
NC Physician Assistant Reprimanded for Poor Monitoring and Overdose Link
The North Carolina Medical Board reprimanded James John Rapalje, P.A., after an investigation found deficient prescribing practices, inadequate patient monitoring, and poor documentation affecting multiple patients, including one who died from an overdose. Rapalje prescribed benzodiazepines (Xanax) and Adderall over years without pill counts, drug screenings, or checks of the North Carolina Controlled Substances Reporting System, and failed to reassess or counsel on long-term benzodiazepine risks. The board also noted supervision concerns by his son. Rapalje inactivated his NC PA license in February 2026; the consent order admitted unprofessional conduct and the reprimand will be made public and reported to NPDB.









