United States Court of Appeals

For the Eighth Circuit

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No. 17-3046

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United States of America

 Plaintiff - Appellee

v.

Antrell Desharron Lewis

 Defendant - Appellant

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Appeal from United States District Court 

for the Northern District of Iowa - Dubuque

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Submitted: June 15, 2018

Filed: July 13, 2018

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Before LOKEN, GRUENDER, and ERICKSON, Circuit Judges.

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ERICKSON, Circuit Judge.

Following a three-day bench trial, the district court found Antrell Desharron

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Lewis guilty of one count of conspiracy to distribute a mixture or substance

containing heroin and furanylfentanyl resulting in death and serious bodily injury, in

The Honorable Leonard T. Strand, Chief Judge, United States District Court

1

for the Northern District of Iowa.
violation of 21 U.S.C. §§ 813, 841(a)(1), 841(b)(1)(C), and 846; and one count of

distribution of a mixture orsubstance containing heroin and furanylfentanyl resulting

in death and serious bodily injury, in violation of 21 U.S.C. §§ 813, 841(a)(1), and

841(b)(1)(C). The court sentenced Lewis to concurrent terms of 252 months’

imprisonment to be followed by concurrent three-year terms of supervised release.

On appeal, Lewis argues the evidence was insufficient to support the

convictions because (1) other individuals might have distributed the heroin laced with

furanylfentanyl that caused the death and/or serious bodily injuries; (2) the

government failed to establish “but-for” causation due to the intervening act of

redistribution by another individual; (3) no conspiracy existed between Lewis and the

individual who distributed the drugs to the victims; and (4) the government failed to

prove Lewis knowingly distributed an analogue of a controlled substance. Having

jurisdiction under 28 U.S.C. § 1291, we affirm. 

I. Background

Joshua Manning testified that for about two months prior to March 2, 2016, he

had been obtaining heroin from Lewis in Dubuque, Iowa. Manning usually

conducted a couple of transactions with Lewis each week involving half gram or

gram quantities. He wassometimes joined by his friend Jeremy Nadermann on these

trips to Dubuque.

According to Manning’s testimony, on March 2, 2016, he contacted Lewis

about obtaining five grams of heroin on a “front.” Manning asked Nadermann to go 2

A “front” in the context of drug trafficking simply means payment for drugs

2

is made at a later date, presumably after smaller portions are sold and the proceeds

from the sales are collected.

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with him because Manning did not have a vehicle. Manning intended to give one or

two grams of heroin to Nadermann for letting him use a car to make the trip.

Nadermann and Manning joined bytwo other individuals, Michael Vanamburg

and Anthony Kelly, drove to Dubuque for the purpose of obtaining heroin. Manning

testified he gave Lewis $200 in proceeds from Manning’s sale of previously-fronted

heroin. Manning explained at trial that five grams was the largest quantity he had

received from Lewis in a single transaction. Nadermann confirmed during his

testimony that a meeting was arranged with Lewis on March 2, 2016, to obtain

heroin. Nadermann added that there was some discussion about the four of them

pooling their money together to obtain a larger amount of heroin, which they would

then divide into portions. According to Manning, Lewis agreed to front five grams

of heroin to him for $800. 

After Manning received the heroin, Nadermann requested the group drive to

Jeremy Stierman’s residence in Dubuque. Manning testified that he and Nadermann

went inside Stierman’s apartment while Vanamburg and Kelly stayed in the car. 

Manning weighed out one or two grams of heroin for Nadermann and a “50 bag”

(about 0.2 grams) for Vanamburg. Manning put the rest in a bag. After dividing the

heroin into portions, Manning and Nadermann returned to the vehicle to get high. 

Manning gave Vanamburg the “50 bag.” Manning used a spoon and water to prepare

a liquid mixture and drew some of it into a syringe for his use, and then gave the

spoon to Kelly so he could use what was left.

Manning testified that he believed the substance he received from Lewis on

March 2, 2016, was more potent than what he usually received. He described feeling

a more intense high. Nadermann testified that he used some of the heroin Manning

received from Lewis that evening and experienced a “strong weird feeling” but did

not lose consciousness. In a very short period of time after using the heroin inside the

vehicle, Manning noticed that Kelly was unresponsive in the backseat. Manning and

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Nadermann attempted to revive Kelly. When they were unsuccessful, Manning took

his portion of heroin back to Stierman’s apartment and called 911. During the

emergency call, Nadermann advised Manning that Vanamburg, too, was

unresponsive. 

Before emergency responders arrived on scene, Manning testified that he saw

Nadermann throw what Manning believed to be a syringe and Nadermann’s portion

of the heroin into a snowbank. Emergency responders, suspecting opiate overdoses,

testified they administered Narcan and revived both Kelly and Vanamburg. Once

alert, Kelly and Vanamburg were transported to the hospital in ambulances. Dr.

Joshua Pruitt, an emergency room physician, the deputy medical examiner for Linn

County, Iowa, and the chief medical examiner for Cedar County, Iowa, testified at

trial. Dr. Pruitt testified that, upon review of the evidence, it was his opinion that

Kelly was rendered unconscious because of an opiate overdose and that Kelly was at

serious risk of death without medical intervention. Dr. Pruitt also testified that

Vanamburg faced the same risks and that Vanamburg would not have been in that

situation without the use of an opiate. Dr. Pruitt noted that Vanamburg had been

prescribed Oxycodone, but discounted the possibility that Vanamburg’s overdose was

caused by the prescription medication, as he was using it as directed and the

frequency dosage would not cause the effects Vanamburg experienced. Dr. Pruitt

opined that Oxycodone was not the cause of Vanamburg’s overdose. 

During the search ofthe vehicle, law enforcement officersfound a metalspoon

containing some residue and a small cotton swab. The items were sent to the crime

lab for testing. The lab report indicated the substance on the spoon was heroin and

furanylfentanyl. In the rear passenger door pocket, officers found a small plastic

baggie with a white rock substance. The lab report indicated the substance in the

baggie contained a mixture of heroin and furanylfentanyl. The substance weighed

0.12 grams.

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Manning admitted he provided false information to law enforcement about the

details of Kelly’s and Vanamburg’s heroin usage because he did not want to go to

jail. Manning and Nadermann were not arrested and were allowed to leave the scene. 

Manning testified that after they left, Nadermann went back to Stierman’s apartment

to get Manning’s heroin as well as the heroin and syringe Nadermann had thrown in

a snowbank. Nadermann denied that he went back to Stierman’s apartment. 

Nadermann testified that he and Manning drove to the hospital to check on

Vanamburg and Kelly, but upon arriving decided not to go inside. According to

Nadermann, he then parted ways with Manning. Nadermann drove back to

Maquoketa while Manning stayed in Dubuque at his mother’s house. 

Brian Koster, Stierman’s co-worker, testified at trial. He testified that during

the evening of March 2, 2016, he was at Stierman’s apartment. Stierman told Koster

that he intended to use drugs that night. Koster was not a drug user and did not see

Stierman use drugs that night. Koster was present at Stierman’s apartment when two

men arrived, went to the kitchen with Stierman for about 15 minutes, and then left. 

Koster identified one of the men as Manning. Koster was also present when Manning

returned to the apartment and announced one of his friends had stopped breathing in

the car. Koster was concerned about getting into trouble for being in the presence of

drugs, so he asked Stierman if drugs were inside the apartment. Stierman confirmed

the presence of drugs. Koster told Stierman he should get rid of them. According to

Koster, Stierman left the apartment and came back about one minute later. Koster

and Stierman remained in the apartment while emergency responders and law

enforcement officers addressed the situation outside. About an hour after law

enforcement officers cleared the scene, Koster left Stierman’s apartment and drove

home.

In the early morning hours of March 3, 2016, Nadermann sent text messages

to Stierman. Stierman did not respond to any of the messages. Koster talked on the

phone to Stierman when Koster arrived home. He noticed Stierman’s state of mind

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was different and Stierman sounded intoxicated. At 2:44 a.m. on March 3, 2016,

almost immediately after the telephone conversation ended, Stierman sent a text

message to Koster that stated: 

So I just wanted to get my story straight again in case jerry asks . . . as

far as cops go we’re in the clear im just hoping jerry isn’t suspicious and

at least ill have you as an alibi . . . just like we talked about me and you

were havin a few beers after work when some random dudes just

knocked on my door . . . call me when you can.

Koster testified that “jerry” was Stierman’s landlord and he was also Koster’s

landlord.

At 2:07 p.m. on March 3, Stierman’s father arrived at Stierman’s apartment to

pick up Stierman and take him to work, as they worked at the same manufacturing

company and Stierman’s father often gave Stierman a ride to work. When Stierman

did not come out, Stierman’s father drove to work. He became concerned when he

learned Stierman did not show up for work. He called Stierman’s sister during his

break around 7:00 p.m. She drove to Stierman’s apartment and found Stierman dead

inside his apartment. 

Dubuque County Sheriff’s Officer Adam Williams testified that a baggie

containing a substance was found in a kitchen cabinet in Stierman’s apartment and

a small amount of white powder was found on the kitchen counter. A lab report

identified the baggie contents as 0.14 grams of furanylfentanyl and heroin. The

powder on the counter consisted of furanylfentanyl.

Manning testified that the only drugs in his possession on March 2-3, 2016,

were those he had obtained fromLewis. Manning acknowledged that Nadermann had

“a little bit” of heroin with him when Nadermann picked Manning up, but that the

group had stopped during the trip and used Nadermann’s heroin before meeting

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Lewis. Manning testified that he received a call from Lewis a couple days later

asking for the money for the heroin that had been fronted. Manning told Lewis that

he did not have the money and never paid Lewis for the heroin.

Dr. Julia Goodin, Chief Medical Examiner for the State of Tennessee, who

previously held the same position for the State of Iowa, performed an autopsy on

Stierman. She offered her expert opinion at trial that furanylfentanyl was the cause

of Stierman’s death based on the toxicology report, her autopsy findings, and

evidence gathered from Stierman’s apartment. Because Stierman’s urine was

presumptively positive for opiates, Dr. Goodin could not rule out the possibility that

another opiate was involved as well. Dr. Goodin testified at trial that it was her

opinion that Stierman would not have died if he had not used furanylfentanyl. 

II. Discussion

Lewis contends the evidence was insufficient to sustain the convictions. He

raises several arguments, but his main argument focuses on whether the district court

erred when it convicted him on the charged offenses because at most he was guilty

of distributing heroin, for which the death/serious bodily injury sentencing

enhancement found in 21 U.S.C. §841(b)(1)(C) would not apply. We consider each

of Lewis’s arguments in turn.

“We review the sufficiency of the evidence de novo, viewing evidence in the

light most favorable to the government, resolving conflicts in the government’s favor,

and accepting all reasonable inferences that support the verdict.” United States v.

Trejo, 831 F.3d 1090, 1093 (8th Cir. 2016) (quoting United States v. Washington,

318 F.3d 845, 852 (8th Cir. 2003)) (internal quotation omitted). “Reversal is

appropriate only where a reasonable [fact finder] could not have found all the

elements of the offense beyond a reasonable doubt.” Id. at 1093–94 (quoting United

States v. Armstrong, 253 F.3d 335, 336 (8th Cir. 2001)) (internal quotation omitted).

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Lewis contendsthe evidence failed to establish a conspiracy between Manning

and him because Manning had no intention of paying for the drugs. It is immaterial

whether Manning repaid Lewis or intended to repay Lewis. “To convict a defendant

of conspiracy to distribute drugs, the government must prove that there was an

agreement to distribute drugs, that the defendant knew of the agreement, and that the

defendant intentionally joined in the agreement.” United States v. Chavez-Alvarez,

594 F.3d 1062, 1066 (8th Cir. 2010) (citing United States v. Benitez, 531 F.3d 711,

716 (8th Cir. 2008)). “An agreement to join a conspiracy need not be explicit and can

be inferred from the facts of the case.” United States v. Davis, 826 F.3d 1078, 1081

(8th Cir. 2016) (citing United States v. Slagg, 651 F.3d 832, 840 (8th Cir. 2011)).

There is overwhelming evidence in the record establishing that Lewis and

Manning were engaged in a heroin trafficking conspiracy. Manning testified that he

had been receiving heroin from Lewis for approximately two months. Manning paid

Lewis $200 from a previously fronted drug transaction when he obtained the five

grams of heroin that gave rise to the charges in this case. Overwhelming evidence

established that Lewis distributed heroin to Manning on March 2, 2016. Lewis

agreed to front the drugs to Manning in return for $800. The charged offense was a

conspiracy to distribute drugs, not to sell them. There wassufficient evidence for the

district court to conclude that Lewis knowingly and voluntarily joined a conspiracy

to distribute heroin, and he shared a common purpose with Manning and others.

Lewis’s identification of evidence that weighs against the verdicts and his

claim that Manning provided “self-serving” testimony are arguments that go to the

district court’s credibility determinations and weight to be given the evidence. “[W]e

will not disturb the district court’s reasoned credibility determinations.” United

States v. Bowie, 618 F.3d 802, 814 (8th Cir. 2010). 

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The court next turns to the focal point of Lewis’s appeal, whether the

sentencing enhancement found in § 841(b)(1)(C) is sustainable on the record. Lewis

contends that the government failed to prove whether it was the heroin,

furanylfentanyl, or combination of heroin and furanylfentanyl that caused the

overdoses and death. Expert testimony provided by medical professionals established

beyond a reasonable doubt that Vanamburg and Kelly would not have overdosed

“but-for” the use of furanylfentanyl and that Stierman would not have died “but-for”

the use of furanylfentanyl. 

The government was not required to prove that Lewis knowingly distributed

an analogue of a controlled substance. We have repeatedly explained that “[a]

defendant does ‘not need to know the exact nature of the substance in [his]

possession, only that it was a controlled substance of some kind.’” United States v.

Anwar, 880 F.3d 958, 967 (8th Cir. 2018) (quoting United States v. Morales, 813

F.3d 1058, 1068 (8th Cir. 2016)). Section 841(b)(1)(C) is a sentencing enhancement,

not a separate offense. To sustain a conviction under 21 U.S.C. § 841(a)(1) with a

serious bodily injury or death enhancement under § 841(b)(1)(C), the government

must prove: “(i) knowing or intentional distribution of [an illicit drug], . . . and (ii)

[serious bodily injury or] death caused by (‘resulting from’) the use of that drug.” 

Burrage v. United States, 571 U.S. 204, 210 (2014). 

The Supreme Court explained that “where use of the drug distributed by the

defendant is not an independently sufficient cause of the victim’s death or serious

bodily injury, a defendant cannot be liable under the penalty enhancement provision

of § 841(b)(1)(C) unless such use is a but-for cause of the death or injury.” Id. at

218–19. Following Burrage, the statutory sentencing enhancement in § 841(b)(1)(C)

may be proved in two ways:(1) “but-for” cause, or(2) independently sufficient cause. 

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There is sufficient evidence in this case to conclude that the government

proved that Lewis knowingly and intentionally distributed an illicit drug and, under

the facts of this case, use of that drug was an independently sufficient cause of the

overdoses and death. Accord United States v. Allen, 716 F.App’x 447, 450–51 (6th

Cir. 2017) (where victim wasfound with a “cocktail of drugs” in her system, the state

medical examiner’s testimony combined with the close proximity of a spoon

containing fentanyl was sufficient for the jury to conclude that fentanyl was an

independently sufficient cause of death). At a minimum, the evidence established

that, without the incremental effect of furanylfentanyl in the heroin, Stierman would

have lived and Kelly and Vanamburg would not have suffered serious bodily injury. 

The statutory requirementsfor the sentencing enhancement set forth in § 841(b)(1)(C)

have been met.

 

Finally, Lewis argues that even if it was proven that he provided the heroin to

Manning, who then supplied it to Vanamburg, Kelly, and Stierman, the redistribution

constitutes an intervening cause of the injuries and death for which Lewis cannot be

held responsible. Nothing in Burrage or the plain language of the statute limits

responsibility to only the last person to distribute the drug before the harm occurs.

III. Conclusion

For the foregoing reasons, the judgment of the district court is affirmed.

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