What Happened
Vivian Letizia, a dentist practicing in Stone Ridge, New York, used one of her own patients' identities to fraudulently obtain oxycodone for herself.
On December 16, 2019, Letizia submitted a prescription for oxycodone using a dental patient's name and date of birth, then filled it at a pharmacy in Woodstock, New York. She knew at the time that she was not actually treating that patient and intended to consume the oxycodone herself.
Letizia pleaded guilty in April 2022 to acquiring a controlled substance by misrepresentation, fraud, deception, or subterfuge. As part of her plea, she agreed to surrender her New York medical license and to be barred from ever holding a DEA registration to prescribe controlled substances again.
What Went Wrong
- A prescriber used a real patient's identity without any cross-check. The pharmacy that filled the prescription had no way to know the patient named on it had not actually been treated that day, since dental visit records and prescription fills are not typically cross-referenced at the point of sale.
- Self-prescribing controls were absent. Nothing in the described case stopped a solo dental practitioner from writing a prescription in a patient's name for her own use.
- Detection depended on a broader investigation. There is no indication the scheme was caught through routine practice oversight rather than external law enforcement activity.
How It Could Have Been Prevented
- State PDMP checks that flag prescriptions issued on dates with no matching appointment or treatment record for that patient.
- Periodic third-party audits of solo-practitioner prescribing patterns, since these settings lack the internal review layers of larger health systems.
- Pharmacy-side verification that a prescription date aligns plausibly with a documented office visit for controlled substances.
- Dental and medical boards should require attestation and periodic review of self-prescribing and prescribing-to-family/patients-of-convenience practices.
Related Guidance
- Regulatory Guide — PDMP checks and DEA registrant obligations for individual practitioners.
- 15 Red Flags of Drug Diversion — Prescription-pattern indicators of self-diversion by prescribers.
- Investigation Playbook — Investigating suspected prescriber self-diversion.
- Training Materials — Ethics and compliance training for solo and small-practice prescribers.