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A worm attack that forced three London hospitals to shut down their computer networks late last year was entirely avoidable and represented a major failing by the organizations' IT staff, according to an independent review of the incident.

In mid-November, the Mytob worm wiggled its way into 4,700 PCs used by St Bartholomew's (Barts), the Royal London Hospital in Whitechapel, and The London Chest Hospital in Bethnal Green, and this forced the hospitals to reroute ambulances and scale back some "non-essential activities" while the infection was being contained. In some cases, doctors had to resort to pen and paper backup systems.

"The review concluded that the incident was 'entirely avoidable' and there was a 'substantive failure' of the Trust's information governance processes, 'especially those operational processes in the ICT domain,'" the independent review concluded. Only a portion of the report (PDF) was made public to prevent the airing of sensitive security details.

The failure at least partially involved the incorrect configuration of anti-virus software, which the report claimed left a back door for the worm to infiltrate the network. While the review didn't identify the package, IDG News says here that the hospitals used McAfee 8.5 anti-virus product, which had been able to identify Mytob for more than three years prior to the infection.

Mytob, which also goes under the name MyDoom, was introduced "accidentally" into the network with "no malicious intent," the report concluded without providing details.

The vulnerability of hospitals and other health organizations to malware attacks continues to be a major concern for administrators. Last month, hospitals around Sheffield in the UK came under attack by virulent worm known alternately as Downadup and Conficker. At least 800 PCs were confirmed to be infected, with many more potentially suspected.

The mass infiltration was allowed to take hold after administrators disabled Windows security updates, which were blamed for causing computers to reboot during surgery. Microsoft has offered a patch for the Conficker vulnerability since October, when it released an emergency update and strongly advised all customers to install it immediately.

The independent review offered 11 specific recommendations that fell into five categories:

• Additional training to specific staff groups
• Command and control arrangements
• Administration and documentation within the control room
• Categorized identification of Trust priority areas
• Register of staff skills that can aid Trust response

The report also found hospital staff were able to ensure patient safety even during the outbreak.

"The Trust maintained a safe environment for its patients and was able to keep its theatres and outpatients clinics operational throughout the incident," it stated. "No urgent operations were cancelled, although a very small number of other operations were postponed and immediately rescheduled." ®

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