STOCKTON — A Santa Rosa air ambulance company was fined nearly $33,000 last week by San Joaquin County officials for deviating from the county's transport plan for trauma patients.

The county also renewed its agreement with REACH Air Medical Services, which has been transporting patients in San Joaquin County since 2005.

The company replaced the manager responsible for its 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. 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. The patient survived 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 an injured child 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 deviated from the county's new trauma plan, which outlines procedures to treat 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," Blair said. 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.

The county Board of Supervisors voted unanimously to renew its agreement with REACH. The board also agreed to allow REACH to pay the $32,652 fine rather than suspend operations for three days. The fine was based on what REACH would have lost over three days of non-operation.

Founded in 1987, REACH provides air ambulance services in California, Oregon and Texas. The company, which is based in Santa Rosa, was acquired last December by Air Medical Group Holdings.