Consulting Services

Dr. Stark trained at Harvard Medical School and the Dana-Farber Cancer Institute, with research interests in kidney cancer and melanoma. He is board-certified in Internal Medicine and Medical Oncology, a Fellow of the American College of Physicians, a member of the American Society of Clinical Oncology, and Professor of Medicine at Eastern Virginia Medical School. Since becoming a Florida resident in 2017, he has also taught at the University of Miami Miller School of Medicine.

He moved to Hampton Roads in 1977 as the area's first board-certified medical oncologist and practiced there for thirty-four years. Throughout his clinical career he taught at Eastern Virginia Medical School and served as a consultant to attorneys, insurers, and manufacturers in product liability and malpractice matters — for both plaintiffs and defendants. Stark Oncology Consulting, founded in 2011, formalizes that work into a dedicated medico-legal practice.

Typical engagements include:

• Case review and written opinions on standard of care
• Deposition and trial testimony
• Product liability consultation involving oncology drugs and devices
• Second-opinion review of diagnosis and proposed treatment

The most common cause of cancer malpractice litigation is failure to diagnose cancer promptly. The typical sources of conflict fall into two categories — failure to act on a symptom, and failure to act on an abnormal study or laboratory value.

Failure to act on a symptom

• Breast cancer — a palpable lump dismissed without triple assessment
• Lung cancer — persistent cough or chest pain attributed to a benign cause without imaging
• Colon cancer — a change in bowel habits or frank bleeding not endoscopically evaluated

Failure to act on an abnormal study or value

Depending on office workflow, reports can reach the chart without ever being reviewed — or be reviewed and then not acted upon. Recurring examples include:

• Abnormal chest x-ray. A recommendation to obtain a CT or to repeat the film in six to eight weeks is simply ignored.
• Abnormal PSA. The test is ordered as part of routine practice and the abnormal result is not followed up. A PSA still within the normal range but substantially higher than a prior value also warrants action.
• Iron deficiency anemia. Iron deficiency in a man or a post-menopausal woman is never normal. In any woman over forty, the colon must be considered as a possible source of bleeding.
• Abnormal Pap smear. Atypical or dysplastic results sometimes enter the chart without any action being taken.

Dr. Stark analyzes the significance of any such delay and assesses whether the patient's outcome would meaningfully have changed had the workup proceeded on time. The answer is not always obvious — and the honest answer is the one that holds up at deposition.