How Locked-In Syndrome Changes Your Present and Future
Locked-in syndrome happens when damage to the brainstem—most often from a stroke—severs the connection between a person’s mind and their body. The person is conscious. They can often think clearly, hear every conversation in the room, and understand everything happening to them. What they’ve lost is the ability to move or speak, aside from blinking or small eye movements in most cases.
This is not a condition someone recovers from over a few months of physical therapy. Locked-in syndrome typically means a lifetime of round-the-clock support: skilled nursing, respiratory care, feeding assistance, mobility equipment, communication devices, and a home or facility environment built around total dependency. Families are rarely prepared for what that costs, or for how long it lasts.
| Type of Care | Estimated Cost in South Dakota |
| Private duty nurse (hourly rate) | $92/hour |
| Private duty nurse (visit rate) | $100/hour |
| Long-term care facility, e.g., nursing home (semi-private room) | $113,333/year |
| Long-term care facility, e.g., nursing home (private room) | $122,275/year |
Source: Genworth
These are just the baseline figures. A person living with locked-in syndrome typically needs a ventilator or tracheostomy care, a feeding tube, a specialized wheelchair, home modifications, assistive communication technology, and ongoing physician oversight. These are costs that stack on top of the numbers above and grow as equipment wears out and needs change over decades.
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Medical Review
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When a Stroke Outcome May Point to Medical Negligence
Not every devastating outcome is the result of a mistake. Strokes can be severe, and even excellent care doesn’t guarantee a good result. We say this upfront because we think families deserve honesty, not a sales pitch dressed up as sympathy.
That said, locked-in syndrome sometimes follows a chain of decisions that didn’t go the way they should have, such as:
- A stroke that wasn’t recognized quickly enough in the emergency room
- Symptoms dismissed or misread as something else entirely
- A patient who needed transfer to a specialized stroke center but didn’t get there in time
- Treatment that was delayed, withheld, or never offered
- A patient sent home before it was safe to do so
- Signs of awareness in an “unresponsive” patient that went unnoticed by staff
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Why Timing and Transfers Matter So Much in Treatment
Stroke treatment operates on a clock. Clot-dissolving medication (called tPA) and mechanical clot removal both lose effectiveness—and gain risk—with every additional minute. When a patient presents at a hospital that can’t provide advanced stroke intervention, they need to be evaluated and moved to a comprehensive stroke center quickly. This is a big problem in South Dakota, where the median door-in-door-out times (the time from when a person arrives at a hospital to when they leave for a more capable hospital) are as follows:
- 146-209 minutes for acute ischemic stroke eligible for endovascular therapy
- 194-215 minutes for other acute ischemic stroke
Source: JAMA
Both median times well exceed the nationwide guideline of less than 120 minutes.
South Dakota is not immune to this challenge. The American Heart Association committed more than $5 million to South Dakota specifically to strengthen stroke care in rural parts of the state and close gaps affecting patients who live far from a comprehensive stroke center. If your loved one was treated at a rural facility, or spent hours waiting for transfer before receiving definitive stroke care, that timeline deserves a close look.
Misdiagnosis Is Its Own Danger
Locked-in syndrome is sometimes mistaken for coma or a vegetative state, particularly in the earliest hours after a stroke, when a patient’s ability to communicate through eye movement hasn’t yet been tested or noticed. This isn’t a rare mix-up; noticing someone is locked in requires a deliberate bedside evaluation to catch it, and it’s often family members, not medical staff, who first realize a loved one is tracking movement or blinking in response to questions. When that recognition comes late, it can mean delayed treatment decisions and prolonged uncertainty for everyone involved.
A legal and medical review can help answer the question every family in this position eventually asks: could this have gone differently? We work with medical experts to examine the records, the timeline, and the decisions that were made, and we tell families honestly what we find, including when the answer is that no one is legally at fault.
How Newsome Law Works With Your Family
We think of our role as more than legal representation. Families come to us at one of the hardest points in their lives, and we try to make the legal process the part they have to think about least.
That starts with direct access to the attorney handling your case, not a rotating cast of paralegals you’ve never met. It continues with a thorough medical review by qualified experts who can identify exactly where care fell short, if it did. And it means staying closely involved with your family throughout, because the legal process for a case like this can take time, and you shouldn’t have to chase updates.
A successful outcome, whether through settlement or verdict, is meant to cover what your family will actually need:
- A lifetime of medical and custodial care
- Adaptive equipment
- Home modifications
- Lost income
- Compensation for the pain, disruption, and loss of the life your loved one had before
Done right, it’s meant to give your family the financial footing to stop worrying about how care gets paid for and start focusing on your loved one.
Our process is straightforward: we listen first, we obtain and review the full medical record, and we bring in independent medical experts who can evaluate what happened without bias toward either side.
If the review shows the care was appropriate and nothing was missed, we’ll tell you that directly. If the review shows negligence led to your loved one’s diagnosis, we can manage the legal process on your behalf. We’ve handled complex, high-stakes cases involving catastrophic brain injury for years, and we know how to build them carefully.
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If you’re trying to understand what your family is facing, we’re glad to help you work through it. The consultation is free, confidential, and comes with no obligation to move forward. Whether you decide to work with us or simply want a second, informed perspective on your loved one’s care, we’re here.
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