Ghost of Sessions Past: Distributed and Forward Secure Key Establishment for Implantable Medical Devices

Implantable Medical Devices (IMDs) operate for decades in dynamic and adversarial environments, where device loss, backend compromise, and eventual post-explantation access are realistic long-term threats. Existing IMD security mechanisms largely focus on secure pairing and access control, but rely on long-lived secrets. As a result, a compromise occurring years after deployment can retroactively expose previously recorded patient telemetry. Limiting such damage requires forward secrecy. However