Doctor Disciplined by RIDOH — Receives Reprimand and Suspension From Prescribing Controlled Substances

Doctor Disciplined by RIDOH — Receives Reprimand and Suspension From Prescribing Controlled Substances

The Rhode Island Department of Health has taken disciplinary action against a Rhode Island physician.

According to a document secured by GoLocal, Frank P. Maggiacomo, D.O., has been reprimanded, and his license to prescribe controlled substances has been suspended.

Maggiacomo faced two counts by the disciplinary board of the RIDOH

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According to RIDOH in Count I:

On July 31, 2024, the complaint referenced in Count I was filed with the Board. It alleged that Respondent was overprescribing opioids to patients. Based upon the allegations, the Board reviewed records from the Prescription Drug Monitoring Program ("PDMP") to analyze Respondent's prescription history. The review of the PDMP discovered that in a one-year period, from October 6, 2023 through August 6, 2024, Respondent wrote nearly 3,000 controlled substance prescriptions for 436 patients. The record also indicated that Respondent has multiple patients who had been prescribed opioids on a continuous basis since 2017, with several patients receiving opioid prescriptions throughout that entire timeframe. PDMP entries for a number of patients revealed a practice of co-prescribing opioids and benzodiazepines for extended periods. As a result of its initial inquiry, the Board then sought and obtained medical records on 10 patients of Respondent for the purpose of examining the prescription history.

 

Respondent was invited to provide a written response to the allegations set forth in the complaint and to also respond to the information gathered by the Board. On October 23, 2024, Respondent submitted a written reply to the Board. Additionally, on October 29, 2025, Respondent appeared before the Board's Investigative Committee. The Investigative Committee analyzed medical records relating to the Respondent's treatment of 5 specific patients.

 

The records demonstrated that Respondent had a practice of prescribing opioids, and other controlled substances, over a period of years without first documenting the clinical purpose for such continued medications, including the absence of a thorough physical examination and documentation of consultations with pain management specialists. Likewise, there was no assessment for substance use disorders or drug diversion when circumstances warranted. With respect to one such patient, for example, the records indicated that the patient was on both oxycodone and chlorpromazine.

 

The medical record indicated that the patient's son was receiving and providing medications to the patient. Despite the existence of repeat negative findings for both drugs from toxicology screening tests, and letters from the patient's insurance company raising the possibility of substance use disorder, Respondent continued to prescribe both medications and did not consider the possibility of diversion. With respect to another patient, the medical record indicates that Respondent determined that the patient violated the governing substance abuse contract based upon bloodwork that was conducted on June 30, 2017. Respondent continued to prescribe opioids to the patient, despite the violation of the substance abuse contract. While the patient was prescribed opioid pain medication for an extended period, Respondent had not clinically evaluated the patient to determine the cause of the pain. Nor did Respondent seek or obtain any medical records from pain management physicians who had evaluated the patient.

 

Determination of Unprofessional Conduct

Based upon the review and assessment of Respondent's medical records, the written response provided, as well as Respondent's appearance before the Investigative Committee, the Investigative Committee voted to make a probable cause determination of unprofessional conduct in violation of R.I. Gen. Laws § 5-37-5.1(19).

 

Further, in Count II, the RIDOH finds:

This matter arises from a complaint alleging that Respondent simultaneously prescribed opioids and a stimulant, phendimetrazine, to a patient over an extended period of years. The complaint was filed by a relative of the patient, who complained that the patient was addicted to opioids and had experienced a critical loss of weight while on the prescription for phendimetrazine.

 

As a result of the complaint, the Board's Investigative Committee examined the patient's medical records, reviewed the RI Prescription Drug Monitoring Program ("PDMP"), and interviewed the Respondent. The Investigative Committee also received and considered a written reply from Respondent.

 

An examination of the PDMP revealed an extended history of prescribing both hydrocodone-acetaminophen, an opioid used for treating moderate to severe pain, as well as phendimetrazine, which is a stimulant used for appetite suppression.

 

The Investigative Committee's examination of the medical record disclosed that the patient was prescribed hydrocodone-acetaminophen to address chronic back pain, with a history of compression fractures of the spine, and to improve the patient's activities of daily living.

 

The examination of the patient's medical record did not reveal any clinical basis for the prescription of phendimetrazine, particularly with its prescription history extending over many years. Of significance, the medical records revealed indications of adverse effects from the extended use of phendimetrazine, including a significant loss of weight, with a resulting body weight of 87 with a BMI of 15.7 (with "underweight" defined as a BMI < 18.5), and difficulty sleeping. The patient also suffered from heart palpitations, which can be caused or exacerbated by the use of phendimetrazine. Despite the loss of weight, difficulty sleeping and heart palpitations, no modification or cessation of the stimulant was made or even discussed with the patient. Instead, the prescriptions continued unaltered over a period of many years.

 

The Investigative Committee interviewed Respondent to determine the clinical basis for the continued and extensive history of phendimetrazine. Respondent could not present any explanation for the current use, noting that the medication may have first been introduced to allow for the patient to work an overnight shift, over 20 years earlier. Respondent could not adequately explain to the Investigative Committee why phendimetrazine continued to be prescribed to the patient after her retirement years earlier and given the presentation of critical weight loss, heart palpitations and difficulty sleeping.

 

During his appearance, Respondent informed the Investigative Committeе that he contacted his patient when he learned of the complaint. Respondent reported that he canceled the prescription for phendimetrazine following his phone conversation with the patient. Despite the known consequences of withdrawal from the medication, Respondent ceased the prescription for phendimetrazine immediately; Respondent did not provide his patient with instructions for tapering the dosage in order to avoid known side effects from an abrupt cessation of the stimulant medication.

 

Based upon a review and assessment of the medical records, Respondent's appearance before the Investigative Committee, and a review of Respondent's written reply to the complaint, the Investigative Committee voted to make a probable cause determination of unprofessional conduct, in violation of R.I. Gen, Laws § 5-37-5.1(19). The Investigative Committee found that Respondent failed to assess and document the need for the continued prescription for phendimetrazine over an extended period of years.

 

Disciplinary Actions:

As a result, RIDOH has issued a reprimand, issued fines of $2,000, and:

Respondent's Controlled Substance Act Registration ("CSR") is immediately suspended and said suspension shall remain in full force and effect until Respondent completes all of the terms and conditions set forth in this Consent Order, including the satisfactory completion of the courses set forth below. Upon successful completion of the terms of this Consent Order and upon submission of an application, Respondent's CSR shall be reinstated.

 

The disciplinary action was made public on June 10.