FRENCH CAMP — Major trauma patients no longer are being transported to San Joaquin General Hospital for treatment.

Under a temporary policy that expires Oct. 31, anyone north of Eight Mile Road, between Stockton and Lodi, suffering from a major physical injury occurs such as a fall, car crash, industrial accident or gunshot wound, will be taken by ambulance to Kaiser Medical Center South Sacramento. Patients south of Eight Mile Road will be taken to one of two Modesto trauma centers: Doctors Medical Center or Memorial Medical Center.

For most Stocktonians in need of trauma care, that means a 30-mile trip south to Modesto.

If those Level II trauma centers are full, patients could be taken even farther to “the next closest trauma center,” according to the official policy memorandum issued Friday by the San Joaquin County Emergency Medical Services Agency.

Pediatric major trauma and major burn patients will continue to be transported primarily to the University of California, Davis Medical Center in Sacramento.

The only exception to the rule is when the base hospital physician determines that it’s in the best interests of the patient to transport the patient to the nearest hospital, regardless of its trauma center designation.

“On Friday, we were notified by the hospital that they could not provide a guaranteed call panel starting Friday evening. Based on that notification, we took action to direct all major trauma patients to Kaiser South Sacramento and Stanislaus County,” said Dan Burch, San Joaquin County’s emergency medical services administrator.

“They still cannot guarantee coverage, so we have an interruption in trauma services.”

On Sept. 9, the 196-bed county-owned hospital was put on notice that its official designation as a Level III trauma center is in jeopardy if it does not comply with mandated standards by Oct. 10. The county EMS agency found the hospital trauma center out of compliance with several staffing and management requirements established by state and federal law as well as the American College of Surgeons.

That was followed by a “vote of no trust” letter directed at Trauma Medical Director Dr. Larry Gentilello. The letter was signed by 12 physician leaders at the hospital and sent to the San Joaquin County Board of Supervisors.

The physicians stated they no longer would work in the trauma center effective Oct. 15 under Gentilello’s leadership.

That no longer appears to be an issue since Gentilello’s employment with San Joaquin General ended suddenly Friday afternoon.

“Two physicians left us last Friday — Dr. Gentilello and Dr. (Ahmed) Mahmoud. I have no further comment on that since it’s a personnel matter,” hospital Chief Executive Officer David Culberson said Monday. “Both of those two are not here at San Joaquin General Hospital anymore.”

Neither Gentilello nor Mahmoud could be reached for comment. But their departure prompted the hospital to notify EMS that it did not have enough surgeons available to meet trauma center guidelines.

The loss of Mahmoud, the longtime director of the hospital’s surgical residency program, was the most surprising since he participates in about 600 operations a year.

In the case of Gentilello, The Record learned that during his seven-month tenure with the hospital, he was certified by the American Board of Surgery but listed as “clinically inactive,” a designation he voluntarily selected four years ago when he was not managing patients or supervising surgery residents. He did both, as well as participate in several surgeries, while he was employed by the hospital.

Dr. Frank Lewis, executive director of the American Board of Surgery, said Monday that it typically is the hospital’s responsibility to check out a physician’s credentials. He said it was “not the usual thing” for a physician who heads a trauma center to be clinically inactive, but there is nothing that prohibits it as far as the American Board of Surgery is concerned.

“I don’t know if he forgot to notify us. But there are no implications at all regarding his abilities,” Lewis said. “It is relatively straightforward for him to convert back to clinically active status. It’s purely an administrative procedure.”

Culberson declined to discuss Gentilello’s status during his employment except to say that the hospital confirmed he was board-certified in surgery and surgical critical care.

Despite the sudden loss of two surgeons during the period when the trauma center is working to regain compliance, Culberson continued to say as he has all along that everything possible is being done to meet the Monday deadline set by the EMS Agency.

“We are trying to make sure we are coming into full compliance with EMS mandates that require board-certified general surgeons and critical-care trained surgeons at all times. That is a higher standard of what is required from the American College of Surgeons in their trauma guidelines. It will ensure we have the finest-caliber trauma surgeon available at all times,” he said.

Culberson said a new team of physicians who meet those standards have been recruited. Also, a new trauma medical director and a trauma consultant will be brought in. All of this, he said, is expected to occur this week.

Burch, with the EMS agency, said he has seen San Joaquin General’s draft plan for how it intends to complete the plan of correction it submitted earlier.

Within a day or two after the deadline, Burch said, “we will make a determination if the hospital successfully completed the plan of correction. Either they have or they have not, and we will have to move forward based on those findings.”

— Contact reporter Joe Goldeen at (209) 546-8278 or jgoldeen@recordnet.com. Follow him at recordnet.com/goldeenblog and on Twitter @JoeGoldeen.