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A proposed class action accuses University Hospitals of negligence after an October 22 cyberattack that took its MyChart portal offline; the Cleveland patient's suit, filed October 28, claims more than a million records were exposed, a number University Hospitals has not confirmed. University of New Mexico Health Sciences Center disclosed a cyberattack October 26 that diverted ambulances for about two hours; the BYOD extortion group claims it compromised 36,000 systems, a figure UNM has not confirmed. Philips updated its Node2Shell advisory October 27 for CVE-2026-111497, the Node.js Brotli decoder flaw it first flagged October 26 against PIC iX 4.x; the advisory still names no impacted products or fixed version. Philips updated its PHP2Shell advisory October 27 for CVE-2026-109618 and CVE-2026-109619, adding five more affected products including IntelliSpace Portal V12 and Philips Axon to the seven already listed. NorthShore Health Centers disclosed a data breach to patients October 27, one of several Midwest provider notifications issued that week. Denver Health Medical Plan notified more than 238,000 members October 26 about a vendor-related data incident. A proposed class action accuses University Hospitals of negligence after an October 22 cyberattack that took its MyChart portal offline; the Cleveland patient's suit, filed October 28, claims more than a million records were exposed, a number University Hospitals has not confirmed. University of New Mexico Health Sciences Center disclosed a cyberattack October 26 that diverted ambulances for about two hours; the BYOD extortion group claims it compromised 36,000 systems, a figure UNM has not confirmed. Philips updated its Node2Shell advisory October 27 for CVE-2026-111497, the Node.js Brotli decoder flaw it first flagged October 26 against PIC iX 4.x; the advisory still names no impacted products or fixed version. Philips updated its PHP2Shell advisory October 27 for CVE-2026-109618 and CVE-2026-109619, adding five more affected products including IntelliSpace Portal V12 and Philips Axon to the seven already listed. NorthShore Health Centers disclosed a data breach to patients October 27, one of several Midwest provider notifications issued that week. Denver Health Medical Plan notified more than 238,000 members October 26 about a vendor-related data incident.

Vulnerability

Fresenius says Fresenius Kabi pumps and Conox do not use the Nucleus TCP/IP stack behind NUCLEUS:13

MedDevice Cyber Staff · Nov 24 · 2 min read · Via Fresenius NUCLEUS:13 statement

Fresenius published a NUCLEUS:13 statement on November 24, 2021. The 13 vulnerabilities, found in the Siemens Nucleus RTOS by Forescout Research Labs and Medigate, are tracked as CVE-2021-31344 to CVE-2021-31346 and CVE-2021-31881 to CVE-2021-31890. ICSA-21-313-03 gives them an overall CVSS score of 9.8.

Fresenius Kabi lists its Agilia, Exelia and INfusia infusion pumps, Amika and Enfusia enteral nutrition pumps, Conox monitoring devices, the Vigilant Software Suite, the Agilia, Exelia and Amika Partner accessories and INfusia Centro as not affected in all versions, because the devices do not use the affected TCP/IP stack. The advisory itself notes Nucleus runs in anesthesia machines, patient monitors and ventilators, so a stack-level answer with the reason attached is what biomed teams need from each vendor.

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Remediation Desk

For ProvidersOperators, hospitals, and clinical engineering

Fresenius says the listed Fresenius Kabi devices do not use the Nucleus TCP/IP stack, so NUCLEUS:13 requires no device update for them. Other devices on the same network may run Nucleus and need vendor confirmation. Keep Fresenius devices in a dedicated, firewalled medical network.

Record the assessment. File the November 24, 2021 Fresenius statement with the Fresenius Kabi asset records.
Ask other vendors. Request a written Nucleus RTOS answer for monitors, anesthesia machines and ventilators from other makers on the network.
Monitor medical network traffic. Monitor and control access and traffic to the dedicated medical network, per the Fresenius recommendations.

For Device ManufacturersAm I affected, and how to fix the class

Am I affected?

This class applies to devices with the signals and properties below. Check them against your product to gauge exposure.

Required

Named operating system

Contributing

Hospital network

Fix the class in your product

The advisory is not for a bug you wrote; it is in a component you embed. As the maker, pin dependencies to fixed versions, generate an SBOM on every build including transitive components, and gate the pipeline on known-vulnerable components so an advisory maps to your products automatically.

Pin and inventory. Exact versions, and a CycloneDX or SPDX SBOM as a build artifact including transitive deps.
Gate on advisories. A CI scan fails a release carrying a component with a known advisory.
Own the field patch path. Know how you deliver a dependency or platform patch to fielded devices before you need it.

Mapped EMB3D mitigations

Questions & Answers

Are Fresenius Kabi Agilia infusion pumps affected by NUCLEUS:13?

No. Fresenius's November 24, 2021 statement says Fresenius Kabi devices, including Agilia, Exelia and INfusia pumps, Amika and Enfusia pumps and Conox, do not use the TCP/IP stack affected by NUCLEUS:13 (ICSA-21-313-03).

What CVEs make up NUCLEUS:13?

NUCLEUS:13 covers 13 Siemens Nucleus RTOS vulnerabilities, CVE-2021-31344 to CVE-2021-31346 and CVE-2021-31881 to CVE-2021-31890, rated 9.8 overall in ICSA-21-313-03. Fresenius says none can be exploited on the Fresenius Kabi products it listed.

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