statements in support of their opinion. Jd. But if the record shows the expert’s opinion is meaningfully independent and not based on testimonial hearsay, it will not violate the Confrontation Clause even where the expert may have reviewed another expert’s report in preparation for trial. See, e.g., Jeremias uv. State, 134 Nev. 46, 54, 412 P.3d 43, 51 (2018) (concluding that a substitute coroner’s testimony did not violate the Confrontation Clause where she testified to the independent conclusion she had formed based on photographs); Vega v. State, 126 Nev. 332, 340, 236 P.3d at 682, 638 (2010) (concluding the expert could offer an independent opinion based on her review of a video recording and diagram); see also Gordon, 266 N.E.3d at 400-01 (Georges, J., concurring) (focusing “on whether the testifying expert's opinion is meaningfully independent, based on the totality of the information reviewed,” and listing cases allowing testifying experts to form conclusions based on “raw data”).
Statements are testimonial when they “would lead an objective witness to reasonably believe that the statements would be available for use at a later trial.” Medina, 122 Nev. at 354, 143 P.3d at 476 (citation modified); see also Davis v. Washington, 547 U.S. 813, 822 (2006) (explaining that statements are testimonial where “the primary purpose of the interrogation is to establish or prove past events potentially relevant to later criminal prosecution”). Whether autopsy reports are testimonial is a subject of debate. See Carolyn Zabrycki, Toward a Definition of “Testimonial”: How Autopsy Reports Do Not Embody the Qualities of a Testimonial Statement, 96 Calif. L. Rev. 1093, 1093-94 (2008); cf State v. Maxwell, 9 N.E.3d 930, 950 (Ohio 2014) (concluding autopsy reports are created primarily to document the cause of death for the public records and
public health, and are therefore nontestimonial); State v. Bass, 132 A.3d
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1207, 1225 (N.J. 2016) (concluding the autopsy report was testimonial where the autopsy was conducted in the presence of two law enforcement officers shortly after the shooting, and the medical examiner transmitted collected evidence to an investigator). Nevada law has not addressed whether autopsy reports are generally nontestimonial or may be testimonial when considered in context, and the parties do not provide sufficient information about Nevada’s rules regarding autopsies or the circumstances surrounding Garibay’s autopsy to determine that point here.
Regardless, we need not resolve that question. Even assuming arguendo the autopsy report was testimonial, Matadamas-Serrano fails to show a Confrontation Clause violation on this record. Though Dr. Simons acknowledged she had reviewed the autopsy report, she also reviewed and relied on the hospital records and photographs of the victim’s wounds. Notably, in denying Matadamas-Serrano’s motion in limine to bar the substitute coroner, the district court instructed that the substitute coroner could testify to her own “opinions based on the autopsy photos,” which were admitted into evidence and are nontestimonial. Cf People v. Nadey, 555 P.3d 961, 1009 (Cal. 2024) (explaining testimony based on autopsy photographs does not violate the Confrontation Clause because “photographs [are] not hearsay”); People v. Leon, 352 P.3d 289, 314 (Cal. 2015) (explaining photographs are not testimonial statements and that “the admission of autopsy photographs, and competent testimony based on such photographs, does not violate the confrontation clause”) (emphasis added). The record shows that Dr. Simons relied on those photos as the basis for the findings and opinion she expressed to the jury. Consistent with the district court’s ruling on the pretrial motion in limine, the record does not show that
Dr. Simons’ testimony depended on the truth of the original autopsy report
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or that she merely conveyed the absent expert’s testimonial statements, as was problematic in Smith.
But even had the district court erroneously admitted some testimonial hearsay, that error would have been harmless beyond a reasonable doubt. Dr. Simons testified that Garibay had been stabbed and that those wounds caused significant blood loss, leading to her death. And Matadamas-Serrano did not contest that he fatally stabbed Garibay. Accordingly, any error on this point would not be reversible. See Polk, 126 Nev. at 184, 233 P.3d at 359 (explaining a Crawford violation will be harmless if the State can show beyond a reasonable doubt the error did not
contribute to the verdict).
C.
Next, Matadamas-Serrano complains that when the district court allowed him to read Aguilar’s preliminary hearing testimony into the record, it improperly “allowed the State to make new objections” and then “redacted the preliminary hearing transcript based on those new rulings” instead of concluding, as it should have done, that “the State’s new objections were waived because they were not contemporaneously made in the justice court.” See NRS 51.325 (if the witness is unavailable at trial, their preliminary hearing testimony is admissible). Matadamas-Serrano argues this violated his Confrontation Clause rights, as those “redactions negated the defense’s opportunity to effectively cross-examine [Aguilar] because the defense had no opportunity to rephrase its questions or ask different questions in light of the court’s rulings on the State’s new objections,” and that while “the complete preliminary hearing transcript could have been used to attack [Aguilar’s] credibility, ...the redactions
limited the defense’s ability to do that at trial.”
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Our caselaw does not address how the contemporaneous objection rule applies in this context, cf. Riddle v. State, 96 Nev. 589, 591, 613 P.2d 1031, 1033 (1980) (noting that generally a contemporaneous objection is needed to preserve an issue for appeal). Assuming it applies, Matadamas-Serrano does not identify what redacted portions he believes were improperly excluded, much less show that their exclusion violated the Confrontation Clause. Nor does he explain why the redactions harmed his ability to attack Aguilar’s credibility in view of the portions that were admitted. See Jeremias, 134 Nev. at 59, 412 P.3d at 54 (this court may decline to consider arguments that are not supported by cogent argument); Morrison v. State, 140 Nev., Adv. Op. 24, 548 P.3d 431, 441 (Nev. Ct. App. 2024) (faulting defendant for failing to cite portions of the record supporting his argument, as required by NRAP 28(e)(1)). Nevertheless, having reviewed the admitted transcript, which includes Matadamas-Serrano’s cross-examination about gaps in Aguilar’s memory of the crime, his questions about Aguilar’s short-term memory loss and PTSD, and instances of Aguilar bristling at questions and being uncooperative, we conclude Matadamas-Serrano fails to show the district court erred by redacting the transcript. Cf. State v. Eighth Jud. Dist. Ct. (Baker), 134 Nev. 104, 106-07, 412 P.3d 18, 21-22 (2018) (explaining the conditions that must be met before a preliminary hearing transcript may be used at trial and reviewing the trial court’s decision for an abuse of discretion). Moreover, under these facts any error would be harmless. See Polk, 126 Nev. at 184, 233 P.3d at 359 (noting any error will be harmless if the State can show beyond a reasonable
doubt that the error did not contribute to the verdict).
SUPREME COURT OF NEvaADA
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D.
Wataderes- Serrano contends that the district court committed evidentiary and constitutional error because it did not allow his addiction specialist, Dr. Pohl, to testify that Matadamas-Serrano was so intoxicated he could not have formed the specific intent required for first-degree murder. “A district court’s decision to admit or exclude evidence is reviewed on appeal under an abuse-of-discretion standard.” Collins v. State, 133 Nev. 717, 724, 405 P.3d 657, 664 (2017). But “whether an evidentiary error rises to the level of a constitutional violation” presents a legal question that we review de novo. United States v. Pineda-Doval, 614 F.3d 1019, 1032-33 (9th Cir. 2010). .
Voluntary intoxication does not excuse criminal conduct. NRS 193.220. It may negate the specific intent required for first-degree murder, however, thereby reducing the degree of the crime. Id.; see King vu. State, 80 Nev. 269, 271-72, 392 P.2d 310, 311 (1964) (recognizing that intoxication may prevent the premeditation and deliberation needed for first-degree murder); Tucker v. State, 92 Nev. 486, 488-89, 553 P.2d 951, 952-53 (1976) (recognizing that intoxication may defeat the specific intent required for burglary as a predicate to felony murder). These principles derive from NRS 193.220, which states:
No act committed by a person while in a state of voluntary intoxication shall be deemed less criminal by reason of his or her condition, but whenever the actual existence of any particular purpose, motive or intent is a necessary element to constitute a particular species or degree of crime, the fact of the person’s intoxication may be taken into consideration in determining the purpose, motive or intent.
Li
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Whether voluntary intoxication negates the specific intent needed to commit certain crimes “is normally a fact issue for the jury to resolve.” King, 80 Nev. at 272, 392 P.2d at 311; Tucker, 92 Nev. at 489, 553 P.2d at 952. As such, it may be the subject of expert testimony, see NRS 50.275 (providing that a qualified expert may testify when “scientific, technical or other specialized knowledge will assist the trier of fact to understand the evidence or determine a fact in issue”), so long as the evidence is “otherwise admissible,” NRS 50.295, and the witness “does not stray from [qualified expert opinions] about factual matters to conclusions about the appropriate verdict,” Pundyk v. State, 1836 Nev. 373, 378, 467 P.3d 605, 609 (2020), or “sive a direct opinion on the defendant's guilt or innocence in a criminal case, Collins, 133 Nev. at 724, 405 P.3d at 664.
At trial, Matadamas-Serrano presented testimony from Dr. Pohl to establish his intoxication defense to first-degree murder. Dr. Pohl interviewed Matadamas-Serrano, who told him he blacked out and had no memory of the crime, and reviewed video footage and hospital records establishing his extreme intoxication the night it occurred. Because Matadamas-Serrano did not testify at trial, the district court sustained the State’s hearsay objection to Dr. Pohl relating what Matadamas-Serrano told him about blacking out. Through Dr. Pohl, however, the jury learned that (1) Matadamas-Serrano was extremely intoxicated when the crime occurred, as evidenced by a video showing him passed out in his car about an hour beforehand and a blood-alcohol level of .276 two hours afterwards; (2) this level of intoxication impairs judgment, coordination, impulse- control, and memory—‘“the thinking, judging, remembering, deciding part of the brain, —and can cause blackouts; (3) in a blackout, a person “can’t
record memory. And if you are unable to record memory, it’s impossible to
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decide to do something and follow through on that decision, which is, as I understand, at the basis of intent.” In closing argument, the defense relied on Dr. Pohl’s testimony to argue that Matadamas-Serrano’s intoxication put him in a blackout state such that he could not and did not premeditate or deliberate, as required for first-degree murder, or act with the specific intent required for burglary, which was the predicate to the felony-murder charge.
During Dr. Pohl’s testimony, the State objected that he should not be allowed to testify to legal conclusions or to give opinions as to guilt or innocence. The district court heard argument outside the presence of the jury and partially sustained these objections. It ruled that the defense could ask Dr. Pohl whether “the level of intoxication that you've testified to [could] affect a person’s ability to form specific intent,” including whether “in his opinion, could the level of his intoxication that he’s already testified to, the .276, have affected the ability of Ruben Matadamas|-Serrano] to form a specific intent.” Dr. Pohl was then asked and answered the question(s) the district court authorized.
Citing Pundyk, 136 Nev. at 375-76, 467 P.3d at 607-08, Matadamas-Serrano argues that “Dr. Pohl should have been permitted to testify [directly] to whether Ruben [Matadamas-Serrano] was able to form specific intent.” In Pundyk, the defendant pleaded not guilty by reason of insanity (NGRD and sought to introduce expert opinion testimony about his mental state, specifically, that “he failed to appreciate the wrongfulness of his conduct due to a delusional state.” Jd. at 375, 467 P.3d at 607. The district court excluded the evidence. Reversing, we held that NRS 50.295 allows expert testimony on a defendant’s mental state equally with any
other ultimate issue of fact, so long as the expert does not offer a direct
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opinion on the defendant's guilt or innocence. Id. at 376, 467 P.3d at 608. In doing so, we overruled our decision in Wintarz v. State, 104 Nev. 43, 51 n.6, 752 P.2d 761, 766 n.6 (1988), which purported to incorporate FRE 704(b) into Nevada law. Like FRE 704(a), NRS 50.295 declares that opinion evidence is not objectionable because it embraces an ultimate issue. FRE 704(b) creates an exception to FRE 704(a), providing that an expert in a criminal case may not testify that the defendant “did or did not have a mental state or condition that constitutes an element of the crime charged or of a defense.” But because Nevada’s evidence code omits the FRE 704(b) exception, Pundyk concluded that judicially adding it as Winiarz did “is contrary to NRS 50.295.” 136 Nev. at 377 n.2, 467 P.3d at 608 n.2.
The State argues that Pundyk is limited to NGRI pleas, but we disagree. The part of Wintarz that Pundyk overruled did not concern an NGRI plea but testimony that the defendant did not premeditate or deliberate the killing because he was too drunk to form such intent. Jd. at 376-77, 467 P.3d at 608 (citing Winiarz, 104 Nev. at 50-51, 752 P.2d at 766). Such testimony, Pundyk held, was admissible under NRS 50.295. Jd. While Pundyk recognized that the testimony in Winiarz that went beyond premeditation and deliberation to state that the defendant “murdered her husband in cold blood” was properly excluded because it was prejudicial and an improper opinion on the defendant’s guilt or innocence, its holding permitting expert testimony on the effect a defendant’s intoxication had on their capacity to premeditate or deliberate applies here.
We therefore conclude, based on Pundyk, that the district court erred in limiting Dr. Pohl’s testimony as it did. The error, however, was evidentiary, not constitutional. See 29 Charles Alan Wright & Arthur Miller, Fed. Prac. & Proc. Evid. § 6286 (2d ed. 2016) (collecting cases holding
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that FRE 704(b)’s exclusion of expert testimony on a defendant's state of mind in a criminal case does not “deny due process, equal protection, or the right to compulsory process’) (footnotes omitted). And, as the State argues, the error was harmless. Given the substantial evidence and argument the jury heard about Matadamas-Serrano’s intoxication and his incapacity to form the specific intent required for first-degree murder, there is not a reasonable probability that the limits the district court placed on Dr. Pohl’s testimony affected the outcome of the trial. See Bell v. State, 110 Nev. 1210, 1215, 885 P.2d 1311, 1315 (1994) (holding that, in a case of evidentiary error, the test is whether “there is a reasonable probability that the
witness [s] testimony would have affected the outcome of the trial”).
E.
Matadamas-Serrano argues due process, equal protection, and his right to present a defense were violated when the State provided the jury with an uncertified transcript of Aguilar’s 911 call. Other courts addressing transcripts as a listening aid have allowed their use where the transcript helps the jurors follow the audio tape and precautions are taken. See, e.g., United States v. Holton, 116 F.3d 1536, 1541 (D.C. Cir. 1997) (describing the various procedures a district court may follow before allowing a transcript); United States v. Howard, 80 F.3d 1194, 1198-1200 (7th Cir. 1996) (explaining that court’s preferred procedure and concluding the district court did not abuse its discretion in allowing the transcript where it reviewed portions of the tape against the transcript and properly instructed the jurors). Importantly, this transcript was not admitted into evidence, and Matadamas-Serrano points to no Nevada law regarding listening aids that would bar the district court from exercising its discretion to allow such here. Further, the record shows the district court assessed
the transcript’s accuracy before allowing the jury to view it, and the court
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also instructed the jurors that if they detected any discrepancies between the transcript and the audio, the audio would control. Cf 23A CJS. Criminal Procedure and Rights of the Accused § 1475 (2025) (explaining that courts have wide discretion in allowing written transcripts as listening aids to audiotape recordings, that one accepted procedure is for the trial court to assess the accuracy of the transcript against the recording before allowing the jury to see it, and that the court should instruct the jury that the audiotape controls in the event of any discrepancy between the two). On these facts, the district court did not abuse its discretion by allowing the jury to view the transcript while listening to the 911 call. Cf, Howard, 80 F.3d at 1198 (reviewing the district court’s decision to permit written transcripts as a listening aid for an abuse of discretion); Chavez v. State, 125 Nev. 328, 339, 213 P.3d 476, 484 (2009) (reviewing evidentiary rulings for an abuse of discretion). F.
Finally, Matadamas-Serrano contends cumulative error applies and warrants reversal. But cumulative error requires multiple errors to cumulate, and here there was only one. See Barlow v. State, 138 Nev. 207, 221, 507 P.3d 1185, 1199 (2022) (“Because we discern only one error, there is nothing to cumulate.”). Further, even were we to credit Matadamas- Serrano’s allegations of error as to the substitute coroner and Aguilar’s preliminary hearing testimony, those would not tip the scale here. Cumulative error’s balancing test requires us to weigh “(1) whether the issue of guilt is close, (2) the quantity and character of the error, and (3) the gravity of the crime charged.” Valdez v. State, 124 Nev. 1172, 1195, 196 P.3d 465, 481 (2008). Though the third factor favors Matadamas-Serrano, the other two do not. As explained above, the alleged errors were
insignificant when viewed in context of the other evidence presented at trial
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and the purpose for which the evidence was admitted, and we conclude they would not cumulate to reversible error here. See Pascua v. State, 122 Nev. 1001, 1008 n.16, 145 P.3d 1031, 1035 n.16 (2006) (rejecting appellant's argument of cumulative error where the errors alleged were insignificant or nonexistent).
We therefore affirm.
Pickering J We concur: Herndo 2. oA oy Parraguirre J. Bell (C/V ¢ , a Stiglich J Cadish J. Lee 25