Background
Brent Bredhold’s daughter, A.B., was diagnosed with type 1 diabetes at age eight. Her treatment team repeatedly taught the family that she could not miss insulin, that she needed adult help calculating doses, and that prolonged high blood sugar could cause life-threatening diabetic ketoacidosis. Bredhold attended regular appointments. As A.B.’s control worsened, providers suggested alarms, direct parental supervision, a structured bedtime routine, and rewards for taking long-acting insulin.
By 2023, A.B.’s hemoglobin A1C showed chronically high blood sugar, and she sometimes reported readings above 600. School personnel and clinicians continued warning that she could not safely manage the disease alone. She nevertheless died from diabetic ketoacidosis at age twelve. The State charged Bredhold with Level 1 felony neglect of a dependent, and a jury convicted him of the lesser included Level 3 felony offense resulting in serious bodily injury. He received a nine-year sentence.
Before and during trial, Bredhold objected to evidence that A.B. had previously been hospitalized for high blood sugar and related conditions. The trial court permitted the evidence under Evidence Rule 404(b) for knowledge, absence of mistake, and lack of accident, while barring the State from using the hospitalizations simply to portray a pattern of bad parental conduct. On appeal, Bredhold also challenged broader evidence of his failure to manage the diabetes.
The Court’s Holding
The Indiana Court of Appeals affirmed. Judge Pyle first held that Bredhold had waived his broader challenge. He objected to the hospitalization evidence, but not to other testimony about inadequate diabetes management. Indeed, he had told the trial court that the State possessed considerable non-hospital evidence of his knowledge. A party cannot change or add evidentiary grounds on appeal, and Bredhold did not separately argue fundamental error.
The panel did not decide whether admitting the prior hospitalizations violated Rule 404(b). Instead, it held that any error was harmless under Indiana Appellate Rule 66(A). The question was whether the evidence probably affected substantial rights when considered with the entire record, with Bredhold bearing the burden to show an impact that undermined confidence in the verdict.
Extensive independent evidence supported the jury’s decision. Providers testified that A.B. was unable to manage insulin reliably, that Bredhold knew she needed supervision, and that he received repeated instruction about missed doses and the lethal danger of diabetic ketoacidosis. The jury also heard about chronically elevated readings, unsuccessful efforts to build routines, and warnings from multiple professionals. Against that record, references to earlier hospitalizations were unlikely to drive an average jury’s result. The conviction therefore stood without resolving the precise 404(b) boundary.
Key Takeaways
- An evidentiary objection preserves only the grounds actually presented to the Indiana trial court.
- A party who does not preserve an objection must distinctly argue fundamental error to obtain that form of review.
- An appellate court may affirm without deciding admissibility when substantial independent evidence makes any assumed error harmless.
- Under the probable-impact test, the appellant must explain why the challenged evidence undermines confidence in the outcome as a whole.
Why It Matters
For Indiana criminal practitioners, the opinion is primarily a preservation and harmless-error decision. Counsel confronting Rule 404(b) material should identify each category of challenged proof, renew objections when the evidence is offered, and explain the unfair inference the jury may draw. A motion in limine alone will not necessarily preserve related testimony admitted without objection.
The case also illustrates why appellate briefing must address probable impact, not simply show that evidence might have been inadmissible. When numerous witnesses establish the same knowledge and risk through unchallenged testimony, reversal becomes difficult. Prosecutors defending a verdict should map that independent evidence element by element; defense counsel should explain why the disputed proof added a qualitatively different and prejudicial narrative.
Because the panel assumed error without deciding the Rule 404(b) question, practitioners should not read the opinion as blanket approval for evidence of a dependent’s earlier medical crises. The admissibility analysis remains fact-specific, including the purpose for which the State offers the evidence and whether that purpose is genuinely disputed.