CVE-2022-4992: Dräger Patient Monitor DoS Vulnerability

CVE-2022-4992 Overview

CVE-2022-4992 affects Dräger Infinity Acute Care System (IACS) and Standalone Infinity M540 patient monitors running firmware versions VG4.1.1, VG4.0.3, and lower, with VG4.2 partially affected. The vulnerability stems from insufficient verification of data authenticity [CWE-345] in network message handling. Remote attackers on the network can inject spoofed or tampered messages to modify device settings, including alarm states and alarm limits. Attackers can also flood the device with excessive network traffic, forcing the Cockpit or M540 monitor to reboot and lose network functionality.

Critical Impact

Network-adjacent attackers can tamper with patient monitor alarm configurations or trigger denial-of-service reboots, directly affecting clinical safety in care environments.

Affected Products

• Dräger Infinity Acute Care System (IACS) firmware VG4.1.1 and earlier
• Dräger Standalone Infinity M540 patient monitors firmware VG4.0.3 and earlier
• Dräger IACS and M540 firmware VG4.2 (partially affected)

Discovery Timeline

• 2026-06-02 - CVE-2022-4992 published to NVD
• 2026-06-03 - Last updated in NVD database

Technical Details for CVE-2022-4992

Vulnerability Analysis

The vulnerability resides in how the Infinity Acute Care System Cockpit and the Standalone Infinity M540 monitor handle inbound network messages between monitoring components. The devices accept messages without sufficiently verifying the authenticity or integrity of the sender. An attacker with network access to the patient monitoring subnet can craft spoofed messages that the targets accept as legitimate. Successful tampering allows modification of clinical parameters such as alarm states and alarm limits, while flooding the same interface forces the device to reboot and drop from the monitoring network. The flaw is classified under [CWE-345] (Insufficient Verification of Data Authenticity).

Root Cause

The Infinity communication protocol does not enforce message authentication or integrity checks on data received over the monitoring network. The receiver trusts source identifiers and payload content without cryptographic validation. The same code path also lacks rate limiting, so a high volume of crafted packets exhausts processing capacity and triggers reboot conditions on the M540 and Cockpit components.

Attack Vector

Exploitation requires only network reachability to the affected device, with no authentication and no user interaction. An attacker on the clinical network can either inject forged control messages to manipulate alarm configuration or generate sustained traffic volume to cause a denial-of-service reboot. Refer to the Dräger Product Security Advisory and the VulnCheck Advisory for DoS Vulnerability for protocol-level details.

No verified public exploit code is available for this issue at the time of publication.

Detection Methods for CVE-2022-4992

Indicators of Compromise

• Unexpected reboots or network drop-outs on Infinity M540 monitors or IACS Cockpit workstations during clinical operation.
• Alarm limit or alarm state changes on patient monitors that do not correlate with operator actions logged at the bedside.
• Sudden spikes in traffic volume targeting monitoring VLAN endpoints associated with Dräger devices.

Detection Strategies

• Deploy network intrusion detection signatures that flag malformed or duplicated Infinity protocol messages on the patient monitoring VLAN.
• Baseline normal message rates between IACS Cockpit and M540 endpoints, then alert on volumetric deviations consistent with flooding.
• Correlate device reboot events from biomedical asset management systems against network telemetry to identify induced denial-of-service.

Monitoring Recommendations

• Log all traffic to and from clinical monitoring subnets and retain it for forensic review of alarm tampering claims.
• Enable SNMP or syslog forwarding from Dräger devices where supported and alert on repeated unscheduled restarts.
• Monitor switch port counters on segments hosting M540 and Cockpit nodes for unexpected broadcast or unicast floods.

How to Mitigate CVE-2022-4992

Immediate Actions Required

• Inventory all Infinity Acute Care System Cockpit and Standalone Infinity M540 devices and identify units running VG4.1.1, VG4.0.3, or earlier, plus VG4.2.
• Coordinate with Dräger service to schedule firmware updates on affected monitors during planned clinical maintenance windows.
• Isolate the patient monitoring network from general hospital LAN traffic using dedicated VLANs and strict access control lists.

Patch Information

Dräger has published remediation guidance in Product Security Advisory PSA-19-255-03. Customers should contact Dräger service representatives to obtain the corrective firmware update applicable to their installed VG4.x baseline and confirm post-update version reporting from the device.

Workarounds

• Place IACS Cockpit and M540 endpoints on an isolated, dedicated monitoring VLAN with no routing to general-purpose networks.
• Restrict physical and logical access to network drops in patient care areas to authorized biomedical engineering staff only.
• Apply switch-level storm control and port security to limit broadcast volume reaching Dräger devices.
• Continuously monitor the monitoring VLAN for unauthorized devices using NAC or 802.1X enforcement.

# Example: restrict monitoring VLAN with an ACL on the upstream switch
# Replace 10.20.30.0/24 with your patient monitoring subnet
access-list 150 permit ip 10.20.30.0 0.0.0.255 10.20.30.0 0.0.0.255
access-list 150 deny   ip any 10.20.30.0 0.0.0.255 log
access-list 150 deny   ip 10.20.30.0 0.0.0.255 any log
interface Vlan30
 description Patient-Monitoring-IACS-M540
 ip access-group 150 in
 ip access-group 150 out
 storm-control broadcast level 1.00
 storm-control multicast level 1.00