State of Iowa v. Jacob Ryan Ballard

IN THE COURT OF APPEALS OF IOWA
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No. 24-1997
Filed April 1, 2026
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State of Iowa,
Plaintiff–Appellee,
v.
Jacob Ryan Ballard,
Defendant–Appellant.
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Appeal from the Iowa District Court for Dallas County,
The Honorable Charles C. Sinnard, Judge.
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AFFIRMED
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Martha J. Lucey, State Appellate Defender, and Rachel C. Regenold,
Assistant Appellate Defender, attorneys for appellant.

Brenna Bird, Attorney General, and Katherine Wenman, Assistant Attorney
General, attorneys for appellee.
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Considered without oral argument
by Greer, P.J., and Schumacher and Chicchelly, JJ.
Opinion by Schumacher, J.

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SCHUMACHER, Judge.

Following a jury trial over the death of his one-year-old son, Jacob
Ballard appeals his conviction of child endangerment resulting in death in
violation of Iowa Code sections 726.6(1)(a), 726.6(4), and 726.6(5) (2024),
asserting there was insufficient evidence to support the conviction. He also
argues the State engaged in prosecutorial misconduct and the district court
abused its discretion in admitting evidence of his substance-use treatment.
Upon our review, we affirm.

I. Background Facts & Proceedings.

In late April 2023, Ballard, a recovering addict, forgot to set an alarm
and woke up late, missing his methadone treatment appointment. He left his
apartment to deliver for DoorDash and texted a dealer, requesting seven
fentanyl pills. Ballard obtained those pills and returned to the apartment later
that afternoon. He placed the sandwich bag of pills on his bedroom desk,
within reach of J.B., his one-year-old son. Ballard later found J.B. with the
sandwich bag in his hands and three or four pills on the floor. One pill was
wet, indicating it had been in J.B.’s mouth. Ballard thought there had been
three or four pills in the bag but he was not sure. Ballard stated he flushed the
remaining pills down the toilet after finding J.B. with them.

Ballard alerted his fiancée about what had occurred and they decided
to monitor J.B. rather than call emergency services because J.B. was “being
normal.” Later, Ballard and his fiancée took J.B. to Walmart for groceries,
returning home around 10:30 p.m. They put J.B. to bed and checked on him
periodically, determining that he seemed okay. When they checked on him
the last time, J.B. was limp, had liquid in his throat, and his toes and fingers
were blue. Ballard had previously Googled whether they could administer

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Narcan to a child. He attempted to give a dose to J.B. after they found him
unresponsive.

After the attempt to administer the dose, the parents called 911 at
around 12:20 a.m. and began performing CPR with the assistance of the 911
operator. When emergency services arrived at the apartment, J.B. was
unresponsive, not breathing, and had no pulse. J.B. was transported to the
hospital and pronounced deceased at 1:30 a.m. The cause of death was
determined to be acute fentanyl toxicity.

Ballard met with law enforcement two days later. He informed the
officers that he induced J.B. to vomit by sticking his fingers down the child’s
throat after finding him with the pills, assuming J.B. had placed one in his
mouth. The vomit appeared to be only baby formula. Ballard again stated he
and his fiancée, while concerned, did not call 911 for several hours because
J.B. appeared to be fine. Ballard repeated that J.B. was acting normally during
the trip to Walmart.

The State charged Ballard with child endangerment resulting in death.
A jury convicted Ballard as charged. Ballard appeals.

II. Analysis.

(A) Sufficiency of the Evidence.

Ballard asserts there was insufficient evidence to convict him of child
endangerment causing death under either of the two alternative theories
proffered by the State. He focuses on a lack of connection between his
purchase of the pills and the creation of a risk of harm to J.B. and maintains
that he “did not willfully deprive J.B. of medical care.”

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We “review[] sufficiency-of-evidence claims for the correction of
errors at law.” State v. Swartz, 7 N.W.3d 756, 763 (Iowa 2024). If a conviction
is supported by substantial evidence, we will not disturb the finding of guilt.
Id. at 764. “Substantial evidence is evidence sufficient to convince a rational
trier of fact the defendant is guilty beyond a reasonable doubt.” Id. (citation
omitted). When reviewing these claims, we view “the evidence in the light
most favorable to the State, including all legitimate inferences and
presumptions that may fairly and reasonably be deduced from the record
evidence.” Id. (cleaned up). When a “defendant does not object to the
relevant jury instruction, the instruction is ʻthe law of the case for purposes
of reviewing the sufficiency of the evidence.’” Id. (citation omitted). The
relevant jury instructions which the State had to prove in this case are as
follows:
In the trial information, Jacob Ballard is charged with committing
Child Endangerment Resulting in Death under two different theories.
Under the first theory, the State must prove all of the following elements:

1. On or about April 29th through April 30, 2023, Jacob Ballard
was either

a. the parent, guardian, person having custody or control of [ J.B.];
or

b. a member of the household in which [ J.B.] resided.

2. [ J.B.] was under the age of fourteen years.

3. Jacob Ballard acted with knowledge that he was creating a
substantial risk to [ J.B.]’s physical health or safety.

4. Jacob Ballard’s act resulted in death to [ J.B.].

....

Under the alternative theory, the State must prove all the following
elements:

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1. On or about April 29th through April 30, 2023, Jacob Ballard
was either:

a. the parent, guardian, person having custody or control of [ J.B.];
or

b. a member of the household in which [ J.B.] resided.

2. [ J.B.] was under the age of fourteen years.

3. Jacob Ballard willfully deprived [ J.B.] of necessary healthcare
appropriate to [ J.B.]’s age.

4. Jacob Ballard was reasonably able to provide necessary
healthcare.

5. As a result [ J.B.] suffered substantial physical harm.

6. The harm to [ J.B.] was death.

Concerning the first alternative, the “substantial risk theory,” Ballard
contests that the State proved elements three and four beyond a reasonable
doubt. Ballard argues that he did not know he was creating a substantial risk
to J.B., and if he did create the risk, it did not cause J.B.’s death. He points to
the time between the implied ingestion of the fentanyl by J.B. and the child’s
death.

“Substantial risk” within the framework of child endangerment is
defined by our courts as “[t]he very real possibility of danger to a child’s
physical health or safety.” State v. Folkers, 941 N.W.2d 337, 339 (Iowa 2020)
(citation omitted). And within “the context of parental drug use, the State
must show some nexus between the drug use and the creation of a substantial
risk of harm to the child.” Id. The risk “needs to be real or identifiable as
opposed to speculative or conjectural.” Id.

The evidence reflects that Ballard, in multiple interviews with law
enforcement, admitted he purchased the pills and brought them into the

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apartment. His actions, including inducing J.B. to vomit, googling to find out
if Narcan can save a one-year-old, and statements to law enforcement,
indicated that he was aware that fentanyl is a dangerous substance. Ballard
left the pills on his desk, where J.B. had previously been able to reach items.
The evidence demonstrates that J.B. died from acute fentanyl toxicity.

Ballard’s main argument concerning the substantial risk theory is that
because there was a large amount of fentanyl found in J.B.’s system, and he
did not show symptoms before or during the trip to Walmart, then J.B. must
have obtained the fentanyl from another source. But the jury was free to
reject Ballard’s timeline and theory based on other evidence. See State v.
Mathis, 971 N.W.2d 514, 519 (Iowa 2022). And Ballard failed to put forward
any evidence of an alternative source of the fentanyl that J.B. ingested.

Viewing the evidence in a light favorable to the State, we find there was
substantial evidence to convince the jury of Ballard’s guilt under the
substantial risk theory. See Swartz, 7 N.W.3d at 764. Because we find there
was sufficient evidence that Ballard “acted with knowledge that he was
creating a substantial risk to [ J.B.]’s physical health or safety,” we need not
determine whether substantial evidence supports the State’s alternative
theory that Ballard “willfully deprived [ J.B.] of necessary healthcare.” See
Iowa Code § 814.28 (“[A]n appellate court shall not set aside or reverse [a
general verdict] on the basis of a defective or insufficient theory if one or
more of the theories presented and described in the . . . jury instruction is
sufficient to sustain the verdict on at least one count.”).

(B) Prosecutorial Misconduct.

Ballard asserts the State engaged in prosecutorial misconduct during
closing arguments by stating that after J.B. was taken to the hospital, Ballard

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“[d]idn’t go the hospital for his child. Selfish decision.” The State argues that
error was not preserved on this issue. We agree.

“We review a district court’s decision on claims of prosecutorial
misconduct for abuse of discretion, which occurs when ʻa court acts on
grounds clearly untenable or to an extent clearly unreasonable.’” State v.
Coleman, 907 N.W.2d 124, 134 (Iowa 2018) (citation omitted).

To obtain relief based on prosecutorial misconduct occurring during
closing arguments, “a defendant ʻmust make timely and proper objection to
the offending argument. Unless objection is made at the time of the
argument, the defendant has waived his right to complain.’” State v. Smith,
No. 18-2052, 2020 WL 376554, at *3 (Iowa Ct. App. Jan. 23, 2020) (quoting
State v. Romeo, 542 N.W.2d 543, 552 (Iowa 1996)). A defendant need not
“interrupt closing argument with an objection” and can timely preserve error
if objections are “urged at close of argument and in a motion for mistrial
made before submission to the jury.” Romeo, 542 N.W.2d at 552 n.5 (citation
omitted).

While Ballard properly objected to the statement at the close of the
State’s argument and moved for mistrial, his objection was based on lack of
notice to counsel, not prosecutorial misconduct. While defense counsel did
maintain that “[t]he only reason that statement was made was to elicit an
emotional response from the jury,” the record shows the objection was
grounded in an alleged lack of notice to the defense that the statement would
be made: “We had no notice. Had I had notice that this was going to be
utilized against my client, I would have asked [a law enforcement witness]
whether my client was allowed to visit his kid or not . . . .” And, although
Ballard raised the prosecutorial-misconduct issue in his motion for new trial,

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it should have been raised “before submission to the jury.” Id. We hold that
error was not preserved on this issue. See Smith, 2020 WL 376554, at *4.

Even if Ballard had preserved the prosecutorial-misconduct issue, we
do not find that the statement prejudiced Ballard. See id. To prove
prosecutorial misconduct, there must be proof of misconduct and that “the
misconduct resulted in prejudice to such an extent that the defendant was
denied a fair trial.” State v. Graves, 668 N.W.2d 860, 869 (Iowa 2003). “[I]t
is the prejudice resulting from the misconduct, not the misconduct itself that
entitles a defendant to a new trial.” Id. (citation omitted).
In determining prejudice the court looks at several factors “within the
context of the entire trial.” We consider (1) the severity and pervasiveness
of the misconduct; (2) the significance of the misconduct to the central
issues in the case; (3) the strength of the State’s evidence; (4) the use of
cautionary instructions or curative measures; and (5) the extent to which
the defense invited the misconduct.

Id. (internal citations omitted).

Even if we were to find that misconduct occurred, which we do not,
the statement in the State’s closing argument was not significant to “the
central issues of the case,” which were whether Ballard knowingly created
substantial risk to J.B. or if he willfully deprived J.B. of necessary healthcare.
Also, “the strength of the State’s evidence” weighs against a finding of
prejudice resulting from prosecutorial misconduct. See id. And supposing the
alleged misconduct was severe, it was an isolated statement and not so
pervasive as to result in prejudice. See State v. Anderson, 448 N.W.2d 32, 34
(Iowa 1989) (observing that prejudice does not usually “result from isolated
prosecutorial misconduct”).

Regarding a curative instruction, the court offered to instruct the jury,
reminding them that closing arguments are not evidence, but defense counsel

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refused such an instruction. Lastly, while the defense did not invite the
misconduct, the other elements weigh against prejudice. See Graves, 668
N.W.2d at 869. Ballard’s claim of prosecutorial misconduct also fails on the
merits, and the district court did not abuse its discretion in its findings on the
issue.

(C) Admission of Ballard’s Methadone Treatment.

Lastly, Ballard argues the district court abused its discretion in
allowing the State to present evidence of his missed methadone treatment the
morning of J.B.’s death. The State asserts this issue is not preserved for our
review.

We review the district court’s evidentiary ruling for abuse of
discretion. State v. Thoren, 970 N.W.2d 611, 620 (Iowa 2022). “A district
court abuses its discretion when it bases its decisions on grounds or reasons
clearly untenable or to an extent that is clearly unreasonable . . . [or] if it bases
its conclusions on an erroneous application of the law.” Id. (alterations in
original) (citation omitted).

Concerning the State’s error-preservation argument, we note that the
determination of admissibility of evidence regarding Ballard’s substance-use
treatment was a result of Ballard’s motion in limine. Ballard’s motion
“sought to prohibit the State from introducing testimony, other evidence, or
arguments about the . . . defendant’s treatment at a methadone clinic . . . .”
The district court ruled that evidence of Ballard missing his methadone
appointment was “inextricably intertwined with the charged crime and
severance of that evidence would leave the narrative confusing or
misleading” and thus admissible under State v. Nelson, 791 N.W.2d 414, 420
(Iowa 2010).

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“Generally, denial of a motion in limine does not preserve error for
appellate review.” Thoren, 970 N.W.2d at 620–21. When such a motion is
denied, “the resisting party must object at the time the evidence is offered at
trial to preserve a challenge to the evidence on appeal.” Id. at 621. “Error
arises when the evidence is introduced at trial, not from ruling on the motion
in limine.” Id. But an objection to preserve evidentiary error is not required
when “the ruling . . . reaches the ultimate issue and declares the evidence
admissible or inadmissible, [and] it is . . . a final ruling and need not be
questioned again during trial.” Id. (citation omitted). So, we need to
determine whether the district court’s ruling on Ballard’s motion in limine
was a “final ruling” to qualify as an exception to error-preservation
requirements. See id.

The district court’s ruling on the challenged motion in limine
concerning Ballard’s prior substance-use treatment and a previous overdose
stated, in relevant part, “If admitted, and weighing factors outlined in State
v. Taylor, the court cannot say the danger of unfair prejudice substantially
outweighs the probative value of this evidence.” Concerning the missed
methadone appointment, the court determined “the evidence is admissible.”
Nowhere in the order does the district court indicate that either ruling was
final.

This language shows the district court issued an equivocal ruling on
the motion, reserving its duty to deny or admit evidence based on balancing
probative value and prejudice. Also, the order quoted Thoren, stating that a
“party must object at the time evidence is offered at trial to preserve a
challenge to evidence on appeal,” and “[e]rror arises then the evidence is
introduced at trial, not from the motion in limine.” 970 N.W.2d at 621.
Further, in a conversation between defense counsel and the court during trial

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about different evidence, the district court reiterated its order was not a final
order:
DEFENSE COUNSEL: Your Honor, just because Court ruled on
the motion in limine prior to having all the exhibits and the evidence that
we have so far does not mean that I can’t bring up the same objection.

First of all the Court may change its mind on those, on that
particular evidence. Second I need to preserve it for the purposes of
appeal.

....

COURT: All right.

So [defense counsel] you are correct. A motion in limine is only a
preliminary determination on the evidence. You’re also correct in the fact
that to preserve error in the Court’s ruling an objection has to be made at
the time of trial to the proffered evidence. The motion in limine by itself is
not enough to preserve that objection and ruling by the Court.

Accordingly, the district court did not issue a final ruling on the motion
in limine, and counsel was required to object to the admission of the evidence
to preserve appellate review. See id. (holding there was a final ruling on a
motion in limine when the district court concluded “the State will be allowed
the opportunity to present evidence of prior incidents” absent equivocation);
see also State v. Alberts, 722 N.W.2d 402, 405–07 (Iowa 2006) (discussing in
the context of rulings on motions in limine and error preservation, “[t]he key
to our analysis is to determine what the trial court ruling purported to do,”
and giving weight to the fact that “both parties treated the court’s ruling on
the motion as a final decision”); State v. Curtis, No. 22-1069, 2023
WL 4104116, at *4 (Iowa Ct. App June 21, 2023) (noting “the words of the
district court must be given due consideration to evaluate the unequivocal
intent of the ruling,” “[b]ecause that language can mean the ruling could be
reconsidered at a later time during the trial, the ruling was not unequivocal”).

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Because the ruling on the motion in limine was not final, and because
Ballard did not object to the evidence of his missed methadone appointment,
error was not preserved on this issue. See Thoren, 970 N.W.2d at 621.

AFFIRMED.

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