3D Bioprinter Firmware Attacks: Categorization, Implementation, and Impacts

3D bioprinting has emerged as a transformative tool in bioengineering, offering the capability to fabricate complex geometries with precision and minimal material waste. With its growing adoption in security-critical applications, securing them against adversarial threats becomes imperative. The global supply chain further exacerbates the risk by providing adversaries with practical avenues for hardware malware injection. This study introduces a structured categorization of adversarial objectives achievable through malicious firmware in 3D bioprinting technology. To ensure the persistence of malicious firmware, we propose a four-step attack vector leveraging a trojan (MalBoot) to maintain the compromised firmware on the infected device. We identified 26 potential attacks across the proposed categories and implemented and evaluated ten firmware-assisted sabotage attacks. These include intellectual property theft and targeted sabotage of the printer and the printed construct. The attacks were demonstrated on a real-world extrusion-based bioprinter, using live A549 human lung cancer cells to fabricate bioconstructs. Quality assurance parameters, such as printability and cell viability, were employed to demonstrate the immediate and long-term effects of compromise on the bioprinted construct. The attacks targeting the physical hardware components of the bioprinter were carefully evaluated under controlled conditions. The study provides an initial understanding of the adversarial effects of the potential firmware compromise, aiming to facilitate further security research in the field.