Secure coding in C and C++ for medical devices

4 days
On-site or online
Medical devices

32 Labs


12 Case Studies


C/C++ developers developing medical devices


General C/C++ development

Standards and references

SEI CERT, CWE and Fortify Taxonomy

Group size

12 participants


  • Cyber security basics
  • Memory management vulnerabilities
  • Memory management hardening
  • Common software security weaknesses
  • Wrap up

What you will learn

  • Getting familiar with essential cyber security concepts
  • Learning about security specialties of the healthcare sector
  • Correctly implementing various security features
  • Identify vulnerabilities and their consequences
  • Learn the security best practices in C and C++
  • Input validation approaches and principles


Your application written in C and C++ works as intended, so you are done, right? But did you consider feeding in incorrect values? 16Gbs of data? A null? An apostrophe? Negative numbers, or specifically -1 or -2^31? Because that’s what the bad guys will do – and the list is far from complete.

The most important concern in the healthcare industry is naturally safety. However, once isolated medical devices became highly connected to date, which poses new kinds of security risks: from exposing sensitive patient information to denial of service. And remember, there is no safety without security!

Handling security needs a healthy level of paranoia, and this is what this course provides: a strong emotional engagement by lots of hands-on labs and stories from real life, all to substantially improve code hygiene. Mistakes, consequences, and best practices are our blood, sweat and tears.

All this is put in the context of medical devices developed in C and C++, and extended by core programming issues, discussing security pitfalls of these languages.

So that you are prepared for the forces of the dark side.

So that nothing unexpected happens.


Table of contents

  • Cyber security basics
    • What is security?
    • Threat and risk
    • Cyber security threat types – the CIA triad
    • Cyber security threat types – the STRIDE model
    • Consequences of insecure software
    • Regulations and standards
      • Healthcare data protection regulations
        • HIPAA
        • HIPAA and security requirements
        • GDPR
      • Regulations for medical devices
        • Regulations and standards for medical devices
        • ANSI/CAN/UL 2900
        • ISA/IEC 62443
        • NIST Guide to Industrial Control Systems (ICS) Security
        • Other standards
    • Cyber security in the healthcare sector
      • Risk analysis in healthcare
      • Threats to medical devices
      • Attackers and motivation
      • The problem of legacy systems
  • Memory management vulnerabilities
    • Assembly basics and calling conventions
      • x64 assembly essentials
      • Registers and addressing
      • Most common instructions
      • Calling conventions on x64
        • Calling convention – what it is all about
        • Calling convention on x64
        • The stack frame
        • Stacked function calls
    • Buffer overflow
      • Memory management and security
      • Vulnerabilities in the real world
      • Buffer security issues
      • Buffer overflow on the stack
        • Buffer overflow on the stack – stack smashing
        • Exploitation – Hijacking the control flow
        • Lab – Buffer overflow 101, code reuse
        • Exploitation – Arbitrary code execution
        • Injecting shellcode
        • Lab – Code injection, exploitation with shellcode
        • Case study – Stack BOF in boot file handling of MQX DHCP client
      • Buffer overflow on the heap
        • Unsafe unlinking
        • Case study – Heap BOF in VxWorks DHCP options parsing
        • Case study – Heartbleed
      • Pointer manipulation
        • Modification of jump tables
        • Overwriting function pointers
  • Memory management vulnerabilities
    • Best practices and some typical mistakes
      • Unsafe functions
      • Dealing with unsafe functions
      • Lab – Fixing buffer overflow
      • What’s the problem with asctime()?
      • Lab – The problem with asctime()
      • Using std::string in C++
    • Some typical mistakes leading to BOF
      • Unterminated strings
      • readlink() and string termination
      • Manipulating C-style strings in C++
      • Malicious string termination
      • Lab – String termination confusion
      • String length calculation mistakes
      • Off-by-one errors
      • Case study – Off-by-one error in VxWorks TCP ‘Urgent Data’ parsing
      • Allocating nothing
  • Memory management hardening
    • Securing the toolchain
      • Securing the toolchain in C and C++
      • Compiler warnings and security
      • Using FORTIFY_SOURCE
      • Lab – Effects of FORTIFY
      • AddressSanitizer (ASan)
        • Using AddressSanitizer (ASan)
        • Lab – Using AddressSanitizer
      • RELRO protection against GOT hijacking
      • Heap overflow protection
      • Stack smashing protection
        • Detecting BoF with a stack canary
        • Argument cloning
        • Stack smashing protection on various platforms
        • SSP changes to the prologue and epilogue
        • Lab – Effects of stack smashing protection
        • Bypassing stack smashing protection
    • Runtime protections
      • Runtime instrumentation
      • Address Space Layout Randomization (ASLR)
        • ASLR on various platforms
        • Lab – Effects of ASLR
        • Circumventing ASLR – NOP sleds
        • Circumventing ASLR – memory leakage
        • Heap spraying
      • Non-executable memory areas
        • The NX bit
        • Write XOR Execute (W^X)
        • NX on various platforms
        • Lab – Effects of NX
        • NX circumvention – Code reuse attacks
          • Return-to-libc / arc injection
        • Return Oriented Programming (ROP)
          • Lab – ROP demonstration
          • Protection against ROP
  • Common software security weaknesses
    • Security features
      • Authentication
      • Authorization
        • Access control basics
        • Case study – Broken authn/authz in Conexus protocol for Medtronic devices
        • File upload
          • Unrestricted file upload
          • Good practices
        • File system access control
          • Improper file system access control
          • Ownership
          • chroot jail
          • Using umask()
          • Hardening the Linux filesystem
          • Lightweight Directory Access Protocol (LDAP)
  • Common software security weaknesses
    • Security features (continued)
      • Password management
        • Inbound password management
        • Outbound password management
          • Hard coded passwords
          • Best practices
          • Lab – Hardcoded password
          • Case study – Compromising Abbott FreeStyle Libre sensors via NFC
          • Protecting sensitive information in memory
            • Challenges in protecting memory
            • Heap inspection
            • Compiler optimization challenges
  • Common software security weaknesses
    • Input validation
      • Input validation principles
      • Denylists and allowlists
      • Case study – Improper input validation in Natus Xltek NeuroWorks 8
      • What to validate – the attack surface
      • Where to validate – defense in depth
      • When to validate – validation vs transformations
      • Output sanitization
      • Encoding challenges
      • Unicode challenges
      • Validation with regex
      • Regular expression denial of service (ReDoS)
      • Lab – ReDoS
      • Dealing with ReDoS
      • Integer handling problems
        • Representing signed numbers
        • Integer visualization
        • Integer promotion
        • Integer overflow
        • Lab – Integer overflow
        • Signed / unsigned confusion
        • Lab – Signed / unsigned confusion
        • Integer truncation
        • Lab – Integer truncation
        • Best practices
          • Upcasting
          • Precondition testing
          • Postcondition testing
          • Using big integer libraries
          • Best practices in C
          • UBSan changes to arithmetics
          • Lab – Handling integer overflow on the toolchain level in C and C++
          • Best practices in C++
          • Lab – Integer handling best practices in C++
  • Common software security weaknesses
    • Input validation
      • Injection
        • Code injection
          • OS command injection
            • Lab – Command injection
            • OS command injection best practices
            • Avoiding command injection with the right APIs
            • Lab – Command injection best practices
            • Case study – Shellshock
            • Lab – Shellshock
            • Case study – Command injection in GE Healthcare MobileLink
      • Process control
        • Library injection
        • Lab – Library hijacking
        • Library injection best practices
        • Case study – DLL injection in Vyaire Medical CareFusion Upgrade Utility
      • Files and streams
        • Path traversal
        • Lab – Path traversal
        • Virtual resources
        • Path traversal best practices
        • Lab – Path canonicalization
      • Format string issues
        • The problem with printf()
        • Lab – Exploiting format string
    • Time and state
      • Race conditions
        • File race condition
          • Time of check to time of usage – TOCTTOU
          • TOCTTOU attacks in practice
          • Lab – TOCTTOU
          • Insecure temporary file
    • Errors
      • Error and exception handling principles
      • Error handling
        • Returning a misleading status code
        • Error handling in C
        • Error handling in C++
        • Using std::optional safely
        • Information exposure through error reporting
      • Exception handling
        • In the catch block. And now what?
        • Empty catch block
        • Lab – Exception handling mess
    • Code quality
      • Code quality and security
      • Data handling
        • Type mismatch
        • Lab – Type mismatch
        • Initialization and cleanup
          • Constructors and destructors
          • Initialization of static objects
          • Lab – Initialization cycles
        • Unreleased resource
          • Case study – Unreleased resource in VxWorks TCP ‘Urgent Data’ parsing
          • Array disposal in C++
          • Lab – Mixing delete and delete[]
      • Object oriented programming pitfalls
        • Inheritance and object slicing
        • Implementing the copy operator
        • The copy operator and mutability
        • Mutability
          • Mutable predicate function objects
          • Lab – Mutable predicate function object
  • Wrap up
    • Secure coding principles
      • Principles of robust programming by Matt Bishop
      • Secure design principles of Saltzer and Schroeder
    • And now what?
      • Software security sources and further reading
      • C and C++ resources


4 days Session Price

3000 EUR / person

  • Live, instructor led classroom training
  • Discussion and insight into the hacker’s mindset
  • Hands-on practice using case studies based on high-profile hacks and live lab exercises
Customized course

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