An Arizona woman pleaded not guilty in federal court Thursday to a charge of distributing a prescription drug, obtained at some point from former Casper doctor Shakeel Kahn, that allegedly killed another person.

Shawnna Thacker entered the plea during her arraignment before U.S. District Court Judge Alan Johnson in Cheyenne, according to minutes from the hearing.

Thacker was named in the second superseding indictment in the multi-state prescription drug conspiracy organized by former Casper doctor Shakeel Kahn, according to the new indictment filed in November.

She was charged with a sole count of "Conspiracy to Dispense & Distribute Oxycodone, Alprazolam, Hydromorphone & Carisoprodol Resulting in Death."

Conviction of distributing oxycodone and certain other drugs resulting in death is punishable by 20 years to life imprisonment, according to federal sentencing guidelines.

The new superseding indictment did not identify the victim or say where or when the death occurred.

Thacker was arrested in Topock, Ariz., north of Lake Havasu on Dec. 13, and was ordered to appear in Cheyenne for her arraignment. She is not in custody pending trial. A trial date has not been set.

The new superseding indictment also named previous co-defendants Kahn, his wife Lyn, his brother Nabeel "Sonny" Khan (sometimes spelled Kahn), and Paul Beland.

These defendants entered not guilty pleas to the new charges on Nov. 28.

The previous superseding indictment about them in May listed 23 counts including conspiracy to distribute oxycodone and alprazolam (the generic for Xanax); dispensing of oxycodone; possession with intent to distribute oxycodone and aid and abet; use of firearms in a federal drug trafficking crime; unlawful use of a communication facility; and engaging in monetary transactions derived from criminal activity.

Shakeel Kahn also was charged with running a prescription drug criminal enterprise. If convicted on that count alone, he faces between 20 years and life imprisonment.

Health care professionals call the mix of at least one opioid such as oxycodone, a benzodiazepine such as alprazolam, and carisoprodol (a skeletal muscle relaxant) as the "Holy Trinity" of drugs sought for their incredible high. The combination can cause death.

The nation has been in the throes of an opioid crisis. In 2015, 52,404 people in the United States died of overdoses, with 33,091 -- or 91 a day -- of them dying from overdoses involving opioids.

The new charge of a death marks the latest development in the complex case started in Wyoming nearly two years ago when the Wyoming State Board of Pharmacy asked the DEA to investigate Kahn, who was issuing large prescriptions for controlled substances under two DEA licenses in Arizona and Wyoming. The Arizona and Wyoming boards of medicine subsequently suspended Kahn's medical licenses for  prescribing controlled substances outside the standard of care.

Shakeel and Lyn Kahn were arrested at their house on Thorndike Avenue in Casper on Nov. 30, and initially charged with one count of conspiracy to distribute oxycodone.

Court documents say they dealt with customers who paid them $500 in cash for a prescription. Customers often would resell the drugs.

Meanwhile, the Natrona County District Attorney's Office last year indicted 15 people with conspiracy to deliver a Schedule II controlled substance (oxycodone and oxycontin); conspiracy to deliver a Schedule IV controlled substance alprazolam; and two counts of conspiracy to deliver heroin.

Tuesday, Natrona County District Court Judge Daniel Forgey sentenced one of those defendants, Charles Edwards, to two concurrent four- to seven-year prison terms on one count of conspiracy to distribute oxycodone, a Schedule II drug, and one count of conspiracy to distribute heroin.

Forgey also heard a not guilty plea from a new defendant, Joseph Washakie, who is charged with conspiracy to deliver Schedule II and Schedule IV drugs.