Brent M. Bredhold v. State of Indiana
CourtIndiana Court of Appeals
Date FiledOctober 30, 2026
Docket25A-CR-02899
JudgeJudge Pyle
StatusPublished
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Full Opinion
Pursuant to Ind. Appellate Rule 65(E), the trial court and parties shall not take any
action in reliance upon this Opinion until it is certified.
IN THE
Court of Appeals of Indiana
Brent M. Bredhold, FILED
Oct 30 2026, 9:00 am
Appellant-Defendant
CLERK
Indiana Supreme Court
Court of Appeals
and Tax Court
v.
State of Indiana,
Appellee-Plaintiff
October 30, 2026
Court of Appeals Case No.
25A-CR-2899
Appeal from the Vanderburgh Circuit Court
The Honorable Ryan D. Hatfield, Judge
Trial Court Cause No.
82C01-2408-F1-5079
Opinion by Judge Pyle
Judges May and Scheele concur.
Court of Appeals of Indiana | Opinion 25A-CR-2899 | October 30, 2026 Page 1 of 18
Pyle, Judge.
Statement of the Case
[1] After twelve-year-old A.B. (“A.B.”) died from diabetic ketoacidosis (“DKA”),1
the State charged her father, Brent Bredhold (“Bredhold”), with Level 1 felony
neglect of a dependent. A jury convicted Bredhold of the lesser included
offense of Level 3 felony neglect of a dependent.2 Bredhold now appeals and
argues that the trial court abused its discretion in admitting certain evidence.
Concluding that any error in the admission of certain evidence was harmless,
we affirm Bredhold’s conviction.
[2] We affirm.
Issue
Whether the trial court abused its discretion in admitting certain
evidence.
1
DKA “is the medical condition of insufficient insulin.” (Tr. Vol. 2 at 99).
2
IND. CODE § 35-46-1-4.
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Facts
[3] The facts most favorable to the judgment reveal that forty-year-old Bredhold
and his wife (“Mother”) are the parents of daughter A.B., who was born in
October 2011.3 In March 2020, when A.B. was eight years old, she was
diagnosed with type 1 diabetes.
[4] Following her diagnosis, A.B. and her parents were provided with education
about the disease. Specifically, diabetes is an autoimmune disease wherein the
body’s immune system creates antibodies that attack the insulin-producing cells
in the pancreas. Insulin is an important hormone because it helps the body use
sugar as an energy source. If the body lacks the necessary amount of insulin,
the sugar sits in the blood and causes high blood sugar. In addition, if the body
cannot use sugar as an energy source, the body turns its attention to alternative
sources of energy, including fat tissue. When fat tissue is broken down to be
used as an energy source, it leaves behind acids, which are called ketones. As
the ketones build up in the blood, a diabetic is at risk of developing DKA,
which is potentially fatal.
[5] A.B. and her family were also provided with education regarding how to
manage A.B.’s diabetes. Specifically, to manage her diabetes, A.B. needed to
take insulin, including long-acting insulin (“long-acting insulin”), which is
3
Bredhold and Mother are also the parents of a teenaged son (“A.B.’s Brother”) and a three-year-old
daughter.
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taken once a day, and rapid-acting insulin (“rapid-acting insulin”), which is
taken multiple times a day.
[6] Long-acting insulin lasts for about twenty-four hours and is taken at the same
time each day. The purpose of long-acting insulin is to provide a “sprinkle of
insulin in the body at all times because all of us, our own body is constantly
making a little bit of insulin to keep our blood sugars steady.” (Tr. Vol. 2 at
132). Long-acting insulin is “very important[,]” and it is “absolutely necessary”
to take it every day. (Tr. Vol. 2 at 133). Most diabetic children take it in the
evening. If a child misses several days of long-acting insulin, her blood sugars
are probably chronically high, and chronically high blood sugars can lead to
organ damage and death.
[7] Rapid-acting insulin works more quickly and has a higher peak effect. Further,
rapid-acting insulin mimics the body’s natural process of lowering blood sugar
following the consumption of carbohydrates. In addition, rapid-acting insulin is
used to correct for an elevated blood sugar by bringing higher blood sugar back
down into a target range.
[8] During the diabetes management education sessions, A.B. and her parents
learned how to check A.B.’s blood sugar, how to count carbohydrates, how to
determine how much insulin A.B. needed to take to cover for carbohydrates
and correct for an elevated blood sugar, and how to check A.B.’s urine for
ketones. A.B. and her parents also learned that the target for A.B.’s
hemoglobin A1C, which is the average blood sugar for a three-month period,
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was 7% or lower. Further, the goal for A.B.’s blood sugar was 70 to 180.
A.B.’s parents were included in the education process because A.B., who was a
child, needed parental supervision. Specifically, because management of
diabetes is complicated, it was important for A.B.’s parents to supervise her
care.
[9] In sum, during the education process, A.B. and her family learned that A.B.
needed to take long-acting insulin every night. They also learned that A.B.
needed to check her blood sugar a minimum of four times each day, including
at mealtimes and before bedtime, and to count carbohydrates before each meal
to determine how much rapid-acting insulin she needed to take. Specifically,
before each meal, eight-year-old A.B. needed to determine how many
carbohydrates she was going to eat at the meal, and she had to take one unit of
insulin for every fourteen carbohydrates. For example, if A.B. was going to eat
ninety-eight grams of carbohydrates for breakfast, she had to divide ninety-eight
(the number of carbohydrates) by fourteen to determine the number of units of
insulin that she needed to take. Under this scenario, she would need to take
seven units of insulin (ninety-eight divided by fourteen). In addition, if her
blood sugar was high, she also had to calculate a correction dose of insulin.
The formula for a blood sugar correction is to subtract 120 from the current
blood sugar and divide that figure by fifty. Thus, if her blood sugar was 500,
she would have to subtract 120, which would be 380. Then she would have to
divide the 380 by fifty, which would be 7.6. She would then have to round up
that 7.6 to eight units of insulin. Thereafter, A.B. had to add the seven units of
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insulin for the carbohydrates to the eight units of insulin necessary for the
correction dose, which would result in an insulin dose of fifteen units. These
calculations had to be made before every meal.
[10] Following A.B.’s diagnosis, in August 2020, A.B. and her family met with
pediatric endocrinologist Dr. Eric Chang (“Dr. Chang”). During the meeting,
Dr. Chang reviewed type 1 diabetes with A.B. and her family and emphasized
the importance of maintaining well-controlled diabetes for both short-term and
long-term health. At that time, A.B. was experiencing the honeymoon period
(“the honeymoon period”) of diabetes. Specifically, during the honeymoon
period, it is easier to control diabetes because the body is likely to still have a
little bit of insulin left. And, as the child begins to receive insulin, the leftover
insulin in the body is also released, and blood sugars are much more within the
goal range. At the time of A.B.’s initial visit with Dr. Chang, her hemoglobin
A1C was 6%.
[11] Following the August 2020 visit, Dr. Chang referred A.B. and her family to
Megan Brown, the nurse practitioner in Dr. Chang’s Evansville office (“NP
Brown”), for follow-up education and monitoring of A.B.’s diabetes.
Specifically, A.B. met with NP Brown every three months so that NP Brown
could check A.B.’s hemoglobin A1C. Bredhold accompanied A.B. to every
office visit. During the visits, NP Brown also spent time re-educating A.B. and
Bredhold on the management of A.B.’s diabetes. At every visit, NP Brown
specifically discussed the importance of A.B. not missing any insulin injections,
including the long-acting insulin injections, which are “kind of like that
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lifeline.” (Tr. Vol. 2 at 190). NP Brown also reviewed with A.B. and Bredhold
the necessary calculations for determining how much rapid-acting insulin A.B.
needed at mealtimes. Because A.B. was not always able to correctly calculate
her rapid-acting insulin dosages, NP Brown reminded Bredhold that he needed
to supervise A.B.’s calculations. In addition, NP Brown reviewed with A.B.
and Bredhold the long term effects of high blood sugar on the body, including
damage to organs and DKA, which could be life-threatening.
[12] In early 2021, following the honeymoon period, NP Brown began to see a rise
in A.B.’s hemoglobin A1C. Specifically, in 2021 and 2022, A.B.’s hemoglobin
A1C was 9%. A.B. told NP Brown that she was not taking her long-acting
insulin once or twice a week. NP Brown attempted to strategize with Bredhold
ways to remind A.B. to take her long-acting insulin, such as setting alarms and
parental supervision. In addition, NP Brown emphasized to Bredhold the
importance of a parent supervising the management of A.B.’s diabetes because
A.B. lacked the consistent ability to properly calculate her doses of insulin.
[13] In June 2023, A.B.’s hemoglobin A1C increased to 11.2%, which suggested that
A.B. “live[d] chronically at a high blood sugar[,]” and was at a higher risk of
DKA. (Tr. Vol. 2 at 153). In October 2023, A.B. and her family were referred
to a pediatric psychologist, Dr. Sandy Bowersox (“Dr. Bowersox”), to establish
routines so that A.B. could better manage her diabetes.
[14] In November 2023, Dr. Bowersox met with twelve-year-old A.B. and Bredhold,
who both identified that it was difficult for A.B. to remember to take her long-
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acting insulin at night. From November 2023 through early July 2024, Dr.
Bowersox had thirteen outpatient visits with A.B., and Bredhold attended
twelve of those visits. Dr. Bowersox worked with A.B. and Bredhold to
establish a bedtime routine to include A.B. setting aside her cell phone, taking
her long-acting insulin, and getting to bed at a reasonable hour. Specifically,
Dr. Bowersox recommended that at 8:30 p.m., A.B. and a parent participate in
a brief family activity to signal the beginning of the bedtime routine, which
would include brushing her teeth, taking a shower, putting on her pajamas, and
taking her long-acting insulin before going to bed. In addition, Dr. Bowersox
suggested that A.B. choose a reward, such as being able to watch a video on her
cell phone, for completing the bedtime routine, including taking her long-acting
insulin.
[15] During the ensuing months, A.B. twice arrived at her appointments with Dr.
Bowersox with a self-reported blood sugar of greater than 600. In addition,
A.B. reported to Dr. Bowersox that she was having “a lot of negative symptoms
related to her diabetes.” (Tr. Vol. 2 at 234). Bredhold “was always very
attentive and listening to A.[B.], and . . . he expressed . . . empathy that he felt
bad that she had to feel bad in that way.” (Tr. Vol. 2 at 234). However, during
the course of their visits with Dr. Bowersox, A.B. and Bredhold did not
demonstrate success in establishing a routine to better manage A.B.’s diabetes.
[16] In addition to meeting regularly with NP Brown and Dr. Bowersox, during the
2023-24 academic year, when twelve-year-old A.B. was in the sixth grade, she
met twice daily with school nurse Debra Seib (“Nurse Seib”). Specifically, A.B.
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met with Nurse Seib every morning when she got to school so that Nurse Seib
could check A.B.’s blood sugar before A.B. had breakfast at school. A.B. and
Nurse Seib would then calculate the carbohydrates that A.B. was going to eat
for breakfast and determine her insulin dose based on her blood sugar and the
carbohydrates that she was planning to eat. At lunch time, A.B. returned to
Nurse Seib’s office to check her blood sugar, calculate the carbohydrates that
she was going to eat for lunch, and again determine her insulin dose based on
her blood sugar and the carbohydrates that she was planning to eat.
[17] Generally, Nurse Seib calculated the insulin dose and had A.B. go over
calculations with her. Because A.B. had difficulty doing the calculations, Nurse
Seib got her a calculator, and they would use their calculators together.
However, even with the calculator and daily practice, A.B. “had difficulty
doing the math.” (Tr. Vol. 3 at 13).
[18] During the spring of 2024, Nurse Seib was concerned that more often than not
A.B. arrived at school with an elevated blood sugar, which was typically greater
than 300. Specifically, Nurse Seib was concerned that A.B. was not taking her
long-acting insulin at night. When Nurse Seib asked A.B. if she had taken her
long-acting insulin the previous night, A.B. would say that she did not know.
In addition, Nurse Seib was concerned that A.B. reported that she frequently
stayed up late at night and only got a couple hours of sleep. When Nurse Seib
asked A.B. if she had eaten snacks during the night, A.B. responded that she
could not remember. Nurse Seib was concerned because if A.B. had eaten late
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night snacks, she would have needed to cover those carbohydrates with a dose
of insulin.
[19] Based on her concerns, Nurse Seib sometimes tested A.B.’s urine for ketones.
If the ketones were high, Nurse Seib would contact Bredhold, who was the
parent at home during the day, and ask him to pick up A.B. from school.
Specifically, Nurse Seib explained to Bredhold that she was concerned about
A.B.’s elevated blood sugar damaging her body. When Nurse Seib asked
Bredhold if A.B. had taken her long-acting insulin the previous night, Bredhold
“just kind of look[ed] at [her][,]” and she never got an answer. (Tr. Vol. 3 at
18). Nurse Seib emphasized to Bredhold that, at a minimum, he needed to
contact Dr. Chang and let Dr. Chang know that A.B.’s blood sugar was
elevated in the mornings.
[20] Nurse Seib also explained her concerns to A.B. Specifically, Nurse Seib told
A.B. that she needed to be sure to take her long-acting insulin every night. In
addition, when Nurse Seib asked A.B. if a parent was supervising her insulin,
“[i]t became pretty apparent that . . . she . . . had no adult supervision with her
insulin whatsoever.” (Tr. Vol. 3 at 21).
[21] On July 4, 2024, an Evansville Police Department officer (“the officer”), who
had been dispatched to the Bredholds’ home for an unresponsive child,
discovered that A.B. was deceased. A.B.’s Brother told the officer that the last
time that he had seen A.B. alive had been the previous night between 9:00 and
10:00 p.m. when the family had eaten dinner. According to A.B.’s Brother, he
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had checked on A.B. at 3:00 p.m. that day and had seen her sleeping on the
floor. When she had not woken up by 5:00 p.m., he and Mother had tested
A.B.’s blood sugar, given her insulin, and realized that she was not breathing.
Bredhold was working out of town when A.B. passed away.
[22] Forensic pathologist Dr. James Jacobi (“Dr. Jacobi”) performed A.B.’s
autopsy. During the autopsy, Dr. Jacobi observed that A.B.’s liver was four
times its normal size and bright yellow. According to Dr. Jacobi, when a
diabetic fails to take insulin, the diabetic’s blood sugar rises, and, as the body
tries to process the extra sugar, the liver gets larger over a period of months or
years. In addition, when looking at A.B.’s liver under a microscope, Dr. Jacobi
noticed that A.B.’s liver contained glycogen, or sugar, which would indicate
that A.B. was “a chronic diabetic with significant out of control diabetes.” (Tr.
Vol. 2 at 96). In addition, Dr. Jacobi also observed that A.B.’s heart was twice
its normal size. According to Dr. Jacobi, poorly managed diabetes impairs the
function of the heart, and the heart “tries to compensate by getting bigger to try
to overcome its poorer function.” (Tr. Vol. 2 at 99).
[23] Dr. Jacobi determined that A.B.’s cause of death was DKA, “which is the
medical condition of insufficient insulin.” (Tr. Vol. 2 at 99). Further,
according to Dr. Jacobi, A.B.’s enlarged liver and enlarged heart, which
“represent[ed] chronic problems of diabetes[,]” were also contributing factors to
her death. (Tr. Vol. 2 at 100). In other words, A.B.’s enlarged liver and
enlarged heart “made it more difficult for her body to fight off the DKA[.]” (Tr.
Vol. 2 at 100). Further, a post-mortem lab report revealed that A.B.’s
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hemoglobin A1C was 10.5% and her blood sugar was 500. A hemoglobin A1C
of 10% indicates that a child “has uncontrolled diabetes where [she is]
persistently living at a blood sugar that is higher than the target range.” (Tr.
Vol. 2 at 145).
[24] In August 2024, the State charged Bredhold with Level 1 felony neglect of a
dependent resulting in death. Specifically, the charging information alleged
that Bredhold had knowingly placed A.B. in a situation that had endangered
her life and health and that had resulted in her death.
[25] On September 9, 2025, Bredhold filed a motion in limine, wherein he asked the
trial court to exclude, pursuant to Evidence Rule 404(b), evidence of his prior
bad acts.4 The motion did not specify the prior bad acts that he was seeking to
exclude from evidence. That same day, the State filed a motion in limine and a
memorandum of law “in support of admission of evidence relating to [A.B.’s]
prior hospitalizations.” (App. Vol. 2 at 62) (capitalization removed). At a
hearing on the motions in limine, the State asked the trial court to allow it to
admit evidence of A.B.’s prior hospitalizations, including three hospitalizations
in 2022, two hospitalizations in 2023, and one hospitalization in 2024.
Specifically, the State argued that evidence of A.B.’s prior hospitalizations went
4
Pursuant to Evidence Rule 404(b), evidence of “a crime, wrong, or other act is not admissible to prove a
person’s character in order to show that on a particular occasion the person acted in accordance with the
character.” Evid. R. 404(b)(1). But such evidence “may be admissible for another purpose, such as proving
motive, opportunity, intent, preparation, plan, knowledge, identity, absence of mistake, or lack of accident.”
Evid. R. 404(b)(2).
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“to knowledge because of [Bredhold], having gone through all of these
hospitalizations, should have realized that A.[B.] had . . . uncontrolled diabetes
and had consistently high blood sugars that put her at a greater risk of entering
into a diabetic ketoacidosis event that would kill her.” (Tr. Vol. 2 at 37).
Bredhold responded that there was “a lot of other evidence available to the
State to prove knowledge of the education as to the care and control of A.[B.]’s
diabetes that ha[d] nothing to do with the particular hospitalizations.” (Tr. Vol.
2 at 38-39).
[26] Thereafter, the trial court told the State that it was not to “elicit testimony of
prior hospitalizations to show a pattern of behavior and/or actions from
[Bredhold].” (Tr. Vol. 2 at 41). The trial court explained that Bredhold’s
“point and concern [was] well[-]taken that this particular issue cut[] very close
to being able to allow [the State] to argue bad acts and/or argue the subsequent
hospitalizations necessarily le[]d to bad actions of [Bredhold]. The Court
believe[d] that would be a violation of 404[(b)][.]” (Tr. Vol. 2 at 41). However,
the trial court further found that evidence of A.B.’s prior hospitalizations would
be admissible pursuant to the knowledge, absence of mistake, and lack of
accident exceptions to Evidence Rule 404(b).
[27] During a three-day trial in September and October 2025, the jury heard the facts
as set forth above during the testimony of Dr. Chang, NP Brown, Dr.
Bowersox, and Nurse Seib. In addition, during the trial, Dr. Chang testified
that A.B. had been hospitalized three times in 2022 for high blood sugar and
DKA, two times in 2023, once for severe constipation and once for pancreatitis,
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and one time in 2024 for high blood sugar. According to Dr. Chang, Bredhold
was present for all of A.B.’s hospitalizations. In addition, Dr. Wendy
Woodword testified that she had treated A.B. when A.B. was hospitalized in
October 2023 and that she had referred A.B. to Dr. Bowersox. Further, Dr.
Bowersox testified that A.B. had been referred to her while A.B. was
hospitalized in October 2023.
[28] The jury convicted Bredhold of the lesser-included offense of Level 3 felony
neglect of a dependent resulting in serious bodily injury. Following a
sentencing hearing, the trial court sentenced Bredhold to nine (9) years in the
Department of Correction.
[29] Bredhold now appeals.
Decision
[30] Bredhold argues that the trial court abused its discretion when it admitted
certain evidence. He specifically contends that “the trial court abused its
discretion by allowing the admission of A.B.’s prior hospitalizations and
evidence of Bredhold’s failure to control A.B.’s diabetes because this evidence
constitutes classic propensity evidence prohibited by Indiana Evidence Rule
404(b).” (Bredhold’s Br. 5) (emphasis removed).
[31] As a preliminary matter, we note that, as set forth above, both before and
during the trial, Bredhold objected to evidence of A.B.’s prior hospitalizations.
However, he did not object to other evidence of Bredhold’s failure to control
A.B.’s diabetes. Indeed, at the hearing on the motions in limine, Bredhold
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specifically told the trial court that there was “a lot of other evidence available
to the State to prove knowledge of the education as to the care and control of
A.[B.]’s diabetes that have nothing to do with the particular hospitalizations.”
(Tr. Vol. 2 at 38-39).
[32] This Court has previously explained that “[a]ny grounds for objections not
raised at trial are not available on appeal, and a party may not add to or change
his grounds in the reviewing court.” Hunter v. State, 72 N.E.3d 928, 932 (Ind.
Ct. App. 2017), trans. denied. A claim of evidentiary error must first be
presented to the trial court “in order to permit consideration of the objection
and appropriate corrective action by the trial court.” Id. Because Bredhold did
not object at trial to the evidence of his failure to manage A.B.’s diabetes, the
trial court had no opportunity to rule on its admissibility. Therefore, Bredhold
has waived appellate review of this argument. See id. (concluding that the
defendant waived appellate review of an evidentiary argument that he had not
raised at trial). Further, Bredhold has waived review of this issue for
fundamental error because he did not argue fundamental error in his appellate
brief. See Tandy v. State, 273 N.E.3d 1148, 1157 (Ind. Ct. App. 2025)
(explaining that the defendant waived review of his evidentiary issue for
fundamental error because he did not argue fundamental error in his appellate
brief), trans. denied.
[33] We now turn to Bredhold’s argument that the trial court abused its discretion
when it admitted evidence of A.B.’s prior hospitalizations. Bredhold
specifically contends that although the trial court determined that evidence of
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A.B.’s prior hospitalizations was admissible pursuant to the knowledge, absence
of mistake, and lack of accident exceptions to Evidence Rule 404(b), none of
those exceptions applied because he did not put his state of mind at issue.
[34] The admission or exclusion of evidence is within the sound discretion of the
trial court, and we will reverse only for an abuse of that discretion. Russell v.
State, 234 N.E.3d 829, 858 (Ind. 2024), cert. denied. A trial court abuses its
discretion if its decision is clearly against the logic and the effect of the facts and
circumstances before the court. Id.
[35] Here, however, we need not determine whether the trial court abused its
discretion when it admitted evidence of A.B.’s prior hospitalizations because
any error in the admission of this evidence was harmless. The basic premise of
the harmless error rule is “that a conviction may stand when the error had no
bearing on the outcome of the case.” Durden v. State, 99 N.E.3d 645, 652 (Ind.
2018). Under Indiana Appellate Rule 66(A), an error is harmless “where its
probable impact, in light of all the evidence in the case, is sufficiently minor so
as not to affect the substantial rights of the parties.” Under this probable impact
test, Bredhold bears the burden of demonstrating how “the error’s probable
impact undermines confidence in the outcome of the proceeding below.”
Hayko v. State, 211 N.E.3d 483, 492 (Ind. 2023), reh’g denied, cert. denied. In
determining whether Bredhold has met his burden, we consider the likely
impact of improperly admitted evidence on a reasonable, average jury
considering all evidence in the case. See id. If substantial independent evidence
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of guilt exists and our confidence in the outcome is not undermined, the error is
harmless. Id.
[36] Here, Bredhold cannot meet his burden on this record. Specifically, our review
of the evidence reveals that during a three-day trial, the jury heard a plethora of
evidence that twelve-year-old A.B. was unable to manage her diabetes as shown
by her chronically high hemoglobin A1C and her inability to calculate her
insulin doses without supervision. In addition, the jury heard evidence that
Bredhold knew that A.B. was unable to manage her diabetes, that medical
providers had repeatedly warned him that A.B. needed parental supervision to
manage her diabetes, and that a failure to manage A.B.’s diabetes could result
in her death.
[37] Bredhold does not provide any reason to believe that evidence of A.B.’s prior
hospitalizations “would have moved the needle.” Russell, 234 N.E.3d at 859
(concluding that appellant had provided no reason to believe that his proffered
evidence “would have moved the needle”). In other words, in light of all the
evidence in this case, the probable impact of any possible error in admitting the
challenged evidence is sufficiently minor so as not to undermine our confidence
in the outcome of this case. See Hayko, 211 N.E.3d at 492. Thus, even if the
trial court had erred in admitting into evidence A.B.’s history of prior
hospitalizations, the error would be harmless. See id.
[38] Affirmed.
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May, J., and Scheele, J., concur.
ATTORNEY FOR APPELLANT
Matthew J. McGovern
Fishers, Indiana
ATTORNEYS FOR APPELLEE
Theodore E. Rokita
Attorney General of Indiana
Caroline G. Templeton
Assistant Section Chief, Criminal Appeals
Indianapolis, Indiana
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