25+ years in Healthcare and Life Sciences

U.S. - Led engagements, global delivery

Aligned to FDA 524B, ISO 14971, IEC 62304 and IEC 81001-5-1

Overview

Medical Device Software Development Overview representative image

Cybersecurity has become a lifecycle discipline

Connected medical devices continue to evolve long after launch. A single software release can change a device’s security posture, its validation evidence and its regulatory record at the same time.


Expectations have risen accordingly. FDA may refuse to accept a cyber device submission that lacks a threat model, a software bill of materials, security testing or a postmarket plan. The Quality Management System Regulation, in effect since February 2026, brings security records within the scope of inspection. Health system security teams now require the same evidence before purchase.


Security addressed late, by a separate team, in the weeks before submission no longer meets this standard. Leading manufacturers are building it into engineering and sustaining it across the life of the device.

Submissions that meet FDA's cybersecurity content expectations at intake

Prompt, consistent responses to hospital security reviews

A prioritized remediation plan, carried through by engineers

Security records that reflect the device as built and shipped

A defined, documented response to vulnerabilities after launch

Submissions that meet FDA's cybersecurity content expectations at intake

Prompt, consistent responses to hospital security reviews

A prioritized remediation plan, carried through by engineers

Security records that reflect the device as built and shipped

A defined, documented response to vulnerabilities after launch

Our Approach

One integrated team, from design to postmarket

Security engineering and documentation are delivered together, by the same team. Every threat, requirement, control, test and software component is connected, giving reviewers a clear line of sight and product teams full visibility into the impact of every change.

Assess

Device, documentation and software components evaluated against current FDA expectations and recognized standards

Prioritized roadmap

Design

Threat modeling and security requirements, integrated with the ISO 14971 risk file.

Requirements traceable to risk

Build and Verify

Code and firmware remediation, penetration testing, fuzzing and a complete SBOM.

Verified fixes and test evidence

Submit

Evidence structured to current FDA guidance, with support for hospital security reviews.

Submission-ready documentation

Sustain

Continuous vulnerability monitoring, triage, patch planning and verification.

An auditable record of every update

Why EZEN

The EZEN difference

Engineering-led

EZEN develops medical device software and firmware. Findings are not simply handed over. They are remediated, tested and documented by the same team, in step with how the product is designed, built and released.

Discovery, feasibility and product roadmap

System and software architecture

Technology and platform selection

Interface, data-flow and release planning

Built around existing systems

There is no proprietary platform to license, integrate or validate. EZEN works within the established quality system, tools and procedures, so progress begins immediately rather than after a lengthy implementation.

Embedded applications, firmware and device-control software

Drivers, middleware, sensors and instrument integration

Hardware-software integration, diagnostics and logging

Performance, reliability and update mechanisms

Senior leadership, continuity of team

Every engagement is led by senior U.S.-based specialists who remain with the program from start to finish, supported by global delivery capacity that scales ahead of submission deadlines.

Clinical workflow and user research

Touchscreen, workstation and device-panel interfaces

Data, image, alarm and status visualization

Usability risk-control implementation and GUI verification

Security and safety, managed as one

Each threat is scored, recorded in the ISO 14971 risk file and traced through requirements, design and verification, providing a complete and reviewable chain of evidence.

Discovery, feasibility and product roadmap

System and software architecture

Technology and platform selection

Interface, data-flow and release planning

AI applied with discipline

AI accelerates analysis such as SBOM triage and document review. Its role is clearly defined, its outputs are verified by qualified engineers, and nothing enters a regulatory file without human approval.

Embedded applications, firmware and device-control software

Drivers, middleware, sensors and instrument integration

Hardware-software integration, diagnostics and logging

Performance, reliability and update mechanisms

Enterprise rigor, sized to the program

The discipline of a large manufacturer's security program, scaled to the product, the timeline and the team.

Clinical workflow and user research

Touchscreen, workstation and device-panel interfaces

Data, image, alarm and status visualization

Usability risk-control implementation and GUI verification

Know exactly where the device stands

The two-week Cybersecurity Evidence Sprint delivers a clear assessment of the device and its documentation, with a prioritized plan to close the gaps.

Medical device cybersecurity services

Capabilities across the device lifecycle

Engagements range from a single service to full lifecycle coverage. Each pairs the engineering work with the evidence to support it.

Cybersecurity Gap Assessment

Evaluation of the device, development process and documentation against FDA expectations, QMSR and recognized standards.

Gap report and prioritized roadmap

Threat Modeling and Risk Assessment

Analysis of architecture, data flows, connected applications and cloud services to identify attack paths. Each threat is scored and linked to the ISO 14971 risk file.

Threat model, attack-surface map, security risk assessment

Secure Architecture and Design

Security requirements defined early, when they are least costly to implement, and traced from design input to verification.

Security requirements, architecture recommendations, traceability matrix

Secure Software and Firmware Engineering

Code and firmware review, followed by remediation of the issues identified.

Review findings and remediated code

Security Testing and Verification

Penetration testing, fuzzing, and static and dynamic analysis, each mapped to a security requirement.

Test protocols, reports and remediation evidence

SBOM and Supply Chain Security

A complete software bill of materials in CycloneDX or SPDX, assessed for known vulnerabilities and exploitability, and maintained with every release.

SBOM, VEX assessment, continuous monitoring

AI-Enabled Device Security

Assessment of AI-specific threats, including training-data tampering, model manipulation and adversarial inputs, integrated into the threat model and test plan.

AI threat assessment, controls and test evidence

FDA Cybersecurity Documentation

Engineering evidence organized to current FDA guidance and prepared for submission.

Submission-ready cybersecurity package

Hospital Security Review Support

Preparation of the MDS2 forms, security questionnaires and SBOM disclosures that health systems require during procurement.

Completed MDS2 and customer security documentation

Postmarket Vulnerability Management

Monitoring, triage, impact assessment, patch planning and verification, supported by a coordinated vulnerability disclosure process.

Postmarket plan, triage records, verified updates

Legacy Device Security

Risk assessment and compensating controls for devices already in clinical use, with a practical update roadmap.

Legacy risk assessment and compensating-controls plan

Regulations and standards addressed

Every engagement is aligned to the regulations and standards applied by FDA, EU authorities and health system security teams.

FDA Section 524B, FD&C Act

Cybersecurity requirements for cyber device premarket submissions, including an SBOM and a postmarket vulnerability plan.

Complete submission content: threat model, SBOM, test evidence and postmarket plan.

FDA cybersecurity guidance (premarket and postmarket)

Expectations for a secure product development framework, SBOM management and vulnerability handling after launch.

Evidence organized to the current guidance, section by section.

FDA QMSR (21 CFR 820) and ISO 13485

The quality system in which cybersecurity design controls, risk and supplier records are maintained and inspected.

Security records structured to fit the quality system and design history file.

ISO 14971

Medical device risk management, including security risk.

Each security threat linked to the risk file.

IEC 62304 and IEC 81001-5-1

The software lifecycle and the security activities that accompany it.

Security activities integrated without rebuilding the existing process.

AAMI SW96, TIR57 and TIR97

Security risk management and postmarket security management.

Applied to the security risk assessment and postmarket process.

EU MDR / IVDR and MDCG 2019-16

Cybersecurity requirements for devices placed on the EU market.

Evidence mapped so one body of work supports both markets.

MDS2 form (ANSI/NEMA HN 1-2019)

The standard disclosure form used by health systems to review device security.

Completed accurately from the device evidence.

NIST CSF and SSDF, UL 2900, OWASP, CVE, NVD and CISA KEV

Security frameworks, testing standards and vulnerability databases.

We use them to shape the security risk assessment and your postmarket communication.

Disclaimer: EZEN does not guarantee clearance, approval or any specific regulatory outcome. EZEN supports the preparation of cybersecurity evidence for regulatory review. Decisions rest with the regulator.

Built for everyone who signs off

Built for everyone who signs off

Functional Testing

Engineering leaders

More hands on security work, from engineers who already speak medical device software. No new headcount.

QMS Services

Regulatory and quality

Cybersecurity records that fit straight into your QMS, your design history file and your ISO 14971 risk file.

Success

Product and commercial

Answers ready when a hospital’s security team starts asking, and fewer surprises on the way to launch.

Stategy

Executive leadership

A defined scope and cost, and a view of product security risk across your portfolio.

Frequently asked questions

What happens if a submission lacks cybersecurity information

FDA may refuse to accept it, returning the file before substantive review begins. A gap assessment ahead of submission identifies and closes these issues in advance.

Typically an SBOM, a completed MDS2 form, security documentation and patching commitments. Prepared in advance, these materials keep procurement on schedule.

Most device software includes open-source and third-party components, and the manufacturer is accountable for each one. An SBOM identifies every component and shows which known vulnerabilities can affect the device.

Devices often remain in service for a decade or more. EZEN establishes the monitoring, triage and update process and can operate it alongside the manufacturer’s team.

Since February 2026, FDA’s Quality Management System Regulation has incorporated ISO 13485. Cybersecurity records sit within design controls and risk management and are subject to inspection. EZEN prepares them to fit the existing quality system.

Yes. AI introduces risks such as training-data tampering and model manipulation. These are addressed in the threat model, the test plan and the documentation.

No. EZEN works alongside engineering, regulatory and quality teams, adding capacity and specialist expertise. Design and submission decisions remain with the manufacturer.

EZEN is engineering-led: issues are fixed, not only reported. Senior specialists remain with each program, work is carried out within existing tools, and teams are sized to the device and the deadline

Yes. Additional testing and documentation capacity can be deployed to meet fixed dates. The Evidence Sprint is the fastest route to a clear plan.

No responsible provider can. EZEN helps prepare complete, well-organized cybersecurity evidence aligned to current FDA guidance. Clearance decisions rest with FDA.

Start the conversation

Share the device, its stage of development and the target submission date. An EZEN specialist will respond with an initial view of readiness and recommended next steps.

Contact Us

Contact Us