The Record
STOCKTON, Calif. — Officials fined one of the four air ambulance companies moving medical patients in the sky over San Joaquin County nearly $33,000 for running afoul of the county’s transport plan for trauma patients.
Though officials, at first, moved to revoke REACH Air Medical Services’ permit to operate in the county, San Joaquin and the company eventually settled on the fine. County officials also renewed its agreement with the air-ambulance company, which has been transporting patients in the county since 2005.
The company replaced the manager responsible for the operations in San Joaquin County and submitted a corrective plan of action that includes new training and more communication. Both county and company officials said the plan goes beyond ensuring the ambulance company follows the county plan in the future.
“It makes REACH a new partner in our local EMS strategy,” county Emergency Medical Services administrator Dan Burch said.
The fine stems from two August incidents. On Aug. 4, a REACH helicopter took a patient to a hospital in Stanislaus County after being told to take the patient to San Joaquin General Hospital, according to a county report. A car struck a bicycle, and paramedics who took the patient a short distance to rendezvous with the air ambulance told the air crew from the physician directing the response to take the person to San Joaquin General.
After the REACH helicopter took flight, the air crew changed its route to a hospital with a higher-level trauma center because of the patient’s head injury, according to a record of the incident completed by a REACH paramedic cited by the county. The patient did survive the accident, according to the county.
“At no point was the patient in danger,” said Anna Blair, REACH vice president of business relations.
In the second incident, on Aug. 11, a REACH helicopter initially insisted on taking a child injured in a traffic accident to Oakland Children’s Hospital when told it should be heading to UC Davis Medical Center in Sacramento. The helicopter ultimately complied with the county order.
Both incidents were contrary to the county’s new trauma plan, which outlines policies and procedures on how to deal with patients suffering from traumatic injuries, including where to take them, depending on the severity of the injury.
The plan is designed and directed by physicians to give patients the best chance for survival, Burch said. “We know, based on scientific evidence, that trauma systems save lives,” he said. “We came down hard on REACH because it was a willful act of refusal.”
At a revocation hearing, an attorney representing the company said REACH staff members were acting in the best interest of the patients. At the hearing and later, REACH officials agreed it had not followed county policies. “There was a deviation that occurred by our staff. (San Joaquin County) was appropriate in identifying the deficiency,” said REACH’s Blair. That, and the newness of the county’s policy, contributed to the incidents, she said. The corrective-action plan will improve coordination with the county, she said.
San Joaquin General became the county’s designated center for most trauma cases on Aug. 1, but other policy updates had been put in place on July 1, according to the county.
REACH is based in Santa Rosa and provides air ambulance services both in and out of California. It is one of four air ambulance companies permitted to operate in San Joaquin County, but it is the only one with a helicopter based in the county, at Stockton Metropolitan Airport.
The county Board of Supervisors renewed its agreement with REACH at its Tuesday meeting with a unanimous vote. The board also agreed to allow REACH to pay the $32,652 fine rather than a possible three-day suspension. The fine was based on what REACH would have lost over three days of non-operation.
The two August incidents were, “really an unacceptable situation and certainly not in keeping with our mission to provide the best care we can for the citizens of San Joaquin County,” Supervisor Bob Elliott said before the vote to extend the agreement. “Don’t hesitate to come back to the board if we continue to have problems of this nature,” he told staff.
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