Incident: Irish Health Service Cyber-Attack: Ransomware Disrupts Healthcare Systems, Data Breach.

Published Date: 2021-12-10

Postmortem Analysis
Timeline 1. The software failure incident happened in May 2021 [122241].
System 1. Irish health service computer systems 2. IT infrastructure 3. Covid-19 vaccination systems 4. Specific medical devices 5. Software developed by Conti group
Responsible Organization 1. Criminal gang behind the email containing malware that compromised the systems [122241] 2. Group known as Conti, whose software was used by the attackers [122241]
Impacted Organization 1. Irish Health Service Executive (HSE) - The HSE was severely impacted by the software failure incident, with more than 80% of its IT infrastructure affected, leading to disruptions in healthcare provision and loss of key patient information [122241].
Software Causes 1. The software cause of the failure incident was the opening of a compromised spreadsheet containing malware by someone in the Irish Health Service Executive, leading to the infiltration of ransomware into the systems [122241].
Non-software Causes 1. Lack of investigation despite multiple warning signs of the criminal gang's activities [122241]. 2. Opening a compromised spreadsheet from an email, leading to the introduction of malware into the system [122241]. 3. Frail Irish technology systems that were vulnerable to serious attacks [122241]. 4. Missed opportunities to spot warning signs and intervene in the attack [122241]. 5. Lack of preparation or contingency planning for a widespread disruptive IT event [122241].
Impacts 1. More than 80% of IT infrastructure was affected, leading to the loss of key patient information and diagnostics, severely impacting the health service and care provision [122241]. 2. Doctors, nurses, and other healthcare workers lost access to systems for patient information, clinical care, and laboratories, forcing them to resort to pen and paper for record-keeping [122241]. 3. Lab test data had to be handwritten and manually entered, increasing the risks of mistakes [122241]. 4. Thousands of people's healthcare was disrupted, with incidents such as a surgeon operating on a patient who had already undergone surgery due to the lack of proper information access [122241]. 5. Confidential medical files were stolen, with hackers threatening to release the data, leading to a significant breach of patient confidentiality [122241].
Preventions 1. Proper cybersecurity training and awareness to recognize warning signs of potential cyber-attacks [122241]. 2. Timely investigation and intervention upon detecting warning signs of malicious activity within the network [122241]. 3. Implementation of robust cybersecurity measures to prevent unauthorized access and ransomware attacks [122241]. 4. Regular system updates and patches to address vulnerabilities and enhance system security [122241]. 5. Contingency planning and preparedness for widespread disruptive IT events to ensure a swift and effective response in case of an attack [122241].
Fixes 1. Implementing robust cybersecurity measures to prevent future cyber-attacks [122241]. 2. Enhancing technology systems to make them less vulnerable to attacks [122241]. 3. Improving monitoring and detection capabilities to identify warning signs of potential attacks [122241]. 4. Developing and implementing contingency plans for widespread disruptive IT events [122241]. 5. Conducting regular cybersecurity training for staff to increase awareness and prevent incidents like opening compromised files [122241].
References 1. PricewaterhouseCoopers (PWC) - The independent report commissioned by the healthcare executive [122241] 2. Irish Health Service Executive (HSE) - The organization affected by the cyber-attack [122241] 3. Irish Defence Forces - Called in to help with the response to the cyber-attack [122241]

Software Taxonomy of Faults

Category Option Rationale
Recurring unknown The articles do not provide information about the software failure incident happening again at either the same organization (one_organization) or at other organizations (multiple_organization).
Phase (Design/Operation) design, operation (a) The software failure incident in the Irish health cyber-attack was primarily due to design-related factors introduced during system development and operation. The report highlighted that the Irish technology systems were "frail," and there were missed opportunities to spot warning signs during the development phase. Additionally, the attackers exploited vulnerabilities in the system design, such as opening a compromised spreadsheet that led to the spread of malware through the networks [122241]. (b) The operation of the system also played a significant role in the software failure incident. The criminal gang behind the attack spent two months working their way through the networks, indicating operational weaknesses in monitoring and response. The failure to investigate warning signs and intervene during the operation phase allowed the attackers to unleash ransomware that severely disrupted healthcare services in Ireland [122241].
Boundary (Internal/External) within_system, outside_system (a) within_system: The software failure incident in the Irish health cyber-attack was primarily due to contributing factors that originated from within the system. The incident was caused by ransomware that locked staff out of their computer systems, severely disrupting healthcare in the country [122241]. The attack was initiated when someone within the Irish Health Service Executive opened a compromised spreadsheet that had been sent to them via email, leading to the infiltration of malware into the system [122241]. Additionally, the report highlighted that the Irish technology systems were considered "frail," indicating internal vulnerabilities that were exploited by the attackers [122241]. (b) outside_system: However, external factors also played a role in the software failure incident. The criminal gang behind the attack targeted the system by sending a compromised file via email, which was the initial entry point for the malware [122241]. The attackers demanded payment to restore access to the computer systems, indicating an external threat actor seeking financial gain [122241]. Furthermore, the ransomware used in the attack was developed by a group known as Conti, which has been linked to Russian criminal gangs, suggesting an external origin of the attack [122241].
Nature (Human/Non-human) non-human_actions, human_actions (a) The software failure incident in the Irish health cyber-attack was primarily due to non-human actions, specifically the introduction of ransomware by criminal gangs. The attack involved ransomware that locked staff out of their computer systems, severely disrupting healthcare in Ireland [122241]. The criminals behind the attack compromised a file with malware, which then spread through the networks, affecting more than 80% of the IT infrastructure and leading to the loss of key patient information and diagnostics [122241]. (b) However, human actions also played a role in the incident. The report highlighted that there were missed opportunities to spot warning signs and launch investigations as multiple indicators of the criminal gang's activities were present in the system [122241]. Additionally, the lack of preparation and contingency planning for such a widespread IT event was criticized, indicating a human factor in the response to the attack [122241].
Dimension (Hardware/Software) hardware, software (a) The software failure incident in the Irish health cyber-attack was primarily due to contributing factors originating in hardware. The ransomware attack locked staff out of their computer systems and severely disrupted healthcare in the country. The attackers demanded payment to restore access to the computer systems, and it took the service four months to fully recover. More than 80% of IT infrastructure was affected, with the loss of key patient information and diagnostics, resulting in severe impacts on the health service and the provision of care. Doctors, nurses, and other workers lost access to systems for patient information, clinical care, and laboratories, leading to disruptions in healthcare services [122241]. (b) The software failure incident was also influenced by contributing factors originating in software. The criminal gang behind the attack compromised a file with malware that was opened by someone in the Irish Health Service Executive, allowing them to work their way through the networks for two months. The ransomware attack unleashed by the criminals had devastating impacts, affecting confidential medical files, disrupting healthcare services, and leading to the loss of access to critical systems for patient information and care. The attackers used software developed by a group known as Conti, and the ransomware has previously been linked to Russian criminal gangs. The attackers left instructions on how to get in touch and threatened to release stolen data, indicating a software-based attack strategy [122241].
Objective (Malicious/Non-malicious) malicious, non-malicious (a) The software failure incident in the Irish health cyber-attack was malicious in nature. The incident involved a cyber-attack where ransomware was used to lock staff out of their computer systems, severely disrupting healthcare in the country [122241]. The attackers demanded payment to restore access to the computer systems, and they even stole confidential medical files with the threat of releasing the data [122241]. The criminals behind the attack were identified as using software developed by a group known as Conti, which has been linked to Russian criminal gangs [122241]. (b) The software failure incident was also non-malicious in the sense that there were missed opportunities to spot warning signs and intervene before the attack escalated. The report highlighted that the Irish technology systems were "frail" and several opportunities to detect warning signs were missed, indicating a lack of proactive measures to prevent such incidents [122241]. Additionally, the report criticized the lack of preparation or contingency planning for a widespread disruptive IT event, suggesting a lack of readiness for such failures [122241].
Intent (Poor/Accidental Decisions) poor_decisions (a) The software failure incident in the Irish health cyber-attack was partly due to poor decisions. The report highlighted that there were multiple warning signs of the impending attack, but no investigation was launched, leading to a missed opportunity to intervene [122241]. Additionally, the report criticized the lack of preparation or contingency planning for such a loss of systems, indicating a lack of proactive decision-making in terms of cybersecurity readiness [122241].
Capability (Incompetence/Accidental) development_incompetence, accidental (a) The software failure incident in the Irish health cyber-attack was partially attributed to development incompetence. The report by PricewaterhouseCoopers (PWC) highlighted that the Irish technology systems were described as "frail" and that several opportunities to spot warning signs were missed by cyber-security experts [122241]. Additionally, the criminal gang behind the attack was able to compromise the system after an employee in the Irish Health Service Executive (HSE) opened a compromised spreadsheet, indicating a lack of awareness or training regarding cybersecurity measures within the organization. (b) The software failure incident in the Irish health cyber-attack also had elements of accidental factors contributing to the failure. The report mentioned that there were multiple warning signs of the criminal gang's activities within the network, but no investigation was launched, leading to a missed opportunity to intervene [122241]. This lack of action could be seen as an accidental oversight or negligence on the part of the organization, contributing to the severity of the attack.
Duration temporary (a) The software failure incident in the Irish health cyber-attack reported in Article 122241 was temporary. The ransomware attack locked staff out of their computer systems and severely disrupted healthcare in the country. However, the attackers eventually provided a decryption key that allowed for the recovery of systems, indicating that the failure was not permanent [122241].
Behaviour crash, omission, other (a) crash: The software failure incident in the Irish health cyber-attack resulted in a crash as more than 80% of the IT infrastructure was affected, leading to the loss of key patient information and diagnostics, causing severe impacts on the health service and the provision of care. This resulted in doctors, nurses, and other workers losing access to systems for patient information, clinical care, and laboratories, with emails going down and staff having to resort to pen and paper [122241]. (b) omission: The software failure incident involved an omission as there were multiple warning signs that cybercriminals were at work within the Irish Health Service Executive's networks, but no investigation was launched, leading to a crucial opportunity to intervene being missed. This omission allowed the criminals to progress through the networks and eventually unleash the ransomware attack [122241]. (c) timing: The software failure incident did not specifically involve a timing issue where the system performed its intended functions either too late or too early. The focus was more on the impact of the attack and the consequences rather than the timing of the system's functions [122241]. (d) value: The software failure incident did not involve the system performing its intended functions incorrectly in terms of providing incorrect outputs or results. The primary issue was the loss of access to critical systems and data, rather than the system producing incorrect values [122241]. (e) byzantine: The software failure incident did not exhibit a byzantine behavior where the system behaved erroneously with inconsistent responses and interactions. The attack was more focused on locking staff out of computer systems, disrupting healthcare, and demanding ransom rather than exhibiting inconsistent behaviors [122241]. (f) other: The software failure incident also involved a lack of preparation or contingency planning for such a loss of systems, which could be categorized as an organizational failure. The response teams were unable to focus on the highest priority response and recovery tasks due to the lack of preparedness for a widespread disruptive IT event, as highlighted in the report [122241].

IoT System Layer

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

Other Details

Category Option Rationale
Consequence property The consequence of the software failure incident described in the articles is as follows: (d) property: People's material goods, money, or data was impacted due to the software failure. - The ransomware attack on Ireland's health service resulted in the loss of key patient information and diagnostics, affecting the provision of care [122241]. - Confidential medical files were stolen by hackers, who threatened to release the data [122241]. - Lab test data had to be handwritten and manually entered, leading to greater risks of mistakes [122241]. - Thousands of people's healthcare was disrupted due to the attack [122241].
Domain health (a) The failed system was intended to support the health industry. The software failure incident occurred in the Irish health service, impacting healthcare provision and patient care [Article 122241].

Sources

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