Mandiant / FDA / CISA Joint Briefing
Technical and policy retrospective on the January 2026 Sandworm attack against Stryker's SmartLink medical device management infrastructure — the first confirmed nation-state attack to physically wipe connected medical devices at scale. Covers the spear-phishing initial access, the lateral movement through Stryker's GitLab CI/CD environment, the HSM signing agent access that allowed legitimate-certificate signing of a malicious firmware wiper, the 4:00 AM detonation that wiped 34,000 devices at 340 hospitals in 90 minutes, the 4,800 cancelled surgeries, and the six FDA adverse event filings. Examines the FDA Emergency Guidance 2026-01, the Protecting Medical Devices from Cyberattack Act, and why the SmartLink attack is the medical device equivalent of NotPetya: one compromised update infrastructure, unlimited blast radius. Black Hat archives all talks at blackhat.com.