Incident: Ransomware Attack on Fertility Clinic's Document Management System

Published Date: 2021-11-10

Postmortem Analysis
Timeline 1. The software failure incident, a ransomware attack on a document management firm affecting the Lister Fertility Clinic and other organizations, happened in November 2021 as per the article published on November 10, 2021 [Article 121150].
System 1. Stor-a-file IT system [121150] 2. Third-party document management services supplier [121150]
Responsible Organization 1. A cyber-gang was responsible for causing the software failure incident at the document management firm used by the Lister Fertility Clinic and other organizations [121150].
Impacted Organization 1. Lister Fertility Clinic [Article 121150] 2. Nuffield Health Leicester Hospital [Article 121150]
Software Causes 1. Ransomware attack on a document management firm led to the exposure of medical data from a private fertility clinic, causing the software failure incident [121150].
Non-software Causes 1. The failure incident was caused by a ransomware attack on a document management firm, Stor-a-file Limited, which led to the exposure of data from a private fertility clinic and other organizations [121150].
Impacts 1. The software failure incident resulted in the risk of medical data from a private fertility clinic being exposed due to a ransomware attack on a document management firm, affecting around 1,700 patients [121150]. 2. The incident led to the potential unauthorized access of medical information, including consent forms, medical history, test results, treatment recommendations, and fertility treatment records [121150]. 3. The clinic had to inform patients about the breach, offer support, and monitor the dark web for any potential release or sale of the accessed medical records [121150]. 4. The incident prompted the clinic to terminate its contract with the document management company, instructing them to return or delete any data they held, and take steps to enhance cybersecurity measures to prevent similar issues in the future [121150]. 5. The attack also affected another healthcare organization, the Nuffield Health Leicester Hospital, although it confirmed that no sensitive patient information had been published online [121150].
Preventions 1. Implementing robust cybersecurity measures such as regular security audits, penetration testing, and employee training to prevent ransomware attacks like the one that targeted the document management firm [121150]. 2. Ensuring secure data encryption and access controls to protect sensitive medical information from unauthorized access [121150]. 3. Regularly updating and patching software systems to address known vulnerabilities and prevent exploitation by cybercriminals [121150]. 4. Having a comprehensive incident response plan in place to quickly detect, contain, and mitigate the impact of a cyber attack, including ransomware incidents [121150].
Fixes 1. Enhancing cybersecurity measures such as implementing stronger firewalls, intrusion detection systems, and regular security audits to prevent future ransomware attacks [121150]. 2. Conducting thorough security assessments and due diligence when selecting third-party vendors for handling sensitive medical data to ensure they have robust cybersecurity protocols in place [121150]. 3. Implementing data encryption and access controls to protect sensitive medical records from unauthorized access in case of a breach [121150]. 4. Regular employee training on cybersecurity best practices and awareness programs to prevent phishing attacks and other social engineering tactics used by cybercriminals [121150].
References 1. The Lister Fertility Clinic 2. Stor-a-file Limited 3. Nuffield Health Leicester Hospital 4. The Register 5. Ukranian police 6. Information Commissioner's Office (ICO) 7. Leicestershire Cyber Crime Unit

Software Taxonomy of Faults

Category Option Rationale
Recurring one_organization, multiple_organization (a) The software failure incident having happened again at one_organization: The Lister Fertility Clinic experienced a software failure incident due to a ransomware attack on a document management firm, Stor-a-file Limited, which they used for scanning medical records [121150]. The incident involved the potential exposure of sensitive medical data of around 1,700 patients. This incident highlights the vulnerability of the clinic's data management systems and the risks associated with third-party service providers. (b) The software failure incident having happened again at multiple_organization: In addition to the Lister Fertility Clinic, the same software failure incident also affected the Nuffield Health Leicester Hospital, as confirmed by Stor-a-file Limited, the document management services supplier that was targeted in the ransomware attack [121150]. This indicates that multiple healthcare organizations were impacted by the same cyber attack, emphasizing the widespread nature of the incident within the healthcare sector.
Phase (Design/Operation) design, operation (a) The software failure incident in the article was primarily due to a design-related factor introduced by the system development and operation procedures. The incident occurred when a ransomware attack hit a document management firm, Stor-a-file Limited, which was used by the Lister Fertility Clinic for scanning medical records. The clinic's patient medical records, including sensitive information like consent forms, medical history, test results, recommendations for treatment, and fertility treatment records, were stored on the Stor-a-file IT system that was affected by the attack [121150]. This design flaw in the system's architecture and data management processes led to the exposure of sensitive medical information to a cyber-gang, highlighting a failure in the system's design and security measures. (b) Additionally, the software failure incident also involved operational factors related to the misuse of the system. The incident was exacerbated by the fact that the cyber-gang behind the attack made a ransom demand, which was not paid by the affected organizations, including the Lister Fertility Clinic and Nuffield Health Leicester Hospital. Despite not paying the ransom, the cyber-gang released some of the accessed data on the dark web, raising concerns about the potential misuse of the compromised medical records. The clinic informed patients that the hackers could sell the medical records to third parties, indicating a risk arising from the operational handling of the data breach situation [121150]. This aspect of the incident highlights the operational challenges faced in responding to and mitigating the consequences of a cyber-attack on the system.
Boundary (Internal/External) within_system, outside_system (a) within_system: The software failure incident at the Lister Fertility Clinic and Nuffield Health Leicester Hospital was primarily within the system. The incident occurred due to a ransomware attack on a document management firm, Stor-a-file Limited, which was used by these healthcare organizations for scanning medical records [121150]. The attack led to the potential exposure of medical information, including patient records, stored within the system of the document management firm. The clinic and hospital had to take steps to address the breach and mitigate the impact on their patients, indicating that the failure originated within the system where the data was stored and managed.
Nature (Human/Non-human) non-human_actions, human_actions (a) The software failure incident in this case was primarily due to non-human actions, specifically a ransomware attack on a document management firm, Stor-a-file Limited, which led to the exposure of medical data from a private fertility clinic and other organizations [121150]. The attack was carried out by a cyber-gang, and the ransom demand made by the hackers was not paid. The incident involved the unauthorized access to electronic medical records stored on the Stor-a-file IT system, potentially putting sensitive patient information at risk. The attack was not a result of human actions but rather a deliberate cyber intrusion. (b) Human actions also played a role in this software failure incident. The clinic mentioned in the article, the Lister Fertility Clinic, had its patient medical records stored on the Stor-a-file IT system that was affected by the attack. While the attack itself was non-human in nature, the decision-making processes related to data management, cybersecurity measures, and the response to the incident involved human actions. For example, the clinic had to inform patients, offer support, terminate its contract with the document company, and take steps to monitor and safeguard patient data [121150].
Dimension (Hardware/Software) software (a) The software failure incident reported in the news article was primarily due to a cyberattack involving ransomware targeting a document management firm used by the Lister Fertility Clinic and other organizations. The attack led to the compromise of medical data, including patient records, stored electronically on the affected IT system. The incident was described as a hack by a cyber-gang, and the firm confirmed that medical information had been accessed, potentially putting data at risk [121150]. (b) The software failure incident was attributed to a ransomware attack on the document management firm, resulting in the compromise of electronic medical records. The attack impacted multiple organizations, including healthcare-related entities like the Lister Fertility Clinic and the Nuffield Health Leicester Hospital. The incident highlighted the importance of cybersecurity measures, with the firm emphasizing the seriousness of cyber security and taking steps to enhance their systems' security to prevent similar issues in the future [121150].
Objective (Malicious/Non-malicious) malicious, non-malicious (a) The software failure incident in Article 121150 was malicious. The incident involved a ransomware attack on a document management firm, Stor-a-file Limited, which resulted in the potential exposure of sensitive medical data from a private fertility clinic and other organizations. The attack was carried out by a "cyber-gang" who accessed the systems and demanded a ransom. The attackers released some of the accessed data on the dark web, and there were concerns that they could sell the medical records to third parties. The incident was linked to the Cl0p ransomware gang, and there was no communication with the hackers, and no ransom was paid. The clinic took steps to terminate its contract with the document company and instructed the deletion or return of any data held by them [121150]. (b) The software failure incident in Article 121150 was also non-malicious. The incident involved a failure in the cybersecurity measures of the document management firm, Stor-a-file Limited, which led to the unauthorized access of sensitive medical data. The firm mentioned that the incident was limited to a small number of records held electronically, and they took steps to enhance their cybersecurity measures by removing all third-party software from their system to prevent similar issues in the future. The incident affected multiple organizations, including a fertility clinic and a hospital, highlighting the importance of robust cybersecurity practices to protect sensitive data [121150].
Intent (Poor/Accidental Decisions) poor_decisions, accidental_decisions (a) The software failure incident in Article 121150 was primarily due to poor decisions made by the document management firm, Stor-a-file Limited. The firm was hacked by a cyber-gang, leading to the exposure of sensitive medical data from various organizations, including the Lister Fertility Clinic and Nuffield Health Leicester Hospital. Stor-a-file Limited did not pay the ransom demanded by the hackers, and the cyber-gang released some of the accessed data on the dark web. The incident highlighted poor decisions in terms of cybersecurity measures and data protection practices by the document management firm, ultimately resulting in the compromise of medical records [121150]. (b) Additionally, accidental decisions or unintended consequences may have played a role in the software failure incident. For example, the Lister Fertility Clinic and other affected organizations may not have anticipated the extent of the breach or the potential consequences of relying on a vulnerable third-party document management service. The accidental exposure of sensitive medical data due to the cyber-attack could be seen as an unintended consequence of the security vulnerabilities present in the systems used by these organizations [121150].
Capability (Incompetence/Accidental) accidental (a) The software failure incident in Article 121150 was not explicitly attributed to development incompetence. The incident was primarily caused by a ransomware attack on a document management firm, leading to the exposure of medical data from a fertility clinic and other organizations. The attack was carried out by a cyber-gang, and the firm involved took steps to enhance its cybersecurity measures to prevent similar incidents in the future. (b) The software failure incident in Article 121150 was accidental in nature, as it was the result of a ransomware attack on the document management firm that was not intentionally caused by the clinic or the affected organizations. The attack led to the unauthorized access of medical records, and the firm involved took immediate actions to address the breach, including informing the authorities and enhancing their cybersecurity protocols.
Duration temporary The software failure incident reported in the articles can be categorized as a temporary failure. The incident was caused by a ransomware attack on a document management firm, affecting multiple organizations, including the Lister Fertility Clinic and Nuffield Health Leicester Hospital [121150]. The attack led to the potential exposure of medical records and other sensitive information, prompting immediate actions such as informing the police, the Information Commissioner's Office, terminating contracts with the affected firm, and enhancing cybersecurity measures to prevent similar incidents in the future. The incident was a result of specific circumstances, such as the ransomware attack, rather than being a permanent failure inherent to the software systems themselves.
Behaviour crash, omission, value, other (a) crash: The software failure incident in the article can be categorized as a crash as the system lost its state and was not able to perform its intended functions. The ransomware attack on the document management firm led to the system being hacked, affecting the electronic records of various organizations, including the Lister Fertility Clinic and Nuffield Health Leicester Hospital [121150]. The incident resulted in the system being compromised and unable to function properly, leading to potential data breaches and risks to patient information. (b) omission: The software failure incident can also be categorized as an omission as the system omitted to perform its intended functions at an instance(s). The attack resulted in the omission of proper data protection measures, leading to the exposure of sensitive medical information of patients. The clinic mentioned that the cyber-gang accessed their systems and made a ransom demand, which was not paid, resulting in the release of some data on the dark web [121150]. (c) timing: The software failure incident does not align with a timing failure as the system was not performing its intended functions too late or too early. The incident was more focused on the system being compromised and losing control over the data it was supposed to protect, rather than issues related to timing [121150]. (d) value: The software failure incident can be associated with a value failure as the system was performing its intended functions incorrectly. The attack led to unauthorized access to medical records, including consent forms, medical history, test results, treatment recommendations, and fertility treatment records. Although credit or debit card details were not compromised, the breach of medical records was a significant violation of data security [121150]. (e) byzantine: The software failure incident does not exhibit characteristics of a byzantine failure, which involves inconsistent responses and interactions within a system. The incident described in the article primarily focused on the ransomware attack and the unauthorized access to sensitive medical information, rather than displaying erratic or inconsistent behavior within the system [121150]. (f) other: The software failure incident can be further categorized as a security breach. The incident involved a cyber-gang hacking into the document management firm's system, leading to the exposure of medical records and potential data leaks. The breach highlighted vulnerabilities in the system's security measures and the need for enhanced cybersecurity protocols to prevent such incidents in the future [121150].

IoT System Layer

Layer Option Rationale
Perception None None
Communication None None
Application None None

Other Details

Category Option Rationale
Consequence property, theoretical_consequence (d) property: People's material goods, money, or data was impacted due to the software failure The software failure incident, which was a ransomware attack on a document management firm affecting the Lister Fertility Clinic and other organizations, resulted in the potential exposure of sensitive medical data. The attackers accessed the systems of the document management firm and made a ransom demand, threatening to release the data they accessed on the dark web. While the clinic confirmed that no data belonging to Lister patients had been released, there was a risk that the hackers could sell the medical records to a third party. The incident led to concerns about the security and privacy of the patients' medical information, prompting actions such as terminating contracts with the document company and monitoring the dark web for any information about the patients [121150].
Domain information, health (a) The failed system was intended to support the production and distribution of information. The software failure incident involved a ransomware attack on a document management firm, Stor-a-file Limited, which resulted in the exposure of medical data from a private fertility clinic, the Lister Fertility Clinic. The incident put at risk various types of medical information, including consent forms, medical history, test results, recommendations for treatment, and fertility treatment records [Article 121150].

Sources

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