This means that they knowingly or with reckless negligence unleashed such an attack on the world. If they had been more "scrupulous" criminals, they would have more narrowly tailored their attack on targets they believed deserved to be extorted or where such extortion would not interfere with life critical systems.
I'm not a lawyer, but if they were a nation state, I believe they would have violated the Geneva Convention's prohibition on attacking hospitals.
That said, I think this attack gives more weight to NSA critics that contend that their exploit research should be focused more on defense rather than offensive capabilities. Their carelessness combined with another group wanting to embarrass them is what allowed this indiscriminate attack to be inflicted on civilian infrastructure.