking based algorithm) are correlated to prove whether a potential attack scenario is responsible of the occurrence of heart-related emergency situations or the death of a patient. Based on the proposed techniques, we design a decision-support system that reconciles in the same framework the medical and technical investigation aspects.
Keywords:Cardiac IMD security  Lethal attacks  Forensic investigation  Medical investigation  Model Checking  Inference system
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