Understanding What Locked-In Syndrome Actually Means
Locked-in syndrome (LIS) is not a coma. It is not a vegetative state. People with LIS are awake, thinking, feeling, and, in many cases, hearing every word spoken around them. What they cannot do is move or speak. The most common cause is damage to the brainstem, often from a stroke or traumatic brain injury that severs the connection between the brain and the muscles that control movement.
Most people with LIS retain the ability to move their eyes vertically and blink, and for many, those movements become their only avenue for communication. Some individuals, with the right technology and support, learn to communicate through eye-tracking software and augmentative devices. But the care they require from day one, and for every day that follows, is intensive.
A person living with LIS will typically need around-the-clock skilled nursing care, respiratory support, specialized feeding, physical therapy to prevent complications like pressure injuries, occupational therapy to support communication, and adaptive technology to maintain any degree of independence or quality of life. This is not episodic care; it is continuous, and it is expensive.
What Care Costs in Tennessee
The table below draws from the 2025 CareScout Cost of Care Survey, reflecting Tennessee-specific median rates. These figures reflect the baseline cost of care — they do not account for the full scope of what a person with locked-in syndrome typically requires, which goes well beyond what a standard nursing home provides.
| Type of Care | Estimated Cost in Pennsylvania |
| Private duty nurse (hourly rate) | $79/hour |
| Private duty nurse (visit rate) | $290/visit |
| Long-term care facility, e.g., nursing home (semi-private room) | ~$9,400/month |
| Long-term care facility, e.g., nursing home (private room) | ~$10,000/month |
Source: CareScout
These numbers add up fast, and they continue for years, often decades. A person in their 40s or 50s who survives a stroke and is left with locked-in syndrome may need this level of care for 30 or more years. A successful legal claim doesn’t just address what happened. It creates a financial foundation that makes long-term care possible.
Our Process
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Medical Review
Our team conducts a thorough investigation with qualified medical experts to determine if malpractice occurred.
Legal Action
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Secure Recovery
We fight to secure the financial resources your family needs for long-term care and peace of mind.
Tennessee’s Place in the Stroke Belt—and Why Transfer Times Matter
Tennessee is one of eight states that make up what researchers call the Stroke Belt, a region defined by significantly higher stroke mortality than the national average. Part of that disparity comes down to access and distance from care centers. For patients in rural areas of the state, that distance isn’t a minor inconvenience; it can mean the difference between a treatable stroke and a catastrophic one.
When a patient arrives at a rural or community hospital that cannot provide advanced stroke treatment, they need to be stabilized and transferred quickly. That transfer window, measured from the moment a patient arrives at the first hospital to the moment they leave for a higher-level facility, is called the door-in-door-out (DIDO) time. Current clinical guidelines set a target of 120 minutes or less.
According to a national registry-based study published in JAMA, Tennessee-specific median DIDO scores are:
- 126 to 131 minutes for acute ischemic stroke eligible for endovascular therapy
- 115 to 167 minutes for other acute ischemic stroke
Every minute beyond the treatment window is brain tissue that cannot be recovered.
What We Do for Tennessee Families
Newsome Law is not a law firm that processes cases from a distance. We take a small number of serious cases and work them closely—listening to families, retrieving and reviewing medical records, engaging the right medical experts, and giving families a realistic picture of what happened and what their options are.
When negligence contributes to a loved one’s locked-in syndrome, the financial recovery we pursue is built around one central question: what will this person need for the rest of their life? That means we look at the full picture:
- The cost of skilled nursing care
- The specialized equipment required to communicate and maintain function
- Modifications to a home or the need for a long-term care facility
- Lost income and earning capacity
- The pain and suffering that come with this profound loss of function and independence
A settlement or verdict in a case like this can mean that your loved one receives the level of care they deserve, not the level their insurance or savings can scrape together. It can mean that caregiving doesn’t fall entirely on family members who have their own lives and limitations. It can mean a future that still holds dignity, connection, and choice.
We work on contingency; you pay nothing unless we recover compensation for your family. Every initial consultation is free, private, and carries no obligation.
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Could Negligence Have Played a Role? What Families in Tennessee Should Know
This is often the hardest question for families to sit with. Not every devastating medical outcome is malpractice. Strokes can cause severe damage even when a medical team responds appropriately. We understand that, and we will be honest with you about what we find, even if that isn’t what you want to hear.
That said, there are circumstances where locked-in syndrome follows a failure in care, such as:
Delayed Recognition or Treatment of Stroke
The brain damage that causes locked-in syndrome often results from a brainstem stroke. When stroke symptoms are not recognized quickly, or when a patient is discharged before the true diagnosis is made, the treatment window can close. In acute ischemic stroke, brain tissue dies at a rate that makes every minute critical.
Failure to Transfer
In rural Tennessee, many patients arrive first at a hospital that cannot perform advanced stroke interventions like mechanical thrombectomy. If that facility delays initiating a transfer, a patient who might have been saved can arrive at a comprehensive stroke center too late.
Misdiagnosis of Locked-in Syndrome Itself
This is more common than most people realize. Because LIS patients cannot move or speak, they are sometimes assumed to be in a coma or a vegetative state. A patient who is fully conscious may spend days or weeks without anyone understanding that they can hear and understand everything around them. Families often notice the signs first, a flicker of eye movement or a blink in response to a name, before medical staff catch up.
When LIS is missed, appropriate communication support and care planning are delayed, and families may make decisions without knowing that their loved one is aware and able to express preferences.
Ignored Warning Signs
Many strokes are preceded by transient ischemic attacks (TIAs) — sometimes called “mini-strokes” — that can present and resolve before a patient even seeks care. When a patient does seek care for TIA symptoms and is sent home without appropriate evaluation and treatment, the stroke that follows the failure to diagnose can be catastrophic.
A legal and medical review looks at the timeline of what happened:
- What symptoms were present
- When they were documented
- What was done and when
- What a reasonably careful provider would have done differently
That review can help families understand whether negligence played a role—and if so, what a legal claim might accomplish.
If you’re not sure whether your situation involves negligence, the right first step is a conversation. We’ll review what you tell us, and if we need to look further, we’ll say so.
How We Investigate
We start by listening. Before we review a single record, we want to understand what your family experienced:
- What you noticed
- What you were told
- What questions haven’t been answered
That conversation guides everything that follows.
From there, we gather the medical records:
- Emergency room records
- Imaging
- Transfer documentation
- Nursing notes
- Physician orders
- Specialist consultations
We look at the full timeline of care, not just isolated moments. We work with medical experts who understand stroke care and brainstem injuries, and we ask them the same question families are asking: Did this have to happen this way?
If the answer is no—if a reasonably careful provider, following appropriate standards of care, would have acted differently and that difference could have changed the outcome—then we may have the foundation for a case.
If the answer is that the care was appropriate and the outcome was not preventable, we will tell you that. We believe families deserve the truth, not a lawsuit that leads nowhere.
Our attorneys handle cases like this directly. You won’t be passed off to a paralegal or left waiting for a call back. You’ll know where your case stands.
No Upfront Costs. No Pressure. No Obligation.
Legal help in a case like this costs nothing unless we recover compensation for your family. There are no fees to meet with us, no retainers to sign, and no invoices while a case is pending. You pay for our time if we win.
We also understand that families in the middle of a medical crisis are not in a position to make rushed decisions. There’s no pressure to retain us after a consultation. Take the time you need. Ask the questions you have. Call Newsome Law; we’re here when you’re ready
What Our Clients Say
Real stories from families we've helped through difficult times.
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Newsome Law are fantastic! They have been working on my case for the past 3+ years and I have not once had a bad experience with anyone who works there. They have worked tirelessly to help me through my accident and the medical bills that loomed overhead. I am extremely pleased and grateful to have them, fighting on my side during this period in my life.
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Newsome Law Is a step above all the rest. They are not some run-of-the-mill Firm. But rather an experienced Team of established excellence and success. As one of Newsome Law’s grateful clients, they always operated in the best interest of my family. Were always available to take my call , and were compassionate to the pain and needs of my family. Newsome Law is the right Firm for you to choose.
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Newsome Law represented me in a very positive manner. Always professional, courteous, supportive and attentive. They were always able to keep me apprised of the status of my case. The team on my case were always easy to work with and on top of all issues. I never had to wonder where we were at in the process. I would recommend them to anyone needing this type of help in the future.
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I am so pleased to have worked with this firm. They went above and beyond for my sons case. I would highly recommend this firm to anyone. Always communicated with us, always answered all our questions and fought for my sons case to get the best. Newsome Law thank so much again for all you did. God Bless!
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Partnered with this law firm under unfortunate circumstances and ended up being a great success. They understood the mission and intent, and collectively, conducted all of the behind the scenes work, resulting in a successful end result. If you want one of the best, here’s your opportunity and highly recommended.
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When you’re in a hospital bed all jacked up from an accident and you google best personal injury attorneys, this is who you will find, and they are. Never had been in a lawsuit before and had never needed an attorney. They took such amazing care of me, and handled everything so professionally. A great team of paralegals and attorneys. Thank you so much guys.
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