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By Jorge L. Flores, Esq. | Florida Bar #53244 | AV Preeminent Rated | Martindale & Avvo 2024 Top Rated Lawyer | FindLaw Rated 30+ Years Experience
Member, Florida Justice Association | Member, American Association for Justice
⚠️ Medical Emergency: If you or someone you know is experiencing symptoms of stroke such as sudden dizziness, difficulty speaking, facial drooping, or weakness on one side of the body, call 911 immediately. Time-sensitive treatment like tPA must be administered within hours to prevent permanent damage.
Locked-In Syndrome occurs when a basilar artery occlusion or brainstem stroke destroys the motor pathways in the ventral pons while leaving consciousness fully intact, trapping the victim in a state of complete paralysis with full cognitive awareness. The Miami medical malpractice attorneys at The Law Offices of Jorge L. Flores, P.A. represent victims and families throughout Florida who have suffered this catastrophic injury due to emergency room misdiagnosis, delayed treatment, and failure to perform the HINTS examination that could have identified the stroke in time for intervention.
For over 30 years, our firm has investigated complex stroke malpractice cases against Baptist Health South Florida, Jackson Memorial Hospital, HCA Florida Kendall Hospital, and other major healthcare systems throughout Miami-Dade County. We work with board-certified neurologists and neuroradiologists to prove that healthcare providers failed to recognize the warning signs of posterior circulation stroke. We handle cases involving basilar artery occlusion, vertebral artery dissection, missed HINTS test findings, and tPA administration delays. These failures rob patients of their chance for recovery.
Unlike high-volume settlement firms, The Law Offices of Jorge L. Flores, P.A. prepares every brainstem stroke case as if it will reach a courtroom and jury. Locked-in syndrome victims require lifetime care that only substantial verdicts can provide. Call (305) 598-2221 today to schedule a free consultation with a Miami brainstem stroke malpractice attorney who understands the medical complexity and devastating human cost of these cases.
What is Locked-In Syndrome?
Locked-In Syndrome, clinically known as ventral pontine syndrome, is a rare neurological condition caused by damage to the brainstem. The most common cause is a basilar artery occlusion. The basilar artery supplies blood to the pons, the critical segment of the brainstem that controls motor function. When this artery becomes blocked, the resulting stroke destroys the pathways that carry movement signals from the brain to the body. The victim loses all voluntary muscle control. In most cases, only vertical eye movement and blinking remain.
What makes this condition so devastating is the preservation of consciousness. The part of the brainstem responsible for awareness remains intact. The patient can see, hear, think, and feel. They cannot move or speak. Medical literature describes this as a pseudocoma because the victim appears unresponsive while remaining fully aware of their surroundings. Victims often describe the experience as being imprisoned within their own body.
The basilar artery forms where two vertebral arteries meet at the base of the skull. This posterior circulation supplies the brainstem, cerebellum, and portions of the brain that process vision. Unlike the more common strokes that affect the front of the brain, posterior circulation strokes present with different symptoms. Dizziness, vertigo, nausea, double vision, slurred speech, and difficulty swallowing are hallmark signs. Emergency room physicians frequently misdiagnose these symptoms as inner ear infections or intoxication.
In Florida, patients who survive basilar artery occlusion with locked-in syndrome typically have a normal life expectancy but require 24-hour skilled nursing care, ventilator support, feeding tubes, and sophisticated communication technology such as eye-gaze devices. The cost of this lifetime care routinely exceeds $20 million. This makes these cases among the highest-value medical malpractice claims in tort litigation.
How Brainstem Strokes Are Misdiagnosed: The Stroke Chameleon
Neurologists refer to posterior circulation strokes as stroke chameleons. They mimic benign conditions that emergency physicians see every day. A patient with a basilar artery occlusion often arrives at the ER complaining of severe dizziness, nausea, vomiting, and difficulty walking. These symptoms overlap almost entirely with vestibular neuritis, labyrinthitis, and benign paroxysmal positional vertigo. These are common inner ear conditions that resolve without serious treatment. The overlap creates a dangerous trap for patients.
The diagnostic error typically unfolds in a predictable pattern. The patient arrives with vertigo so severe they cannot stand. The ER physician orders a CT scan of the head. The scan returns negative for bleeding. Based on this negative scan and the vertigo symptoms, the doctor diagnoses an inner ear problem. The patient receives Antivert or meclizine and is sent home. Within hours or days, the stroke progresses. The patient returns in full neurological crisis or is found unresponsive at home.
In our experience handling over 50 stroke malpractice cases in Miami-Dade County, this diagnostic failure stems from a fundamental misunderstanding of posterior fossa imaging. Standard CT scans are unreliable for detecting strokes in the brainstem during the early hours. The bone at the base of the skull creates artifacts that obscure the brainstem on CT imaging. A negative CT scan does not rule out basilar artery occlusion. The standard of care requires either an MRI with diffusion-weighted imaging or a CT angiogram to visualize the vessels directly.
Another common misdiagnosis occurs when victims present with slurred speech, unsteady gait, and altered mental status. Emergency room staff frequently attribute these symptoms to alcohol intoxication or drug use. This happens especially if the patient is young or presents during evening hours. In Florida, failing to consider stroke in a patient who appears intoxicated but denies substance use is a deviation from accepted medical standards.
The HINTS Test: The Standard of Care for Dizzy Patients
The HINTS examination, which stands for Head Impulse, Nystagmus, and Test of Skew, is a bedside physical examination that can differentiate central vertigo caused by stroke from peripheral vertigo caused by inner ear dysfunction. A 2009 study published in Stroke journal found the HINTS examination was 100% sensitive for stroke detection in patients with acute vestibular syndrome, outperforming early MRI in the first 24 to 48 hours (Kattah et al., Stroke 2009;40:3504-3510). It requires no equipment. It takes less than five minutes to perform.
The three components evaluate distinct neurological functions. The Head Impulse test checks the reflex that keeps eyes stable when the head moves. The doctor rapidly turns the patient’s head while the patient looks at a target. A normal response suggests a peripheral cause. An abnormal result raises concern for stroke.
The Nystagmus component examines involuntary eye movements. Direction-changing nystagmus or purely vertical nystagmus indicates a central lesion in the brainstem. The Test of Skew evaluates vertical eye alignment by alternately covering each eye. When positive, it suggests brainstem involvement.
In Florida, when an emergency physician evaluates a patient with acute dizziness and fails to perform the HINTS examination, that omission may represent a breach of the standard of care. This is especially true when the patient has vascular risk factors such as hypertension, diabetes, smoking history, or prior stroke. We’ve seen hospitals argue that the CT scan was normal, but we counter with expert testimony showing that CT cannot reliably exclude brainstem stroke. Relying solely on a CT scan is the foundation of many successful malpractice claims.
Types of Brainstem Stroke and Locked-In Syndrome Cases We Handle
Every brainstem stroke case The Law Offices of Jorge L. Flores, P.A. investigates is analyzed by board-certified neurologists, neuroradiologists, and emergency medicine specialists to determine whether the claim meets Florida’s threshold requirements.
The Law Offices of Jorge L. Flores, P.A. handles brainstem stroke cases including basilar artery occlusion misdiagnosis, vertebral artery dissection, failure to perform HINTS examination, failure to administer tPA within the treatment window, and stroke misdiagnosed as vertigo or intoxication. Our Miami medical malpractice attorneys investigate all forms of medical negligence that result in preventable brainstem stroke injury or delayed treatment causing locked-in syndrome.
Complete list of case types we handle:
- Basilar Artery Occlusion Misdiagnosis
- Vertebral Artery Dissection
- Posterior Circulation Stroke
- Locked-In Syndrome from Medical Negligence
- Ventral Pontine Syndrome
- Cerebellar Stroke Misdiagnosis
- Stroke Misdiagnosed as Vertigo
- Stroke Misdiagnosed as Inner Ear Infection
- Stroke Misdiagnosed as Intoxication
- Stroke Misdiagnosed as Migraine
- Failure to Perform HINTS Examination
- Failure to Order MRI for Dizzy Patient
- Failure to Order CT Angiography
- Missed Hyperdense Basilar Sign on CT
- Radiology Misread of Stroke Imaging
- Teleradiology Errors
- Failure to Administer tPA Within Treatment Window
- Delayed Stroke Code Activation
- Failure to Activate Thrombectomy Team
- Failure to Transfer to Comprehensive Stroke Center
- Emergency Room Triage Failures
- Delayed Neurology Consultation
- Chiropractic Manipulation Causing Vertebral Artery Dissection
- Hospital Protocol Violations
- Communication Failures Between Radiologist and ER Physician
- Young Patient Stroke Misdiagnosis
- Brainstem Stroke Wrongful Death
Proving Brainstem Stroke Malpractice in Florida
In Florida, medical malpractice law requires plaintiffs to establish four elements. First, the healthcare provider owed a duty of care. Second, the provider breached the accepted standard of care. Third, this breach was the proximate cause of the injury. Fourth, the patient suffered damages as a result. In brainstem stroke cases, the central question is whether earlier diagnosis and treatment would have given the patient a better outcome.
Florida Statute §766.102 establishes that the standard of care is defined by what a reasonably prudent healthcare provider with similar training would have done under the same circumstances. In Florida, the standard of care requires emergency physicians evaluating dizzy patients with stroke risk factors to consider stroke in the differential diagnosis and order appropriate diagnostic testing beyond a simple CT scan. Failing to perform a HINTS examination or order vascular imaging when clinically indicated represents a deviation from this standard.
Before filing a medical malpractice lawsuit in Florida, the law requires a pre-suit investigation period. Florida Statute §766.106 mandates that the plaintiff’s attorney send a Notice of Intent to Initiate Litigation. Both sides then conduct a 90-day investigation during which medical records are exchanged and expert opinions are obtained. Florida Statute §766.203 requires a medical expert to provide a verified written opinion that the standard of care was breached before the lawsuit can proceed.
In Florida, there is a two-year statute of limitations for medical malpractice claims under Florida Statute §95.11(4)(b). This runs from the date the injury was discovered or should have been discovered through reasonable diligence. A four-year statute of repose provides an absolute deadline regardless of discovery. Limited exceptions exist for fraud, concealment, and injuries to minors. If you believe your loved one suffered a preventable brainstem stroke, contacting an attorney promptly protects your right to pursue compensation.
Damages in Locked-In Syndrome Cases
In Florida, the Supreme Court declared damage caps in medical malpractice cases unconstitutional in 2017. Juries can now award full compensation for the actual losses suffered by locked-in syndrome victims. There are no artificial limits. Because patients with locked-in syndrome typically have normal life expectancy but require comprehensive medical support, the economic damages in these cases are among the highest in personal injury litigation.
A Life Care Plan is the central document in locked-in syndrome litigation. This comprehensive projection, prepared by specialized life care planning experts, details every medical need the patient will have for the remainder of their life. In Florida, the cost of 24-hour skilled nursing care alone can exceed $250,000 annually. When projected over a 30 or 40-year life expectancy with inflation adjustments, nursing care costs alone can reach $15 million or more.
Additional economic damages include home modifications for wheelchair accessibility, specialized hospital beds, ventilator and respiratory equipment, feeding tubes, physical therapy, eye-gaze communication devices, medications, and ongoing physician care. Vocational economists calculate lost earning capacity. This represents what the victim would have earned over their working lifetime had the injury not occurred.
In Florida, locked-in syndrome victims can recover both economic damages for lifetime care exceeding $20 million and non-economic damages for pain and suffering without damage caps. These patients remain cognitively aware of their condition. The psychological suffering is profound and ongoing. Courts have recognized that the conscious experience of being trapped inside a paralyzed body constitutes extraordinary pain and suffering. Verdicts exceeding $40 million in non-economic damages have been upheld in locked-in syndrome cases.
Family members may recover loss of consortium damages for the destruction of the marital or familial relationship. Spouses lose the companionship, affection, and intimacy of their partner. Children lose the guidance and active participation of their parent. These relational losses, while difficult to quantify, are compensable under Florida law.
Our Brainstem Stroke Case Results
Confidential Multi-Million Dollar Settlement: Brainstem Stroke Misdiagnosed as Vertigo. A 52-year-old patient was sent home from the emergency room with an “inner ear infection” diagnosis after presenting with severe dizziness and imbalance. The ER physician relied on a negative CT scan and failed to perform a HINTS examination. Six hours later, the patient returned in a locked-in state. Our investigation revealed the hyperdense basilar sign was visible on the original CT but was missed by both the ER physician and radiologist. The settlement provided lifetime 24-hour nursing care and secured the family’s financial future.
$9.2 Million Verdict: Sepsis Malpractice. For a patient whose hospital had six separate opportunities to diagnose and treat a life-threatening infection but repeatedly chose less aggressive treatment options. This verdict demonstrates our ability to prove systemic failures in hospital care through detailed timeline analysis and expert testimony from infectious disease specialists.
Multi-Million Dollar Settlement: Surgical Error. A 45-year-old patient suffered catastrophic, life-altering injury following what was supposed to be a routine procedure. Our team retained top medical experts nationally and analyzed over 3,000 pages of medical records. The settlement covered lifetime medical needs, ongoing treatments, assistive care, and home modifications.
Past results do not guarantee a similar outcome. Each case is unique and must be evaluated on its own merits.
Why Choose The Law Offices of Jorge L. Flores, P.A. for Your Brainstem Stroke Case
Brainstem stroke and locked-in syndrome cases require an attorney who understands both the complex neurology involved and the strategies insurance defense firms use to minimize these claims. Attorney Jorge L. Flores brings a unique triple perspective to medical malpractice litigation. He gained experience as a former prosecutor. He spent years working as an insurance defense attorney at a top-rated Miami defense firm. For over 30 years, he has represented injured victims as a plaintiff’s advocate. He holds an AV Preeminent rating from Martindale-Hubbell, placing him in the top 5% of attorneys for legal ability and ethics. Attorney Flores has presented on stroke malpractice litigation at the Florida Justice Association annual conference.
This background means we understand how hospitals and their insurers attempt to escape liability. We know the defense playbook because we helped write it. When defense counsel argues that the CT scan was normal, we have neuroradiologists ready to testify about the hyperdense basilar sign that was missed. When they claim the symptoms looked like an inner ear infection, we have emergency medicine experts prepared to explain why the HINTS test should have been performed.
The Law Offices of Jorge L. Flores, P.A. has handled brainstem stroke cases against Baptist Health South Florida, Jackson Memorial Hospital, HCA Florida Kendall Hospital, and other major healthcare systems throughout Miami-Dade County. We maintain relationships with board-certified neurologists, neuroradiologists, emergency medicine specialists, and life care planners. These experts provide the testimony necessary to prove complex cases.
We limit our caseload so every client receives personalized attention from Attorney Flores directly. You won’t be passed off to a paralegal or junior associate. Our firm operates on a contingency fee basis, meaning you pay no attorney fees unless we recover compensation for your family.
We understand the cultural dynamics of Miami’s diverse communities and provide complete legal services in English, Spanish, and Portuguese. When your family is facing the overwhelming challenge of caring for a loved one with locked-in syndrome, you deserve an attorney who treats you like family while fighting aggressively to secure the resources needed for lifetime care.
Frequently Asked Questions About Brainstem Stroke Malpractice
Can I sue if my family member’s stroke was misdiagnosed as vertigo?
In Florida, emergency room misdiagnosis of brainstem stroke as an inner ear problem may constitute medical malpractice when the physician fails to perform appropriate diagnostic testing. The standard of care requires physicians to consider stroke in dizzy patients with vascular risk factors and to perform the HINTS examination to differentiate central from peripheral causes of vertigo.
What is the HINTS test and why does it matter for my case?
The HINTS test is a bedside examination that identifies stroke in patients with acute vertigo more accurately than early MRI. According to research published in Stroke journal, the HINTS examination was 100% sensitive for detecting posterior circulation stroke. It evaluates Head Impulse response, Nystagmus patterns, and Test of Skew eye alignment. When an ER physician fails to perform this test and instead relies solely on a CT scan, that omission may breach the standard of care.
How long do I have to file a brainstem stroke malpractice lawsuit in Florida?
In Florida, there is a two-year statute of limitations from discovery of the injury and a four-year statute of repose from the date of the incident. Given these strict deadlines and the extensive pre-suit investigation required by Florida law, you should consult with an attorney as soon as you suspect malpractice occurred.
Can I sue both the ER doctor and the radiologist?
In Florida, liability in brainstem stroke cases is often shared between multiple defendants. The emergency physician who failed to consider stroke in the differential diagnosis and the radiologist who missed findings on imaging studies may both be liable. The hyperdense basilar sign, which indicates a clot in the basilar artery, is frequently overlooked on CT scans. The Law Offices of Jorge L. Flores, P.A. examines all potential defendants to maximize recovery.
What damages can a locked-in syndrome victim recover in Florida?
In Florida, locked-in syndrome victims can recover both economic damages for lifetime care exceeding $20 million and non-economic damages for pain and suffering without damage caps. Economic damages include nursing costs, equipment, home modifications, and lost earning capacity. Florida has no damage caps in medical malpractice cases following the 2017 Supreme Court ruling, so juries can award full compensation.
My loved one had a stroke after a chiropractic adjustment. Is that malpractice?
Vertebral artery dissection following cervical manipulation is a recognized complication that can lead to brainstem stroke. If the chiropractor failed to screen for risk factors, performed inappropriate techniques, or failed to recognize stroke symptoms after treatment, that may constitute malpractice. If the patient sought emergency care afterward and the ER missed the dissection, the hospital may share liability.
What is the tPA window and why is it important?
TPA, or tissue plasminogen activator, is a clot-dissolving medication that must be administered within 3 to 4.5 hours of stroke symptom onset to be effective. Delays in triage, imaging, or diagnosis that push the patient outside this treatment window rob them of their chance for intervention. Delays in stroke code activation are a common basis for malpractice claims in Florida.
Why was my family member’s CT scan negative if they were having a stroke?
Standard CT scans are unreliable for detecting ischemic strokes in the brainstem during the early hours. The bone at the skull base creates artifacts that obscure the posterior fossa. A negative CT does not rule out basilar artery occlusion. The standard of care often requires MRI with diffusion-weighted imaging or CT angiography to visualize the blood vessels directly.
Can I file a lawsuit if my family member died from a brainstem stroke?
In Florida, wrongful death law allows surviving family members to pursue claims for medical expenses, funeral costs, lost financial support, and loss of companionship. The same two-year statute of limitations applies. The Law Offices of Jorge L. Flores, P.A. handles wrongful death claims arising from delayed stroke diagnosis and treatment failures.
How much does it cost to hire a brainstem stroke malpractice attorney?
The Law Offices of Jorge L. Flores, P.A. handles medical malpractice cases on a contingency fee basis. You pay no attorney fees unless we recover compensation for your family. We also advance the costs of medical experts, life care planners, and other expenses necessary to build your case. There is no financial risk to you.
Contact Our Miami Brainstem Stroke Malpractice Attorneys
If your loved one suffered locked-in syndrome or permanent injury from a brainstem stroke that was misdiagnosed or treated too late, The Law Offices of Jorge L. Flores, P.A. can help you understand your legal options. We offer free consultations to families throughout Florida who believe medical negligence contributed to their loved one’s catastrophic injury.
Call (305) 598-2221 today to speak with a Miami medical malpractice attorney who has the experience, resources, and determination to pursue justice for brainstem stroke victims. You can also visit our office at 7700 N Kendall Dr #708, Miami, Florida 33156.
Do not wait. Florida’s statute of limitations strictly limits the time you have to file a claim. Every day of delay is a day the evidence fades and your legal rights erode. Contact us now to schedule your free case evaluation.
The information on this page is for general informational purposes only and does not constitute legal advice.
Page reviewed and updated: January 2026
Medical content reviewed for accuracy by consulting neurologist.
Call (305) 598-2221 today to speak with a Miami medical malpractice attorney who has the experience, resources, and determination to pursue justice for brainstem stroke victims. You can also visit our office at 7700 N Kendall Dr #708, Miami, Florida 33156.
Do not wait. Florida’s statute of limitations strictly limits the time you have to file a claim. Every day of delay is a day the evidence fades and your legal rights erode. Contact us now to schedule your free case evaluation.
The information on this page is for general informational purposes only and does not constitute legal advice.
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Who created this content: This page was written by Jorge L. Flores, P.A., Florida Bar Member 53244, and was reviewed by our legal team for accuracy and compliance with current Florida law. AV Preeminent® rating since 2015. Also Featured as top lawyer on FindLaw.
How this page was prepared: The content was developed based on 30+ years of medical malpractice case experience in Miami-Dade County, a review of current Florida statutes, and adherence to Florida Bar advertising guidelines. Medical standards referenced were verified with board certified physicians.
Why this page exists: To provide Florida residents with accurate, accessible information about their legal rights after medical negligence, and to explain the malpractice claims process in clear, understandable terms.
Last reviewed: 01 / 18 / 2026
Disclaimer: This content is for informational purposes regarding legal rights. It does not constitute medical or legal advice. Each case is unique. Results depend on the specific facts and law applicable to your situation. No attorney client relationship is formed until a fee agreement is signed.
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