Provider Says Digital Images From A Surgery Less Than Two Years Ago Are No Longer Accessible After A 51-day Records Request

Location: Washington State.

I'm looking for guidance on a medical records issue.

I submitted a formal Patient Request for Access seeking the original digital arthroscopic images from two knee surgeries performed within the last two years.

What concerns me is not only whether the records are available, but the process that led to that conclusion.

The request remained unresolved for more than seven weeks.

Before contacting the surgeon's office, I had already submitted the records request and had worked with both Medical Records and Imaging multiple times. Medical Records directed me to Imaging, Imaging directed me back to Medical Records, and both departments repeatedly told me they could not locate the files, did not have access to them, and could not see them within their systems.

Because those departments were unable to help, I contacted the surgeon's office directly and explained that Medical Records and Imaging had already been unable to locate the files.

The surgeon's office directed me back to Medical Records. Medical Records again advised that they could not locate the files and did not have access to them.

After that, the surgeon's office informed me that there was "no digital source."

When I asked how printed surgical photographs had been generated if no digital source existed, I was then told the images were maintained within a system used to print copies for patients.

I was subsequently offered a copy of the images on a flash drive. I was told the surgeon would work with the OR team to obtain the images. Later I was told a vendor was preparing the flash drive. I was then informed in writing that the flash drive contained original digital images from both surgeries.

During the records request process, I also contacted Patient Relations, met with the clinic's Senior Manager of Operations, and filed a complaint with the healthcare system's Integrity/Compliance hotline in an effort to locate the records and obtain a response to my request.

Approximately 37 days after my records request, a flash drive was finally produced. However, the drive was encrypted and inaccessible.

During an in-person meeting two days before I was finally given the password, the clinic's Senior Manager of Operations advised me that the flash drive contained images from both surgeries and that this was the method being used to provide the digital files.

I was later told there should not have been a password and that a replacement drive would be sent. No replacement drive was ever sent. Instead, approximately 14 days after receiving the drive, I was given a password for the original drive.

When I finally opened it, it contained images from only one surgery.

Only after I reported that the other surgery was missing—51 days after my original records request—was I told for the first time that the earlier surgery's digital image files were no longer accessible because the provider had changed vendors.

I was also told that only two hard-copy printed sets of those surgical photographs remain, one of which had been provided to me after surgery.

The Integrity/Compliance complaint was closed on the same day I was informed that the earlier surgery's digital files were allegedly unavailable due to a vendor change.

My questions are:

1. What obligations does a healthcare provider have under Washington law and HIPAA when requested records are later claimed to be unavailable?

2. If a provider says it no longer has access to requested records because of a vendor change, is it required to determine whether those records still exist elsewhere?

3. Is a patient entitled to a written explanation of whether records were lost, destroyed, archived, transferred, or otherwise became unavailable?

4. What options are available to a patient in Washington when requested medical records cannot be produced after a formal records request?

I'm not asking whether I have a lawsuit. I'm trying to understand the provider's obligations and what options are available to a patient in this situation.