STATE OF INDIANA ) 

) SS: 

COUNTY OF ST. JOSEPH ) 

KEITH BIXLER, as Special Personal 

Representative of the ESTATE OF 

PAULA BIXLER, DECEASED, 

c/o Chester Law Office 

230 North Main Street, Suite 2 

P.O. Box 1768 

Elkhart, IN 46515-1768 

Plaintiff, 

v. 

IN THE ST. JOSEPH CIRCUIT/SUPERIOR COURT 

CAUSE NO.: 71 ()85 -1608-CT-0()0 35C/ 

HCR MANORCARE MEDICAL SERVICES 

OF FLORIDA, LLC d/b/a 

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HEARTLAND HOSPICE, 

c/o CT Corporation System, 

Its Registered Agent 

150 W. Market Street, Suite 800 

Indianapolis, IN 46204 

-andELKHART OPERATING, LLC d/b/a 

GOLDEN LIVINGCENTER-ELKHART, 

c/o Corporation Service Company, 

Its Registered Agent 

251 E. Ohio Street, Suite 500 

Indianapolis, IN 46204 

Defendants. 

COMPLAINT FOR RECOVERY OF DAMAGES DUE TO WRONGFUL DEATH, 

FOR PERSONAL INJURIES. AND REQUEST FOR TRIAL BY JURY 

COMES NOW Plaintiff, Keith Bixler, in his capacity as Special Personal Representative of 

the Estate of Paula Bixler, deceased, and for his Complaint for Damages, alleges as follows: 

1. On December 14, 2015, by Order of the Elkhart Superior Court No. 2, under Cause 

No. 20D02-1512-ES-00071 , Keith Bixler was appointed as Special Personal Representative of the 

USDC IN/ND case 3:16-cv-00616-MGG document 5 filed 08/11/16 page 1 of 8
estate of his wife, Paula Bixler, deceased, and in such capacity brings this cause of action against 

Defendants. 

2. At all times relevant to this case, the decedent, Paula Bixler, was a citizen of the 

United States of America, State of Indiana, and resided in Elkhart, Indiana. Heartland Hospital home 

health care treated her in her home and she eventually became a resident at Golden LivingCenterElkhart. 

3. At all times relevant to this case, Defendants owned, operated, controlled and 

maintained their facilities. Heartland Hospice is located at 230 West Catalpa Drive, Mishawaka, 

Indiana 46545. Golden LivingCenter-Elkhart is located at 1001 West Hively Avenue, Elkhart, 

Indiana 4651 7. 

4. On February 2, 2015, Paula Bixler resided at home with her husband. Heartland 

Hospice home health care program was retained to help aid her husband in caring for Paula's 

multiple medical issues including paraplegia, morbid obesity and COPD. 

5. Records from Heartland Hospice indicate that a Stage I and/or II pressure ulcer on 

Paula's coccyx was noted on February 13, 2015. By February24,2015, Heartland Hospice records 

indicate that the same pressure ulcer first identified on February 13, 2015 was noted be a solid Stage 

II, but it was resolving and there were no open areas. 

6. Additional Heartland Hospice records dated March 3, 2015 to March 17, 2015 

continue to address Paula's coccyx area. These records describe Paula's skin conditions during this 

period as being reddened, blanchable, mild excoriation, and an open area had developed on her right 

buttock. 

-2-

USDC IN/ND case 3:16-cv-00616-MGG document 5 filed 08/11/16 page 2 of 8
7. Paula's husband, Keith Bixler, suffered a heart attack in early 2015, as a result of 

which he could no longer assist Paula. Consequently, the decision was made to transfer Paula to a 

skilled nursing facility, and she was transferred and admitted as a patient at Golden LivingCenterElkhart on March 26, 2015. 

8. Shortly after Paula's admission to Golden LivingCenter-Elkhart, its nursing staff 

created a Minimum Data Set record that noted she was a high risk for pressure ulcers. However, 

these records generated at the time of Paula's admission failed to identify any pressure ulcers or other 

skin abnormalities. Golden LivingCenter-Elkhart' s nursing staff created another Minimum Data Set 

record in June 2015, and once again that record failed to identify any pressure ulcers or other skin 

abnormalities on Paula Bixler's body. 

9. On or about August 10, 2015, Golden LivingCenter-Elkhart's nursing staff created 

yet another Minimum Data Set record and noted for the first time a pressure ulcer in the area of 

Paula's coccyx. That record described Paula's pressure ulcer as "unstageable," and it measured 4.0 

cm in length and 2.5 cm in width. 

10. Paula Bixler was taken to the emergency department at Elkhart General Hospital on 

August 10, 2015 for a low grade fever she had experienced for two to three days, which had spiked 

to I 02° the prior night. She was lethargic, restless, confused, and agitated. She was diagnosed by 

Elkhart General Hospital medical staff as having a Stage IV decubitus ulcer to her sacrum with foulsmelling drainage. 

11. Paula underwent debridement surgery on August 14, 2015 for the Stage IV pressure 

ulcer on her sacrum. The opening measurements of this ulcer were 6 x 9 x 2 cm in depth and dosing 

measurements were 15 x 20 x 4 cm in depth. 

-3-

USDC IN/ND case 3:16-cv-00616-MGG document 5 filed 08/11/16 page 3 of 8
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12. On August 26, 2015, Paula Bixler died as a result of sepsis that was directly related 

to the Stage IV decubitus ulcer she developed while she was a patient under the care and treatment 

of Defendants. 

13. Defendants, acting by and through their nursing staff, medical staff, and other agents 

and employees, were careless and negligent and breached the applicable standard of care in the care 

and treatment they provided to Paula Bixler. 

14. As a direct and proximate result of the carelessness and negligence of Defendants, 

Paula Bixler was caused to endure considerable pain, suffering, and mental anguish. Her death was 

directly related to the Stage IV pressure ulcer on her sacrum described in paragraphs 10, 11 and 12 

of this Complaint, and she died despite the fact that her pressure ulcers were completely preventable 

and avoidable conditions which should not have caused her death at the age of 60. 

15. As a further direct and proximate result of the carelessness and negligence of 

Defendants, Plaintiff Keith Bixler has lost the love, affection, companionship, and services of his 

wife, Paula Bixler, along with incurring on her behalf substantial medical, funeral, and other losses. 

WHEREFORE, Plaintiff requests judgment against Defendants for the wrongful death of 

Paula Bixler, for compensatory damages including all damages allowed by Indiana law; for costs and 

expenses of this action including attorney's fees and costs of administration; and for all other just 

and proper relief. 

Respectfully submitted this L day of August, 2016. 

-4-

USDC IN/ND case 3:16-cv-00616-MGG document 5 filed 08/11/16 page 4 of 8
. " 

CHESTER LAW OFFICE 

230 North Main Street, Suite 2 

P.O. Box 1768 

Elkhart, _IN 46~1_5-1768 

(574) 296-1515 Office 

(574) 295-9316 Fax 

REQUEST FOR TRIAL BY JURY 

Plaintiff requests trial by jury. 

-5-

USDC IN/ND case 3:16-cv-00616-MGG document 5 filed 08/11/16 page 5 of 8
APPENDIX B TO LOCAL GENERAL AND ADMINISTRATIVE RULES, 

100 SERIES 

NOTICE OF INTENT TO DESTROY 

CIVIL CAUSE OF ACTION 

Pursuant to Local Rulet t 2 of the St. Joseph County Courts ("Rule"), all 

models, diagrams, documents, or material admitted in evidence or pertaining to this 

case that has been or will be placed in the custody of the Official Court Reporter 

as exhibits must be taken away by the parties offering them in evidence, four (4) 

months after the case is decided unless an appeal is taken. If an appeal is taken, 

/ 

all such exhibits must be retained by the Official Court Reporter for two (2) years 

from termination of the appeal, retrial, or subsequent appeal and termination, 

whichever is latest. These time periods may be altered by Court order. 

Evidence which is not retaken after expiration of the applicable retention period, 

above, will be disposed of by the Sheriff, or his agent, on the Court's Order. 

Notwithstanding any provision of the Rule or this Notice to the contrary, the Judge 

of the St. Joseph Circuit Court, the Judge of the St. Joseph Probate Court, and the Chief 

Judge of the St. Joseph Superior Court shall have the authority to order the destruction of 

any evidence that is compromised by age, damage, lack of case identifiers, or inadvertent 

destruction. 

Revised April 21, 2014 Page 39 Effective January 1, 2015 

USDC IN/ND case 3:16-cv-00616-MGG document 5 filed 08/11/16 page 6 of 8
TERRI RETHLAKE 

ST JOSEPH COUNTY CLERKS OFFICE 

101 S MAIN ST 

SOUTH BEND, IN 46601-1897 

FIRST-CLASS® 

ELECTRONIC SCAN REQUIRED 

F 

USPS FIRST-CLASS® 

TERRI RETHLAKE 

ST JOSEPH COUNTY CLERKS OFFICE 

101 S MAIN ST 

SOUTH BEND, IN 46601-1897 

ELKHART OPERATING, LLC D/B/A GOLDEN 

LIVNG CENTER251 E OHIO ST STE 500 

INDIANAPOLIS, IN 46204-2184 

USPS SIGNATURE TRACKING# 

9202 1901 0661 5400 0090 7436 67 

Electronic Rate Approved #901066154 

Non-Ma

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USDC IN/ND case 3:16-cv-00616-MGG document 5 filed 08/11/16 page 8 of 8