Notice of Data Incident
August 1, 2023

Dear Patients:
We post this Notice pursuant to the United States Health Insurance Portability and Accountability Act (“HIPAA”) to inform you about a data incident involving an unauthorized release of patient Protected Health Information (“PHI”), as that is defined by HIPAA, at Gary Motykie, M.D., a Medical Corporation and Gary Motykie, M.D. (“Practice”), a covered entity under HIPAA.

PHI, as defined by HIPAA, is information that is “created, received, maintained, or transmitted by or on behalf of the health care component of the Covered Entity.” § 164.105 (a)(2)(i)(D). Information that is created or received by a Covered Entity and that relates to the past, present, or future physical or mental health or condition of an individual; or the past, present, or future payment for the provision of healthcare to an individual is considered PHI. PHI is required to be protected when transmitted or maintained in any form by a Covered Entity. Individual identifiers (including but not limited to name, address, telephone number, fax, email address, social security number, medical record number, etc.) maintained in a designated record set along with health information (including but not limited to x-rays, images, scans, physician notes, diagnoses, treatment, eligibility approvals, claims, remittances, etc.) are collectively considered PHI.

Event Description:
On or about June 6, 2023, an initial technical analysis of the Practice’s information technology network determined an unauthorized release of PHI occurred to an unknown third party. The initial analysis determined that the unknown third party accessed the Practice’s network. It was further determined that the unknown third party acquired some of the Practice’s patient’s unencrypted PHI and that party was not authorized to do so and did so in an unlawful manner.

The information that may have been accessed or acquired during this unauthorized access included:

  • First and last name 
  • Social Security Number (if provided)
  • Address
  • Driver’s license or identification card number
  • Financial account or payment card number, in combination with any required CVV code
  • Intake forms, which may include medical information and history
  • Images taken in connection with the services rendered at our office
  • Health insurance information (if provided)
Steps Taken to Address:
Upon discovery, the Practice took the following immediate steps to address the situation:
  • Computers and servers replaced
  • Network passwords changed
  • Endpoint detection, virus, and malware detection tools and software installed on workstations and server
  • Limitations concerning Internet access
  • Access controls put in place for users based on role and responsibility
  • Server policies in place
  • Device locking mechanisms
  • Multi factor authentication enabled
  • Network segregation efforts
  • Encryption of devices
  • Additional workforce training
Risk Assessment:

The Practice conducted a risk assessment to evaluate the potential harm to potentially impacted individuals. Based on that assessment, it is determined that there is a high risk of harm. It is essential for potentially impacted individuals to remain vigilant in monitoring their personal accounts and data and promptly report any suspicious activity to law enforcement or their financial institutions.

Assistance and Resources:
Starting on or about June 22, 2023, letters were mailed to patients providing the following resources to assist the potentially impacted individuals, offering at no cost:
  • two (2) years of no cost Triple Bureau Credit Monitoring/Triple Bureau Credit Report/Triple Bureau Credit Score/Cyber Monitoring services.
  • the services also include reviewing whether Information appears on the dark web and alert the individual if such Information is found online.
  • proactive fraud assistance to help with any questions in event a potentially impacted persons becomes a victim of fraud.

Steps to Prevent Future Incidents: We deeply regret any inconvenience or concern this Incident may cause. The Practice is taking numerous steps to help prevent similar Incidents in the future. We will continue to review and enhance our security measures, policies, and employee training.

If you failed to receive your letter in the mail, and/or if there is a concern your mailing address has changed since you were a patient at the Practice, please contact 1-800-405-6108 or call our office immediately at 310-246-2355 from 9:00 am to 5:00 pm Pacific time, Monday through Friday.

Day of Surgery

Pre-Operative Marking

Prior to your surgery, you will have the opportunity to speak with Dr Motykie about any part of your surgical procedure and/or recovery process. You will be asked to change into a surgical gown and Dr Motykie will place surgical markings on your chest. All markings are performed in the standing position to ensure proper reference points such as your current nipple height and breast fold location. Lastly, wear loose fitting clothing the day of your surgery that is easy to get in and out of such as sweat pants and a shirt that zippers in the front.

Anesthesia and Operating Facility

For almost all breast lift and augmentation techniques you will most likely receive general anesthesia (you are asleep) for your own personal comfort, safety and surgical ease.  It is Dr Motykie’s opinion that the safest and most effective way to perform revision breast surgery is under general anesthesia since it allows for ease of breast pocket creation, relaxation of the chest muscles, additional comfort as well as allowing you to be sat up during surgery to assess final breast volume, symmetry and shape. It is not in your best interest to undergo revision breast surgery using awake anesthesia.

Dr. Motykie uses only Board Certified Anesthesiologists to administer anesthesia and monitor your safety during your surgery. You may be given medication before reaching the operating room so you will feel relaxed before surgery. The surgery takes approximately one hour to perform in its entirety. Every surgery is performed in a fully accredited, state of the art (AAAASF) surgical facility where your safety, comfort and privacy are of the utmost importance.   Deep vein thrombosis (blood clots) precautions are taken with every patient and include a minimum of anti-embolic stockings and sequential compression devices (SCDs) on the lower extremities during the entire length of your procedure.

Surgical

After general anesthesia is administered (you are put to sleep), an incision is made for placement of a breast implant sizer. The breast implant pocket is developed underneath the chest muscle for placement of the breast implnnt sizer in order to preserve the natural, healthy blood supply to the overlying nipples. This is done on both sides of the chest and the sizers are then filled to the desired volume. The breast lift procedure is then performed utilizing the markings that were drawn by Dr Motykie prior to the surgery. The standard technique for those with severe ptosis is with an anchor-shaped incision that surrounds the areola, descends vertically to the where the breast crease meets the rib cage and then crosses along the lower portion of the breast at its natural crease (inframammary fold). Dr Motykie is very careful to not extend the incisions beyond the bikini line or into the cleavage (the “bikini triangle”). The breast mound is then reshaped and the patient sat upright in the operating room in order to better evaluate the final implant position, breast shape and breast symmetry before choosing the size and shape of the permanent breast implants. Once the final size and shape of the implants has been determined, the patient is laid down once again, the implant sizers are removed and the permanent breast implants are placed into the breast pockets. Either saline or silicone gel-filled breast implants can be inserted through this incision. The breast lift incisions are closed with fine dissolvable sutures that are placed underneath the skin to minimize post-operative scarring. Once the procedure is completed, small surgical tapes will be placed over the incision sites. A surgical brassiere and compression ACE wrap is placed prior to the patient leaving the operating room in order to help decrease swelling and bruising after the procedure.

Recovery Room

After surgery you will be brought to the recovery area where you will be allowed to rest and completely recover from anesthesia. Nurses will be on staff by your bedside to make sure you are recovering properly as well as being able to provide you with pain medications and small amounts of water and/or ice chips while you are becoming more awake and alert. After you have fully recovered from anesthesia, you may be released to home with a responsible adult or you may choose to stay overnight in an outpatient recovery retreat where there are nurses on staff 24hrs to assist you with post-operative care and medications.

The most comfortable position to recover in after surgery is a reclining chair with your head elevated.  Over the first night you will most likely find yourself having to use the bathroom frequently. This is normal and is due to the intravenous fluids you received during your surgical procedure. Leave all dressings intact until the next morning when you will return to Dr Motykie’s office to have your dressings changed and receive further instruction for the rest of the week. The night following your surgery, you may experience some pain and discomfort that can be controlled with your prescribed pain medication. The majority of the sutures used during your surgery will be dissolvable and all of them are covered by thin surgical tape that should be left in place for the first week after your surgery.

To find out more about breast lift with augmentation surgery please contact us at 310-246-2355

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