Episode 22- Ransom or Rebuild? Claudia Rast on the Hard Math of Hospital Cyberattacks

Alarms don’t always sound when hospitals are under attack. Sometimes the first signal is a locked EHR, diverted ambulances, and a clinical team scrambling to deliver care without the tools they trained on. We sit down with Butzel attorney Claudia Rast—leader of cybersecurity and AI practices and former co-chair of the ABA’s presidential cybersecurity task force—to unpack how threat actors use agentic AI, why ransom demands can look rational in a crisis, and what real resilience looks like when patient safety is on the line.

Claudia traces the evolution from broken-English phish to sophisticated campaigns backed by help desks, localization, and AI that scouts vulnerabilities without human prompting. We explore the uncomfortable math of ransom vs. rebuild, how cyber insurance shapes early decisions, and the practical controls that shorten downtime: endpoint detection and response, network segmentation, immutable backups, and tested recovery plans. The conversation gets candid about healthcare’s unique weaknesses—legacy systems, aging devices, and hundreds of tightly coupled apps that can turn one misconfiguration into a cascading failure.

On the legal front, we break down the surge in class action lawsuits after breach notifications, California’s privacy framework and its limits, and the rise of claims under old wiretap laws aimed at website tracking. We also dig into AI risk beyond cyber: how feeding code or confidential prompts into public models can burn trade secrets, why blocking public AI tools often beats long unread policies, and how to contract for third-party AI use, data stewardship, and derivative works. We close with the human layer: deepfake-enabled fraud, out-of-band verification, and a culture that practices the plan before the worst day arrives.

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