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HIGH severity

GHSA-3653-68v6-rq57 — org.hl7.fhir.dstu2

HIGH

GHSA-3653-68v6-rq57 is a high-severity (CVSS 7.5) CWE-1333 vulnerability in ca.uhn.hapi.fhir:org.hl7.fhir.dstu2. A fix is available for ca.uhn.hapi.fhir:org.hl7.fhir.dstu2 — see the affected versions and patch details below.

HAPI FHIR: ReDoS via FHIRPath matches()/replaceMatches() in FHIR Validator HTTP Endpoint

Also known asCVE-2026-45367
Published
May 18, 2026
Updated
Sep 10, 2026
Affected
8 pkgs
Patched
8 / 8
Exploits
None indexed
Exploitation data as of Sep 30, 2026 · OSV.dev, NVD, FIRST.org (EPSS)

Exploitation Status

No confirmed exploitation observed yet

  • CISA assesses this as automatable — exploitation doesn’t require manual, per-target effort, which raises the odds of mass scanning and opportunistic attacks.
  • CISA’s own triage has not observed active exploitation or public proof-of-concept code for this CVE as of its last assessment.

Exploitation and automatability from CISA’s SSVC triage for GHSA-3653-68v6-rq57.

EPSS Exploitation Probability

via FIRST.org ↗
0.7%probability of exploitation in next 30 days
Lower Risk0.00%
Lower risk than most CVEs51th percentile — riskier than 51% of all scored CVEsHighest risk
0.18%0.52%0.85%1.18%0.7%0.7%Sep 26Sep 26

Probability of exploitation in the next 30 days, from FIRST.org EPSS.

How urgent is this, really

GHSA-3653-68v6-rq57 by exploitation likelihood (EPSS) against impact (CVSS). Outside the shaded patch-first corner.

Where this sits among everything scored

Of 381,682 CVEs with a current EPSS score, this one falls in the < 10% band (highlighted). Counts from FIRST.org, log-scaled.

Real-World Exposure

8 pkgs affected
☕ca.uhn.hapi.fhir:org.hl7.fhir.dstu2☕ca.uhn.hapi.fhir:org.hl7.fhir.dstu2016may☕ca.uhn.hapi.fhir:org.hl7.fhir.dstu3☕ca.uhn.hapi.fhir:org.hl7.fhir.r4☕ca.uhn.hapi.fhir:org.hl7.fhir.r4b☕ca.uhn.hapi.fhir:org.hl7.fhir.r5☕ca.uhn.hapi.fhir:org.hl7.fhir.validation☕ca.uhn.hapi.fhir:org.hl7.fhir.validation.cli

Real-time download stats are indexed for npm and PyPI packages. This vulnerability affects Maven packages — download data is not available via public APIs for these ecosystems.

Description

Summary

All implementations of FHIRPathEngine accept arbitrary FHIRPath expressions and evaluate them without input validation. The FHIRPath functions matches(), matchesFull(), and replaceMatches() pass user-controlled regular expressions directly to Java's Pattern.compile() and String.replaceAll() without complexity checks or timeouts. An attacker can send a resource containing an evil regex pattern that causes catastrophic backtracking, exhausting system resources, and causing Denial-of-Service.

Details

The vulnerability exists in regex execution in FHIRPathEngine implementations across multiple code modules. For example the org.hl7.fhir.r5 module:

Entry point 1 — FHIRPathEngine.java:5929 (R5 funcMatches):

private List<Base> funcMatches(ExecutionContext context, List<Base> focus, ExpressionNode exp) {
    String sw = convertToString(swb); // attacker-controlled regex pattern
    // ...
    Pattern p = Pattern.compile("(?s)" + sw); // VULNERABLE: no complexity check
    Matcher m = p.matcher(st);                // no timeout
    boolean ok = m.find();

Entry point 2 — FHIRPathEngine.java:5951 (R5 funcMatchesFull):

Pattern p = Pattern.compile("(?s)" + sw); // VULNERABLE: same pattern
Matcher m = p.matcher(st);
boolean ok = m.matches();

Entry point 3 — FHIRPathEngine.java:5120 (R5 funcReplaceMatches):

result.add(new StringType(convertToString(focus.get(0))
    .replaceAll(regex, repl)).noExtensions()); // VULNERABLE: replaceAll uses Pattern internally

The same vulnerabilities exist in the dstu2, dstu2016may, dstu3, r4, and r4b modules, and the FHIRPathEngine is used in the validation module functionality.

Why this is exploitable:

  • No timeout mechanism covers FHIRPath evaluation — the ValidationTimeout class only protects InstanceValidator operations, not evaluateFhirPath()
  • Java's Pattern.compile() with a pattern like (a+)+$ against input "aaaaaaaaaaaaaaaaaaaaaa!" causes exponential backtracking (O(2^n) time complexity)

Impact

  • CPU Exhaustion: The exponential backtracking in Java's regex engine consumes 100% of a CPU core for the duration of the hang (effectively infinite for sufficiently long input strings) for callers of FHIRPathEngine.

Affected Packages

8 total 8 fixed
EcosystemPackageVulnerable rangeFix
☕Mavenca.uhn.hapi.fhir:org.hl7.fhir.dstu2all versions6.9.7ca.uhn.hapi.fhir:org.hl7.fhir.dstu2:6.9.7
☕Mavenca.uhn.hapi.fhir:org.hl7.fhir.dstu2016mayall versions6.9.7ca.uhn.hapi.fhir:org.hl7.fhir.dstu2016may:6.9.7
☕Mavenca.uhn.hapi.fhir:org.hl7.fhir.dstu3all versions6.9.7ca.uhn.hapi.fhir:org.hl7.fhir.dstu3:6.9.7
☕Mavenca.uhn.hapi.fhir:org.hl7.fhir.r4all versions6.9.7ca.uhn.hapi.fhir:org.hl7.fhir.r4:6.9.7
☕Mavenca.uhn.hapi.fhir:org.hl7.fhir.r4ball versions6.9.7ca.uhn.hapi.fhir:org.hl7.fhir.r4b:6.9.7
☕Mavenca.uhn.hapi.fhir:org.hl7.fhir.r5all versions6.9.7ca.uhn.hapi.fhir:org.hl7.fhir.r5:6.9.7

Detection & mitigation playbook

Open-source dependency
  1. Detect

    Scan your dependency tree (package-lock.json, pnpm-lock.yaml, requirements.txt, go.sum, etc.) for ca.uhn.hapi.fhir:org.hl7.fhir.dstu2, including transitive dependencies — a direct dependency you never call can still pull in a vulnerable version.

  2. Fix

    Update ca.uhn.hapi.fhir:org.hl7.fhir.dstu2 to 6.9.7 or later, then make sure no transitive (indirect) dependency still pins the vulnerable range — O3 confirms GHSA-3653-68v6-rq57 is resolved across your whole dependency graph.

  3. Workarounds

    If you can't upgrade right away: gate or disable the affected feature, validate untrusted input at the boundary, and avoid passing attacker-controlled data into the vulnerable path. O3's runtime protection blocks exploitation in production as an interim safeguard until the upgrade lands.

Frequently Asked Questions

## Summary All implementations of FHIRPathEngine accept arbitrary FHIRPath expressions and evaluate them without input validation. The FHIRPath functions `matches()`, `matchesFull()`, and `replaceMatches()` pass user-controlled regular expressions directly to Java's `Pattern.compile()` and `String.replaceAll()` without complexity checks or timeouts. An attacker can send a resource containing an evil regex pattern that causes catastrophic backtracking, exhausting system resources, and causing Denial-of-Service. ## Details The vulnerability exists in regex execution in FHIRPathEngine implemen
O3 Security · Impact-Aware SCA

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GHSA-3653-68v6-rq57: org.hl7.fhir (High 7.5) | O3 Security