North Carolina Board Reprimands P.A. James Rapalje After 1 Patient Overdose Death
Updated
Updated · JoCo Report · May 27
North Carolina Board Reprimands P.A. James Rapalje After 1 Patient Overdose Death
1 articles · Updated · JoCo Report · May 27
Summary
An April 20 consent order publicly reprimanded James John Rapalje after investigators tied his care failures to multiple patients, including one long-term patient who later died from an overdose.
From 2018 to 2024, Rapalje prescribed Xanax and Adderall to that patient but failed to do pill counts, drug screens or routine database checks despite signs of possible diversion; toxicology later found illicit drugs and no prescribed benzodiazepine.
The board also found he kept issuing long-term benzodiazepine, stimulant, opioid and narcotic prescriptions without documented diagnostic assessments, risk reviews, counseling or monitoring for misuse, dependence and adverse effects.
Four other patients were cited in the order, including 2 cases combining narcotic painkillers with benzodiazepines and 1 multiple myeloma patient given oxycodone without documented reassessment or misuse monitoring.
Rapalje, licensed in North Carolina since 1976, inactivated his license on Feb. 9, 2026, admitted unprofessional conduct and waived appeal; the reprimand will be reported to national disciplinary databases.