CVE-2019-11687
An issue was discovered in the DICOM Part 10 File Format in the NEMA DICOM Standard 1995 through...
An issue was discovered in the DICOM Part 10 File Format in the NEMA DICOM Standard 1995 through 2019b and continuing in current implementations. The 128-byte preamble of a DICOM file that complies with this specification can contain arbitrary executable headers for multiple operating systems, including Portable Executable (PE) files for Windows and Executable and Linkable Format (ELF) files for Linux-based systems. This space is left unspecified so that dual-purpose files can be created. For example, dual-purpose TIFF/DICOM files are used in digital whole slide imaging applications in medicine. This design flaw enables system-wide compromise as malicious DICOM files are routinely shared between medical devices and hospital systems and transported via removable media for patient care coordination. To exploit this vulnerability, someone must execute the maliciously crafted file. These files can be executable even with the .dcm file extension. Anti-malware configurations at healthcare facilities often ignore medical imagery. DICOM files exist on systems that process protected health information, and successful exploitation could result in violations of regulatory compliance requirements such as HIPAA and FDA postmarket obligations.
Attack profile
How easy it is to exploit
- Attack vector
- Local
- Complexity
- Low
- Privileges needed
- None
- User interaction
- Required
What an attacker can affect
- Confidentiality
- High
- Integrity
- High
- Availability
- High
Exploit likelihood
What each source reports
CVE List
7.8
An issue was discovered in the DICOM Part 10 File Format in the NEMA DICOM Standard 1995 through 2019b and continuing in current implementations. The 128-byte preamble of a DICOM file that complies with this specification can contain arbitrary executable headers for multiple operating systems, including Portable Executable (PE) files for Windows and Executable and Linkable Format (ELF) files for Linux-based systems. This space is left unspecified so that dual-purpose files can be created. For example, dual-purpose TIFF/DICOM files are used in digital whole slide imaging applications in medicine. This design flaw enables system-wide compromise as malicious DICOM files are routinely shared between medical devices and hospital systems and transported via removable media for patient care coordination. To exploit this vulnerability, someone must execute the maliciously crafted file. These files can be executable even with the .dcm file extension. Anti-malware configurations at healthcare facilities often ignore medical imagery. DICOM files exist on systems that process protected health information, and successful exploitation could result in violations of regulatory compliance requirements such as HIPAA and FDA postmarket obligations.
- Record
CVE-2019-11687- CVSS 3.1
- 7.8 High
CVSS:3.1/AV:L/AC:L/PR:N/UI:R/S:U/C:H/I:H/A:H - Weakness
- CWE-20
- Updated
- 2026-11-02
EUVDEUVD-2019-3357
7.8
An issue was discovered in the DICOM Part 10 File Format in the NEMA DICOM Standard 1995 through 2019b and continuing in current implementations. The 128-byte preamble of a DICOM file that complies with this specification can contain arbitrary executable headers for multiple operating systems, including Portable Executable (PE) files for Windows and Executable and Linkable Format (ELF) files for Linux-based systems. This space is left unspecified so that dual-purpose files can be created. For example, dual-purpose TIFF/DICOM files are used in digital whole slide imaging applications in medicine. This design flaw enables system-wide compromise as malicious DICOM files are routinely shared between medical devices and hospital systems and transported via removable media for patient care coordination. To exploit this vulnerability, someone must execute the maliciously crafted file. These files can be executable even with the .dcm file extension. Anti-malware configurations at healthcare facilities often ignore medical imagery. DICOM files exist on systems that process protected health information, and successful exploitation could result in violations of regulatory compliance requirements such as HIPAA and FDA postmarket obligations.
- Record
EUVD-2019-3357- CVSS 3.1
- 7.8 High
CVSS:3.1/AV:L/AC:L/PR:N/UI:R/S:U/C:H/I:H/A:H - Updated
- 2026-11-02
GitHub AdvisoriesGHSA-9f2r-228g-m882
7.8
An issue was discovered in the DICOM Part 10 File Format in the NEMA DICOM Standard 1995 through...
An issue was discovered in the DICOM Part 10 File Format in the NEMA DICOM Standard 1995 through 2019b. The preamble of a DICOM file that complies with this specification can contain the header for an executable file, such as Portable Executable (PE) malware. This space is left unspecified so that dual-purpose files can be created. (For example, dual-purpose TIFF/DICOM files are used in digital whole slide imaging for applications in medicine.) To exploit this vulnerability, someone must execute a maliciously crafted file that is encoded in the DICOM Part 10 File Format. PE/DICOM files are executable even with the .dcm file extension. Anti-malware configurations at healthcare facilities often ignore medical imagery. Also, anti-malware tools and business processes could violate regulatory frameworks (such as HIPAA) when processing suspicious DICOM files.
- Record
GHSA-9f2r-228g-m882- CVSS 3.0
- 7.8 High
CVSS:3.0/AV:L/AC:L/PR:N/UI:R/S:U/C:H/I:H/A:H - Weakness
- CWE-20
- Updated
- 2026-11-02
NVD
7.8
An issue was discovered in the DICOM Part 10 File Format in the NEMA DICOM Standard 1995 through 2019b and continuing in current implementations. The 128-byte preamble of a DICOM file that complies with this specification can contain arbitrary executable headers for multiple operating systems, including Portable Executable (PE) files for Windows and Executable and Linkable Format (ELF) files for Linux-based systems. This space is left unspecified so that dual-purpose files can be created. For example, dual-purpose TIFF/DICOM files are used in digital whole slide imaging applications in medicine. This design flaw enables system-wide compromise as malicious DICOM files are routinely shared between medical devices and hospital systems and transported via removable media for patient care coordination. To exploit this vulnerability, someone must execute the maliciously crafted file. These files can be executable even with the .dcm file extension. Anti-malware configurations at healthcare facilities often ignore medical imagery. DICOM files exist on systems that process protected health information, and successful exploitation could result in violations of regulatory compliance requirements such as HIPAA and FDA postmarket obligations.
- Record
CVE-2019-11687- CVSS 3.1
- 7.8 High
CVSS:3.1/AV:L/AC:L/PR:N/UI:R/S:U/C:H/I:H/A:H - CVSS 3.0
- 7.8 High
CVSS:3.0/AV:L/AC:L/PR:N/UI:R/S:U/C:H/I:H/A:H - CVSS 2.0
- 9.3 High
AV:N/AC:M/Au:N/C:C/I:C/A:C - Weakness
- CWE-20
- Updated
- 2026-11-02
Affected products
Public exploits
Links only. Every CVE stores no exploit code.
| Source | Link | Date |
|---|---|---|
| PoC in GitHub | kosmokato/bad-dicom | 2019-12-15 |
History
| Recorded | Changed | Sources |
|---|---|---|
| first indexed | CVE List, EUVD, GitHub Advisories, NVD, PoC in GitHub |
Dates are when Every CVE recorded each change. Upstream dates may differ.
In short
CVE-2019-11687 is a high vulnerability (CVSS 7.8) in Nema Dicom Standard, published May 2, 2019. Public exploit code exists. EPSS puts the chance of exploitation in the next 30 days at 2.77%, the 86th percentile. No source names a fixed version.
References
labs.cylera.com/2019.04.16/pe-dicom-medical-malware
github.com/d00rt/pedicom/blob/master/doc/Attacking_Digital_Imaging_and_Communication_in_Medicine_%28DICOM%29_file_format_standard_-_Markel_Picado_Ortiz_%28d00rt%29.pdf
github.com/d00rt/pedicom
securityfocus.com/bid/108730
praetorian.com/blog/elfdicom-poc-malware-polyglot-exploiting-linux-based-medical-devices
nvd.nist.gov/vuln/detail/CVE-2019-11687
github.com/d00rt/pedicom/blob/master/doc/Attacking_Digital_Imaging_and_Communication_in_Medicine_(DICOM)_file_format_standard_-_Markel_Picado_Ortiz_(d00rt).pdf
github.com/advisories/GHSA-9f2r-228g-m882