Orosco v. McShcd ( 2017 )


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  •                      NOTICE: NOT FOR OFFICIAL PUBLICATION.
    UNDER ARIZONA RULE OF THE SUPREME COURT 111(c), THIS DECISION IS NOT PRECEDENTIAL
    AND MAY BE CITED ONLY AS AUTHORIZED BY RULE.
    IN THE
    ARIZONA COURT OF APPEALS
    DIVISION ONE
    BRANDON OROSCO and JENNIFER OROSCO, husband and wife,
    individually, and as parents and next friends of KAYLEN OROSCO,
    MARISSA OROSCO, and SILAS OROSCO,
    Plaintiffs/Appellees,
    v.
    MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, a body
    politic for and dba MARICOPA INTEGRATED HEALTH SYSTEM,
    Defendant/Appellant.
    No. 1 CA-CV 15-0580
    FILED 2-2-2017
    Appeal from the Superior Court in Maricopa County
    No. CV2012-004724
    The Honorable John Christian Rea, Judge
    AFFIRMED IN PART, VACATED AND REMANDED IN PART
    COUNSEL
    Harris Powers & Cunningham PLLC, Phoenix
    By Frank I. Powers
    Counsel for Plaintiffs/Appellees
    Slattery Petersen, PLLC, Phoenix
    By Elizabeth A. Petersen
    Counsel for Defendant/Appellant
    OROSCO v. MCSHCD
    Decision of the Court
    MEMORANDUM DECISION
    Presiding Judge Diane M. Johnsen delivered the decision of the Court, in
    which Judge Jon W. Thompson and Chief Judge Michael J. Brown joined.
    J O H N S E N, Judge:
    The Maricopa County Special Health Care District
    ("MCSHCD") appeals the superior court's orders denying judgment as a
    matter of law and a new trial or remittitur and imposing costs and
    sanctions. For the following reasons, we affirm in part and vacate and
    remand in part.1
    FACTS AND PROCEDURAL BACKGROUND
    Brandon Orosco sought treatment at MCSHCD for severe
    burns. During the insertion of a central line, MCSHCD's medical resident
    negligently left a two-foot long guidewire in Brandon's artery and failed to
    inform her supervising physician or the radiologists when she could not
    locate the guidewire after the procedure.
    About six weeks later, Brandon presented with excruciating
    pain; on imaging, the guidewire was seen running from his chest down to
    his right thigh. Doctors attempted several times over the course of three
    days to remove the wire, which had embedded in Brandon's femoral artery.
    During that time, Brandon suffered severe groin pain and doctors warned
    him movement could be fatal. After the wire was removed, Brandon's
    femoral artery collapsed, necessitating stent placement. The stent became
    blocked and infected, requiring bypass surgery that eventually failed.
    Ultimately, doctors removed Brandon's femoral artery.
    Brandon was 34 at the time and was expected to live about
    another 42 years. Experts testified that as a result of the guidewire incident,
    Brandon now suffers emotional distress, PTSD and major depression. He
    1      The District also argues the superior court erred by awarding
    sanctions under Arizona Rule of Civil Procedure 68(g) calculated from the
    date of the first of the Oroscos' two offers of judgment. In a separate
    opinion, we affirm the court's decision to impose sanctions calculated from
    the date of the first offer. See Arizona Rule of Civil Appellate Procedure
    28(c).
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    OROSCO v. MCSHCD
    Decision of the Court
    tried to commit suicide, and there is a chance he might lose his leg. Further,
    he has nerve damage, permanent scars, difficulty walking and takes pain
    medication daily.
    Before the close of evidence at trial, MCSHCD moved for
    judgment as a matter of law on Brandon's children's loss of consortium
    claim, which the superior court denied.
    The jury rendered a $4.25 million verdict in favor of Brandon
    and his family, allocating 99% of fault to MCSHCD and 1% fault to the
    codefendant radiology group. The superior court denied MCSHCD's
    motion for new trial or remittitur and awarded taxable costs and sanctions
    to the Oroscos.
    We have jurisdiction over this timely appeal pursuant to
    Arizona Revised Statutes ("A.R.S.") sections 12-2101(A)(1), (5)(a) (2017) and
    -2102(B) (2017).2
    DISCUSSION
    A.     Denial of Motion for Judgment as a Matter of Law.
    MCSHCD argues the superior court erred by denying its
    motion for judgment as a matter of law on the children's claim for loss of
    consortium because there was no evidence of damage to the parent-child
    relationship.
    We review de novo the denial of judgment as a matter of law.
    Glazer v. State, 
    237 Ariz. 160
    , 167, ¶ 29 (2015). The superior court should
    grant judgment as a matter of law when there is no issue of fact and the
    movant is entitled to judgment as a matter of law. 
    Id. We review
    the
    evidence in the light most favorable to the children as the non-moving
    parties. 
    Id. at ¶
    28. If reasonable people could differ about the conclusions
    drawn from the evidence, the court should deny the motion. 
    Id. A child
    claiming loss of parental consortium must
    demonstrate that the injury caused damage to the normal parent-child
    relationship. See Villareal v. State Dep't of Transp., 
    160 Ariz. 474
    , 481 (1989);
    Miller v. Westcor Ltd. P'ship, 
    171 Ariz. 387
    , 395 (App. 1991). If the superior
    court determines that "the threshold of a significant interference with the
    normal relationship between parent and child has been met," the jury
    2     Absent material revision after the relevant date, we cite a statute's
    current version.
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    OROSCO v. MCSHCD
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    "determines the question of recovery or the amount recoverable based on
    the degree of that interference." Pierce v. Casas Adobes Baptist Church, 
    162 Ariz. 269
    , 272 (1989).
    Brandon, his wife, and her sister all testified that after
    Brandon suffered injury due to the guidewire, Brandon and his children no
    longer enjoyed physical activities together to the same extent as before. The
    three children are all school-age teenagers. Viewing this evidence in the
    light most favorable to the children, reasonable jurors could find the
    negligence by MCSHCD interfered with the children's normal parent-child
    relationships with Brandon.
    Citing Peterson v. Sun State International Trucks, LLC, 
    56 So. 3d 840
    (Fla. Dist. App. 2011), MCSHCD argues the children needed to testify
    about how the guidewire event and their father's resulting injuries affected
    their relationship with their father. In Peterson, both the husband who
    claimed loss of consortium and his wife testified about the damage to their
    marital relationship. 
    Id. at 843.
    Peterson does not hold that a party claiming
    loss of consortium must testify. Under Arizona law, the jury may draw a
    negative inference when a party declines to testify in a civil case. Melissa
    W. v. Dep't of Child Safety, 
    238 Ariz. 115
    , 116-17, ¶ 5 (App. 2015). There is no
    requirement in Arizona law, however, that children have to testify in
    support of a loss of consortium claim. Thus, the superior court properly
    denied MCSHCD's motion for judgment as a matter of law.
    B.     Denial of Motion for New Trial or Remittitur.
    We review for abuse of discretion the denial of a motion for
    new trial or remittitur. Hutcherson v. City of Phoenix, 
    192 Ariz. 51
    , 53, ¶ 12
    (1998). We view the evidence in the light most favorable to upholding the
    jury's verdict. 
    Id. at ¶
    13. We will affirm if "any substantial evidence exists
    permitting reasonable persons to reach such a result." 
    Id. 1. Evidentiary
    rulings.
    a.     Standard-of-care testimony.
    MCSHCD argues the superior court erred in allowing the
    Oroscos' expert witness to testify MCSHCD breached the standard of care
    because MCSHCD conceded negligence.
    Regardless of MCSHCD's admission, its fault was at issue at
    trial because the codefendant radiology group denied negligence and
    causation and the defendants disputed comparative fault. Fault includes
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    OROSCO v. MCSHCD
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    negligence. A.R.S. § 12-2506(F)(2) (2017). In determining comparative fault,
    the jury compares the relative fault of all codefendants. 
    Id. § 12-2506(B)
    ("[T]he trier of fact shall consider the fault of all persons who contributed to
    the alleged injury."); 
    id. § 12-2506(C)
    (trier of fact shall determine and
    apportion the "relative degree of fault" of the claimant, the defendants and
    the nonparties); Piner v. Super. Ct., 
    192 Ariz. 182
    , 187-89, ¶¶ 20-25, 30 (1998)
    (A.R.S. § 12-2506(B) does not "require limiting liability by apportioning
    damages but by apportioning fault"); Zuern v. Ford Motor Co., 
    188 Ariz. 486
    ,
    491-92 (App. 1996). Thus, the superior court did not err in admitting
    evidence bearing on MCSHCD's fault, including evidence of how
    MCSHCD allegedly breached the standard of care.
    MCSHCD also argues the superior court improperly
    permitted duplicative expert standard-of-care testimony. Contrary to
    MCSHCD's argument, the record shows that only the Oroscos' standard-of-
    care expert testified that the resident deviated from the standard of care.
    Finally, MCSHCD challenges the qualifications of the
    Oroscos' standard-of-care expert. We need not decide this issue because
    MCSHCD admitted its resident deviated from the standard of care and
    there is no dispute that it is negligent to leave a guidewire in a patient and
    to fail to notify appropriate individuals after doing so.
    b.     Preclusion of evidence about the origin of Brandon's
    burns.
    Before trial, the superior court ruled that because Brandon's
    comparative fault was not at issue, it was irrelevant that Brandon had
    caused the fire in which he was burned. On the record, the court stated,
    "Certainly, the burns, the traumatic events, all of that is relevant to claim
    psychological damages, but evidence of how the fire started and casting
    fault on Mr. Orosco is not relevant."
    At the conclusion of the evidence, MCSHCD filed an offer of
    proof, asking to offer excerpts of Brandon's deposition testimony and his
    medical records and to recall an expert witness, all to show that Brandon
    suffered nightmares of the fire and had related anxiety and mental trauma
    related to the fire. MCSHCD argued the court's pretrial ruling unfairly had
    prevented it from cross-examining the expert about the mental distress
    Brandon suffered from the fire. After reviewing the offer of proof, the court
    observed that it was "not sure that the pretrial ruling precluding
    comparative fault was quite as broad" as MCSHCD had understood. The
    court continued, "There was always the burns and the nature of the burns
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    OROSCO v. MCSHCD
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    were always fair game, and if asked, we could have probably gone into
    some of these issues as long as nobody was casting fault on Mr. Orosco."
    Notwithstanding MCSHCD's argument, however, it indeed
    cross-examined the expert witness about Brandon suffering
    psychologically due to his burns. Moreover, as the court indicated after
    reviewing the offer of proof, its pretrial ruling did not bar MCSHCD from
    offering proof that Brandon suffered mental distress as a result of his burns.
    In any event, because the expert testified about those psychological injuries,
    no ruling by the court affected MCSHCD's substantial rights. Ariz. R. Evid.
    103(a).
    c.     Admission of evidence of the risk of amputation.
    MCSHCD argues the superior court erred in permitting
    evidence and argument that negligence by MCSHCD caused Brandon an
    increased risk of leg amputation.
    The Oroscos' vascular surgery expert testified that because
    the guidewire had been embedded in Brandon's femoral artery for five or
    six weeks, Brandon developed an infection necessitating removal of the
    entire artery. The expert also testified that although remaining collateral
    arteries provide blood flow to Brandon's leg, Brandon is at a higher risk
    than a normally healthy person for developing future infection that might
    require his leg to be amputated. Brandon's treating surgeon testified the
    chance of Brandon losing his leg is "very low" but "more so than the general
    population."
    Relying on Thompson v. Sun City Community Hospital, Inc., 
    141 Ariz. 597
    (1984), MCSHCD argues this evidence did not rise to the threshold
    level of "increased risk of harm" necessary to establish causation, and
    contends the superior court erred in denying its motion for new trial on this
    basis.
    MCSHCD confuses causation with damages. In the ordinary
    negligence case, a plaintiff must prove the defendant probably caused his
    or her injury. Benkendorf v. Advanced Cardiac Specialists Chartered, 
    228 Ariz. 528
    , 530, ¶ 8 (App. 2012). In a limited class of cases relying on the "loss of
    chance" theory of causation, a plaintiff only needs to show that negligence
    "increased the risk" of harm. 
    Thompson, 141 Ariz. at 605-08
    . Here, the
    evidence of risk of amputation was not offered to prove MCSHCD caused
    Brandon harm, but rather as an element of damages.
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    OROSCO v. MCSHCD
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    "Greater susceptibility to physical harm has been recognized
    as an element of damage[s] in Arizona." Kenyon v. Hammer, 
    142 Ariz. 69
    , 75
    (1984) (increased risk of future fetal fatality is "damage which will sustain a
    cause of action in tort"). Moreover, an increased risk of future harm is
    compensable when accompanied by physical deterioration. See Felder v.
    Physiotherapy Assocs., 
    215 Ariz. 154
    , 166, ¶ 54 (App. 2007) (plaintiff could
    recover for anxiety over his less than 1% chance of loss of vision).
    The jury found MCSHCD liable for failing to remove the
    guidewire after the procedure. The evidence showed that as a result of
    MCSHCD's negligence, Brandon suffered serious physical injury and has
    an increased risk of leg amputation compared to the average person. The
    superior court did not err in denying the motion for new trial due to the
    admission of amputation-risk evidence.
    2.     Closing argument.
    a.      "Conscience of the community" statement.
    Although no claim for punitive damages was before the jury,
    MCSHCD argues that the Oroscos' lawyer improperly suggested the jury
    should punish MCSCHD by its damage verdict. It points to comments by
    the Oroscos' lawyer during closing argument that the jury should "keep in
    mind you're the conscience of the community" and should "tell them with
    your verdict that our community deserves better."
    In support for its contention that these comments improperly
    influenced the jury, MCSHCD cites Maercks v. Birchansky, 
    549 So. 2d 199
    (Fla. App. 1989), and Janssen Pharmaceutica, Inc. v. Bailey, 
    878 So. 2d 31
    (Miss.
    2004). The court in Maercks reversed a medical malpractice award due to a
    long list of improper statements by the plaintiff's lawyer, including, but not
    limited to: "[C]ounsel for plaintiff three times asked the jury as the
    'conscience of the community' to 'send a message with its verdict,' and
    additionally commented on the expense of past medical bills when there
    was no claim for past medical expenses as damages, made derogatory
    personal remarks about opposing counsel, and asserted his personal
    opinion as to the credibility of a witness, the justness of his client's cause
    and the perfidy of the 
    defendant." 549 So. 2d at 200
    . And in Janssen,
    plaintiffs' counsel not only asked the jury to "send a message," but also
    repeatedly told the jury that the defendant had lied to and defrauded the
    public, notwithstanding the court's prior dismissal of a claim for
    
    misrepresentation. 878 So. 2d at 62
    .
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    OROSCO v. MCSHCD
    Decision of the Court
    The comments by Oroscos' lawyer on which MCSHCD bases
    its argument came at the end of a passage in which counsel called the jury's
    attention to each item on a verdict form. Counsel concluded:
    When you answer these questions, keep in mind you're the
    conscience of the community. You're the one that needs to
    consider all the harm in the lives that have been forever
    changed. . . . What happens to Mr. Orosco is up to you. Make
    sure the debt the defendants have created is paid in full. Tell
    them with your verdict that they seriously harmed this
    family. Tell them with your verdict that our community
    deserves better.
    We do not agree that these comments effectively asked the jury to punish
    MCSHCD. Nothing similar to the improprieties in Maercks or Janssen
    occurred here. Taken as a whole, counsel's statements properly urged the
    jury to consider the verdict forms. See Cota v. Harley Davidson, 
    141 Ariz. 7
    ,
    15 (App. 1984) (rejecting contention that telling the jury to "send a message"
    was an improper request for punitive damages).
    b.     Comment on MCSHCD's failure                to   call   an
    independent medical examiner.
    MCSHCD argues the court erred by denying its motion to
    preclude any reference to the fact that it decided not to offer testimony by
    an independent medical examiner that it had retained to examine Brandon.
    MCSHCD argues Brandon's testimony about the examination and his
    lawyer's reference in closing argument to the fact that MCSHCD failed to
    call the examiner improperly permitted the jury to draw an adverse
    inference.
    MCSHCD relies on Gordon v. Liguori, 
    182 Ariz. 232
    (App.
    1995), to support its argument that Arizona law precludes comment on the
    defense's failure to call the examiner. The jury may draw an adverse
    inference from the failure to call a witness "only under limited
    circumstances." 
    Gordon, 182 Ariz. at 236
    . But Brandon testified that the
    expert's examination caused him pain; he did not go on to point out that the
    examiner was not a witness at trial. As to the closing argument comment,
    under Gordon, relevant considerations are whether the witness is under the
    control of the party that failed to call the witness to testify, whether the
    party naturally would call the witness to testify if that testimony would be
    favorable to the party, and "whether the existence or nonexistence of a
    certain fact is uniquely within the knowledge of the witness." Id.; see also
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    OROSCO v. MCSHCD
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    Ponce v. Indus. Comm'n, 
    120 Ariz. 134
    , 136 (App. 1978). When the particular
    perspective is uniquely within the witness's knowledge, the jury may draw
    an adverse inference from the failure to testify. See Melissa 
    W., 238 Ariz. at 117
    , ¶ 8. The first two factors clearly weigh in favor of allowing the
    argument; moreover, because only the examiner knew the details and
    results of his examination of Brandon, that factor also weighs against
    MCSHCD's contention that the court erred by denying its motion to
    preclude. See 
    id. C. Jury
    Instructions.
    MCSHCD argues the superior court erred in failing to instruct
    the jury that A.R.S. § 12-820.04 (2017) did not allow an award of punitive
    damages. The jury, however, was properly instructed on the nature and
    elements of the damages for which the Oroscos were entitled to seek
    compensation. MCSHCD cites no authority for the proposition that under
    these circumstances, the jury must be told it should not award punitive
    damages or otherwise punish the defendant by its verdict.
    MCSHCD also argues the superior court erred by not
    instructing the jury that it was not liable for damages arising from
    Brandon's burns and a subsequent motor vehicle accident. MCSHCD did
    not request a jury instruction related to the burns and the motor vehicle
    accident. The superior court properly instructed the jury that Brandon was
    not entitled to compensation for physical conditions pre-existing
    MCSHCD's fault and that it must decide the amount of money that would
    compensate the Oroscos for the damages caused by MCSHCD's fault. The
    superior court did not err in failing to a give a more specific jury instruction.
    D.     Damages Award.
    MCSHCD contends a new trial or remittitur was warranted
    because the evidence did not support the $4.25 million verdict.
    The jury decides the appropriate amount of damages.
    Creamer v. Troiano, 
    108 Ariz. 573
    , 576 (1972). If the verdict is "so
    unreasonable and outrageous as to shock the conscience of this court" and
    derives from passion or prejudice, we will remand for a new trial. Stallcup
    v. Rathbun, 
    76 Ariz. 63
    , 65-67 (1953). A large verdict does not necessarily
    derive from passion or prejudice. 
    Hutcherson, 192 Ariz. at 57
    , ¶ 36. If the
    verdict signals "an exaggerated measurement of damages," remittitur is
    appropriate. See 
    Stallcup, 76 Ariz. at 65-67
    . On review, reference to other
    jury verdicts is "dangerous" because no two persons, injuries or juries are
    alike. Wry v. Dial, 
    18 Ariz. App. 503
    , 514-15 (1972); see also Ahmad v. State,
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    OROSCO v. MCSHCD
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    240 Ariz. 381
    , 385-86, ¶¶ 12-16 (App. 2016). Instead, we examine whether
    the evidence supports the damages award. See 
    Ahmad, 240 Ariz. at 385
    , ¶
    10; In re Estate of Hanscome, 
    227 Ariz. 158
    , 162, ¶ 14 (App. 2011).
    MCSHCD essentially asks us to reweigh the evidence, which
    we cannot and will not do. See 
    Creamer, 108 Ariz. at 576
    . In particular, in
    considering the damages evidence supporting Brandon's pain and
    suffering, we are not shocked by the amount of the verdict, nor is the verdict
    an exaggerated measurement of damages. On this record, the superior
    court did not err in denying a new trial or remittitur based on the damages
    award.
    E.     Cost Award and Sanctions.
    1.     Costs.
    Under A.R.S. § 12-341 (2017), the superior court must award
    costs to the successful party. Graville v. Dodge, 
    195 Ariz. 119
    , 130, ¶ 52 (App.
    1999). We review a cost award for abuse of discretion. See 
    id. at ¶
    53.
    a.       Verification.
    MCSHCD argues the superior court erred in awarding costs
    in the absence of a timely verification by the Oroscos in support of their cost
    claim. Although the requesting party must file a verified statement of costs
    within ten days after judgment, the superior court may extend the time for
    compliance for good cause. A.R.S. § 12-346(A) (2017).
    When the Oroscos timely submitted their statement of costs,
    they omitted the requisite accompanying verification, but they submitted
    the verification with their reply. We infer from the superior court's cost
    award that it found good cause to extend the time to submit the verification.
    See Wippman v. Rowe, 
    24 Ariz. App. 522
    , 525 (1975). In the absence of any
    argument to the contrary, the superior court did not err in extending the
    time for compliance.
    b.       Specific objections to costs.
    In a separate opinion, we hold the superior court did not err
    by awarding the Oroscos the costs of service of process. MCSHCD also
    challenges the award of costs for video deposition fees, contending the
    Oroscos only could recover costs for a deposition transcript/court reporter
    or a deposition video/videographer, but not both. The superior court has
    discretion to award both sets of costs, "[b]ased on an individualized
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    OROSCO v. MCSHCD
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    determination of reasonableness and necessity." Reyes v. Frank's Serv. &
    Trucking, LLC, 
    235 Ariz. 605
    , 611, ¶ 23 (App. 2014). We infer from the
    superior court's ruling that it determined both sets of costs were reasonable
    and necessary. See 
    Wippman, 24 Ariz. App. at 525
    . Because there is evidence
    supporting the reasonableness and necessity of using both methods for the
    taking of depositions, the superior court did not abuse its discretion in
    awarding costs for both memorialization methods.
    Next, MCSHCD challenges the award of costs for copies of
    deposition transcripts sent to experts. Because the cost of deposition
    transcript copies is recoverable as a "cost incidental to the taking of the
    deposition," we reject MCSHCD's argument. Visco v. First Nat'l Bank of
    Ariz., 
    3 Ariz. App. 504
    , 508 (1966).
    MCSHCD also challenges the award of costs for private
    mediation fees. Recoverable costs include "[o]ther disbursements that are
    made or incurred pursuant to an order." A.R.S. § 12-332(A)(6) (2017); see
    also 
    Graville, 195 Ariz. at 130
    , ¶ 54 (affirming assessment of court-appointed
    physician witness fees against respondent as a taxable cost under A.R.S. §
    12-332(A)(6) because the payment of fees by the prevailing party was made
    pursuant to court order). Here, because the superior court ordered the
    parties to participate in private mediation, the superior court did not err in
    awarding costs for private mediation fees. See 
    Graville, 195 Ariz. at 130
    , ¶
    54.
    MCSHCD also challenges other expenses claimed as taxable
    costs. The Oroscos claimed $4,000 billed by one expert and $4,500 billed by
    another for the time spent in traveling to Arizona for the trial. Fees paid to
    an expert witness for travel time, however, are not taxable as witness fees
    under § 12-332(A) and the version of Arizona Rule of Civil Procedure
    54(f)(2) in effect at the time. Foster v. Weir, 
    212 Ariz. 193
    , 195, ¶ 8 (App.
    2006). Similarly, the Oroscos cite no authority for their cost claim for $721
    in travel expenses for another expert. Further, we find no authority, and
    the Oroscos cite none, under which $153.55 in meal expenses incurred
    during a deposition and a settlement conference are taxable costs. Because
    the Oroscos could only recover costs pursuant to statutory authorization,
    Ahwatukee Custom Estates Management Ass'n v. Bach, 
    193 Ariz. 401
    , 402, ¶ 6
    (1999), on remand, the superior court should vacate the portion of the cost
    award relating to meals, experts' travel time and experts' travel expenses.
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    2.     Rule 68 sanctions.
    We review a sanctions award under Arizona Rule of Civil
    Procedure 68 for abuse of discretion. Berry v. 352 E. Va., L.L.C., 
    228 Ariz. 9
    ,
    15, ¶ 31 (App. 2011). In a separate opinion, we reject the argument by
    MCSHCD that the superior court erred as a matter of law by calculating
    sanctions from the date of the Oroscos' first offer of judgment pursuant to
    Rule 68.
    MCSHCD also raises other issues concerning the superior
    court's sanction award. Under Rule 68(g), the Oroscos were entitled to be
    reimbursed their "reasonable expert witness fees." The Oroscos sought
    sanctions under Rule 68(g) for the fees paid to several expert witnesses,
    including those whose travel time we addressed as claimed taxable costs,
    supra ¶ 43. Although expert fees incurred during travel are not recoverable
    as a taxable cost pursuant to § 12-332, they may be recovered as expert fees
    under Rule 68(g). Levy v. Alfaro, 
    215 Ariz. 443
    , 445, ¶ 14 (2007). We cannot
    discern from the record how the superior court's sanctions award treated
    these fee claims. On remand, the court may take whatever additional
    briefing or evidence is required to sort out the claimed fees.
    MCSHCD otherwise argues the superior court erred by
    doubling some of the Oroscos' expert witness fees as a sanction under Rule
    68(g). At the time relevant to this appeal, Rule 54(f)(2) provided that
    reasonable fees paid to expert witnesses for testifying at trial in a medical
    malpractice case are "witness fees" as set forth in A.R.S. § 12-332(A)(1) and
    are considered a taxable cost. In turn, Rule 68(g) requires the doubling of
    taxable costs incurred after making the offer of judgment as a sanction for
    rejecting an offer. The superior court thus did not err to the extent it
    awarded the Oroscos double the amount they paid in fees to expert
    witnesses for testifying at trial as a sanction pursuant to Rule 68.
    There is no authority under Rule 68, however, for doubling
    any other fees incurred by expert witnesses. See 
    Foster, 212 Ariz. at 195
    , ¶ 8
    (Rule 54(f)(2) did not apply to expert fees other than fees incurred for
    testifying at trial). Therefore, on remand, the court should reconsider its
    sanctions award to ensure that the sanctions it awarded under Rule 68(g)
    did not include improper double expert witness fees.
    Finally, MCSHCD also challenges the sanction award based
    on fees paid to expert Jared Armstrong because he was not timely disclosed
    and did not testify at trial. Rule 68(g) provides that an offeree must pay as
    a sanction reasonable expert witness fees. Rule 68(g) does not limit fees
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    OROSCO v. MCSHCD
    Decision of the Court
    only to experts testifying at trial. See 
    Levy, 215 Ariz. at 445
    , ¶ 14 (rejecting
    the argument that a party can only recover expert fees under Rule 68 for
    time spent testifying at trial); Scottsdale Ins. Co. v. Cendejas, 
    220 Ariz. 281
    ,
    289, ¶¶ 39-42 (App. 2009) (affirming Rule 68 sanctions based on expert fees
    paid to withdrawn expert). The record shows the Oroscos incurred an
    expert witness fee for Armstrong after making the Rule 68 offers. Thus, the
    superior court did not abuse its discretion by awarding sanctions based on
    fees paid to Armstrong.
    CONCLUSION
    For the foregoing reasons, we affirm the judgment except that
    we vacate, in part, the superior court's award of taxable costs and sanctions
    under Rule 68(g). On remand, the superior court shall reconsider the items
    addressed supra ¶¶ 43, 45-47 and modify its award, if necessary, consistent
    with this decision. Contingent on its compliance with Arizona Rule of Civil
    Appellate Procedure 21, we grant MCSHCD the costs it incurred on appeal
    that it can demonstrate relate to those taxable costs and sanctions.
    AMY M. WOOD • Clerk of the Court
    FILED: AA
    13