On That Dusseldorf Hospital Ransomware Attack and the Resultant Death

Wired has a detailed story about the ransomware attack on a Dusseldorf hospital, the one that resulted in an ambulance being redirected to a more distant hospital and the patient dying. The police wanted to prosecute the ransomware attackers for negligent homicide, but the details were more complicated:

After a detailed investigation involving consultations with medical professionals, an autopsy, and a minute-by-minute breakdown of events, Hartmann believes that the severity of the victim’s medical diagnosis at the time she was picked up was such that she would have died regardless of which hospital she had been admitted to. “The delay was of no relevance to the final outcome,” Hartmann says. “The medical condition was the sole cause of the death, and this is entirely independent from the cyberattack.” He likens it to hitting a dead body while driving: while you might be breaking the speed limit, you’re not responsible for the death.

So while this might not be an example of death by cyberattack, the article correctly notes that it’s only a matter of time:

But it’s only a matter of time, Hartmann believes, before ransomware does directly cause a death. “Where the patient is suffering from a slightly less severe condition, the attack could certainly be a decisive factor,” he says. “This is because the inability to receive treatment can have severe implications for those who require emergency services.” Success at bringing a charge might set an important precedent for future cases, thereby deepening the toolkit of prosecutors beyond the typical cybercrime statutes.

“The main hurdle will be one of proof,” Urban says. “Legal causation will be there as soon as the prosecution can prove that the person died earlier, even if it’s only a few hours, because of the hack, but this is never easy to prove.” With the Düsseldorf attack, it was not possible to establish that the victim could have survived much longer, but in general it’s “absolutely possible” that hackers could be found guilty of manslaughter, Urban argues.

And where causation is established, Hartmann points out that exposure for criminal prosecution stretches beyond the hackers. Instead, anyone who can be shown to have contributed to the hack may also be prosecuted, he says. In the Düsseldorf case, for example, his team was preparing to consider the culpability of the hospital’s IT staff. Could they have better defended the hospital by monitoring the network more closely, for instance?