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 upper eyes. The upper eyelids should be marked while you are awake so that accurate animated makings can be made. This marking technique will help to ensure a natural result and prevent under-resection of loose skin as well as over resection which can lead to the avoidable ”wide-eyed” appearance after surgery. The incision will be placed in your upper eyelid crease and it is not visible while your eyes are open. 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  

You can either have general anesthesia or awake anesthesia with sedation for your own personal comfort, safety and surgical ease.  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 30 minutes 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 anesthesia is administered, an incision is made along the previously made markings that were drawn by Dr Motykie prior to your surgery. If a brow lift has been planned it is imperative that I be performed prior to the upper eyelid surgery because it will inherently improve the appearance of the upper eyes by lifting any attached drooping upper eyelid skin. Once this procedure is completed, the remaining upper eyelid skin needs to be reassessed in order to remove only the necessary amount during surgery. If a brow lift is not being performed attention can immediately be turned to the upper eyelid surgery. The standard technique involves placing an incision in the crease above each upper eyelid. Careful removal of the upper extra upper eyelid skin is then performed with care taken to preserve several important underlying structures of the upper eyelid. I prefer to remove very little upper orbital fat pads in order to preserve the youthful fullness of the upper eyelids. If too much fat is removed from this area, a sunken, tired appearance can result long-term after surgery. The incisions are then closed with a very thin suture that is typically removed 5-7 days after surgery.  No dressings are needed on the upper eyes after the procedure is completed. Antibiotic ointment will be placed on the eyes and should be left in place overnight.

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. The night following your surgery, you may experience some pain and discomfort that can be controlled with your prescribed pain medication.  The area surrounding the eyes may become swollen following the surgery. It should begin to subside after the first day. Some blurring vision is normal overnight due to swelling around the eyes.

To find out more about eyelid surgery please contact us at 310-246-2355

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