Unzueta v. Akopyan ( 2019 )


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  • Filed 11/18/19
    CERTIFIED FOR PUBLICATION
    IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
    SECOND APPELLATE DISTRICT
    DIVISION SEVEN
    ZULMA UNZUETA,                           B284305
    Plaintiff and Appellant,         (Los Angeles County
    Super. Ct. No. BC495137)
    v.
    ASMIK AKOPYAN,
    Defendant and
    Respondent.
    APPEAL from a judgment of the Superior Court of Los
    Angeles County, Anthony J. Mohr, Judge. Conditionally reversed
    and remanded with instructions.
    McMurray Henriks and Yana G. Henriks for Plaintiff and
    Appellant.
    Cole Pedroza, Kenneth R. Pedroza, Matthew S. Levinson,
    Zena Jacobsen; Packer, O’Leary & Corson, Robert B. Packer and
    Paul M. Corson for Defendant and Respondent.
    __________________________
    Zulma Unzueta appeals from a judgment entered after a
    jury trial in favor of defendant Asmik Akopyan, M.D., on
    Unzueta’s action for medical malpractice. Dr. Akopyan served as
    the anesthesiologist during the birth of Unzueta’s child, after
    which Unzueta’s right leg was permanently paralyzed. The jury
    found Dr. Akopyan breached the duty of care she owed Unzueta,
    but the breach did not cause Unzueta’s paralysis. On appeal,
    Unzueta contends the trial court erred in denying the
    Batson/Wheeler 1 motion the court made sua sponte after
    Dr. Akopyan’s attorney exercised peremptory challenges to six
    Hispanic prospective jurors out of his seven total challenges.
    Unzueta argues the court erred in not requiring defense counsel
    to offer nondiscriminatory reasons for his first four challenges
    that formed the basis of the trial court’s prima facie finding of
    racial bias. We agree.
    We conditionally reverse for the limited purpose of
    conducting the second and third steps of the Batson/Wheeler
    inquiry as to all six challenged Hispanic jurors. The prohibition
    against the exercise of peremptory challenges to exclude
    prospective jurors on the basis of race or other group bias applies
    to civil as well as criminal cases. We credit the trial court for
    raising a Batson/Wheeler challenge on its own motion. But once
    the court found a prima facie showing of racial bias as to all six
    Hispanic prospective jurors, it was required to elicit from
    Dr. Akopyan’s attorney justifications for each of the six
    prospective jurors, including the four prospective jurors excused
    the prior day and the two excusals that immediately precipitated
    the court’s sua sponte motion. On remand the court should
    1    Batson v. Kentucky (1986) 
    476 U.S. 79
    (Batson); People v.
    Wheeler (1978) 
    22 Cal. 3d 258
    (Wheeler).
    2
    require defense counsel to state his reasons for challenging the
    first four prospective jurors, and the court must decide in light of
    the record as to all six jurors whether Unzueta has proved
    purposeful racial discrimination. If the court finds it cannot
    adequately perform the second and third stages of the
    Batson/Wheeler analysis on remand because of the passage of
    time or other reason, or if it determines Dr. Akopyan’s attorney
    exercised the peremptory challenges based on racial bias, it
    should set the case for a new trial. If the court finds
    Dr. Akopyan’s attorney exercised his peremptory challenges in a
    permissible fashion, it should reinstate the judgment.
    Unzueta also contends the trial court erred in excluding
    evidence of Dr. Akopyan’s dishonesty in representations she
    made to obtain her medical license and denying Unzueta’s motion
    to exclude testimony from Dr. Akopyan’s expert for failure to
    designate the witness as an expert. Further, Unzueta asserts
    defense counsel’s closing argument was improper. As to these
    contentions, we affirm.
    FACTUAL AND PROCEDURAL BACKGROUND
    A.    The Complaint
    On November 6, 2012 Unzueta filed her complaint against
    Dr. Akopyan, Adventist Health White Memorial Medical Center
    (White Memorial), and 50 Doe defendants alleging medical
    malpractice in the delivery of her first child. Unzueta alleged
    Dr. Akopyan’s negligent administration of an epidural injection
    resulted in “paralysis of her right leg from the knee down.”
    3
    B.     Designation and Deposition of Expert Witness Dr. Zakowski
    On August 5, 2014 White Memorial served its designation
    of expert witnesses on Unzueta. White Memorial designated
    Mark Zakowski, M.D., and stated, “The general substance of the
    testimony that this expert witness is expected to give: standard of
    care, causation and damages.”
    On March 12, 2015 White Memorial served its second
    designation of expert witnesses on Unzueta, in which it again
    designated Dr. Zakowski to testify on the “standard of care,
    causation and damages.” Dr. Akopyan did not include
    Dr. Zakowski in her expert witness designations. However,
    Dr. Akopyan reserved “the right to call any expert witness
    identified by any other party.” On July 2, 2015 Unzueta deposed
    Dr. Zakowski.
    Before trial, White Memorial settled with Unzueta and
    withdrew its designation of Dr. Zakowski. On February 3, 2017
    Unzueta filed a motion in limine (No. 3) to exclude Dr. Zakowski’s
    testimony at trial on the basis Dr. Akopyan had failed to
    designate him as her expert witness. Unzueta also argued
    Zakowski’s testimony was cumulative of the testimony of
    Dr. Akopyan’s designated anesthesiology expert, Dr. Kevin
    Becker. Dr. Akopyan opposed the motion, arguing she could
    properly rely on the expert designation by codefendant White
    Memorial because Unzueta deposed Dr. Zakowski on July 2,
    2015. The trial court denied the motion to exclude Dr. Zakowski
    without prejudice. 2
    2      Although the trial court’s ruling on motion in limine No. 3
    is not reflected in the appellate record, Dr. Zakowski was allowed
    to testify at trial.
    4
    During trial, Unzueta filed another motion in limine (No. 4)
    seeking to limit the scope of Dr. Zakowski’s testimony by barring
    testimony as to the standard of care applicable to Dr. Akopyan.
    Unzueta argued that because Dr. Zakowski was designated as
    the expert for White Memorial, she deposed him only as to the
    standard of care applicable to White Memorial’s nursing staff, not
    Dr. Akopyan. Unzueta attached excerpts from her deposition of
    Dr. Zakowski in which he stated he would not be testifying on the
    standard of care applicable to Dr. Akopyan. Unzueta in her
    motion did not seek to preclude Dr. Zakowski’s testimony on
    causation. In the excerpts of Dr. Zakowski’s deposition attached
    to Unzueta’s motion, counsel for White Memorial stated, “[H]e
    does have some opinion as to what caused this injury based on
    his background, training, education and experience . . . .”
    At a hearing on March 1, 2017 during trial, the court
    clarified it had granted motion in limine No. 4, precluding
    Dr. Zakowski from testifying about standard of care, but allowing
    him to testify about causation.
    C.    Unzueta’s Offer of Proof Regarding Dr. Akopyan’s Criminal
    Record and Medical License Applications
    On February 8, 2017 Unzueta filed a written “offer of
    proof,” seeking to admit evidence Dr. Akopyan was convicted in
    1992 of theft (Pen. Code, § 484, subd. (a)), was arrested but not
    convicted in 1999 for the same offense, and had concealed her
    criminal record from the Medical Board of California (Medical
    Board) in her 1999 application for a medical license and
    subsequent renewals. Unzueta sought to introduce testimony
    from Dr. Akopyan about these events; testimony from
    Dr. Akopyan’s husband, Dr. Manvel Michael Mazmanyan,
    regarding his participation in these events and his criminal
    5
    conviction and license suspension; certified court records from
    Drs. Akopyan’s and Mazmanyan’s criminal cases; and records
    from the Medical Board regarding the licensure of Drs. Akopyan
    and Mazmanyan. Dr. Akopyan opposed introduction of the
    proposed evidence and requested an opportunity to investigate
    Unzueta’s allegations. The trial court ordered the Medical Board
    to produce to the court Dr. Akopyan’s medical licensure and
    renewal applications.
    After a hearing, the trial court excluded all evidence of
    Dr. Akopyan’s criminal record and medical license applications.
    The trial court found, “[T]here’s no question she failed to disclose
    a misdemeanor conviction from 1992. [¶] That is extremely
    remote to the point where I think Evidence Code [section] 352’s
    factor[s] substantially outweigh its probative value.” The court
    noted 15 years had passed since Dr. Akopyan had last failed to
    disclose her conviction on her 2002 medical license application.
    The court reasoned, “At some point, you know, these
    transgressions have got to fade into black.” The trial court also
    found Dr. Akopyan had not lied on her medical license renewal
    applications because the applications asked only whether
    Dr. Akopyan had “been convicted of any felony or any crime in
    any state since you last renewed,” which she had not. With
    respect to the evidence relating to Dr. Mazmanyan’s conviction,
    the court found “the [Evidence Code section] 352 factors with the
    husband are just overwhelming.”
    D.    Testimony at Trial
    1.    Unzueta’s case
    On August 26, 2011 White Memorial admitted Unzueta for
    the delivery of her baby. Unzueta testified she was in great pain
    when she arrived at the hospital to give birth. Dr. Akopyan
    6
    administered an anesthetic by epidural injection for the pain. A
    nurse provided Unzueta with a document to sign providing her
    informed consent to the epidural anesthesia, but Dr. Akopyan
    injected Unzueta with the epidural before she signed the
    document. Dr. Akopyan did not explain the procedure or
    examine Unzueta. Unzueta would not have consented had she
    been informed the epidural presented a risk of permanent nerve
    injury. After the injection, Unzueta immediately began to shake,
    so nurses brought her a blanket. The anesthetic did not reduce
    Unzueta’s pain, so Dr. Akopyan administered a second epidural
    injection.
    During the final stage of the delivery, the nurses, the
    baby’s father, and the baby’s paternal grandmother held
    Unzueta’s legs. Unzueta gave birth to a healthy baby. After the
    birth, Unzueta was numb in both of her legs. Her left leg
    regained feeling, but her right leg did not. Unzueta never
    regained full use of her right foot.
    Unzueta presented expert testimony from Drs. Karl Norris,
    Hyman Gross, and Sherman Shlomo Elspas that Dr. Akopyan’s
    conduct fell below the standard of care and caused Unzueta’s
    injury either by the administration of epinephrine in the epidural
    injection or by the epidural needle damaging the nerve root
    through direct contact. 3
    3     Unzueta has not included the testimony of Drs. Norris,
    Gross, and Elspas in her designated record on appeal, but the
    parties’ closing arguments and the testimony of Dr. Akopyan’s
    experts make clear the principal theories Unzueta’s experts
    relied on to explain the cause of her injury.
    7
    2.    Dr. Akopyan’s case
    Dr. Akopyan testified as to her procedure for administering
    epidural injections. She acknowledged the first epidural injection
    she administered to Unzueta was not effective, but explained,
    “It’s a common practice to replace epidurals.” Dr. Akopyan
    opined she could not have damaged the nerve responsible for
    Unzueta’s injury because the damaged nerve was in Unzueta’s
    leg above the knee, whereas the epidural needle was placed in
    her back. Dr. Akopyan also testified that damage to the nerve in
    the leg was a “very common complication” for a person who gives
    birth in the position Unzueta was in.
    Dr. Becker, an anesthesiologist, opined Dr. Akopyan’s
    treatment of Unzueta met the standard of care and did not cause
    Unzueta’s injury. He testified anesthesiologists commonly need
    to administer a second epidural when the first proves
    unsatisfactory, which is not a sign of medical negligence.
    Dr. Becker found from his review of Dr. Akopyan’s records that
    she recorded inaccurate blood pressure readings, but the errors
    did not contribute to Unzueta’s injury. He opined the epidural
    injection administered to Unzueta’s back was too far from the
    damaged nerve in Unzueta’s leg to have caused the injury.
    Further, there was no evidence Dr. Akopyan struck a nerve
    during the administration of either epidural injection.
    Dr. Zakowski, an obstetric anesthesiologist, opined it was
    reasonably medically probable Unzueta’s injury was caused by
    the force of labor or external compression by the positioning of
    her legs during the labor and delivery. Further, there was “zero”
    probability Unzueta’s injury was caused by epinephrine
    contained in a test dose for the epidural placement, and there
    was “no way physically” for an epidural needle in the lower part
    of Unzueta’s back directly to strike the nerve root located above
    8
    the knee to cause Unzueta’s injury. Dr. Zakowski opined it was
    not reasonably medically probable Unzueta’s injury was caused
    by the epidural injections.
    E.     Closing Arguments
    During closing arguments, Dr. Akopyan’s attorney, Robert
    Packer, argued Unzueta had failed to prove Dr. Akopyan’s care
    caused Unzueta’s injury, arguing it “was the result of a rare but
    well-described phenomenon of nerve compression, both external
    and internal, from forces of labor.”
    Packer continued, “Now, we discussed at length, I believe
    during our jury selection, opening statements, that in California
    and the United States, our system of what we call civil justice, as
    opposed to criminal justice, we don’t impose liability. We don’t
    take Dr. Akopyan’s purse and give it to Ms. Unzueta . . . .” As he
    spoke, Packer motioned with his hands as if to move an object
    from one place to another. Unzueta’s attorney, Yana Henriks,
    made an objection, which the court overruled. Packer continued,
    “without a proof of fault. We are a fault-based system.” Packer
    went on, “In a civil case for money damages, based upon
    negligence, professional or otherwise, the plaintiff has to prove
    that the defendant was at fault, just as a plaintiff who might sue
    you or you might sue somebody some day in the future has that
    burden of proof.”
    With respect to economic damages, Packer argued,
    “[T]here’s no evidence of income loss in this—in the past or
    reasonably certain to occur in the future.” Packer asserted
    Unzueta’s injury did not prevent her from being employed, but
    “[i]nstead she would like to be supported the rest of her life by
    Dr. Akopyan at an enormous amount of money. I think the figure
    was $875,000.” Henriks did not object. Packer continued, “From
    9
    the time of her birth of her baby until today she’s been a Medi-
    Cal recipient . . . . Medi-Cal has paid over . . . [s]ix years,
    $1200 . . . .” At this point, Henriks made an objection, which the
    trial court overruled.
    F.     Verdict
    The jury returned a special verdict for Dr. Akopyan, finding
    Dr. Akopyan was “negligent in the care and treatment” of
    Unzueta, but Dr. Akopyan’s negligence was not “a substantial
    factor in causing harm” to Unzueta.
    On April 13, 2017 the trial court entered judgment in favor
    of Dr. Akopyan.
    G.    Unzueta’s Motion for New Trial
    Unzueta moved for a new trial based on the trial court’s
    exclusion of evidence of Dr. Akopyan’s conviction and
    misrepresentations to the Medical Board; denial of Unzueta’s
    motion to exclude the testimony of Dr. Zakowski; and Packer’s
    asserted misconduct during closing arguments by referencing
    Dr. Akopyan’s “purse” and stating Unzueta wanted Dr. Akopyan
    to support her for “the rest of her life.” Unzueta also raised
    issues related to Batson/Wheeler, discussed below. After a
    hearing, the trial court denied the motion. Unzueta timely
    appealed.
    10
    DISCUSSION
    A.     The Trial Court Erred by Failing To Require Defense
    Counsel To Justify Excusal of the First Four Hispanic
    Prospective Jurors
    1.     The challenged jurors
    Jury selection began on February 6, 2017. The next day
    Dr. Akopyan’s attorney, Packer, exercised four peremptory
    challenges to excuse prospective jurors R. Medina, J. Quintero,
    G. Henriquez, and R. Villarreal.
    Medina was a civil engineering student, unmarried,
    without children, with no prior jury experience. She had
    “indifferent” medical experiences and no experience with
    childbirth or epidural treatment for pain.
    Quintero was a sanitation worker for the City of Los
    Angeles, was married with four adult children, and was raising
    one grandchild. He had served on four criminal and one civil
    juries, all of which reached verdicts. One of his children did not
    work because of a disability.
    Henriquez was a child specialist, married, with no prior
    jury experience. Her husband was disabled and did not work.
    Henriquez had a pending workers’ compensation case for an
    injury sustained in a workplace fall. She stated she would be
    able to distinguish between the standard of negligence at issue in
    Unzueta’s case and the no-fault standard for workers’
    compensation.
    Villareal was a children’s social worker who supervised
    investigative teams responding to reports of child abuse. She had
    two adult children and no prior jury experience. As a supervisor,
    Villareal was responsible for deciding based on the social
    workers’ investigations whether to file a petition in juvenile court
    11
    regarding the child. Villareal had been criticized for decisions
    she made but strived to act in the best interests of the children.
    Unzueta exercised all six of her peremptory challenges;
    Dr. Akopyan accepted the panel without exercising her final two
    peremptory challenges. On February 7, 2017 the jury panel was
    sworn.
    On February 8 voir dire continued for the selection of the
    alternate jurors. Packer exercised three peremptory challenges
    to excuse prospective jurors D. Winfrey, 4 D. Zaldana, and
    A. Marquez.
    Zaldana was a broadcast engineer, married, with three
    adult children. He had experience on one civil jury, which
    reached a verdict. A relative of Zaldana received heart surgery at
    one of the hospital’s other locations, but “had items left in him” as
    a result of the surgery. Zaldana explained, “I have a doubt about
    medical practices,” but promised to “be as objective as I can be.”
    Zaldana’s father had developed symptoms of Parkinson’s disease
    about two months after having an angiogram performed.
    Zaldana questioned whether the symptoms were brought on by
    the angiogram test. Zaldana believed medical complications
    could “arise in any circumstances” without “necessarily [being]
    the doctor’s fault,” although it may be “the doctor’s
    responsibility.”
    Marquez was single and a sales associate at a hardware
    store, with no prior jury experience. He had previously broken an
    ankle, which was a painful injury and disrupted his daily living
    4     Unzueta does not contend Winfrey was Hispanic, and
    therefore we do not discuss her responses or Packer’s reasons for
    excusing her.
    12
    for three or four months. After the injury, Marquez “sat at
    home.”
    After Packer exercised peremptory challenges to excuse
    Winfrey, Zaldana, and Marquez, the trial court requested all
    jurors and prospective alternate jurors leave the courtroom so the
    court could speak with the attorneys.
    2.     The trial court’s Batson/Wheeler motion and ruling
    Outside of the presence of the jury, the trial court stated,
    “Mr. Packer, the only peremptories you exercised yesterday were
    against Hispanic jurors. Today you have exercised peremptories
    against two Hispanic jurors. [¶] I find a prima facie case that
    you have violated the Wheeler/Batson rulings, and you are going
    to have to justify your peremptories right now.” The court
    continued, “I’m surprised the plaintiffs haven’t made a
    Wheeler/Batson challenge, but I would have from what I’ve seen.”
    Packer responded as to Marquez, “[T]his is what’s in my
    notes.” The trial court noted, “For the record, it looks like just
    about five lines. [¶] . . . [¶] . . . With just a couple of words on
    each line . . . .” Packer described his reasons for challenging
    Marquez: “He’s single. He has no jury experience. I didn’t know
    anything about him. Either I didn’t get to him closely enough or
    the plaintiff didn’t ask any questions, but he appeared to me to be
    disinterested in the case. He didn’t volunteer anything during
    the course of questioning of the other jurors, many of whom had a
    lot of things to say about medicine and about chronic pain, about
    the things I asked about, the facts that we talked about. I felt
    that he, at this point, was completely unknown to me compared
    to the other jurors. That’s why I excused him.”
    The trial court responded, “Very well.” Unzueta’s attorney,
    Henriks, interjected, “Your Honor, we did notice yesterday that
    13
    some very good jurors that . . . could have been very fair were
    challenged.” The court responded, “You didn’t make the motion.”
    Henriks explained, “We’re very desperate to get our expert and
    get the panel—and who has a medical condition. So out of that
    desperation. But we did notice. We didn’t think it proper . . . .”
    Henriks added that “all of [the defense’s] challenges” from the
    previous day were used to excuse jurors “because they’re
    Hispanic” and “[t]here was nothing wrong with them.” The court
    responded, “Well, that water is under the bridge. I’m not going to
    ask counsel to justify yesterday’s peremptories. That is past.”
    Packer reminded the court the panel as constituted
    included at least three Hispanic jurors. The court responded that
    “[o]ne juror improperly challenged justifies the Wheeler/Batson
    motion.” However, the court reiterated, “That’s yesterday’s news.
    I’m not dealing with it now. Plaintiff, for whatever reason, failed
    to raise it. But today, based on what happened yesterday and
    today, that’s why I raised it on my own motion.”
    The trial court did not ask Packer to explain his use of a
    peremptory strike to excuse Zaldana, and Packer did not provide
    an explanation. The court denied the Batson/Wheeler motion,
    finding Packer had justified his use of peremptory challenges as
    to the alternates.
    3.    Unzueta’s motion for new trial
    On June 5, 2017 Unzueta moved for a new trial, arguing,
    among other things, the trial court failed to require Packer to
    justify the four peremptory challenges he exercised as to the
    Hispanic jurors on February 7. Unzueta also asserted the court
    erred by failing to elicit an explanation from Packer for his
    removal of Zaldana on February 8.
    14
    At the hearing on the motion, Henriks explained she had
    not made a Batson/Wheeler motion on February 7 because she
    “wanted to see if [defense counsel was] going to continue the
    pattern . . . .” Packer stated he challenged Zaldana because of
    the “history of his father’s surgery which he felt was the cause of
    his father developing Parkinson’s disease.” Packer explained he
    was concerned Zaldana “believe[d] that anytime there is an
    adverse outcome that somebody must have done something
    wrong.” The trial court acknowledged it “didn’t question [Packer]
    thoroughly enough regarding the challenges.” The trial court
    “urge[d] the Court of Appeal to look at this very closely and
    possibly the Supreme Court, if it gets that far, because this is—I
    just feel very, very conflicted about what happened.” The court
    took the motion under submission.
    As reflected in its July 10, 2017 minute order, the trial
    court denied Unzueta’s motion for a new trial. With respect to
    Dr. Akopyan’s late-proffered explanation for striking Zaldana,
    the court reasoned, “[I]f a post-trial evaluation is permissible on
    remand following an appeal, it should be permissible at a hearing
    on a motion for a new trial, which occurs much more closely in
    time to the complained-of event.” The court explained, “[I]n light
    of the hearing on [Unzueta’s] new trial motion, the court is
    satisfied that no Wheeler/Batson violation occurred. During the
    hearing which this court initiated, [d]efense counsel pointed to
    several portions of the reporter’s transcript as reasons for
    exercising a peremptory challenge against [Z]aldana. The [c]ourt
    is more than satisfied that those reasons are not pretextual.”
    With respect to prospective jurors Medina, Quintero, Henriquez,
    and Villareal, the trial court found Unzueta had not made “a
    motion at any time,” and “[t]he language on which [Unzueta]
    relies in the transcript does not rise to the level of a motion.” The
    15
    court continued, “While the delay itself does not defeat the
    motion, it supports the notion that plaintiff did not actually make
    a motion at the time she claims she did. This is regrettable. It
    appears that the court struck those four Hispanic jurors without
    questioning them. Had [Unzueta] made a proper motion, the
    court might have ordered defense counsel to justify his strikes
    and possibly have granted this motion.” The court concluded,
    “Even though the [c]ourt is denying this [m]otion for a [n]ew
    [t]rial, the facts are troubling. We are in need of appellate
    guidance.”
    4.     Applicable law
    Unzueta, who is Hispanic, 5 contends Dr. Akopyan’s
    exercise of six of her seven peremptory challenges to excuse
    Hispanic prospective jurors was based on race and deprived
    Unzueta of her federal constitutional right to equal protection
    
    (Batson, supra
    , 476 U.S. at p. 88) and state constitutional right to
    a trial by a jury drawn from a representative cross-section of the
    community 
    (Wheeler, supra
    , 22 Cal.3d at pp. 276-277).
    Specifically, Unzueta argues the trial court erred in failing to
    evaluate whether Dr. Akopyan exercised her peremptory
    challenges as to the first four Hispanic prospective jurors based
    on their race.
    “‘[A] party may exercise a peremptory challenge for any
    permissible reason or no reason at all’ [citation] but ‘exercising
    5     Dr. Akopyan does not dispute Unzueta and the six
    prospective jurors are Hispanic. (See People v. Gutierrez (2017)
    2 Cal.5th 1150, 1156, fn. 2 [“We have held that Spanish
    surnames may identify Hispanic individuals, who are members of
    a cognizable class for purposes of Batson/Wheeler motions.”].)
    16
    peremptory challenges solely on the basis of race offends the
    Fourteenth Amendment’s guaranty of the equal protection of the
    laws’ [citations]. Such conduct also ‘violates the right to trial by a
    jury drawn from a representative cross-section of the community
    under article 1, section 16, of the California Constitution.’”
    (People v. Smith (2018) 4 Cal.5th 1134, 1146 (Smith); accord,
    People v. Armstrong (2019) 6 Cal.5th 735, 765 (Armstrong)
    [“Peremptory challenges are ‘designed to be used “for any reason,
    or no reason at all.”’ [Citations.] But there are limits:
    Peremptory challenges may not be used to exclude prospective
    jurors based on group membership such as race or gender.”];
    People v. Winbush (2017) 2 Cal.5th 402, 433 (Winbush) [“Both
    state and federal Constitutions prohibit the use of peremptory
    challenges to remove prospective jurors based on their race or
    membership in a cognizable group.”].) “‘The “Constitution forbids
    striking even a single prospective juror for a discriminatory
    purpose.”’” (People v. Hardy (2018) 5 Cal.5th 56, 76 (Hardy);
    accord, People v. Gutierrez (2017) 2 Cal.5th 1150, 1158 (Gutierrez)
    [“Exclusion of even one prospective juror for reasons
    impermissible under Batson and Wheeler constitutes structural
    error, requiring reversal.”].)
    The prohibition against the exercise of peremptory
    challenges to exclude prospective jurors on the basis of race or
    other group bias applies to civil as well as criminal cases. (Di
    Donato v. Santini (1991) 
    232 Cal. App. 3d 721
    , 731 [“a party to a
    civil lawsuit may not use peremptory challenges to exclude
    women from the jury panel on the basis of their gender”]; accord,
    Holley v. J & S Sweeping Co. (1983) 
    143 Cal. App. 3d 588
    , 592
    [concluding as to Batson/Wheeler motion, “[w]e are persuaded
    that substantially similar constitutional concerns compel a
    uniform application to civil jury trials”].)
    17
    A three-step procedure governs the analysis of
    Batson/Wheeler challenges. 
    (Smith, supra
    , 4 Cal.5th at p. 1147;
    
    Armstrong, supra
    , 6 Cal.5th at p. 766; 
    Winbush, supra
    , 2 Cal.5th
    at p. 433.) “‘First, the defendant must make a prima facie
    showing that the prosecution exercised a challenge based on
    impermissible criteria,’” such as race. (Smith, at p. 1147; accord,
    
    Hardy, supra
    , 5 Cal.5th at p. 75; Winbush, at p. 433.) “[A]
    defendant satisfies the requirements of Batson’s first step by
    producing evidence sufficient to permit the trial judge to draw an
    inference that discrimination has occurred.” (Johnson v.
    California (2005) 
    545 U.S. 162
    , 170; accord, People v. Reed (2018)
    4 Cal.5th 989, 999.) “[A] ‘pattern of systematic exclusion’ of a
    particular cognizable group from the venire raises an inference of
    purposeful discrimination . . . .” (People v. Avila (2006)
    
    38 Cal. 4th 491
    , 549 (Avila); accord, 
    Batson, supra
    , 476 U.S. at
    p. 94 [“Proof of systematic exclusion from the venire raises an
    inference of purposeful discrimination because the ‘result
    bespeaks discrimination.’”].)
    “‘Second, if the trial court finds a prima facie case, then the
    prosecution must offer nondiscriminatory reasons for the
    challenge.’” 
    (Smith, supra
    , 4 Cal.5th at p. 1147; 
    Winbush, supra
    ,
    2 Cal.5th at p. 433 [“‘[I]f the showing is made, the burden shifts
    to the prosecutor to demonstrate that the challenges were
    exercised for a race-neutral reason.’”].) “[T]he prosecutor ‘must
    provide a “‘clear and reasonably specific’ explanation of his [or
    her] ‘legitimate reasons’ for exercising the challenges.”
    [Citation.] “The justification need not support a challenge for
    cause, and even a ‘trivial’ reason, if genuine and neutral, will
    suffice.” [Citation.] A prospective juror may be excused based
    upon facial expressions, gestures, hunches, and even for arbitrary
    or idiosyncratic reasons.’” (Winbush, at p. 434; accord, 
    Hardy, 18 supra
    , 5 Cal.5th at p. 76.) “‘Third, the trial court must determine
    whether the prosecution’s offered justification is credible and
    whether, in light of all relevant circumstances, the defendant has
    shown purposeful race discrimination.’” (Smith, at p. 1147;
    accord, Hardy, at p. 75; 
    Gutierrez, supra
    , 2 Cal.5th at p. 1158 [“In
    order to prevail, the movant must show it was ‘“more likely than
    not that the challenge was improperly motivated.”’”].) “‘“The
    ultimate burden of persuasion regarding [discriminatory]
    motivation rests with, and never shifts from, the [moving
    party].”’” (Smith, at p. 1147; accord, Winbush, at p. 433.)
    We independently review the legal question whether the
    trial court was required to elicit justifications for the first four
    jurors Packer excused. (People v. Parker (2017) 2 Cal.5th 1184,
    1211 [“‘[W]e review the record independently to “apply the high
    court’s standard and resolve the legal question whether the
    record supports an inference that the prosecutor excused a juror”
    on a prohibited discriminatory basis.’”]; People v. Harris (2013)
    
    57 Cal. 4th 804
    , 834 [“Regardless of which standard the trial court
    used, we independently review the record and apply the standard
    required by the high court.”]; People v. Edwards (2013) 
    57 Cal. 4th 658
    , 698 [“[W]e independently review the record and determine
    whether it ‘supports an inference that the prosecutor excused a
    juror on the basis of race.’”].)
    5.     Unzueta did not forfeit her Batson/Wheeler argument
    Dr. Akopyan contends Unzueta forfeited her
    Batson/Wheeler argument by failing timely to raise an objection
    to the first four peremptory challenges, and, when she did object,
    by failing to identify the four jurors, make a prima facie showing,
    and request the jury panel be discharged. Unzueta argues she
    joined in the trial court’s sua sponte motion by asserting
    19
    Dr. Akopyan’s challenges to the first four prospective jurors were
    motivated by improper racial bias. Unzueta has the better
    argument.
    As the trial court observed, six of the seven peremptory
    challenges Packer made were to Hispanic prospective jurors. The
    court specifically identified all six jurors in finding a prima facie
    case of discrimination, stating, “[T]he only peremptories [Packer]
    exercised yesterday were against Hispanic jurors. Today you
    have exercised peremptories against two Hispanic jurors.”
    Henriks’s response—that “yesterday . . . some very good jurors
    that . . . could have been very fair were challenged,” and “all of
    [the defense’s] challenges” were made “because they’re
    Hispanic”—sufficiently identified the challenges she contended
    were discriminatory (those made “yesterday”), as well as the
    alleged discriminatory intent (challenges made “because they’re
    Hispanic”).
    Although Henriks’s articulation of Unzueta’s
    Batson/Wheeler challenge was not a model of clarity, in contrast
    to the authorities cited by Dr. Akopyan, Henriks’s colloquy with
    the trial court left no ambiguity as to which peremptory
    challenges she identified as racially discriminatory and on what
    basis. (Cf. People v. Cunningham (2015) 
    61 Cal. 4th 609
    , 662
    [defendant’s objection “‘Batson again’” was not sufficient to raise
    Batson/Wheeler challenge where record did not reflect “what
    cognizable class defendant was asserting as the basis” for his
    motion]; People v. Booker (2011) 
    51 Cal. 4th 141
    , 161-167
    [defendant who objected to excusal of four Black prospective
    jurors under Batson/Wheeler on grounds of racial discrimination
    forfeited argument dismissals were due to impermissible
    religious discrimination]; People v. Lewis (2008) 
    43 Cal. 4th 415
    ,
    481 [defendant who challenged excusal of five Black prospective
    20
    jurors did not sufficiently raise challenge as to Hispanic
    prospective jurors by identifying one Hispanic juror as being “‘the
    last Spanish that [the prosecutor] kicked out’”], overruled on
    another ground by People v. Black (2014) 
    58 Cal. 4th 912
    , 920;
    People v. Thornton (2007) 
    41 Cal. 4th 391
    , 461-462 [defendant
    forfeited Batson/Wheeler challenge to seating of male alternate
    juror during trial where defendant failed to object to random
    selection of alternate juror instead of seating sole female
    alternate juror].) Because Unzueta sufficiently joined in the trial
    court’s motion, she did not forfeit her argument the trial court’s
    Batson/Wheeler analysis was incomplete. 6
    Further, “neither forfeiture nor application of the forfeiture
    rule is automatic.” (People v. McCullough (2013) 
    56 Cal. 4th 589
    ,
    593 [finding defendant forfeited challenge to imposition of
    booking fee because failure to raise his ability to pay the fee in
    the trial court did not raise purely legal issues]; accord, In re S.B.
    (2004) 
    32 Cal. 4th 1287
    , 1293 [“application of the forfeiture rule is
    not automatic,” although “the appellate court’s discretion to
    excuse forfeiture should be exercised rarely and only in cases
    presenting an important legal issue”].) As the Supreme Court
    explained in S.B., the purpose of the forfeiture rule “is to
    encourage parties to bring errors to the attention of the trial
    court, so that they may be corrected.” (S.B., at p. 1293.) Here,
    Unzueta identified the peremptory challenges against the first
    four Hispanic prospective jurors as racially discriminatory, and
    the trial court addressed Unzueta’s contention by finding her
    objection was untimely, describing the challenges as “water . . .
    6     Dr. Akopyan cites no authority, nor is there any, for her
    contention a moving party must specifically request the jury
    panel be discharged.
    21
    under the bridge.” Therefore, the purpose of the forfeiture rule is
    satisfied, and we decline to find Unzueta forfeited her argument
    as to the exclusion of prospective jurors Medina, Quintero,
    Henriquez, and Villareal.
    6.     The trial court’s Batson/Wheeler motion during
    selection of the alternate jurors was timely as to
    prospective jurors excused during selection of the jury
    panel
    Dr. Akopyan alternatively argues any attempt by Unzueta
    to join the trial court’s motion was untimely as to the peremptory
    challenges exercised the prior day because Unzueta did not raise
    her objection “at the earliest opportunity during the voir dire
    process.” Unzueta contends her objection was timely because
    Packer’s pattern of systematic exclusion of Hispanic jurors was
    not fully manifested on February 7. We agree with Unzueta.
    “A Batson/Wheeler motion is timely if it is made before jury
    impanelment is completed, which does not occur ‘“until the
    alternates are selected and sworn.”’” (People v. Scott (2015)
    
    61 Cal. 4th 363
    , 383; accord, People v. McDermott (2002)
    
    28 Cal. 4th 946
    , 970 [“[T]he defense motion was timely because it
    was made before the alternate jurors were selected and sworn.”].)
    As the Supreme Court has recognized, “discriminatory motive
    may become sufficiently apparent to establish a prima facie case
    only during the selection of alternate jurors, and a motion
    promptly made before the alternates are sworn, and before any
    remaining unselected prospective jurors are dismissed, is timely
    not only as to the prospective jurors challenged during the
    selection of the alternate jurors but also as to those dismissed
    during selection of the 12 jurors already sworn.” (McDermott, at
    p. 969; see People v. Gore (1993) 
    18 Cal. App. 4th 692
    , 705 [“[T]he
    22
    trial court should have considered the motion as to all seven
    challenged Hispanic prospective jurors and not limited its inquiry
    to only the alternate juror selection process. To hold otherwise
    would be to allow a potential prima facie pattern of systematic
    exclusion to go unchallenged.”].) 7
    While there may have been sufficient evidence to support a
    prima facie finding of group bias by the time Packer excused the
    fourth Hispanic juror on February 7, the showing of
    discriminatory bias was strengthened by Packer’s request to
    excuse two additional Hispanic prospective jurors the following
    day. The trial court’s motion, raised during the selection of
    alternate jurors and joined by Unzueta, was timely as to the
    prospective jurors Packer excused from the panel the day before.
    7.    The trial court erred by failing to question defense
    counsel regarding his peremptory challenges to the
    first four Hispanic prospective jurors
    Dr. Akopyan argues the four Hispanic prospective jurors
    challenged on February 7 were not within the scope of the court’s
    sua sponte motion, so the trial court did not err by failing to elicit
    explanations for why they were excused. But the trial court’s
    motion identified both the four Hispanic prospective jurors who
    were excused on February 7 and the two who were excused on
    February 8. The court added its motion was “based on what
    happened yesterday and today.”
    Contrary to Dr. Akopyan’s assertion, the Supreme Court’s
    holding in 
    Avila, supra
    , 
    38 Cal. 4th 491
    , which addressed the
    7     People v. Ortega (1984) 
    156 Cal. App. 3d 63
    , relied on by
    Dr. Akopyan, predates the Supreme Court’s resolution of this
    issue in People v. 
    McDermott, supra
    , 28 Cal.4th at page 969.
    23
    scope of the trial court’s mandatory review on successive
    Batson/Wheeler motions, supports Unzueta’s position. There, the
    defendant objected to the excusal of the first Black prospective
    juror, but the trial court found the defendant failed to establish a
    prima facie case of group bias. (Id. at pp. 541-542.) When the
    defendant objected to the excusal of a second Black prospective
    juror, the trial court found the two excusals constituted a prima
    facie showing under Batson/Wheeler, and it elicited the
    prosecutor’s explanation for excusing the second Black
    prospective juror, but not the first. (Id. at p. 542.)
    On appeal, the defendant argued the trial court erred in
    failing to require the prosecutor to state his reasons for excusing
    the first Black prospective juror after it found a prima facie case
    based on excusal of the second prospective Black juror. (
    Avila, supra
    , 38 Cal.4th at p. 548.) The Supreme Court rejected this
    contention, explaining the trial court had “no sua sponte duty to
    revisit earlier Batson/Wheeler challenges that it had previously
    denied,” although it had discretion to do so upon request when a
    subsequent challenge “casts the prosecutor’s earlier challenges of
    the jurors of that same protected class in a new light, such that it
    gives rise to a prima facie showing of group bias as to those
    earlier jurors.” (Id. at p. 552; accord, 
    Armstrong, supra
    , 6 Cal.5th
    at p. 767 [“Trial courts are no longer obligated to revisit their
    rulings on earlier Wheeler/Batson motions when they conclude
    the defendant has made out a prima facie case in connection with
    a later motion.”].) The Avila court concluded, “[I]f a trial court
    finds a prima facie showing of group bias at a later point in voir
    dire, the court need only ask the prosecutor to explain ‘each
    suspect excusal.’ [Citation.] Each suspect excusal includes the
    excusals to which the [moving party] is objecting and which the
    court has not yet reviewed.” (Avila, at p. 551.)
    24
    Here, Unzueta had not previously challenged the four
    Hispanic prospective jurors excused on February 7. Thus,
    because the trial court identified the basis of its sua sponte
    Batson/Wheeler motion as the excusal of all six prospective
    jurors—not just the two excused on February 8—all six jurors
    were “suspect excusal[s] . . . which the court ha[d] not yet
    reviewed.” (
    Avila, supra
    , 38 Cal.4th at p. 551.) Further, as
    discussed, at the time of the court’s sua sponte motion, Henriks
    specifically raised a concern about Packer’s challenges to the first
    four Hispanic prospective jurors. The fact the challenges were
    made on separate days is immaterial, as is the fact the challenges
    were made to both the jury panel and the alternates. (People v.
    
    Scott, supra
    , 61 Cal.4th at p. 383; People v. 
    McDermott, supra
    , 28 Cal.4th at p. 969.) Once the trial court found a prima
    facie showing of group bias, the court was required to elicit from
    Packer justifications for each of the six challenges forming the
    basis for the prima facie showing.
    8.     Conditional reversal and limited remand are
    appropriate
    Unzueta contends we should remand for a new trial
    because given the passage of time Dr. Akopyan’s attorney will not
    be able to recall the reasons for excusing the prospective jurors or
    the appearance and demeanor of the jurors, and the trial court
    will not have sufficient information on which to conduct a
    complete Batson/Wheeler inquiry. But it is for the trial court to
    determine in the first instance whether it can conduct a complete
    Batson/Wheeler analysis.
    The Supreme Court’s decision in People v. Johnson (2006)
    
    38 Cal. 4th 1096
    (Johnson) is directly on point. There, after the
    United States Supreme Court held the trial court erred in finding
    25
    there was no prima facie case of discrimination, the California
    Supreme Court on remand considered the appropriate remedy for
    the constitutional violation. (Id. at p. 1099.) The California
    Supreme Court concluded although jury selection had taken place
    over seven years earlier, the court and parties could rely on the
    jury questionnaires and a transcript of the jury selection
    proceedings, and therefore a limited remand was appropriate for
    the trial court to conduct the second and third steps of the
    Batson/Wheeler analysis. (Id. at pp. 1103-1104; accord, People v.
    
    Scott, supra
    , 61 Cal.4th at p. 388 [“[W]hen a trial court
    erroneously fails to discern an inference of discrimination and
    terminates the inquiry at that point, an appellate court is
    generally required to order a remand to allow the parties and the
    trial court to continue the three-step Batson/Wheeler inquiry.”].)
    In this case, although jury selection took place almost three
    years ago, as in Johnson, there is a transcript of the jury
    selection proceeding that will assist the trial court and parties in
    conducting a further Batson/Wheeler analysis. In addition, the
    parties’ attorneys may still have their notes from the trial, which
    Packer referenced during his discussion of the reasons he
    challenged Marquez. On remand the trial court should require
    defense counsel to provide Packer’s reasons for challenging the
    first four prospective jurors (Medina, Quintero, Henriquez, and
    Villarreal), 8 evaluate the explanations, “and decide whether
    8     Because remand is necessary for the trial court to conduct a
    complete Batson/Wheeler analysis as to prospective jurors
    Medina, Quintero, Henriquez, and Villarreal, we do not reach
    Unzueta’s argument the trial court failed to conduct a sufficient
    third-step analysis of Packer’s reasons for excusing Zaldana and
    Marquez. As part of the third step of the analysis, the trial court
    will need to make a sincere and reasoned evaluation of Packer’s
    26
    [Unzueta] has proved purposeful racial discrimination. If the
    court finds that, due to the passage of time or any other reason, it
    cannot adequately address the issues at this stage or make a
    reliable determination, or if it determines that [defense counsel]
    exercised his peremptory challenges improperly, it should set the
    case for a new trial. If it finds [defense counsel] exercised his
    peremptory challenges in a permissible fashion, it should
    reinstate the judgment.” 
    (Johnson, supra
    , 38 Cal.4th at pp. 1103-
    1104.)
    B.    The Trial Court Did Not Err in Allowing Dr. Zakowski To
    Testify as an Expert Witness
    Unzueta contends the trial court erred by allowing
    Dr. Zakowski to testify even though Dr. Akopyan did not
    designate him as an expert witness prior to trial pursuant to
    Code of Civil Procedure section 2034.300.9 Dr. Akopyan responds
    justifications as to all six jurors. (
    Gutierrez, supra
    , 2 Cal.5th at
    p. 1159.) In addition, as argued by Unzueta, a comparative juror
    analysis may be appropriate, which “would ask whether the
    prosecutor’s justification for striking one Hispanic individual
    applies just as well to an otherwise similarly situated non-
    Hispanic individual who is permitted to serve on the jury. [A]
    comparative analysis may be probative of purposeful
    discrimination at Batson’s third stage.” (Id. at p. 1173; accord,
    
    Winbush, supra
    , 2 Cal.5th at p. 442 [“‘The rationale for
    comparative juror analysis is that a side-by-side comparison of a
    prospective juror struck by the prosecutor with a prospective
    juror accepted by the prosecutor may provide relevant
    circumstantial evidence of purposeful discrimination by the
    prosecutor.’”].)
    9     Code of Civil Procedure section 2034.300 provides in part,
    “[T]he trial court shall exclude from evidence the expert opinion
    27
    that because White Memorial designated Dr. Zakowski as an
    expert and Unzueta deposed him, Dr. Akopyan could call him as
    an expert witness pursuant to Code of Civil Procedure section
    2034.310. Dr. Akopyan is correct.
    Generally, upon a proper objection, “the trial court ‘shall
    exclude from evidence the expert opinion of any witness that is
    offered by any party who has unreasonably failed,’ inter alia, to
    designate that expert in its expert witness list.” (Pina v. County
    of Los Angeles (2019) 38 Cal.App.5th 531, 546; accord, Tesoro del
    Valle Master Homeowners Assn. v. Griffin (2011) 
    200 Cal. App. 4th 619
    , 641 [“The general rule, set forth in Code of Civil Procedure
    section 2034.300, is that an undesignated expert witness may not
    testify.”].) However, Code of Civil Procedure section 2034.310
    provides an exception to the general rule, stating “[a] party may
    call as a witness at trial an expert not previously designated by
    that party if . . . [¶] (a) [t]hat expert has been designated by
    another party and has thereafter been deposed . . . .”
    Dr. Zakowski was designated by White Memorial and was
    later deposed by Unzueta. Without citation to the record,
    Unzueta asserts Dr. Akopyan “elicited expert opinions from [Dr.]
    Zakowski on subjects not disclosed during his deposition.” But
    Dr. Zakowski testified at trial only as to the cause of Unzueta’s
    injury, a subject on which White Memorial expressly designated
    Dr. Zakowski as an expert. Moreover, White Memorial’s attorney
    of any witness that is offered by any party who has unreasonably
    failed to do any of the following: [¶] (a) List that witness as an
    expert under Section 2034.260. [¶] (b) Submit an expert witness
    declaration. [¶] (c) Produce reports and writings of expert
    witnesses under Section 2034.270. [¶] (d) Make that expert
    available for a deposition under Article 3 (commencing with
    Section 2034.410).”
    28
    stated at the deposition Dr. Zakowski would opine “as to what
    caused this injury based on his background, training, education
    and experience.” 10 Under these circumstances, the trial court did
    not err in denying Unzueta’s motion.
    C.    The Trial Court’s Exclusion of Dr. Akopyan’s Criminal
    Record and Medical License Applications Was Harmless
    Unzueta contends the trial court erred by excluding
    evidence of Dr. Akopyan’s 1992 conviction for theft and her
    applications and renewals to the Medical Board for her medical
    license, which Unzueta argued showed Dr. Akopyan failed to
    report her 1992 theft conviction to the Medical Board. 11 The trial
    court ruled that under Evidence Code section 352 the evidence
    10     The record on appeal contains only a three-page excerpt
    from Dr. Zakowski’s deposition, which addresses whether
    Dr. Zakowski would testify at trial as an expert on the standard
    of care applicable to Dr. Akopyan. Unzueta did not include any
    portion of Dr. Zakowski’s deposition testimony that shows she
    lacked the opportunity to question Dr. Zakowski on his opinions
    as to causation.
    11    Unzueta also sought to introduce evidence of
    Dr. Mazmanyan’s criminal record, medical license applications,
    and related proceeding before the Medical Board. The trial court
    did not abuse its discretion in excluding that evidence. The past
    dishonesty of Dr. Akopyan’s husband does not bear on
    Dr. Akopyan’s credibility as a witness, nor was evidence of the
    Medical Board’s action in response to Dr. Mazmanyan’s
    disclosure admissible to show the action it might have taken if
    Dr. Akopyan had disclosed her prior theft conviction. (See Evid.
    Code, § 350 [“No evidence is admissible except relevant
    evidence.”]; Coyne v. De Leo (2018) 26 Cal.App.5th 801, 813
    [“Only relevant evidence is admissible.”].)
    29
    was unduly prejudicial because of the length of time that had
    passed since Dr. Akopyan made a misrepresentation to the
    Medical Board. We review the trial court’s evidentiary ruling for
    an abuse of discretion. (People v. Trujeque (2015) 
    61 Cal. 4th 227
    ,
    278; People v. Doolin (2009) 
    45 Cal. 4th 390
    , 437.)
    “The law provides that any criminal act or other
    misconduct involving moral turpitude suggests a willingness to
    lie and is not necessarily irrelevant or inadmissible for
    impeachment purposes. [Citations.] However, to the extent such
    misconduct amounts to a misdemeanor or is not criminal in
    nature, it carries less weight in proving lax moral character and
    dishonesty than does either an act or conviction involving a
    felony. [Citations.] Hence, trial courts have broad discretion to
    exclude impeachment evidence other than felony convictions
    where such evidence might involve undue time, confusion, or
    prejudice.” (People v. Contreras (2013) 
    58 Cal. 4th 123
    , 157,
    fn. 24; accord, People v. 
    Doolin, supra
    , 45 Cal.4th at p. 443
    [Under Evidence Code section 352, “‘courts may and should
    consider with particular care whether the admission of [evidence
    of misdemeanor conduct] might involve undue time, confusion, or
    prejudice which outweighs its probative value.’”].) Thus, the trial
    court did not abuse its discretion in excluding evidence of
    Dr. Akopyan’s prior conviction for the purpose of impeaching her
    credibility as a witness.
    However, it is a closer call whether Dr. Akopyan’s
    deception in the procurement of her medical license, even over a
    decade earlier, should have been admitted to impeach her
    credibility and competence to provide a medical opinion at trial. 12
    12   Although the trial court correctly pointed out Dr. Akopyan
    had not lied on her renewal applications because the applications
    30
    However, even if the trial court erred in excluding the evidence,
    Unzueta has the burden on appeal to demonstrate she was
    prejudiced by the error, “and that a different result would have
    been probable if such error . . . had not occurred or existed.”
    (Code Civ. Proc., § 475; see D.Z. v. Los Angeles Unified School
    Dist. (2019) 35 Cal.App.5th 210, 231 [“[A]n erroneous evidentiary
    ruling requires reversal only if ‘“there is a reasonable probability
    that a result more favorable to the appealing party would have
    been reached in the absence of the error.”’”]; Linton v. DeSoto Cab
    Co., Inc. (2017) 15 Cal.App.5th 1208, 1224 [“Plaintiff has the
    burden of affirmatively demonstrating prejudice, that is, that the
    errors have resulted in a miscarriage of justice.”]; Sabato v.
    Brooks (2015) 
    242 Cal. App. 4th 715
    , 724-725 [“‘Reversal is
    justified “only when the court, ‘after an examination of the entire
    cause, including the evidence,’ is of the ‘opinion’ that it is
    reasonably probable that a result more favorable to the appealing
    party would have been reached in the absence of the error.”’”].)
    It is not reasonably probable the jury would have returned
    a verdict for Unzueta on the issue of causation if the
    impeachment evidence had been admitted. Despite
    Dr. Akopyan’s testimony her conduct met the standard of care,
    the jury found her not credible, concluding she provided negligent
    care. Further, the proposed impeachment evidence would not
    have negated the expert testimony of Drs. Becker and Zakowski
    that it was not reasonably medically probable Dr. Akopyan’s
    conduct caused Unzueta’s injury. Both doctors testified the site
    only asked whether she had “been convicted of any felony or any
    crime in any state since [she] last renewed,” by not disclosing the
    prior conviction on her renewal applications Dr. Akopyan
    continued to conceal her conviction from the Medical Board.
    31
    of the epidural injection administered to Unzueta’s back was too
    far from the damaged nerve in Unzueta’s leg to have caused the
    injury. Rather, Dr. Zakowski testified it was reasonably
    medically probable Unzueta’s injury was caused by the force of
    labor or external compression by the positioning of her legs
    during the labor and delivery. 13
    D.    Defense Counsel’s Statements During Closing Argument Do
    Not Require Reversal
    Unzueta argues Packer falsely suggested during his closing
    argument Dr. Akopyan was not insured, and Packer improperly
    appealed to the jury’s sympathies based on the hardship
    Dr. Akopyan would suffer from a verdict for Unzueta. We
    conclude Packer’s statement and gesture regarding “tak[ing]
    Dr. Akopyan’s purse and giv[ing] it to Ms. Unzueta” was not
    improper, and Unzueta forfeited her argument as to Packer’s
    statement Unzueta “would like to be supported the rest of her life
    by Dr. Akopyan” by failing timely to object and request a curative
    instruction.
    13     We deny Unzueta’s January 3, 2019 request for judicial
    notice of the Medical Board’s accusation that Dr. Akopyan
    engaged in unprofessional conduct and procured her medical
    license by fraud, deceit, or misrepresentation, because the
    document is not relevant to disposition of this appeal. (See Coyne
    v. City and County of San Francisco (2017) 9 Cal.App.5th 1215,
    1223, fn. 3 [denying judicial notice as to documents that were not
    relevant to court’s analysis]; Arce v. Kaiser Foundation Health
    Plan, Inc. (2010) 
    181 Cal. App. 4th 471
    , 482 [“We also may decline
    to take judicial notice of matters that are not relevant to
    dispositive issues on appeal.”].)
    32
    “‘“‘“The right of counsel to discuss the merits of a case, both
    as to the law and facts, is very wide, and he has the right to state
    fully his views as to what the evidence shows, and as to the
    conclusions to be fairly drawn therefrom. The adverse party
    cannot complain if the reasoning be faulty and the deductions
    illogical, as such matters are ultimately for the consideration of
    the jury.”’” [Citations.] “Counsel may vigorously argue his case
    and is not limited to ‘Chesterfieldian politeness.’” [Citations.]
    “An attorney is permitted to argue all reasonable inferences from
    the evidence . . . .” [Citation.] “Only the most persuasive reasons
    justify handcuffing attorneys in the exercise of their advocacy
    within the bounds of propriety.”’” (Cassim v. Allstate Ins. Co.
    (2004) 
    33 Cal. 4th 780
    , 795 [statements by plaintiffs’ attorney in
    closing argument equating representations by plaintiffs to claims
    by jurors for pay for days court was not in session was not
    attorney misconduct]; accord, IIG Wireless, Inc. v. Yi (2018)
    22 Cal.App.5th 630, 646.) However, “‘[t]he law, like boxing,
    prohibits hitting below the belt. The basic rule forbids an
    attorney to pander to the prejudice, passion or sympathy of the
    jury.’” (Bigler-Engler v. Breg, Inc. (2017) 7 Cal.App.5th 276, 295;
    accord, Martinez v. Department of Transportation (2015)
    
    238 Cal. App. 4th 559
    , 566-568 [concluding defense counsel’s six
    references to the jury’s interest as taxpayers in the payment of
    damages by defendant public transportation authority, more than
    10 references to plaintiff’s job loss to show his laziness and
    irresponsibility in violation of pretrial rulings, and comparison of
    logo on plaintiff’s motorcycle to Nazi imagery were “truly
    egregious, indisputable instances of misconduct”].)
    Unzueta’s reliance on Hoffman v. Brandt (1966) 
    65 Cal. 2d 549
    and Du Jardin v. City of Oxnard (1995) 
    38 Cal. App. 4th 174
    is
    misplaced. Hoffman involved defense counsel’s statement during
    33
    closing argument that a verdict for the plaintiff would put the
    defendant in a public home for the indigent. (Hoffman, at p. 551,
    fn. 1.) Although the trial court admonished the jury the
    argument was not evidence, the Supreme Court concluded
    defense counsel’s statement was prejudicial misconduct because
    it had no relevance to the case, transparently “appeal[ed] to the
    sympathies of the jury on the basis of the claimed lack of wealth
    of the defendant,” and falsely implied the defendant had no
    insurance. (Id. at pp. 552-555.) Similarly, in Du Jardin, defense
    counsel argued in his closing, “‘When a public agency, be it a
    school or a library or a hospital is held liable for the admittedly
    negligent conduct of other people, we just have to sit back and
    start counting the public services that will disappear when we
    hold a public entity liable for the negligence of other persons.’”
    (Du Jardin, at p. 177.) The Court of Appeal concluded the
    statement was misconduct because it “improperly sought to
    convince the jurors that a litany of public services they currently
    receive would disappear” and “intimated that the [defendant]
    City had no insurance to cover any damages.” (Id. at p. 179.)
    Here, by contrast, Packer did not state (or suggest) an
    award of damages would cause financial hardship to
    Dr. Akopyan, nor did Packer imply Dr. Akopyan was not insured.
    Rather, Packer’s statement and gesture regarding Dr. Akopyan
    giving Unzueta her purse were made in the context of Packer’s
    argument that liability requires proof of fault.
    Unzueta has forfeited her argument of misconduct with
    respect to Packer’s statement Unzueta “would like to be
    supported the rest of her life by Dr. Akopyan,” because Unzueta’s
    attorney failed to object during trial. “‘[T]o preserve for appeal an
    instance of misconduct of counsel in the presence of the jury, an
    objection must have been lodged at trial and the party must also
    34
    have moved for a mistrial or sought a curative admonition unless
    the misconduct was so persistent that an admonition would have
    been inadequate to cure the resulting prejudice.’” (Bigler-Engler
    v. Breg, 
    Inc., supra
    , 7 Cal.App.5th at p. 295; accord, Cassim v.
    Allstate Ins. 
    Co., supra
    , 33 Cal.4th at pp. 794-795 [“In addition to
    objecting, a litigant faced with opposing counsel’s misconduct
    must also ‘move for a mistrial or seek a curative admonition’
    [citation] unless the misconduct is so persistent that an
    admonition would be inadequate to cure the resulting prejudice
    [citation].”].)
    Henriks did not object to Packer’s statement or request a
    curative instruction. Henriks’s later objection to Packer’s
    reference to Unzueta’s reliance on Medi-Cal did not raise a
    concern about Packer’s prior statement.
    DISPOSITION
    The judgment is conditionally reversed, and the matter is
    remanded to the trial court to conduct a complete second and
    third stage Batson/Wheeler analysis. On remand, the trial court
    is to elicit defense counsel’s justifications for the peremptory
    challenges to prospective jurors Medina, Quintero, Henriquez,
    and Villarreal, then make a sincere and reasoned evaluation of
    those explanations. If the court finds, because of the passage of
    time or other reason, it is unable to conduct the evaluation, or if
    any of the challenges to the six Hispanic prospective jurors were
    based on racial bias, the court should set the case for a new trial.
    If the court finds defense counsel’s race-neutral explanations are
    credible and he exercised the six peremptory challenges in a
    permissible fashion, the court should reinstate the judgment. In
    35
    all other respects, we affirm. Each party is to bear her own costs
    on appeal.
    FEUER, J.
    WE CONCUR:
    ZELON, Acting P. J.
    SEGAL, J.
    36