State Says Middlesex County Doctor Pushed Painkillers

PISCATAWAY, NJ — A Middlesex County doctor had his medical license temporarily suspended this week after a state investigation found that he indiscriminately prescribed highly addictive opioids in excessive amounts to his patients over the past year, the state alleges.

Dr. Eddie Gamao, a general practitioner in Piscataway, voluntarily agreed to temporarily surrender his license to the state Board of Medical Examiners amid allegations he gave his patients painkiller prescriptions that far exceeded the safe limits. This allegedly occurred between February 2017 and February 2018, the state Division of Consumer Affairs said.

The 77-year-old physician’s prescribing habits came under scrutiny after a pharmacist filed a complaint on the New Jersey Prescription Monitoring Program Suspicious Activity Report online portal. The pharmacist said he was very worried that Dr. Gamao may have been indiscriminately prescribing controlled dangerous substances to three generations of a South Plainfield family, including an 88-year-old grandmother.

That led the state Board of Medical Examiners to quietly begin a review of Gamao’s prescribing history: The Board says they found that during that 12-month period, he prescribed more than 9,000 oxycodone pain pills in the strongest available dosages to the elderly woman, her son and daughter-in-law. Dr. Gamao was prescribing dosages that more than tripled the CDC’s recommended daily morphine milligram equivalents limits for each person, the state said.

Dr. Gamao also prescribed more than 1,000 units of powerful opioid painkillers to the elderly woman’s two adult grandchildren in dosages that met or exceeded CDC limits.

“One tip from an alert pharmacist on our online portal, followed by an analysis of our Prescription Monitoring Program records, was all we needed to identify and shut down this dangerous operation,” said New Jersey's Attorney General Gurbir Grewal. "This doctor was prescribing highly addictive opioids at a rate that simply had no medical justification."

In addition temporarily surrendering his medical license, Dr. Gamao has agreed to temporarily surrender his NJ CDS registration that allows him to prescribed controlled substances in the state.

Gamao’s prescribing records showed that during a 12-month period he prescribed highly restricted “Schedule II” opioids like oxycodone, morphine, and fentanyl to 106 patients. An analysis of the prescribing data revealed that:

• More than half of all the 1,040 Schedule II opioid prescriptions Gamao wrote resulted in daily morphine milligram equivalents of 270 or higher – at least triple the CDC’s recommended limit.
• Nearly 99 percent of the 639 prescriptions Gamao wrote for oxycodone immediate-release prescriptions resulted in daily morphine milligram equivalents that exceeded the CDC’s recommended limit.
• In the case of the 88-year-old woman, Gamao routinely prescribed high-quantity, high-dosage opioid prescriptions for 30mg oxycodone days apart from one another, which resulted in a combined daily morphine milligram equivalents of 810 – nine times the CDC’s recommended limit.
• Maintained some patients on morphine levels that ranged from 330 to 960 daily morphine milligram equivalents.

The temporary suspension of Gamao’s license marks the first time a physician’s practicing authority has been restricted as a result of allegations that were reported on the state's online Prescription Monitoring Program Suspicious Activity Report portal. The state calls it the PMP SAR for short.

“A review of Dr. Gamao’s entire prescribing history on the PMP revealed that his alleged indiscriminate prescribing of opioids was not limited to the family in question, it spread across his entire patient base,” said Kevin Jespersen, Acting Director for the Division of Consumer Affairs. “To ensure the safety of the public, the Board has acted appropriately to cut off this dangerous flow of opioids and ensure that Dr. Gamao will have no access to a prescription pad until these very serious allegations against him are addressed.”

Dr. Gamao’s medical license will remain suspended until he reapplies for it, which must be approved by the Board of Medical Examiners after a hearing.

The SAR portal is among the latest expansions to New Jersey’s PMP, a database aimed at identifying problem-prescribers.

The SAR portal allows pharmacists and members of the public to report suspicious activities such as the overprescribing of controlled dangerous substances (“CDS”), “doctor shopping” to stockpile drugs, or the circulation of forged or stolen prescriptions.

The MME conversion program automatically converts opioid dosage measurements into a standard value to help prevent overdoses and over prescribing. The PMP automatically converts dosages of commonly-prescribed opioids of differing potency, such as codeine, fentanyl, and oxycodone, into a standard value known as "morphine milligram equivalents" (MME). This conversion allows prescribers to compare the total potency of different opioid medications a patient is consuming with CDC guidelines which advises prescribers to use extra precautions when increasing patients to 50 MME per day and avoid or carefully justify increasing a dosage to 90 MME per day.

Patients who believe that a licensed health care professional is prescribing drugs inappropriately can file an online complaint with the State Division of Consumer Affairs by visiting its website or by calling 1-800-242-5846 (toll free within New Jersey) or 973-504- 6200.

Photo Copyright: Image Point Fr/Shutterstock.com