An attacker with local access the to medical office computer can escalate his Windows user privileges to "NT AUTHORITY\SYSTEM" by exploiting a command injection vulnerability in the Elefant Update Service. The command injection can be exploited by communicating with the Elefant Update Service which is running as "SYSTEM" via Windows Named Pipes.The Elefant Software Updater (ESU) consists of two components. An ESU service which runs as "NT AUTHORITY\SYSTEM" and an ESU tray client which communicates with the service to update or repair the installation and is running with user permissions. The communication is implemented using named pipes. A crafted message of type "MessageType.SupportServiceInfos" can be sent to the local ESU service to inject commands, which are then executed as "NT AUTHORITY\SYSTEM".