Postmortem: Clinic Website Built in 2 Days, Breached in 2 Days

The Timeline

Monday 9am: Clinic owner decides they need a patient portal Monday 2pm: AI generates complete portal in 5 hours Tuesday 10am: Portal goes live Thursday 3pm: Breach detected Friday 9am: Clinic receives HIPAA violation notice

What They Built

A small pediatric clinic (12 employees, 300 active patients) used an AI code generator to build:

• Patient appointment booking
• Medical history forms
• Lab result viewing
• Secure messaging with doctors
• Prescription refill requests

Cost: $0 (used free AI tool) Time: 5 hours Technology: Bolt.new → Deployed on Replit

The owner was thrilled. "It works perfectly!" they told their staff.

How It Was Breached

Day 1 (Tuesday)

9am: Portal goes live 2pm: Hacker finds the site through Google 3pm: Hacker notices it's AI-generated (telltale signs in HTML comments) 5pm: Begins testing for common AI-generated vulnerabilities

Day 2 (Wednesday)

10am: Finds SQL injection vulnerability in search function 11am: Extracts full patient database 2pm: Tests file upload security 3pm: Uploads web shell through "lab results" upload feature

Day 3 (Thursday)

9am: Uses web shell to access server 11am: Finds unencrypted patient data 2pm: Downloads all medical records 3pm: Clinic IT notices unusual database activity 5pm: Breach confirmed

What Went Wrong

1. No Encryption at Rest

Patient data was stored in plain text:

// AI-generated code
const patient = {
  name: "Sarah Johnson",
  ssn: "123-45-6789",
  diagnosis: "Type 2 Diabetes",
  medications: ["Metformin", "Lisinopril"]
};

db.insert('patients', patient);

HIPAA requires: Encryption of all PHI (Protected Health Information) at rest.

2. SQL Injection in Search

The patient search was vulnerable:

// AI-generated vulnerable code
app.get('/search', (req, res) => {
  const query = \`SELECT * FROM patients WHERE name LIKE '%\${req.query.name}%'\`;
  db.query(query);
});

Hacker input: `' OR '1'='1` Result: All patient records returned

3. No File Upload Validation

The lab results upload accepted ANY file type:

// AI-generated code
app.post('/upload-lab-results', (req, res) => {
  const file = req.files.labResult;
  file.mv(\`./uploads/\${file.name}\`);  // No validation!
});

Hacker uploaded: `shell.php` Result: Remote code execution

4. Missing Access Controls

No verification that users could only see their own data:

// AI-generated code
app.get('/patient/:id', (req, res) => {
  const patient = db.getPatient(req.params.id);
  res.json(patient);  // No auth check!
});

Anyone with a patient ID (sequential numbers!) could view any record.

5. No Audit Logging

The clinic had no idea:

• Who accessed what data
• When the breach occurred
• How many records were compromised
• What the hacker did on the server

HIPAA requires: Detailed access logs for all PHI.

The Consequences

Immediate Impact

• 300 patients' data compromised: Names, SSNs, diagnoses, medications, addresses
• 48 hours to notify patients: HIPAA breach notification rule
• Emergency shutdown: Portal taken offline
• Crisis management: Weekend spent handling fallout

Legal Consequences

• HIPAA violation fine: $50,000 (could have been up to $1.5M)
• Legal fees: $15,000 for breach response counsel
• Credit monitoring: $50/patient × 300 = $15,000
• Potential lawsuits: Ongoing

Reputational Damage

• Patient trust lost: 45 families switched clinics
• Revenue impact: $120,000/year lost
• Media coverage: Local news ran story
• Google reviews: Rating dropped from 4.8 to 3.2

How We Fixed It

Emergency Response (Week 1)

1. Forensic analysis: Determined scope of breach
2. Breach notification: Sent to all affected patients
3. System shutdown: Took portal offline
4. Evidence preservation: For legal requirements

Secure Rebuild (Weeks 2-4)

1. HIPAA-compliant architecture:

// Proper encryption
import { encrypt, decrypt } from './encryption';

const patient = {
  name: encrypt("Sarah Johnson"),
  ssn: encrypt("123-45-6789"),
  diagnosis: encrypt("Type 2 Diabetes"),
  medications: encrypt(JSON.stringify(["Metformin"]))
};

1. SQL injection prevention:

// Parameterized queries
app.get('/search', (req, res) => {
  db.query(
    'SELECT * FROM patients WHERE name LIKE $1',
    [\`%\${req.query.name}%\`]
  );
});

1. File upload security:

// Strict validation
const ALLOWED_TYPES = ['application/pdf', 'image/jpeg', 'image/png'];
const MAX_SIZE = 5 * 1024 * 1024; // 5MB

app.post('/upload-lab-results', (req, res) => {
  const file = req.files.labResult;
  
  if (!ALLOWED_TYPES.includes(file.mimetype)) {
    return res.status(400).json({ error: 'Invalid file type' });
  }
  
  if (file.size > MAX_SIZE) {
    return res.status(400).json({ error: 'File too large' });
  }
  
  // Store with random filename, not user input
  const filename = \`\${crypto.randomUUID()}.pdf\`;
  file.mv(\`./uploads/\${filename}\`);
});

1. Authorization checks:

// Verify user owns this data
app.get('/patient/:id', authRequired, (req, res) => {
  const patient = db.getPatient(req.params.id);
  
  if (patient.userId !== req.session.userId && !req.session.isAdmin) {
    return res.status(403).json({ error: 'Access denied' });
  }
  
  res.json(patient);
});

1. Comprehensive audit logging:

// Log all PHI access
function logAccess(action, resource, userId) {
  auditLog.insert({
    timestamp: new Date(),
    action,
    resource,
    userId,
    ipAddress: req.ip,
    userAgent: req.headers['user-agent']
  });
}

app.get('/patient/:id', (req, res) => {
  logAccess('VIEW_PATIENT', req.params.id, req.session.userId);
  // ... rest of endpoint
});

Ongoing Compliance (Months 2-6)

• Regular security audits
• Penetration testing
• Staff HIPAA training
• Incident response plan
• Business Associate Agreements

The Real Cost

All to save $800 on proper development.

Warning Signs They Missed

Before the breach, there were red flags:

1. No security review
2. No HIPAA compliance check
3. No penetration testing
4. "It works" = "It's secure" assumption
5. No security expertise on team

Could This Happen to You?

Ask yourself:

• Did AI generate my healthcare/financial app?
• Have I had a security audit?
• Do I know if I'm HIPAA compliant?
• Is my data encrypted?
• Do I have audit logs?

If any answer is "no" or "I don't know", you're at risk.

What to Do Now

If you handle sensitive data:

1. Stop using your app immediately (if not audited)
2. Get a compliance audit ($500-1000)
3. Fix critical issues before going live
4. Implement audit logging
5. Train staff on security

Don't learn this lesson the hard way.

We Can Help

We specialize in HIPAA compliance for AI-generated apps:

• Compliance audit: $500
• Full HIPAA remediation: $4,500-7,000
• Ongoing compliance monitoring: $500/month

A $50,000 fine is much more expensive than a $6,500 fix.