132 Nev., Advance Opinion 52-
`IN THE SUPREME COURT OF THE STATE OF NEVADA
`
`RAYMOND RIAD KHOURY,
`Appellant,
`vs.
`MARGARET SEASTRAND,
`Respondent.
`
`RAYMOND RIAD KHOURY,
`Appellant,
`vs.
`MARGARET SEASTRAND,
`Respondent.
`
`RAYMOND RIAD KHOURY,
`Appellant,
`vs.
`MARGARET SEASTRAND,
`Respondent.
`
`No. 64702 FILE
`JUL 2 8 201
`
`BY
`
`HIEP 'DE
`
`No. 65007
`
`No, 65172
`
`Consolidated appeals from a district court judgment, pursuant
`
`to a jury verdict, and post-judgment orders awarding costs and denying a
`
`new trial in a personal injury action. Eighth Judicial District Court, Clark
`
`County; Jerry A. Wiese, Judge.
`
`Affirmed in part, reversed in part, and remanded.
`
`Hall Jaffe & Clayton, LLP, and Steven T. Jaffe, Las Vegas; Harper Law
`Group and James E. Harper, Las Vegas; Houser & Allison, APC, and
`Jacob S. Smith, Las Vegas; and Lewis Roca Rothgerber Christie LLP and
`Daniel F. Polsenberg, Joel D. Henriod, and Abraham G. Smith, Las Vegas,
`for Appellant.
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`SUPREME COURT
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`kitia
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`IN THE SUPREME COURT OF THE STATE OF NEVADA
`
`RAYMOND RIAD KHOURY,
`Appellant,
`vs.
`MARGARET SEASTRAND,
`Respondent.
`
`RAYMOND RIAD KHOURY,
`Appellant,
`vs.
`MARGARET SEASTRAND,
`Respondent.
`
`RAYMOND RIAD KHOURY,
`Appellant,
`vs.
`MARGARET SEASTRAND,
`Respondent.
`
`No. 64702 FILE
`JUL 2 8 201
`
`BY
`
`HIEP 'DE
`
`No. 65007
`
`No, 65172
`
`Consolidated appeals from a district court judgment, pursuant
`
`to a jury verdict, and post-judgment orders awarding costs and denying a
`
`new trial in a personal injury action. Eighth Judicial District Court, Clark
`
`County; Jerry A. Wiese, Judge.
`
`Affirmed in part, reversed in part, and remanded.
`
`Hall Jaffe & Clayton, LLP, and Steven T. Jaffe, Las Vegas; Harper Law
`Group and James E. Harper, Las Vegas; Houser & Allison, APC, and
`Jacob S. Smith, Las Vegas; and Lewis Roca Rothgerber Christie LLP and
`Daniel F. Polsenberg, Joel D. Henriod, and Abraham G. Smith, Las Vegas,
`for Appellant.
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`Richard Harris Law Firm and Alison M. Brasier, Benjamin P. Cloward,
`and Richard A. Harris, Las Vegas,
`for Respondent.
`
`BEFORE THE COURT EN BANC.'
`
`By the Court, SAITTA, J.:
`
`OPINION
`
`As any trial attorney is aware, the jury voir dire process can
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`be as important to the resolution of their claim as the trial itself. In this
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`case we are asked to consider whether an attorney may ask prospective
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`jurors questions concerning a specific verdict amount to determine
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`potential bias or prejudice against returning large verdicts and whether
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`repeatedly asking questions about that specific verdict amount results in
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`jury indoctrination warranting a mistrial. We also consider the question
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`of when a district court abuses its discretion in dismissing jurors for cause
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`under Jitnan v. Oliver, 127 Nev. 424, 254 P.3d 623 (2011).
`
`We hold that while it is permissible for a party to use a
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`specific award amount in questioning jurors regarding their biases
`
`towards large verdicts, it is the duty of the district court to keep the
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`questioning within reasonable limits When the district court fails to do
`
`so, this can result in reversible error due to jury indoctrination. We also
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`distinguish our holding in Jitnan to emphasize that a juror's statements
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`must be taken as a whole when deciding whether to dismiss for cause due
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`3-The Honorable Ron Parraguirre, Chief Justice, voluntarily recused
`himself from participation in the decision of this matter.
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`to bias Just as detached language considered alone is insufficient to
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`establish that a juror is unbiased, it is also insufficient to establish that a
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`juror is biased.
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`In the current case, we hold that, while troubling, the
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`plaintiff's questioning of the jurors during voir dire did not reach the level
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`of indoctrination. Furthermore, we hold that the district court abused its
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`discretion by dismissing for cause five jurors because their statements,
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`when taken as a whole, did not indicate that they were biased against
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`large verdict amounts. However, the district court's error was harmless.
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`Next, the district court did not abuse its discretion by admitting opinion
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`and causation testimony by respondent's treating physician, by admitting
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`testimony by respondent's expert witness, or by excluding evidence of the
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`amount that respondent's medical providers received for the sale of her
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`medical liens. However, the district court did abuse its discretion by
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`excluding evidence of the medical lien's existence to prove bias in
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`Seastrand's medical providers, but the error was harmless. Lastly, we
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`hold that the district court abused its discretion by awarding respondent
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`expert witness fees in excess of $1,500 per expert because it did not state a
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`basis for its award. Therefore, we reverse the district court's decision as to
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`the award of expert witness fees and remand to the district court with
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`instructions to redetermine the amount of expert witness fees and, if
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`greater than $1,500 per witness, to state the basis for its decision.
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`FACTUAL AND PROCEDURAL HISTORY
`Respondent Margaret Seastrand and appellant Raymond Riad
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`Khoury were in an automobile accident where Khoury's car rear-ended
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`Seastrand's car. Following the accident, Seastrand received extensive
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`treatment to both her neck and back, including surgeries. Seastrand
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`brought the underlying personal injury action against Khoury to recover
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`damages.
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`Khoury stipulated to liability for the accident, and the only
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`issues contested at trial were medical causation, proximate cause, and
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`damages. Khoury argued that Seastrand's injuries leading to the
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`surgeries were preexisting and were not caused by the accident. During
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`voir dire, Seastrand stated that she was seeking $2 million in damages
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`and was permitted to question the jurors regarding whether they had
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`hesitations about potentially awarding that specific verdict amount. After
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`this questioning, the district court granted Seastrand's motion to dismiss
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`several jurors for causeS but denied Seastrand's motion to dismiss five
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`other jurors for cause. However, the next day, the district court
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`reconsidered its previous ruling and dismissed those five jurors for cause.
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`During trial, multiple expert witnesses testified, including Dr.
`
`Jeffrey Gross, a neurological expert, and Dr. William S. Muir, one of
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`Seastrand's treating physicians. After a ten-day trial, the jury returned a
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`verdict in the amount of $719,776. Seastrand then filed a memorandum of
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`costs in the amount of $125,238.01 and a motion for attorney fees. Khoury
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`opposed the motion and moved to retax costs. The district court granted
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`in part Seastrand's motion for costs, awarding her $75,015.61, denied
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`Seastrand's motion for attorney fees, and denied Khoury's countermotion
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`to retax costs. Khoury then made a motion for a new trial, alleging
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`various errors. The district court denied Khoury's motion. Khoury
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`appeals from the judgment, the costs award, and the order denying his
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`new trial motion.
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`Khoury raises the following issues on appeal: whether the
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`district court abused its discretion by (1) denying Khoury's motion for a
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`mistrial due to jury indoctrination, (2) dismissing jurors for cause that
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`displayed concerns about their ability to award large verdicts and/or
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`damages for pain and suffering, (3) admitting causation and opinion
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`testimony by one of Seastrand's treating physicians, (4) admitting
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`testimony by one of Seastrand's expert witnesses that was outside the
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`scope of his specialized knowledge and/or undisclosed in a timely expert
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`report, (5) excluding evidence of the amount Seastrand's medical providers
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`received for the sale of her medical liens, (6) excluding evidence of her
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`medical liens, (7) refusing to grant a new trial following Seastrand's use of
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`the word "claim" during opening arguments, and (8) awarding costs to
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`Seastrand.
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`The voir dire process
`
`DISCUSSION
`
`Khoury argues that the district court abused its discretion by
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`allowing Seastrand to voir dire the jury panel about their biases regarding
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`large verdicts. Khoury contends that Seastrand's questioning
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`indoctrinated the jury to have a disposition towards a large verdict.
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`Khoury argues that by asking jurors if they were uncomfortable with a
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`verdict in excess of $2 million, Seastrand's attorney "improperly implanted
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`a numerical value in the minds of the jury as representative of plaintiff's
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`damages before the jurors heard or considered any admitted evidence."
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`Therefore, Khoury urges this court to "rule that such questions are per se
`
`improper."
`
`The decision whether to grant or deny a motion for mistrial is
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`within the trial court's discretion. Owens v. State, 96 Nev. 880, 883, 620
`
`P.2d 1236, 1238 (1980).
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`Questioning jurors during voir dire about specific verdict amounts is
`not per se indoctrination
`
`"The purpose of jury voir dire is to discover whether a juror
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`will consider and decide the facts impartially and conscientiously apply
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`the law as charged by the court." Lamb v. State, 127 Nev. 26, 37, 251 P.3d
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`700, 707 (2011) (internal quotation marks omitted). "While counsel may
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`inquire to determine prejudice, he cannot indoctrinate or persuade the
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`jurors." Scully v. Otis Elevator Co., 275 N.E.2d 905, 914 (Ill. App. Ct.
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`1971).
`
`Although we have not yet considered the issue of jury
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`indoctrination in the civil context, we have considered it, albeit briefly, in
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`criminal proceedings. See Hogan v. State, 103 Nev. 21, 23, 732 P.2d 422,
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`423 (1987); see also Johnson v. State, 122 Nev. 1344, 1354-55, 148 P.3d
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`767, 774 (2006). In Hogan, the court indicated that it was not an abuse of
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`discretion for the district court to refuse to allow voir dire questions that
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`were "aimed more at indoctrination than acquisition of information." 103
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`Nev. at 23, 732 P.2d at 423. In Johnson, the court indicated that allowing
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`the State to ask "prospective jurors about their ability to carry out their
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`responsibilities l,1" by sentencing the defendant to death, was within the
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`district court's discretion. 122 Nev. at 1354-55, 148 P.3d at 774.
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`Other jurisdictions have considered the indoctrination issue in
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`the civil context and have addressed the particular issue raised here—
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`whether asking jurors if they have any hesitations about awarding a
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`specific amount of damages results in indoctrination per se. In Kinsey v.
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`Kolber, the Appellate Court of Illinois held that questioning jurors about
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`specific verdict amounts was not indoctrination because it "tended to
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`uncover jurors who might have bias or prejudice against large verdicts."
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`431 N.E.2d 1316, 1325 (Ill App. Ct. 1982); see also Scully, 275 N.E.2d at
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`914 (suggesting that allowing the plaintiff to question jurors about specific
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`amounts was not abuse of discretion because "[s]ome prospective jurors
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`may have had fixed opinions, which indicate bias or prejudice against
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`large verdicts, and which might not readily yield to proper evidence."
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`(internal quotation marks omitted)).
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`Alternatively, some jurisdictions have found that it is within
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`the discretion of the district court to refuse to allow the plaintiff to ask
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`questions about specific dollar amounts. This is because "they may tend to
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`influence the jury as to the size of the verdict, and may lead to the
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`impaneling of a jury which is predisposed to finding a higher verdict by its
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`tacit promise to return a verdict for the amount specified in the question
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`during the voir dire examination." Trautman v. New Rockford-Fessenden
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`Co-op Transp. Ass'n, 181 N.W.2d 754, 759 (N.D. 197W; see also Henthorn
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`v. Long, 122 S.E.2d 186, 196 (W. Va. 1961). However, these courts did not
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`state that questions about specific dollar amounts were per se improper;
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`rather, the courts in these cases merely held that it was within the district
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`court's discretion to refuse to allow the plaintiff to ask questions about
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`specific dollar amounts. See Trautman, 181 N.W.2d at 759 ("It is well
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`within the trial court's discretion to sustain objections to such questions.");
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`Henthorn, 122 S.E.2d at 196 ("While jurors may be interrogated on their
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`voir dire within reasonable limits, to elicit facts to enable the litigants to
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`exercise intelligently their right of peremptory challenge, the nature and
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`extent thereof should be left largely to the discretion of the trial court."
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`(internal quotation marks omitted)).
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`We agree with other courts that have considered this issue
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`and do not find the use of specific dollar amounts in voir dire to be per se
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`improper. Indeed, it may be appropriate to use a specific amount in order
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`to discover a juror's biases towards large verdicts. Simply asking jurors
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`about their feelings regarding "large" awards or some similarly vague
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`adjective may be insufficient to determine if a juror has a preconceived
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`damages threshold for a certain type of case. A juror may consider himself
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`or herself capable of awarding a verdict of $100,000, a verdict which in
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`their mind may be fabulously large, but be unable to follow the law and
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`award a verdict with another zero attached. Therefore, we hold that
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`allowing a party to voir dire the jury panel regarding a specific verdict
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`amount is within the district court's discretion.
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`Courts should remain vigilant of the danger of indoctrination during
`voir dire
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`During the three-day voir dire, Seastrand's attorney asked the
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`jurors the following question:
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`I'm going to be brutally honest with you folks right
`now. I'm going to say something that's a little
`uncomfortable for me to say. My client is suing for
`in excess of $2 million, and that's—you know,
`that's—that's what it is, and I'm putting that out
`there. I'm just going to be brutally honest about
`that. And I know that some of you folks, you
`know, you had different views and different beliefs
`in—in the jury questionnaire, and that's fine. But
`I want to talk about that right now.
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`So who here is a little uncomfortable, even if
`it's just a little bit, with what I just said?
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`Seastrand's attorney did not stop there, however. He repeatedly brought
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`up the $2 million verdict amount with each individual juror. In his quest
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`to discover the jurors' feelings on that specific verdict amount, the record
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`indicates that his actions bordered on badgering. One juror stated that
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`Seastrand's attorney had used a "bullying tactic" in his "overemphasis on
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`money" which "left a very bad taste in [his] mouth." The record also
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`reflects that the questioning almost reduced another juror to tears.
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`Although our review of the voir dire transcript indicates that
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`it was aimed more at acquisition of information than indoctrination, it was
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`uncomfortably close. If the conduct by Seastrand's attorney had been
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`allowed to become any more egregious, it would have reached the level of
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`reversible error due to jury indoctrination. We take this opportunity to
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`remind district court judges of their role in carefully considering the
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`treatment of jurors during the selection process and the ultimate objective
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`of seating a fair and impartial jury. However, we ultimately hold that the
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`district court did not abuse its discretion in finding that the jury was not
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`impermissibly indoctrinated in its denial of Khoury's motion for a mistrial.
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`The dismissals for cause
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`Khoury argues that the district court abused its discretion by
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`misapplying Jitnan v. Oliver, 127 Nev. 424, 254 P.3d 623 (2011), to
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`dismiss jurors for cause who expressed concerns about awarding a large
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`verdict amount. Khoury argues that a juror's prejudice against large
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`verdict amounts or pain and suffering damages is not a foini of bias.
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`Therefore, he maintains that the district court abused its discretion in
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`dismissing for cause jurors displaying such a prejudice. Khoury further
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`asserts that the district court abused its discretion by denying his motion
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`for a mistrial on these issues. See Owens, 96 Nev. at 883, 620 P.2d at
`1238.
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`During voir dire, the district court initially denied a motion to
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`dismiss for cause five individual jurors. However, after reviewing our
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`decision in Jitnan, the district court reconsidered its prior ruling and
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`dismissed the five jurors for cause "in an abundance of caution" because
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`le]ach one of them talked about the fact,. . that $2 million was too
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`much." In making its ruling, the district court was particularly concerned
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`with whether the prospective jurors could state "unequivocally" that they
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`did not have a preconception that a personal injury case could not support
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`a large damages verdict. See Jitnan, 127 Nev. at 432, 254 P.3d at 629
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`(holding that "[d] etached language considered alone is not sufficient to
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`establish that a juror can be fair when the juror's declaration as a whole
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`indicates that she could not state unequivocally that a preconception
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`would not influence her verdict." (emphasis added) (internal quotation
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`marks omitted)). The district court stated that "the unequivocal language
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`[in Jitnan] is the language that I keep coming back to and in order to
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`avoid the potential of bias or prejudice, I'm going to exclude them all."
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`A juror's bias against large verdict amounts or pain and suffering
`damages is a form of bias
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`"[Blias exists when the juror's views either prevent or
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`substantially impair the juror's ability to apply the law and the
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`instructions of the court in deciding the verdict." Sanders v. Sears-Page,
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`131 Nev., Adv. Op. 50, 354 P.3d 201, 206 (Ct. App. 2015).
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`Here, jurors were dismissed for cause on the grounds that they
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`indicated they were predisposed against awarding a large amount of
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`damages or damages for pain and suffering and would not be able to apply
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`the law and the instructions of the court to the evidence presented because
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`of their preconceived views. Inability by a juror to apply the law and
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`instructions of the court displays bias. Therefore, we next consider
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`whether such a bias existed in the jurors dismissed for cause by the
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`district court.
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`The district court abused its discretion by dismissing jurors for cause
`that displayed a "potential" bias against large verdicts
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`"A district court's ruling on a challenge for cause involves
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`factual determinations, and therefore, the district court enjoys broad
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`discretion, as it is better able to view a prospective juror's demeanor than
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`a subsequent reviewing court." Jitnan, 127 Nev. at 431, 254 P.3d at 628
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`(internal quotation marks omitted). 2 In Jitnan, we stated:
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`In determining if a prospective juror should
`have been removed for cause, the relevant inquiry
`focuses on whether the juror's views would
`prevent or substantially impair the performance of
`his duties as a juror in accordance with his
`instructions and his oath. Broadly speaking, if a
`prospective juror expresses a preconceived opinion
`or bias about the case, that juror should not be
`removed for cause if the record as a whole
`demonstrates that the prospective juror could lay
`aside his impression or opinion and render a
`verdict based on the evidence presented in court.
`But detached language considered alone is not
`sufficient to establish that a juror can be fair when
`the juror's declaration as a whole indicates that
`she could not state unequivocally
`that a
`preconception would not influence her verdict.
`
`Id. at 431-32, 254 P.3d at 628-29 (emphasis added) (citations and internal
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`quotation marks omitted).
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`2Khoury argues in his reply brief that the district court
`misinterpreted NRS 16.050 and that therefore the proper standard of
`review is de novo, not abuse of discretion. Because Khoury raises this
`issue for the first time in his reply brief, it is deemed waived and we do not
`consider it here. NRAP 28(c).
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`Here, the district court initially denied Seastrand's motion to
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`dismiss five jurors for cause who had expressed concerns about awarding
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`large verdict amounts and/or pain and suffering damages, but later stated
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`under cross-examination by Khoury that they would be able to follow the
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`law and award a large verdict amount and/or pain and suffering damages.
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`However, the next day, the district court reconsidered its prior ruling and
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`dismissed the jurors for cause, reasoning that "the unequivocal language
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`[in Jitnan] is the language that I keep coming back to and in order to
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`avoid the potential of bias or prejudice, I'm going to exclude them all."
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`(Emphasis added.)
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`This statement encapsulates the district court's error.
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`Potential bias is not a valid basis for dismissing a juror for cause. Jurors
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`should only be excluded on the basis of an actual bias that prevents or
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`substantially impairs the juror's ability to apply the law and the
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`instructions of the court in deciding the verdict or for other grounds
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`defined by statute. See NRS 16.050. It is clear from the district court's
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`oral reasoning that it was focused on the last sentence of Jitnan and,
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`specifically, the single word "unequivocally," while ignoring the context
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`provided by the remainder of the paragraph in which it is contained. If
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`potential bias was all that were required to dismiss a juror for cause, then
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`any expression of doubt, no matter how small, by a juror would be grounds
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`to dismiss for cause. Under such a standard, rehabilitation by the
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`opposing party's attorney would be impossible. No matter how fervent a
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`juror's statements indicating that they could follow the law, the potential
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`for bias would remain.
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`Jitnan, when read in context, states that jurors' statements
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`expressing a potential bias are not enough, when taken alone, to mean
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`that they cannot "unequivocally" follow the law. 127 Nev. at 432, 254 P.3d
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`at 629. While Jitnan only states that "[d]etached language considered
`
`alone is not sufficient to establish that a juror can be fair," this is also true
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`for establishing whether a juror cannot be fair. Id. (internal quotation
`
`marks omitted). Jurors' statements must be taken "as a whole," and
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`"[d] etached language, considered alone [J" indicating that they may have
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`difficulty awarding a large verdict amount is insufficient to demonstrate
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`that they would be unable or substantially impaired in applying the law
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`and the instructions of the court in deciding the verdict and thus actually
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`biased against awarding large verdict amounts.
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`Id. (internal quotation
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`marks omitted).
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`After reviewing the voir dire transcript, we conclude that the
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`district court got it right the first time when it refused to dismiss the five
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`jurors for cause. Therefore, we hold that the district court abused its
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`discretion by improperly dismissing jurors for cause whose statements,
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`when taken as a whole, indicate that they could apply the law and the
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`instructions of the court in deciding the verdict and thus were not actually
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`biased.
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`The error was harmless
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`Khoury argues that excluding jurors for their biases against
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`large verdict amounts was reversible error because it prevented the jury
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`from being a fair cross-section of society. Khoury equates this to excluding
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`jurors on the basis of political affiliation, which some courts do not allow.
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`Although we have not yet considered this issue, most
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`jurisdictions have held that when the district court abuses its discretion in
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`dismissing a juror for cause, it is not reversible error. See Jones v. State,
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`982 S.W.2d 386, 392 (Tex. Crim App. 1998) ("The law in Texas for civil
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`cases is like that of the federal courts and the courts of the other states. It
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`has long been the established rule in this state that even though the
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`challenge for cause was improperly sustained, no reversible error is
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`presented unless appellant can show he was denied a trial by a fair and
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`impartial jury." (internal quotation marks omitted)); see also Basham v.
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`Commonwealth, 455 S.W.3d 415, 421 (Ky. 2014) (holding that even when a
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`trial court abuses its discretion in dismissing a juror for cause, it is not
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`reversible error unless that abuse was "tantamount to some kind of
`
`systematic exclusion, such as for race"). This is because, unlike an abuse
`
`of discretion in refusing to dismiss a juror, which can result in a biased
`
`juror or jury, when the district court improperly strikes a juror, it "[does]
`
`not prejudice the [appellant]." If a "competent and unbiased juror was
`
`selected and sworn," the appellant had "a trial by an impartial jury, which
`
`was all it could demand." N. Pac. R.R. Co. v. Herbert, 116 U.S. 642, 646
`
`(1886).
`
`Khoury is unable to provide any persuasive authority to
`
`support his contention that improperly dismissing jurors with a perceived
`
`bias for cause is reversible error. Rather, Khoury relies on Powers v. Ohio,
`
`499 U.S. 400, 422, (1991), which holds that dismissing jurors on the basis
`
`of race prevents a jury from being "a fair cross section of the community"
`
`We do not conclude exclusion on the basis of race to be comparable to
`
`exclusion due to a mistaken finding of bias. Likewise, we reject Khoury's
`
`argument that dismissing for cause due to bias against large verdicts is
`
`comparable to dismissing for cause due to political affiliations. While at
`
`least one court has held that "falffiliations with political parties constitute
`
`neither a qualification nor disqualification for jury service," State v.
`
`McGee, 83 S.W.2d 98, 106 (Mo. 1935), it did not hold that dismissing for
`
`cause on this issue is reversible error. Therefore, we hold that the district
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`court's error was harmless and does not warrant reversal of the judgment
`
`or the order denying Khoury's new trial motion.
`
`Dr. Muir's testimony
`
`Khoury argues that Seastrand's treating physician, Dr. Muir,
`
`should have been precluded from testifying about the cause of Seastrand's
`
`injuries and his opinion on the treatment provided by Dr. Marjorie E.
`
`Belsky because Seastrand failed to conform to the testifying expert
`
`witness disclosure requirements in presenting Dr. Muir as a witness.
`
`The district court did not abuse its discretion by admitting Dr.
`Muir's testimony
`
`This court reviews the decision of the district court to admit
`
`expert testimony without an expert witness report or other disclosures for
`
`an abuse of discretion. FCH1, LLC v. Rodriguez, 130 Nev., Adv. Op. 46,
`
`335 P.3d 183, 190 (2014) (reviewing for an abuse of discretion a district
`
`court's decision to allow physician testimony without an expert witness
`
`report and disclosure). "While a treating physician is exempt from the
`
`report requirement, this exemption only extends to 'opinions [that] were
`
`formed during the course of treatment." Id., 335 P.3d at 189 (quoting
`
`Goodman v. Staples the Office Superstore, LLC, 644 F.3d 817, 826 (9th Cir.
`
`2011)). "Where a treating physician's testimony exceeds that scope, he or
`
`she testifies as an expert and is subject to the relevant requirements." Id.
`
`On direct examination, the following exchange occurred
`
`between Dr. Muir and Seastrand's attorney:
`
`Q. Dr. Muir, No. 1, do you feel that there
`was an adequate workup of the patient prior to
`getting to you?
`
`A. Yes.
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`Khoury argues that Dr. Muir improperly opined on the reasonableness of
`
`Dr. Belsky's treatment in this exchange because Dr. Muir did not form
`
`this opinion during the course of his treatment of Seastrand.
`
`At trial, evidence was presented supporting the contention
`
`that Dr. Muir's opinion of the workup of Seastrand by Dr. Belsky was
`
`formed in the course of Dr. Muir's treatment. Dr. Muir testified that Dr.
`
`Belsky referred Seastrand to him after the injections given by Dr. Belsky
`
`failed to cause her condition to improve. Dr. Muir testified that both he
`
`and Dr. Belsky believed that Seastrand's symptoms were caused by the
`
`same portions of the spine. Dr. Muir further testified that the injections
`
`given by Dr. Belsky "help [ed] to determine if a particular nerve is being
`
`irritated or maybe damaged." He testified that it is possible that "after a
`
`couple of injections, maybe the body has healed itself. ... [a]nd you can
`
`treat the problem in a less aggressive way or maybe it won't require any
`
`treatment after a period of time." Lastly, Dr. Muir testified that he took
`
`into consideration the course of treatment of other providers in making his
`
`diagnosis and treatment plan.
`
`Dr. Muir's testimony indicates that the injections given by Dr.
`
`Belsky were helpful in determining which of Seastrand's nerves were
`
`damaged and whether aggressive treatment would be necessary. His
`
`testimony also indicated that his review of the treatment of other
`
`providers is helpful in making his diagnosis and treatment plan. Thus,
`
`Dr. Muir's testimony indicates that his opinion of Dr. Belsky's treatment
`
`was formed in the course of his own treatment. Therefore, we hold that
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`the district court did not abuse its discretion by admitting Dr. Muir's
`
`testimony as to whether Dr. Belsky's workup of Seastrand was adequate. 3
`
`Dr. Gross's testimony
`
`Khoury argues that the district court abused its discretion by
`
`allowing Dr. Gross to testify about symptoms that Seastrand experienced
`
`before the accident, as such testimony was outside the scope of his
`
`specialized knowledge as a neurosurgeon and was an opinion that was not
`
`disclosed in Dr. Gross's expert report. Therefore, Khoury argues that the
`
`district court abused its discretion by admitting the testimony.
`
`On direct examination, the following exchange occurred
`
`between Seastrand's attorney and Dr. Gross:
`
`[The court, repeating a question from Seastrand's
`attorney.] Is it more probable those findings
`were—of the numbness and tingling were coming
`from the neck or more probable it was from the
`heart event for which she had a positive stress
`test?
`
`[Dr. Gross]: It is more probable that the arm
`symptoms are unrelated to the neck and more
`likely related to the heart or anxiety or both.
`
`Dr. Gross was referring to symptoms that Seastrand had prior to the
`
`accident giving rise to the current case. This was relevant because
`
`31Choury also argues that Dr. Muir's testimony as to causation
`regarding Seastrand's injuries was improper. However, because Khoury
`did not object to Dr. Muir's testimony on causation, he has waived this
`issue on appeal. See In re Parental Rights as to J.D.N., 128 Nev. 462, 468,
`283 P.3d 842,846 (2012) (" [W]hen a party fails to make a specific objection
`before the district court, the party fails to preserve the issue for appeal.").
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`Khoury's defense was that Seastrand's injuries predated the accident, and
`
`thus, he was not liable for damages related to those injuries.
`
`The district court did not abuse its discretion by admitting testimony
`by Dr. Gross because it was not outside the scope of his specialized
`knowledge
`
`To testify as an expert witness under NRS 50.275,
`the witness must satisfy the following three
`requirements: (1) he or she must be qualified in an
`area of "scientific, technical or other specialized
`knowledge" (the qualification requirement); (2) his
`or her specialized knowledge must "assist the trier
`of fact to understand the evidence or to determine
`a fact in issue" (the assistance requirement); and
`(3) his or her testimony must be limited "to
`matters within the scope of [his or her specialized]
`knowledge" (the limited scope requirement).
`
`Hallmark v. Eldridge, 124 Nev. 492, 498, 189 P.3d 646, 650 (2008). These
`
`requirements are analogous to the requirement in federal law that the
`
`expert testimony "rests on a reliable foundation," which is that "the
`
`knowledge underlying it has a reliable basis in the knowledge and
`
`experience of the relevant discipline." Pyramid Techs., Inc. v. Hartford
`
`Cas. Ins. Co., 752 F.3d 807, 813 (9th Cir. 2014) (internal quotation marks
`
`omitted).
`
`At trial, Dr. Gross testified that he was a board-certified
`
`neurological surgeon with a fellowship in spinal biomechanics. He
`
`regularly treats patients with "neck and back problems, including injuries
`
`and other causes of disk problems, nerve problems, spinal cord problems."
`
`When patients are first referred to him, he asks about their past history
`
`and other medical issues that they have had. He then does a physical
`
`examination, where if the patient appears to have a neck condition, he
`
`tests the neck, head, arms, and hands and reviews films and tests that
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`have been taken of the patient. Lastly, he uses the patient's past history
`
`and the results of the physical examination to "come up with the best
`
`diagnoses that match or co
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