Cases24 cases

11 to 15 of 24

1. IL-0540 Korea's local government administrative services and Government24 went down as a router port dropped most large packets

   Korea Ministry of the Interior and Safety2023

   Symptoms

   On Friday 17 November 2023, the local government administrative computer services in Korea stopped working, and the Government24 service of the National Information Resources Service was down until the next morning.

   Service outagePacket lossHigh latency

   Root cause

   Hardware failure

   Component

   NIC, cable and switch port link

   Contributing factor

   Monitoring blind spotGray failure

   Remediation

   • Replaced the two malfunctioning L4 devices with higher-performance devices, tested them and resumed Government24 at 09:00 on 18 November
   • Moved the connection on the defective port of the Daejeon center router to another port at 07:00 on 19 November
   • Swapped out the module of the router that had the fault

   Action items

   • Inspect all old equipment that may have similar port defects
   • Revise the incident handling manual so the public is told about an outage quickly
   • Announce the status of service recovery quickly through various means
   • Build integrated monitoring of critical service systems and related equipment to catch signs of failure early
   • Form a standing incident response team to send into major outages
   • Prepare administrative measures and a response manual so administrative services can still be provided when core digital government services stop
   • Name a paralysis of the national computer network as a type of disaster and accident, managed from prevention to recovery
   • Build a government-wide crisis response system for linked information systems and strengthen the control tower for outage prevention and response
   • Improve how public IT projects are run and managed, replace hardware and software past their service life quickly and make project pricing realistic
   • Reduce the reliance on outsourcing for developing and operating information systems and bring digital talent into government
   • Review the redundancy, recovery systems and network configuration of the systems in the National Information Resources Service, and its organisation
   • Work with manufacturers on a way to find and monitor failures of internal parts earlier

   Lessons

   The team said that hardware faults like this defective port also happen in the private sector, and that failures of parts inside a device are hard to catch in advance with basic monitoring and daily visual checks. Redundancy did not help because it takes over only when a whole device stops working, and a module that failed only in part did not make the device count as abnormal. The impact was wide because the defective port carried traffic for all the services.

   View case
2. IL-0530 Virtual router controllers in us-central1 ran out of memory in a loop, cutting networking for new and migrated VMs

   Google Cloud2023

   Symptoms

   On 5 October 2023 in us-central1, newly created VMs waited a long time before their networking worked, and VMs that had been live migrated lost connectivity for a long time after the migration. Networking telemetry showed cross-region packet loss to and from us-central1 from 03:08 US/Pacific. Health check state of VMs reached load balancers late.

   Packet lossNetwork unreachableOOMKilledStale endpoint routingCluster or node provisioning stall

   Trigger

   A management plane behaviour change, meant to decouple the processing of API updates to Instance Groups and Network Endpoint Groups used as load balancer backends, was deployed in us-central1 after rolling out to several other regions without incident.

   Root cause

   Faulty deployment

   Component

   Network control plane (SDN)Cloud load balancer

   Contributing factor

   Excessive blast radiusNo alert on limit

   Detection

   Engineers were alerted to slowness in the virtual network control plane in us-central1 at 21:45 US/Pacific on 4 October, before the packet loss started, and to controller failures from memory exhaustion at 02:11 on 5 October. Networking telemetry showed cross-region packet loss from 03:08.

   Remediation

   • Increased the memory allocated to the virtual network router controllers
   • Rolled back the management plane change in us-central1
   • Restarted by hand the routers that were still not accepting updates

   Action items

   • Alert proactively on memory risks and unexpected memory increases
   • Refactor the deployment configuration so engineers can reallocate memory much faster
   • Re-evaluate existing practices and add safety mechanisms for API reconciliation
   • Make management plane changes more visible across teams so the changes can be correlated faster
   • Adjust the deployment footprint so a regional API change is less likely to exhaust memory across the region at once
   • Optimise memory use in the traffic routers and their controllers

   View case
3. IL-0386 After a move to Google Cloud, Postgres connection timeouts and memcached i/o timeouts spiked on GKE nodes

   incident.io2023

   Symptoms

   Shortly after incident.io moved its infrastructure fully into Google Cloud, the application saw a larger-than-normal number of Postgres connection timeouts, and new database connections per second were in the hundreds, spiking up and down. At the same time, the memcached instance used for transient data and faster API responses had sporadic connection timeouts.

   Intermittent timeoutsPacket loss

   Trigger

   After the move to Google Cloud, the application opened hundreds of new Postgres connections per second, and an accidental database join made it send thousands of duplicate calls to an external third party in parallel.

   Root cause

   Capacity exhaustion

   Component

   CNI pluginDatabaseIn-memory cache

   Contributing factor

   Unreviewed defaultsOverlapping failures

   Detection

   An incident was declared when the number of Postgres connection timeouts rose above normal. The remaining cache timeouts were traced through the logs of the Kubernetes node that served an affected request, the request's trace and the node's metrics.

   Remediation

   • Doubled the maximum Postgres connection lifespan from 15m to 30m
   • Made the Postgres connection pools static so they always keep N connections open
   • Raised the memcache client's MaxIdleConns from 2 to 20
   • Moved temporarily from Google's hosted memcached to a memcached inside the Kubernetes cluster
   • Shipped the fix for the accidental database join that made thousands of duplicate external calls

   Action items

   • Set more sensible concurrency limits for outbound network calls

   Lessons

   Network timeouts are not always local to one request or pod: when they appear, the whole activity of the node, including other pods on it, needs to be checked. Staying within a provider's rate limits does not keep outbound calls from affecting a node, so outbound network calls need more sensible concurrency limits.

   View case
4. IL-0225 An IGP purge command made every Microsoft WAN router recompute routes, causing global latency, timeouts and packet loss

   Microsoft Azure2023

   Symptoms

   From 07:08 UTC on 25 January 2023, customers saw long network latency and timeouts when connecting to resources in Azure regions and to other Microsoft services such as Microsoft 365 and Power Platform. Microsoft's monitoring detected DNS and WAN issues from 07:11 UTC.

   High latencyIntermittent timeoutsIntermittent connection failuresPacket lossNetwork unreachable

   Trigger

   A network engineer adding capacity to the global WAN in Madrid ran a step of a recently changed standard operating procedure that purged the IGP database; on the router manufacturer involved, that command runs on all IGP-joined routers instead of only the local one.

   Root cause

   Configuration change

   Component

   Backbone network (WAN)Interior routing (IGP)BGP routing

   Contributing factor

   No configuration testsUnverified assumptionExcessive blast radiusHarmful manual action

   Detection

   Monitoring detected DNS and WAN issues from 07:11 UTC and alerted the on-call engineers within 5 minutes of the command being run. The team reviewed all recent changes and identified the command by 08:20 UTC. The engineer making the change was not informed of the alerts because of the unqualified changes to the SOP.

   Remediation

   • Restarted by hand the paused WAN health and traffic engineering systems, which ended the remaining packet loss

   Action items

   • Audit and block similar widespread-impact commands across all three vendors for all WAN router roles
   • Give on-call engineers real-time visibility of approved and unqualified activity on network devices
   • Run regular mandatory operational training and attestation of following all SOPs
   • Have the Change Advisory Board review all SOPs still pending qualification within 30 days

   View case
5. IL-0532 Azure Software Load Balancer sent packets of one flow to different backends, dropping Firewall and Private Link traffic

   Microsoft Azure2022

   Symptoms

   From 05:26 UTC on 28 June 2022, some Azure customers saw intermittent network failures and packet loss when connecting to resources behind a Software Load Balancer (SLB). Telemetry showed a small increase in errors and customers raised support requests, but the failures were intermittent and were not linked to a recent deployment at first.

   Intermittent connection failuresPacket lossMisrouted requests

   Trigger

   A new SLB code deployment, rolled out through Safe Deployment Practices, made some MUX instances store the backend DIPs of load balancers with more than 15 DIPs in a different order.

   Root cause

   Faulty deployment

   Component

   Cloud load balancer

   Contributing factor

   Ignored early signal

   Detection

   Telemetry showed a small increase in errors and customers raised support requests, but the health checks of Safe Deployment Practices did not correlate these intermittent signals with the deployment until the code had reached 14 regions.

   Remediation

   • Mitigated the VIPs of customers identified as impacted with targeted manual operations
   • Built and tested a hotfix and rolled it out in phases under Safe Deployment Practices
   • Ran automation that scanned all VIPs every five minutes and fixed VIPs in an inconsistent state until the hotfix was out
   • Restored consistent ordering of the backend instances to the state before the incident

   Action items

   • Add Azure Firewall monitoring that detects when the upstream and downstream packets of one flow do not reach the same DIP
   • Keep the IPv6 flow identifier consistent for the lifetime of a connection so all its packets land on one MUX
   • Improve packet capture support for firewalls
   • Add logging of TCP flows, including invalid packets and RST, FIN and FIN-ACK packets
   • Onboard more Azure services to the Gandalf AIOps solution suite for end-to-end monitoring during safe deployments

   Lessons

   Microsoft wrote that the incident showed the need for more thorough end-to-end monitoring during safe deployments.

   View case

By root cause9