United States v. Cordero Seals, 915 F.3d 1203

Cordero Seals sold $40 worth of a heroin/fentanyl mixture to J.V.; J.V. injected it in a gas-station restroom and collapsed within about seven minutes.
Surveillance showed Seals present shortly after the injection; he left the scene after apparently seeing J.V. slumped and flagged another patron for a ride.
First responders found injection paraphernalia and a spoon with residue later identified as heroin mixed with fentanyl/acetyl-fentanyl; Narcan revived J.V. on scene.
Blood testing detected morphine, codeine, fentanyl, and acetyl-fentanyl; testing limitations prevented precise determinations of concentrations or which drug alone caused the overdose.
Experts testified that morphine is a heroin metabolite and that the rapid onset after the bathroom injection made the injected heroin/fentanyl the most likely but-for cause; however, acetyl-fentanyl could also have been independently sufficient.
Seals was convicted of distribution resulting in serious bodily injury and possession with intent to distribute; he challenged sufficiency of the evidence on appeal arguing Burrage required the government to exclude acetyl-fentanyl as an independently sufficient cause.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether evidence was sufficient to show the drug Seals distributed was a but-for cause of J.V.’s serious bodily injury under 21 U.S.C. § 841(b)(1)(C)	Government: the close timing (injection to collapse ~7 minutes), paraphernalia, lab identifications, and expert opinions allow a reasonable jury to find but-for causation	Seals: presence of acetyl-fentanyl means the government failed to exclude an independently sufficient alternate cause; Burrage requires excluding such possibilities	Affirmed: viewed in the light most favorable to the verdict, evidence permitted a reasonable jury to find the distributed heroin/fentanyl mixture was a but-for cause; Burrage does not mandate exclusion of all other possible sufficient causes when the evidence permits a jury finding of causation

Burrage v. United States, 134 S. Ct. 881 (2014) (held §841(b)(1)(C)’s “results from” imports but‑for causation, but recognized multiple independently sufficient causes can still produce liability)
Gaylord v. United States, 829 F.3d 500 (7th Cir. 2016) (found equivocal evidence may render enhancement improper where no showing the distributed drug was the but‑for cause)
United States v. Tillman, 765 F.3d 831 (8th Cir. 2014) (standard for reviewing sufficiency of the evidence de novo, viewing evidence in light most favorable to verdict)
United States v. Tate, 633 F.3d 624 (8th Cir. 2011) (circumstantial evidence can support conviction; need not exclude every reasonable hypothesis)
Klein v. United States, 728 F.2d 1074 (8th Cir. 1984) (evidence must be consistent with guilt but not inconsistent with every other reasonable hypothesis)