State of Arizona v. Penny Ann West ( 2015 )


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  •                              IN THE
    ARIZONA COURT OF APPEALS
    DIVISION TWO
    THE STATE OF ARIZONA,
    Appellee,
    v.
    PENNY ANN WEST,
    Appellant.
    No. 2 CA-CR 2013-0562
    Filed November 13, 2015
    Appeal from the Superior Court in Pima County
    No. CR20063310
    The Honorable John S. Leonardo, Judge
    The Honorable Javier Chon-Lopez, Judge
    AFFIRMED
    COUNSEL
    Mark Brnovich, Arizona Attorney General
    Joseph T. Maziarz, Section Chief Counsel, Phoenix
    By David A. Sullivan, Assistant Attorney General, Tucson
    Counsel for Appellee
    Law Offices of Thomas Jacobs, Tucson
    By Thomas Jacobs
    Counsel for Appellant
    STATE v. WEST
    Opinion of the Court
    OPINION
    Presiding Judge Vásquez authored the opinion of the Court, in
    which Judge Howard and Judge Kelly1 concurred.
    V Á S Q U E Z, Presiding Judge:
    ¶1           After a jury trial, Penny West was convicted of
    criminally negligent child abuse under circumstances likely to
    produce death or serious physical injury. The trial court suspended
    the imposition of sentence and placed her on probation for a period
    of three years, ordering that she serve a six-month jail term as a
    condition of probation. Penny contends the court erred by denying
    her motion for a new trial on the following grounds: (1) the state
    presented four alternate theories of criminal liability that deprived
    her of a unanimous verdict; (2) the court erred in denying her
    request for a unanimous-verdict jury instruction; (3) the verdict was
    against the weight of the evidence; and (4) the prosecutor committed
    misconduct during trial and closing argument. We affirm.
    Factual and Procedural Background
    ¶2           The procedural history of this case is extensive. We
    view the underlying facts in the light most favorable to sustaining
    Penny’s conviction. See State v. Brown, 
    233 Ariz. 153
    , ¶ 2, 
    310 P.3d 29
    , 32 (App. 2013). On August 24, 2005, sixteen-month-old Emily M.
    died from severe head trauma. At the time, she was a foster child in
    the care of Penny and her husband Randall.2 We set forth only the
    relevant facts necessary to resolve this appeal.
    1The  Hon. Virginia C. Kelly, a retired judge of this court, is
    called back to active duty to serve on this case pursuant to orders of
    this court and our supreme court.
    2Penny  and Randall have three children—M., K., and C.—and
    were also caring for two other foster children—D. and K.M.—at the
    time. Emily and K.M. were sisters.
    2
    STATE v. WEST
    Opinion of the Court
    ¶3          Penny was the only adult at home that morning when
    she claimed Emily fell over backward on the carpeted floor. Penny
    took Emily to the bathroom, removed her clothing, and splashed
    water on her in an attempt to revive her. After Emily did not
    respond, Penny called Randall and then 9-1-1. That was the ninth
    telephone call exchanged between Penny and Randall in less than an
    hour. 3 Emily was unconscious when she was transported to the
    hospital. A neurosurgeon performed emergency brain surgery, but
    Emily died shortly thereafter. The county medical examiner
    concluded that Emily’s death was due to one or more “blunt impacts
    to the head with subdural hemorrhage.”
    ¶4           A grand jury indicted Penny and Randall for intentional
    or knowing child abuse likely to produce death or serious physical
    injury in violation of A.R.S. § 13-3623(A). The amended indictment
    alleged that Penny and Randall,
    having the care or custody of Emily . . . ,
    committed child abuse by intentionally or
    knowingly causing physical injury to Emily
    . . . , or causing or permitting the person or
    health of Emily . . . to be injured, or causing
    or permitting Emily . . . to be placed in a
    situation       where    her     health    was
    endangered.
    ¶5          During trial, Penny and Randall filed a motion to
    compel the state “to elect one single act or ‘transaction’ on which it
    seeks to have the jury convict each Defendant.” Alternatively, they
    requested that the trial court give a jury instruction requiring
    unanimity as to the “same act or omission” constituting child abuse.
    In response, the state argued that § 13-3623(A) provides three ways
    3 One call was made so Penny could settle a bet between
    Randall and M., but the content of the others was undisclosed.
    Evidence that the other calls had been placed was admitted at trial,
    but the court prohibited the state from speculating about their
    substance.
    3
    STATE v. WEST
    Opinion of the Court
    to commit child abuse, it did not have to elect one of those ways on
    which to proceed, and the court should instruct the jury that it did
    not have to unanimously agree on the way the offense was
    committed so long as all the jurors found one of the ways proven.
    The court agreed with the state and denied the requests.
    ¶6            During closing argument, the state asserted that “all
    three ways of committing child abuse were done in this case.” The
    trial court instructed the jury: “[I]t is not necessary that all eight of
    you agree on the particular manner in which the crime was
    committed. However, it is necessary that each of you determine that
    the defendant committed child abuse in at least one of the three
    possible manners charged.” The jury found Penny guilty of
    criminally negligent child abuse under circumstances likely to
    produce death or serious injury and found Randall guilty of reckless
    child abuse under circumstances not likely to produce death or
    serious injury.
    ¶7           After trial, Penny and Randall separately filed motions
    for judgments of acquittal, pursuant to Rule 20, Ariz. R. Crim. P.,
    arguing there was insufficient evidence to support their convictions.
    They also filed a joint motion for a new trial. After hearing oral
    argument, the trial court granted their motions for judgments of
    acquittal, concluding that “a rational trier of fact could find beyond
    a reasonable doubt that [Emily’s] injury was caused by an act of
    child abuse” but there was insufficient evidence to show which of
    them had committed that act. The state appealed.
    ¶8            Reviewing the trial court’s Rule 20 determination for an
    abuse of discretion, this court reversed. State v. West, 
    224 Ariz. 575
    ,
    ¶¶ 8, 15, 
    233 P.3d 1154
    , 1156, 1158 (App. 2010) (West I). However, on
    review, our supreme court clarified that the “question of sufficiency
    of the evidence is one of law, subject to de novo review on appeal.”
    State v. West, 
    226 Ariz. 559
    , ¶ 15, 
    250 P.3d 1188
    , 1191 (2011) (West II).
    The court thus vacated our opinion and remanded the case to this
    court to address the merits of the state’s appeal. Id. ¶ 20.
    ¶9         On remand, we concluded there was sufficient evidence
    to support Penny’s conviction. State v. West, No. 2 CA-CR 2008-
    4
    STATE v. WEST
    Opinion of the Court
    0342, ¶ 14 (memorandum decision filed Mar. 5, 2012) (West III). We
    explained that the state needed to present substantial evidence
    “under any of [the] three alternate theories” of § 13-3623(A). Id.
    ¶ 13. Turning to the first means of violating § 13-3623(A), we
    explained that Penny “was the only adult in the house when Emily
    collapsed” and “virtually every doctor involved in Emily’s
    emergency care testified she would not have suffered her severe
    head injury from the standing-height fall Penny had described.” Id.
    ¶ 15. Citing testimony from the state’s experts, we pointed out that
    “Emily’s head injury had occurred ‘recently,’ ‘that morning . . . or
    maybe the evening before,’ and that she would have displayed
    symptoms immediately afterward.” Id. ¶ 17 (alteration in West III).
    We also highlighted the inconsistencies in Penny’s account of the
    injury. Id. ¶ 16. We thus concluded that “there was ‘such proof that
    reasonable persons could accept as adequate and sufficient to
    support a conclusion [that Penny caused or permitted Emily’s
    injury,] beyond a reasonable doubt.’” Id. ¶ 19, quoting West II, 
    226 Ariz. 559
    , ¶ 16, 
    250 P.3d at 1191
     (alteration in West III). And,
    consequently, we did not address the other means of committing
    child abuse under § 13-3623(A). Id.
    ¶10           However, we did not reach the same conclusion as to
    Randall. Id. ¶ 20. We found the evidence “too speculative to
    constitute substantial evidence that Randall, either alone or in
    concert with Penny, injured Emily” under the first means in § 13-
    3623(A). Id. Because the state conceded “there was insufficient
    evidence to support Randall’s conviction under the second means of
    violating” § 13-3623(A), we turned to the third. Id. ¶ 24. We
    declined to rely on the telephone calls between Penny and Randall
    as evidence that he had delayed in seeking medical care for Emily
    because the content of those calls was not contained in the record.
    Id. ¶ 25. We also explained, “When the state alleges that a caretaker
    has endangered a child by failing to obtain prompt medical
    treatment for the child’s injuries, the state must prove the delay
    increased the child’s risk of harm.” Id. ¶ 26. And because the state
    presented no such evidence, we concluded that “there was
    insufficient evidence to support Randall’s conviction under the third
    means of violating § 13-3623.” Id. Accordingly, we affirmed the trial
    5
    STATE v. WEST
    Opinion of the Court
    court’s order granting Randall’s Rule 20 motion but reversed it as to
    Penny. Id. ¶ 27.
    ¶11          After our supreme court denied Penny’s petition for
    review, the case returned to the trial court, where Penny renewed
    and supplemented her motion for a new trial, which the court had
    originally declined to address after granting her motion for
    judgment of acquittal. After hearing oral argument, the court
    denied Penny’s motion and subsequently sentenced her as described
    above. 4 This appeal followed. We have jurisdiction pursuant to
    A.R.S. §§ 12-120.21(A)(1), 13-4031, and 13-4033(A).
    Jury Unanimity
    ¶12           Penny contends the trial court erred by denying her
    motion for a new trial based on a lack of jury unanimity in reaching
    the verdict. 5 Specifically, she asserts the state argued alternate
    theories of criminal liability but substantial evidence did not support
    all the theories. Generally, we review the denial of a motion for a
    new trial for an abuse of discretion. State v. Hoskins, 
    199 Ariz. 127
    ,
    ¶ 52, 
    14 P.3d 997
    , 1012 (2000). However, we review questions of
    law, including constitutional issues, de novo. State v. Bolding, 
    227 Ariz. 82
    , ¶ 5, 
    253 P.3d 279
    , 282 (App. 2011).
    4 The  trial court originally imposed a term of four years’
    probation, including six months’ incarceration. Penny petitioned
    this court for special-action review, however, arguing that the court
    erred in requiring her to serve six months in jail “based on [her]
    failure to admit responsibility and express remorse.” We accepted
    jurisdiction and granted relief, vacating the sentencing order and
    directing the court to resentence Penny. West v. Chon-Lopez, No. 2
    CA-SA 2013-0089 (decision order filed Nov. 8, 2013).
    5Although     Penny argues the lack of jury unanimity “creat[ed]
    a due process violation,” she does not develop the argument in any
    meaningful way. We therefore do not address it. See Ariz. R. Crim.
    P. 31.13(c)(1)(vi); State v. Bolton, 
    182 Ariz. 290
    , 298, 
    896 P.2d 830
    , 838
    (1995) (“Failure to argue a claim on appeal constitutes waiver of that
    claim.”).
    6
    STATE v. WEST
    Opinion of the Court
    ¶13           A criminal defendant has the constitutional right to a
    unanimous jury verdict. Ariz. Const. art. II, § 23; see also State v.
    Payne, 
    233 Ariz. 484
    , ¶ 81, 
    314 P.3d 1239
    , 1263 (2013). The jury
    therefore must be unanimous “‘on whether the criminal act charged
    has been committed.’” State v. Herrera, 
    176 Ariz. 9
    , 16, 
    859 P.2d 119
    ,
    126 (1993), quoting State v. Encinas, 
    132 Ariz. 493
    , 496-97, 
    647 P.2d 624
    , 627-28 (1982). However, “‘the defendant is not entitled to a
    unanimous verdict on the precise manner in which the act was
    committed.’” 
    Id.,
     quoting Encinas, 
    132 Ariz. at 496-97
    , 
    647 P.2d at 627-28
    ; see also State v. Dann, 
    220 Ariz. 351
    , ¶ 79, 
    207 P.3d 604
    , 620
    (2009) (“Jurors may . . . reach a verdict based on a combination of
    alternative findings.”).
    ¶14          A person commits child abuse when he or she,
    [u]nder circumstances likely to produce
    death or serious physical injury, . . . causes
    a child . . . to suffer physical injury or,
    having the care or custody of a child . . . ,
    causes or permits the person or health of
    the child . . . to be injured or . . . causes or
    permits a child . . . to be placed in a
    situation where the person or health of the
    child . . . is endangered.
    § 13-3623(A). “[T]he statute increases the offense level based on the
    actor’s intent: If the offense is ‘done intentionally or knowingly,’ it
    becomes a class 2 felony.” Payne, 
    233 Ariz. 484
    , ¶ 71, 314 P.3d at
    1261, quoting § 13-3623(A)(1). “It is a lesser offense if done
    negligently or recklessly.” Id.; see § 13-3623(A)(2), (3).
    ¶15          In State v. Forrester, 
    134 Ariz. 444
    , 447, 
    657 P.2d 432
    , 435
    (App. 1982), we explained, “If a statute describes a single offense
    which may be committed in more than one way, it is unnecessary
    for there to be unanimity as to the means by which the crime is
    committed provided there is substantial evidence to support each of
    the means charged.” There, the statute at issue was A.R.S. § 13-1802
    governing theft. Id. at 446-47, 
    657 P.2d at 434-35
    . The defendant was
    indicted with theft by controlling the property of another with the
    7
    STATE v. WEST
    Opinion of the Court
    intent to deprive the other of that property, see § 13-1802(A)(1), or
    converting property entrusted to him for an unauthorized term or
    use, see § 13-1802(A)(2). Forrester, 
    134 Ariz. at 447
    , 
    657 P.2d at 435
    .
    The trial court instructed the jury that it could find the defendant
    guilty by either means. 
    Id.
     On appeal, the defendant argued the
    court “erred by failing to require the jury to specify under what
    theory it found him guilty.” 
    Id.
     We rejected that argument after
    determining the theft statute described a single offense capable of
    being committed in various ways and did not require jury
    unanimity on the way it was committed. 
    Id. at 447-48
    , 
    657 P.2d at 435-36
    .
    ¶16          In her motion for a new trial, Penny relied on Forrester
    and argued § 13-3623(A) is an “alternative means” statute requiring
    substantial evidence to support each of the means charged. She
    maintained, however,
    substantial evidence was lacking to prove
    that [she] committed child abuse by either
    the second or third of the statutorily-
    described means, or both—that is, by
    “caus[ing] or permit[ting] the person or
    health of the person to be injured,” and/or
    by “caus[ing] or permit[ting] a child . . . to
    be placed in a situation where the person or
    health of the child . . . is endangered.”
    In her supplemental brief on her motion, Penny relied on this court’s
    determination that substantial evidence did not support Randall’s
    conviction under the third means of the statute and maintained that
    the same reasoning applied to her. See West III, No. 2 CA-CR 2008-
    0342, ¶ 26. At oral argument on her motion for a new trial, Penny
    further asserted the state presented a “buffet of factual options” for
    the jury to choose from, suggesting that there needed to be
    substantial evidence for each of the state’s factual theories.
    ¶17        The trial court rejected Penny’s argument. It noted that
    it was bound by this court’s determination that substantial evidence
    supported Penny’s conviction under the first means of committing
    8
    STATE v. WEST
    Opinion of the Court
    child abuse in § 13-3623(A)—that Penny had caused Emily’s injury.
    See West III, No. 2 CA-CR 2008-0342, ¶¶ 14, 19. And, it reasoned,
    because substantial evidence existed to find
    [Penny] personally injured Emily in the
    morning while she was in [Penny’s] care,
    the jury also necessarily had substantial
    evidence before it to find that [Penny]
    caused or permitted Emily’s person or
    health to be injured and that [Penny]
    permitted Emily to be placed in a situation
    where her person or health was
    endangered.
    The court also concluded that its analysis focused on the substantial
    evidence to support “each alternative means,” not the state’s factual
    theories.
    ¶18          On appeal, Penny repeats her argument but seems to
    focus on the state’s specific factual theories to prove the means
    charged rather than the statutory means charged. She contends “the
    state argued four alternate theories of criminal liability”: (1) “Penny
    personally caused Emily’s head injury”; (2) “Randall personally
    caused Emily’s injury, but Penny culpably left Emily alone with
    him”; (3) “regardless of the genesis of Emily’s injury,” Penny
    delayed calling 9-1-1 “in a joint criminal act with Randall . . . while
    the two exchanged phone calls”; or (4) “regardless of the genesis of
    Emily’s injury,” Penny personally delayed calling 9-1-1 “while she
    stripped and splashed Emily, and then called Randall.” And, she
    maintains “there was no substantial evidence to support three of the
    four theories.”
    ¶19          Penny and the state apparently agree that § 13-3623(A)
    is an alternative-means statute. “Alternative means statutes identify
    a single crime and provide more than one means of committing the
    crime.” In re Det. of Halgren, 
    132 P.3d 714
    , 720 (Wash. 2006); see also
    State v. Brown, 
    284 P.3d 977
    , 985 (Kan. 2012). In Arizona, we use the
    term “single unified offense” to describe a crime proscribed by an
    alternative-means statute. State v. Garcia, 
    235 Ariz. 627
    , ¶ 8, 
    334 P.3d 9
    STATE v. WEST
    Opinion of the Court
    1286, 1289 (App. 2014). We agree that § 13-3623(A) is an alternative-
    means statute and that child abuse under the statute is a single
    unified offense.
    ¶20            In determining whether a statute provides alternative
    means of committing the same offense, we must “ascertain and give
    effect to the intent of our legislature.” State v. Garcia, 
    219 Ariz. 104
    ,
    ¶ 6, 
    193 P.3d 798
    , 800 (App. 2008); see also State v. Manzanedo, 
    210 Ariz. 292
    , ¶ 8, 
    110 P.3d 1026
    , 1028 (App. 2005). In conducting this
    analysis, we may consider: “(1) the title of the statute, (2) whether
    there was ‘a readily perceivable connection between the various
    acts’ listed in the statute, (3) whether those acts were ‘consistent with
    and not repugnant to each other,’ and (4) whether those acts might
    ‘inhere in the same transaction.’” Manzanedo, 
    210 Ariz. 292
    , ¶ 8, 110
    P.3d at 1028, quoting State v. Dixon, 
    127 Ariz. 554
    , 561, 
    622 P.2d 501
    ,
    508 (App. 1980). The plain language of a statute is the best and most
    reliable indicator of the legislature’s intent. State v. Christian, 
    202 Ariz. 462
    , ¶ 5, 
    47 P.3d 666
    , 667-68 (App. 2002). “‘When a statute is
    clear and unambiguous, we apply its plain language and need not
    engage in any other means of statutory interpretation.’” State v.
    Gongora, 
    235 Ariz. 178
    , ¶ 5, 
    330 P.3d 368
    , 369 (App. 2014), quoting
    State v. Arellano, 
    213 Ariz. 474
    , ¶ 9, 
    143 P.3d 1015
    , 1018 (2006).
    ¶21          The language of § 13-3623(A) is clear and unambiguous.
    The title, child abuse, “summarizes the statute as dealing with a
    single offense.” Forrester, 
    134 Ariz. at 448
    , 
    657 P.2d at 436
    . Within
    the first paragraph, the statute plainly provides three ways—or
    means—of committing child abuse. They include: (1) causing a
    child to suffer a physical injury; (2) having the care or custody of a
    child, causing or permitting the person or health of the child to be
    injured; and (3) having the care or custody of a child, causing or
    permitting the child to be placed in a situation where the person or
    health of the child is endangered. § 13-3623(A). The three means are
    not repugnant to each other because proof of one “does not disprove
    the other.” Manzanedo, 
    210 Ariz. 292
    , ¶ 9, 110 P.3d at 1028.
    Moreover, § 13-3623(A) “focuses on a single harm to the victim,”
    and the three means “merely provide different ways of causing that
    single harm.” State v. Paredes-Solano, 
    223 Ariz. 284
    , ¶ 14, 
    222 P.3d 900
    , 906 (App. 2009); see also In re Jeremiah T., 
    212 Ariz. 30
    , ¶ 12, 126
    10
    STATE v. WEST
    Opinion of the Court
    P.3d 177, 181 (App. 2006). The child-abuse statute is therefore
    similar to the theft statute addressed in Forrester. See Paredes-Solano,
    
    223 Ariz. 284
    , ¶ 14, 
    222 P.3d at 906
     (theft statute focuses on single
    harm: “deprivation of control over one’s property”).
    ¶22           We recognize that, in addition to providing the three
    means of committing child abuse, § 13-3623(A) also contains three
    subsections that classify the offense based on the defendant’s mental
    state: intentional or knowing child abuse, reckless child abuse, and
    criminally negligent child abuse. See State v. Freeney, 
    223 Ariz. 110
    ,
    ¶ 16, 
    219 P.3d 1039
    , 1042 (2009) (if elements of one offense differ
    from those of another, they are distinct and separate crimes); Black’s
    Law Dictionary 634 (10th ed. 2014) (defining “elements of crime” as
    “constituent parts,” usually including mens rea); see also Brown, 284
    P.3d at 988 (in considering whether statute provides alternative
    means, court must ask if it lists “distinct, material elements of a
    crime—that is, the necessary mens rea, actus reas, and, in some
    statutes, a causation element”). But regardless of which mental state
    is implicated, child abuse is still one offense that can be committed
    the same three ways. Cf. State v. Valentini, 
    231 Ariz. 579
    , ¶ 9, 
    299 P.3d 751
    , 754 (App. 2013) (“[S]econd-degree murder is one offense
    regardless of the culpable mental state with which it is committed.”).
    The mental states are separate from the means, and the subsections
    merely “increase[] the offense level based on the actor’s intent.”
    Payne, 
    233 Ariz. 484
    , ¶ 71, 314 P.3d at 1261 (mens rea applies to act
    that defendant commits). We therefore conclude that § 13-3623(A) is
    an alternative-means statute, and child abuse is a single unified
    offense, the classification of which changes depending on the
    defendant’s mental state.
    ¶23          For the first time on appeal, Penny argues “there are
    fully eight different ways for a person to commit child abuse” under
    § 13-3623(A). She separates the three means in the statute by
    distinguishing between active and passive conduct and mental and
    physical injury.      She claims that “causing” is active while
    “permitting” is passive, and “person” refers to a physical injury
    while “health” connotes a mental harm. But we are aware of no case
    law supporting this approach. See Brown, 284 P.3d at 992 (“[I]t is
    unlikely that the legislature intended for options within a means to
    11
    STATE v. WEST
    Opinion of the Court
    constitute alternative means . . . .”); cf. Payne, 
    233 Ariz. 484
    , ¶ 86, 314
    P.3d at 1263 (describing “causing or permitting” injury as “discrete
    method of committing child abuse under § 13-3623(A)”). We thus
    treat the statute as providing three alternative means, as the parties
    and the trial court did below, and as we did in our memorandum
    decision in the prior appeal. See West III, No. 2 CA-CR 2008-0342,
    ¶¶ 13-14.
    ¶24           Having determined that child abuse under § 13-3623(A)
    is a single offense that may be committed in three ways, we turn to
    Penny’s Forrester argument.6 As an initial matter, Forrester generally
    requires substantial evidence supporting “each of the means
    charged,” not the state’s factual theories of the case, as Penny seems
    to suggest. 
    134 Ariz. at 447
    , 
    657 P.2d at 435
    ; see also Dixon, 127 Ariz.
    at 561, 622 P.2d at 508. This is consistent with due process, which
    “requires that a defendant be given ‘notice of the specific charge’”
    but not the state’s theory of the charge. State v. Rivera, 
    207 Ariz. 69
    ,
    ¶ 12, 
    83 P.3d 69
    , 73 (App. 2004), quoting State v. Blakley, 
    204 Ariz. 429
    ,
    ¶ 47, 
    65 P.3d 77
    , 87 (2003). However, with an alternative-means
    statute like § 13-3623(A), where the offense level is based on the
    defendant’s mental state, and the jury is provided instructions on
    the lesser mental states, we must determine whether substantial
    evidence supports all three means involving the mental state for
    which the defendant was convicted. See Brown, 284 P.3d at 983
    (requiring substantial evidence to support means “set out in the jury
    instructions”); State v. Smith, 
    154 P.3d 873
    , 875 (Wash. 2007)
    (requiring substantial evidence “of each of the relied-on alternative
    means”).
    6 At  oral argument, the state asserted for the first time that
    Forrester may no longer apply in light of Griffin v. United States, 
    502 U.S. 46
    , 47, 59-60 (1991), where the Supreme Court concluded that “a
    general guilty verdict on a multiple-object conspiracy [need not] be
    set aside if the evidence is inadequate to support conviction as to
    one of the objects.” However, the parties did not brief this issue.
    We therefore do not address it. See State v. Edmisten, 
    220 Ariz. 517
    ,
    ¶ 19, 
    207 P.3d 770
    , 776-77 (App. 2009) (“[A]rguments raised for the
    first time at oral argument are generally waived.”).
    12
    STATE v. WEST
    Opinion of the Court
    ¶25           Here, the indictment essentially mirrored the language
    of § 13-3623(A)(1), alleging that Penny had committed child abuse
    by “intentionally or knowingly causing physical injury to Emily . . . ,
    or causing or permitting the person or health of Emily . . . to be
    injured, or causing or permitting Emily . . . to be placed in a situation
    where her health was endangered.” Penny, however, was convicted
    of the lesser offense of criminally negligent child abuse under § 13-
    3623(A)(3). Substantial evidence supports each of the three means of
    that offense.
    ¶26          Our memorandum decision in West III is now law of the
    case. See State v. Whelan, 
    208 Ariz. 168
    , ¶ 8, 
    91 P.3d 1011
    , 1014 (App.
    2004) (“‘Law of the case concerns the practice of refusing to reopen
    questions previously decided in the same case by the same court or a
    higher appellate court.’”), quoting Davis v. Davis, 
    195 Ariz. 158
    , ¶ 13,
    
    985 P.2d 643
    , 647 (App. 1999). We determined there was substantial
    evidence that Penny had caused Emily’s injury under the first means
    of committing child abuse under § 13-3623(A). West III, No. 2 CA-
    CR 2008-0342, ¶¶ 14, 19. And we also noted that Emily was in
    Penny’s care. Id. ¶¶ 15, 18. We agree with the trial court’s
    determination that these two findings compel the conclusion that
    substantial evidence supports the other two means under § 13-
    3623(A). Because substantial evidence supports a finding that Penny
    “cause[d Emily] to suffer physical injury,” there is also sufficient
    evidence that Penny “cause[d] or permit[ted] the person or health of
    [Emily] to be injured” and that Penny “cause[d] or permit[ted
    Emily] to be placed in a situation where [her] person or health . . .
    [wa]s endangered.” 7 § 13-3623(A). Indeed, Penny admits that
    7At  oral argument, Penny insisted that there was insufficient
    evidence to support the third means because the content of the
    telephone calls exchanged between Penny and Randall was
    unknown and the medical experts testified that the delay
    encompassed by those calls did not contribute to Emily’s injury.
    However, Penny is conflating the means charged and the state’s
    factual theories to prove those means. The issue is whether Penny
    “cause[d] or permit[ted Emily] to be placed in a situation where
    [her] person or health . . . [wa]s endangered.” § 13-3623(A).
    13
    STATE v. WEST
    Opinion of the Court
    causing a child to suffer physical injury under the first means “is
    equivalent” to causing the person of the child to be injured under
    the second.
    ¶27          Penny nevertheless argues that we must “disaggregate
    the different means of commission argued, and then once
    disaggregated, . . . decide if sufficient evidence was presented to
    prove each disaggregated, alternative means.” As we understand
    her argument, she seems to suggest we must be able to identify
    distinct evidence that separately establishes each of the three means.
    But she does not appear to have raised this argument below, and she
    does not cite authority to support her argument on appeal; we
    therefore could deem the argument waived. See State v. Bolton, 
    182 Ariz. 290
    , 297-98, 
    896 P.2d 830
    , 837-38 (1995) (argument not raised
    below generally waived for all but fundamental error on appeal;
    failure to sufficiently argue claim on appeal constitutes waiver). In
    any event, we disagree.
    ¶28           Because child abuse under § 13-3623(A) is a single
    unified offense, the same evidence can be used to prove all three
    means. Cf. State v. Sustaita, 
    119 Ariz. 583
    , 591, 
    583 P.2d 239
    , 247
    (1978) (“We have stated that ‘. . . [a]n offense which requires
    different evidence or elements than the principal charge is a separate
    offense . . . .’”), quoting State v. Woody, 
    108 Ariz. 284
    , 287, 
    496 P.2d 584
    , 587 (1972) (first alteration in Sustaita). Indeed, the connection
    between the means is a unique feature of alternative-means statutes.
    See Manzanedo, 
    210 Ariz. 292
    , ¶ 8, 110 P.3d at 1028 (considering
    “‘readily perceivable connection’” between means and whether
    means “‘inhere in the same transaction’”), quoting Dixon, 127 Ariz. at
    561, 622 P.2d at 508. For example, in Forrester, we recognized that
    the jury could not find the elements of § 13-1802(A)(2) “without
    necessarily finding . . . the elements” of § 13-1802(A)(1). 
    134 Ariz. at 448
    , 
    657 P.2d at 436
    .
    Resolution of that issue is not solely dependent upon whether
    Penny’s delay in calling 9-1-1 caused further injury.
    14
    STATE v. WEST
    Opinion of the Court
    ¶29          Our supreme court’s decision in Payne supports our
    conclusion. In that case, the defendant was charged with several
    offenses, including two counts of child abuse—one for each of his
    children—alleging he had “caused or permitted [their] health to be
    endangered by failing to seek medical attention for them or allowing
    them to starve to death.” Payne, 
    233 Ariz. 484
    , ¶ 88, 314 P.3d at 1263.
    The defendant argued that the “counts were duplicitous because he
    could be found guilty based on two separate acts: failing to seek
    medical attention ‘and/or’ starving the children to death.” Id. The
    court disagreed, however, because “each count of the indictment
    charge[d] only one crime of child abuse, essentially by neglect.”
    Id. ¶ 90. It further reasoned that the counts were not duplicitous
    because the defendant “was not entitled to a unanimous verdict on
    the manner in which the act was performed.” Id. And, the court
    concluded that, even assuming error had occurred, the defendant
    was not prejudiced because no reasonable jury could have found
    him not guilty of child abuse based on his failure to seek medical
    care. Id.
    ¶30          Similarly, although Penny was entitled to a unanimous
    jury verdict on whether she committed child abuse, she was not
    entitled to a unanimous jury verdict “‘on the precise manner in
    which the act was committed.’” Herrera, 
    176 Ariz. at 16
    , 
    859 P.2d at 126
    , quoting Encinas, 
    132 Ariz. at 496
    , 
    647 P.2d at 627
    . And,
    consistent with Forrester, substantial evidence supports Penny’s
    conviction based on all three means of § 13-3623(A). See Forrester,
    
    134 Ariz. at 447
    , 
    657 P.2d at 435
    . The trial court therefore did not err
    by denying Penny’s motion for a new trial based on a lack of jury
    unanimity. See Hoskins, 
    199 Ariz. 127
    , ¶ 52, 
    14 P.3d at 1012
    ; Bolding,
    
    227 Ariz. 82
    , ¶ 5, 
    253 P.3d at 282
    .
    Jury Instructions
    ¶31         Penny also contends the trial court erred by denying her
    motion for a new trial based on State v. Klokic, 
    219 Ariz. 241
    , 
    196 P.3d 844
     (App. 2008). Relying on Klokic, she argues the court should have
    provided a unanimity instruction to the jury or, alternatively,
    required the state to elect one theory of criminal liability on which to
    proceed. Again, we review the denial of a motion for a new trial for
    15
    STATE v. WEST
    Opinion of the Court
    an abuse of discretion, Hoskins, 
    199 Ariz. 127
    , ¶ 52, 
    14 P.3d at 1012
    ,
    but we review questions of law de novo, Bolding, 
    227 Ariz. 82
    , ¶ 5,
    
    253 P.3d at 282
    .
    ¶32           In Klokic, the defendant was convicted of one count of
    aggravated assault stemming from a road-rage incident. 
    219 Ariz. 241
    , ¶¶ 1-2, 
    196 P.3d at 845
    . To prove that count, the state
    introduced evidence at trial that the defendant had pointed a gun at
    the victim on two separate occasions. Id. ¶ 6. The defendant asked
    the trial court to require the state “either to elect which particular act
    it was charging as the assault or to instruct the jurors that they must
    unanimously agree [on the] particular act that constituted the crime
    of assault.” Id. ¶ 7. The court, however, refused. Id.
    ¶33           On appeal, this court explained, “[I]f the State
    introduces evidence of multiple criminal acts to prove a single
    charge, the trial court is normally obliged to take one of two
    remedial measures to insure that the defendant receives a
    unanimous jury verdict”: (1) require the state to elect which of the
    alleged acts constitutes the crime or (2) instruct the jury that they
    must unanimously agree on the act that constitutes the crime.
    Id. ¶ 14. However, we also pointed out that “it is not error for the
    trial court to fail to require such curative measures in those instances
    in which all the separate acts that the State intends to introduce into
    evidence are part of a single criminal transaction.” Id. ¶ 15. We
    explained that “multiple acts may be considered part of the same
    criminal transaction ‘when the defendant offers essentially the same
    defense to each of the acts and there is no reasonable basis for the
    jury to distinguish between them.’” Id. ¶ 18, quoting People v.
    Stankewitz, 
    793 P.2d 23
    , 41 (Cal. 1990). Under the facts of that case,
    we concluded the separate acts were not part of the same criminal
    transaction and, consequently, the trial court erred in refusing to
    provide one of the curative measures. Id. ¶ 38.
    ¶34         In her motion for a new trial, Penny cited Klokic,
    asserting that the state had argued she committed child abuse by
    “any one o[f] several different acts.” She thus maintained the trial
    court should have taken one of the two curative measures outlined
    16
    STATE v. WEST
    Opinion of the Court
    in Klokic but failed to do so. She further asserted that this case did
    not involve a single criminal transaction.
    ¶35           The trial court rejected Penny’s Klokic argument, finding
    that “the acts in this case [were a] single criminal transaction” and,
    consequently, “neither election nor a unanimity instruction was
    required.” The court reasoned that Penny and Randall had “offered
    one unified defense to the child abuse charge”—they “both asserted
    that they did not injure Emily while she was in their care, either the
    night before or the morning of Emily’s tragic injury.” Thus,
    according to the court, “the jury was left with only one issue: was
    [Penny] responsible for Emily’s injury as the State charged or was
    someone else responsible for her injury as [Penny] asserted.” Based
    on the verdict, the court concluded that the jury did not believe
    Penny’s defense. The court further noted that, “in child abuse cases
    in California, a unanimity instruction is not required where . . . the
    offense itself consists of a continuous course of conduct.” See People
    v. Diedrich, 
    643 P.2d 971
    , 980-81 (Cal. 1982). It then concluded,
    “Even if this case were not a single transaction case, it is without
    question a continuous course of conduct child abuse case and no
    unanimity instruction was required.”
    ¶36          Penny repeats her Klokic argument on appeal. In
    particular, she disputes the trial court’s conclusion that this was a
    single criminal transaction. She maintains the court failed to
    “substantiate” its conclusion that Penny presented one unified
    defense to the multiple acts because she had separate defenses to the
    state’s theories that she had delayed in calling 9-1-1. She also
    contends the court omitted any consideration of whether there was a
    reasonable basis for the jury to distinguish between the acts.
    ¶37          However, Klokic does not apply here. Klokic involved
    aggravated assault under A.R.S. § 13-1203(A), which is not a single
    unified offense or an alternative-means statute. 
    219 Ariz. 241
    , ¶¶ 1,
    22, 
    196 P.3d at 845, 849
    ; see Jeremiah T., 
    212 Ariz. 30
    , ¶ 12, 
    126 P.3d at 181
     (describing three subsections of § 13-1203(A) as “different
    crimes”). Klokic addressed those situations where the state charges
    “as one count separate criminal acts that occurred during the course
    of a single criminal undertaking even if those acts might otherwise
    17
    STATE v. WEST
    Opinion of the Court
    provide a basis for charging multiple criminal violations” and then
    “introduces evidence of multiple criminal acts to prove [that] single
    charge.” Klokic, 
    219 Ariz. 241
    , ¶ 14, 
    196 P.3d at 847
    . In other words,
    the curative measures in Klokic are required in cases involving
    multiple acts. See id. ¶ 15.
    ¶38         But multiple-acts cases are distinct from alternative-
    means cases. As the Washington Supreme Court has explained:
    In an alternative means case, where a
    single offense may be committed in more
    than one way, there must be jury
    unanimity as to guilt for the single crime
    charged.      Unanimity is not required,
    however, as to the means by which the
    crime was committed so long as substantial
    evidence supports each alternative means.
    In reviewing an alternative means case, the
    court must determine whether a rational
    trier of fact could have found each means
    of committing the crime proved beyond a
    reasonable doubt.
    In multiple acts cases, on the other
    hand, several acts are alleged and any one
    of them could constitute the crime charged.
    In these cases, the jury must be unanimous
    as to which act or incident constitutes the
    crime.     To ensure jury unanimity in
    multiple acts cases, we require that either
    the state elect the particular criminal act
    upon which it will rely for conviction, or
    that the trial court instruct the jury that all
    of them must agree that the same
    underlying criminal act has been proved
    beyond a reasonable doubt.
    State v. Kitchen, 
    756 P.2d 105
    , 109 (Wash. 1988) (citations omitted),
    abrogated on other grounds by In re Stockwell, 
    316 P.3d 1007
     (Wash.
    18
    STATE v. WEST
    Opinion of the Court
    2014); see also State v. Timley, 
    875 P.2d 242
    , 246 (Kan. 1994),
    disapproved on other grounds by State v. Brooks, 
    317 P.3d 54
     (Kan. 2014).
    Generally, a case will fall into one of the two categories. See State v.
    Hooker, 
    21 P.3d 964
    , 968 (Kan. 2001) (“Our analysis of the
    instructions and charges leads to the conclusion that this was an
    alternative means case, not a multiple acts case, and, thus, no
    unanimity instruction was required.”); State v. Gardner, 
    889 N.E.2d 995
    , 1005 (Ohio 2008) (“[T]he critical inquiry is whether the case
    involves ‘alternative means’ or ‘multiple acts.’”); State v. Bobenhouse,
    
    214 P.3d 907
    , 911 (Wash. 2009) (“The review standard for whether
    the failure to provide a unanimity instruction was error hinges on
    whether we are dealing with an alternative means case or a multiple
    acts case.”) (emphasis omitted).
    ¶39          As explained above, this is an alternative-means case.
    Thus, Penny’s reliance on Klokic’s multiple-acts analysis is
    misplaced. Simply put, unanimity instructions were not required.
    See Hooker, 21 P.3d at 968; see also Schad v. Arizona, 
    501 U.S. 624
    , 631-
    32 (1991) (“‘[D]ifferent jurors may be persuaded by different pieces
    of evidence, even when they agree upon the bottom line. Plainly,
    there is no general requirement that the jury reach agreement on the
    preliminary factual issues which underlie the verdict.’”), quoting
    McKoy v. North Carolina, 
    494 U.S. 433
    , 449 (1990). In similar contexts,
    we have concluded that instructions indicating the jury need not
    unanimously agree on the manner in which an offense was
    committed were proper. See State v. Cotten, 
    228 Ariz. 105
    , ¶ 5, 
    263 P.3d 654
    , 657 (App. 2011); State v. Pena, 
    209 Ariz. 503
    , ¶¶ 11-12, 
    104 P.3d 873
    , 876 (App. 2005).
    ¶40          Penny nevertheless appears to suggest that this case
    involves both alternative means and multiple acts based on the
    state’s various theories of criminal liability. The two concepts may
    overlap where the state charges the defendant with one offense
    under an alternative-means statute and then alleges multiple,
    distinct acts as to the separate means. See Payne, 
    233 Ariz. 484
    ,
    ¶¶ 85-86, 314 P.3d at 1263 (discussing Klokic under § 13-3623(A)).
    However, even assuming this were a multiple-acts case, “‘there is no
    reasonable basis’ for distinguishing” between the acts. Id., quoting
    Klokic, 
    219 Ariz. 241
    , ¶ 25, 
    196 P.3d at 849
    . Rather, we agree with the
    19
    STATE v. WEST
    Opinion of the Court
    trial court that the multiple acts alleged by the state constitute a
    single criminal transaction. In turn, we explain our conclusions that
    Penny offered “‘essentially the same defense to each of the acts’”
    and that there was no “‘reasonable basis for the jury to distinguish’”
    among the acts. Klokic, 
    219 Ariz. 241
    , ¶ 18, 
    196 P.3d at 848
    , quoting
    Stankewitz, 
    793 P.2d at 41
    .
    ¶41           In considering whether Penny presented the same
    defense to the multiple acts alleged by the state, we find Klokic
    instructive. There, the defendant presented two materially different
    defenses. The defendant “both denied drawing the handgun on
    either occasion and also, in the alternative, asserted different
    justifications for each time he drew the handgun.” Id. ¶ 37. We
    concluded that the jury possibly could have disagreed as to which of
    the acts gave rise to the defendant’s criminal liability, “a possibility
    raised by these different defenses,” and the defendant was,
    therefore, entitled to one of the curative measures. Id. ¶¶ 37-38.
    ¶42           Here, Penny’s defenses were inextricably intertwined.
    As the trial court noted, her defenses to the multiple acts can be
    distilled to a denial of liability or a claim of actual innocence. Penny
    maintained she did not injure Emily and offered other possibilities
    as to what ultimately caused her death. See State v. Schroeder, 
    167 Ariz. 47
    , 53, 
    804 P.2d 776
    , 782 (App. 1990) (where defense was acts of
    fondling did not occur, jury left with weighing credibility of
    defendant, and verdict implied jury rejected defense; thus,
    defendant not prejudiced by trial court’s failure to provide
    unanimity instruction or require election by state). Penny’s counsel
    argued in closing that “none of [the acts alleged by the state]
    happened” and that Penny “did everything [she] could to help
    [Emily].”
    ¶43          As for Penny’s assertion that she presented separate
    defenses concerning the state’s theories of delay, we disagree.
    Penny characterizes those separate defenses as follows:
    (1) “Randall’s failure to volunteer information about phone calls he
    traded with Penny . . . cannot circumstantially imply that either
    defendant delayed a 911 call,” (2) evidence that one of the calls was
    made to settle a bet shows that the calls were “of benign content,”
    20
    STATE v. WEST
    Opinion of the Court
    and (3) “absent testimony, no content whatsoever could be imputed
    to any call, making speculative the State’s claim that Emily’s
    distressed condition was the subject of any call except the one made
    right before the 911 call.” But these “defenses” all are directed at
    showing that Penny did not delay in calling 9-1-1, which relates back
    to her overarching claim that she did not injure Emily.8 It is only
    how that injury occurred—by a physical act, delay, or otherwise—
    that changed based on the state’s allegations. These defenses were
    not separate, alternative theories. See Klokic, 
    219 Ariz. 241
    , ¶ 19, 
    196 P.3d at 848
     (suggesting that defenses were same where “defendant
    did not offer different justifications that could have been separately
    believed or disbelieved”). Thus, Penny presented “essentially” the
    same defense to the multiple acts alleged by the state. Id. ¶ 18.
    ¶44          Turning to the next factor in the single criminal-
    transaction analysis, the defendant must demonstrate some
    reasonable basis for the jury to distinguish among the multiple acts
    alleged by the state. See id. ¶¶ 32-34, 36. On appeal, Penny contends
    that her role in the multiple acts alleged by the state provides a
    distinguishing feature: she either “personally caus[ed]” Emily’s
    injury, “passively permitt[ed]” Emily’s injury, or had “no
    knowledge . . . about what caused Emily’s distress.” But she did not
    present this argument below, perhaps explaining why the trial court
    did not explicitly address it in its ruling, as Penny complains.
    Indeed, the court identified the reasonable-basis factor in its ruling,
    suggesting that it did not entirely omit consideration of it. In any
    event, we decline to adopt Penny’s argument on appeal. Penny has
    pointed us to no authority, and we are aware of none, indicating that
    the nature of her conduct in relation to Emily’s injury is a sufficient
    distinguishing feature.
    8In her opening brief, Penny admits she delayed calling 9-1-1
    to the extent she took Emily to the bathroom and splashed her with
    water. She offers this as a further example of how the defenses
    differed. But, for the reasons stated above, the overarching defense
    of innocence is still the same.
    21
    STATE v. WEST
    Opinion of the Court
    ¶45           The multiple acts alleged by the state in this case “only
    caused a single result”—Emily’s death—and were part of a “single
    criminal undertaking.” Id. ¶ 28. Notably, the state had to allege the
    multiple acts in this case because it did not know the precise timing
    and nature of the injury leading to Emily’s death. In addition, the
    multiple acts “occurred over a relatively short period of time,” the
    evening before or morning of the incident. Schroeder, 
    167 Ariz. at 53
    ,
    
    804 P.2d at 782
    . Thus, Penny failed to demonstrate a reasonable
    basis for distinguishing among the multiple acts.
    ¶46          In sum, because this is an alternative-means case, the
    trial court did not need to instruct the jury on unanimity or
    otherwise compel the state to elect the theory on which it wished to
    proceed. See Klokic, 
    219 Ariz. 241
    , ¶ 14, 
    196 P.3d at 847
    . Even if this
    were a multiple-acts case, no curative measures were necessary
    because the acts amounted to a single criminal transaction. See id.
    ¶ 15. Thus, it was sufficient that, in returning a guilty verdict, the
    jurors unanimously agreed Penny committed child abuse; they were
    not required to unanimously agree on how the offense was
    committed. See Herrera, 
    176 Ariz. at 16
    , 
    859 P.2d at 126
    ; Encinas, 
    132 Ariz. at 496-97
    , 
    647 P.2d at 627-28
    . Consequently, the court did not
    err in denying Penny’s motion for a new trial on this basis. See
    Hoskins, 
    199 Ariz. 127
    , ¶ 52, 
    14 P.3d at 1012
    ; Bolding, 
    227 Ariz. 82
    , ¶ 5,
    
    253 P.3d at 282
    ; see also State v. Perez, 
    141 Ariz. 459
    , 464, 
    687 P.2d 1214
    , 1219 (1984) (“We are obliged to affirm the trial court’s ruling if
    the result was legally correct for any reason.”).
    Weight of the Evidence
    ¶47          Penny also contends the trial court erred by denying her
    motion for a new trial because the verdict was against the weight of
    the evidence. Generally, we review a court’s decision on a motion
    for a new trial based on the weight of the evidence for an abuse of
    discretion. State v. Davis, 
    226 Ariz. 97
    , ¶ 5, 
    244 P.3d 101
    , 103 (App.
    2010). The state maintains, however, that this argument is waived
    because Penny did not raise the issue below and failed to argue on
    appeal that the error was fundamental. See State v. Moreno-Medrano,
    
    218 Ariz. 349
    , ¶ 17, 
    185 P.3d 135
    , 140 (App. 2008).
    22
    STATE v. WEST
    Opinion of the Court
    ¶48          In the introductory paragraph of her motion for a new
    trial, Penny listed the reasons requiring a new trial. Those reasons
    largely coincided with the language of Rule 24.1(c), Ariz. R. Crim. P.,
    which provides the grounds upon which a new trial may be granted.
    The first reason listed in the motion was: “[T]he verdicts were
    contrary to law and the weight of the evidence.” See Ariz. R.
    Crim. P. 24.1(c)(1). However, the remainder of Penny’s motion did
    not mention the weight of the evidence. And, in her supplemental
    brief on the motion, that ground likewise was not discussed. It also
    does not appear to have been raised at oral argument on the motion.
    ¶49           A passing reference to the verdict being contrary to the
    weight of the evidence is not sufficient to raise this argument below.
    Cf. State v. Lopez, 
    217 Ariz. 433
    , ¶ 4, 
    175 P.3d 682
    , 683 (App. 2008)
    (general objection insufficient to preserve issue for appeal; objection
    on one ground does not preserve issue on another ground). Indeed,
    as Penny points out, the trial court did not address this ground in its
    ruling on the motion for a new trial, presumably because it did not
    realize it was an issue. And, because Penny does not argue that the
    alleged error is fundamental—and we can find none that can be so
    characterized—we agree with the state that the argument is waived.
    See Moreno-Medrano, 
    218 Ariz. 349
    , ¶ 17, 
    185 P.3d at 140
    . We find
    waiver particularly appropriate here where the Rule 24.1(c)(1)
    determination falls within the trial court’s purview and discretion.
    See State v. Clifton, 
    134 Ariz. 345
    , 348-49, 
    656 P.2d 634
    , 637-38 (App.
    1982).
    Prosecutorial Misconduct
    ¶50          Last, Penny argues the trial court erred in denying her
    motion for a new trial based on prosecutorial misconduct. She
    points to four incidents that she contends demonstrate a “pervasive
    and persistent course of misconduct[,] which deprived [her] of a fair
    trial.” She maintains the prosecutor: (1) attacked the credibility of
    the West family by claiming they conspired to lie; (2) attacked the
    credibility of defense expert witnesses; (3) violated Rule 803(18),
    Ariz. R. Evid., by referring to irrelevant and prejudicial evidence;
    and (4) attacked defense counsel by suggesting they attempted to
    23
    STATE v. WEST
    Opinion of the Court
    mislead the medical examiner.9 We review the denial of a motion
    for a new trial based upon prosecutorial misconduct for an abuse of
    discretion. State v. Anaya, 
    170 Ariz. 436
    , 441, 
    825 P.2d 961
    , 966 (App.
    1991).
    ¶51          “To prevail on a claim of prosecutorial misconduct, a
    defendant must demonstrate that the prosecutor’s misconduct ‘so
    infected the trial with unfairness as to make the resulting conviction
    a denial of due process.’” State v. Hughes, 
    193 Ariz. 72
    , ¶ 26, 
    969 P.2d 1184
    , 1191 (1998), quoting Donnelly v. DeChristoforo, 
    416 U.S. 637
    , 643
    (1974). “‘Reversal on the basis of prosecutorial misconduct requires
    that the conduct be so pronounced and persistent that it permeates
    the entire atmosphere of the trial.’” 
    Id.,
     quoting State v. Atwood, 
    171 Ariz. 576
    , 611, 
    832 P.2d 593
    , 628 (1992), overruled on other grounds by
    State v. Nordstrom, 
    200 Ariz. 229
    , 
    25 P.3d 717
     (2001). However,
    prosecutorial misconduct is harmless if we are satisfied “beyond a
    reasonable doubt that it did not contribute to or affect the verdict.”
    State v. Roque, 
    213 Ariz. 193
    , ¶ 152, 
    141 P.3d 368
    , 403 (2006).
    ¶52           Even if an error is harmless and does not warrant
    reversal by itself, “an incident may nonetheless contribute to a
    finding of persistent and pervasive misconduct if the cumulative
    effect of the incidents shows that the prosecutor intentionally
    engaged in improper conduct and ‘did so with indifference, if not a
    specific intent, to prejudice the defendant.’” Id. ¶ 155 (internal
    citation omitted), quoting Hughes, 
    193 Ariz. 72
    , ¶ 31, 
    969 P.2d at 1192
    .
    Thus, after reviewing each individual incident, we must identify
    those constituting misconduct and evaluate their cumulative effect
    on the trial. 
    Id.
    9  Penny also summarily claims the prosecutor committed
    misconduct by presenting “false evidence in rebuttal regarding
    scientific findings made by the defense pathologists.” However, she
    failed to develop this argument as required by Rule 31.13(c)(1)(vi),
    Ariz. R. Crim. P. It is therefore waived. See State v. Sanchez, 
    200 Ariz. 163
    , ¶ 8, 
    24 P.3d 610
    , 613 (App. 2001).
    24
    STATE v. WEST
    Opinion of the Court
    ¶53          In its ruling on Penny’s motion for a new trial, the trial
    court found “no prosecutorial misconduct occurred in any of these
    incidents alone or in combination.” The court noted that “the
    prosecution may have struck hard blows in this case,” but “it did not
    strike any foul ones in either its cross-examination of defense expert
    witnesses or in its summations to the jury.” And, quoting Pool v.
    Superior Court, 
    139 Ariz. 98
    , 108-09, 
    677 P.2d 261
    , 271-72 (1984), the
    court further determined that, even if any of the incidents
    constituted misconduct, it “was not ‘intentional conduct that the
    prosecutor knew was improper and prejudicial.’” We agree.
    Attack on the West Family’s Credibility
    ¶54          Penny first contends the prosecutor “adopted a strategy
    to attempt to prove that Penny and Rand[all] . . . had coached their
    children to lie” by keeping K. and C. home from school on the
    morning of the incident so Randall could help them “fabricate a lie
    to cover up a crime.” She claims the prosecutor knew the girls had
    been at school that morning based on attendance and telephone
    records and statements from Randall and the girls. She thus
    maintains the prosecutor “chose a strategy of subterfuge to unfairly
    attack the credibility of the entire West family.”
    ¶55          Penny’s argument on this point, however, contains
    absolutely no citations to the record. 10          See Ariz. R.
    Crim. P. 31.13(c)(1)(vi). We therefore cannot confirm that the
    prosecutor knew Randall had taken K. and C. to school that
    morning, as Penny alleges. She also fails to point us to the
    prosecutor’s alleged “subterfuge, innuendo and insinuation.” We
    10Penny’s  attempt to incorporate by reference the arguments
    she made below is improper. An opening brief may not incorporate
    by reference any issue or argument but, rather, must set forth
    specific claims, present sufficient argument supported by legal
    authority, and include citations to the record.         See Ariz. R.
    Crim. P. 31.13(c)(1)(vi); State v. Dominguez, 
    236 Ariz. 226
    , ¶ 8, 
    338 P.3d 966
    , 970 (App. 2014) (“[I]ncorporation by reference is
    forbidden.”).
    25
    STATE v. WEST
    Opinion of the Court
    thus have no conduct to review and deem the argument waived. See
    Bolton, 
    182 Ariz. at 298
    , 
    896 P.2d at 838
     (failure to sufficiently argue
    claim constitutes waiver and abandonment).
    ¶56         In her reply brief, Penny nevertheless directs us to the
    following portion of the prosecutor’s closing argument:
    Now, on the same hand, when
    [defense counsel] suggested to you . . . how
    . . . in control and what a caring, concerned,
    and whatever father [Randall] was, you
    heard [what counsel] said in his opening, in
    his closing statement, and you heard
    testimony not only at trial, but in the
    defendant’s own statements that school
    gets out at 1:15 on Wednesday. I would
    submit, why did he even take the girls to
    school at 11:00 that morning after such a
    traumatic morning?         And by now, he
    clearly knows, because he’s been talking to
    Penny, that this is not a minor injury.
    ....
    Rand[all] said—as far as whether he
    was concerned and caring about what had
    happened that morning, he admits in his
    own statement, when he got home, the
    paramedics are there, and that he didn’t
    ask them anything. He didn’t ask them
    what had happened. He didn’t ask them
    how Emily was. He didn’t ask them
    anything. That’s his words in his statement
    to the detectives that day. He said he
    didn’t recall whether he asked the kids
    anything about what had happened. Folks,
    I would submit to you that that’s got to
    strike you as a little bit odd. His wife
    call[ed] him frantic, Emily has fallen, she
    26
    STATE v. WEST
    Opinion of the Court
    won’t move, she’s not moving, I don’t
    know if she’s breathing, and she’s frantic
    and hysterical, and he has to rush home,
    and he doesn’t ask the paramedics how the
    child is. What happened? He doesn’t ask
    his children what happened this morning?
    He didn’t go to the hospital until after 4:00
    that day to be with his wife.
    ¶57           Even assuming Penny’s argument is not waived, see
    State v. Oakley, 
    180 Ariz. 34
    , 36 n.1, 
    881 P.2d 366
    , 368 n.1 (App. 1994)
    (issue raised for first time in reply brief waived), we can discern no
    suggestion by the prosecutor that Randall kept the girls home from
    school to coach them to lie. Rather, the prosecutor was responding
    to defense counsel’s claim that Randall was a “concerned, caring
    father.”
    ¶58         Moreover, it is not readily apparent to us how Randall’s
    conduct affected Penny’s case. Penny cites nothing to suggest that
    the prosecutor argued she had encouraged or otherwise knew
    Randall had kept the girls home from school in order to “fabricate a
    lie.” We thus agree with the trial court that no prosecutorial
    misconduct occurred as to this incident.
    Attack on Defense Expert Witnesses
    ¶59         Penny contends the prosecutor “unfair[ly] attack[ed]”
    three defense expert witnesses: Dr. Joseph Scheller, Dr. John
    Plunkett, and Dr. Ronald Uscinski. We address each in turn.
    1. Dr. Scheller
    ¶60          As to Scheller, Penny maintains the prosecutor
    “insinuated a bias” by suggesting Scheller trained criminal defense
    attorneys. She points to the following question posed by the
    prosecutor during Scheller’s cross-examination: “When you’ve gone
    and done . . . defense bar training on how to defend child abuse
    cases, have you seen some of your colleagues?” But Penny has not
    directed us to where she objected to this particular question at trial
    27
    STATE v. WEST
    Opinion of the Court
    or raised this instance of alleged misconduct in her motion for a new
    trial. And we cannot find any such challenge in the record. We
    therefore deem the issue waived. See State v. Milton, 
    85 Ariz. 69
    , 74,
    
    331 P.2d 846
    , 849 (1958) (issue waived where not objected to at trial
    or set forth as ground for new trial); see also Moreno-Medrano, 
    218 Ariz. 349
    , ¶¶ 16-17, 
    185 P.3d at 140
     (argument forfeited for all but
    fundamental, prejudicial error if not raised below; argument then
    waived if fundamental error not argued on appeal).
    2. Dr. Plunkett
    ¶61         As to Plunkett, Penny first contends the prosecutor
    created a “false impression” about the existence of more recent
    medical studies on determining the age of brain injuries while cross-
    examining him. Plunkett testified that Emily’s subdural hemorrhage
    “pre-dated” August 17, reasoning that “[i]t takes seven to 10 to 14
    days to get fibroblast growth in the dura to the extent that” Emily
    had. During cross-examination, the following exchange occurred:
    Q.    Could [Emily’s membrane] be
    newer?
    A. Pretty unlikely to be newer. It
    could be. But I wouldn’t go . . . below five
    or six days, at least from the published
    literature  on    the   development       of
    membranes.
    Q. Now can you tell us what the
    published literature says about the
    development of membranes, does it go in
    stages as to how many fibroblasts you
    might expect to see?
    A. Meritt and Munro wrote an
    article in ’36, ’37, ’38, on this topic, it was
    on adults but there is no reason to expect
    that kids are going to be any different. A
    fellow, I am blocking on his name right
    28
    STATE v. WEST
    Opinion of the Court
    now, published an article in the Archives of
    Pathology in 1947 or 1948 in which he
    described the development of iron as his
    primary focus of the article, and the
    development of a membrane as a
    secondary focus of the article. And so he
    plugged this into the Meritt and Munro
    chart, and that’s about what you come up
    with.
    ....
    Q. Now, again, you have read the
    more recent literature? When you said ’38,
    you are talking 1938 when these studies
    came out. Have you read more recent
    literature about the development of
    fibroblasts?
    A. There isn’t one. ’47 is the most
    recent one I’m aware of. Well, there are a
    whole number of articles in Japanese
    written by Japanese neuro-surgeons
    published in the Journal of Neuro-surgery
    in this country. . . .
    Q. You are not aware though of
    any more recent literature that talks about
    how rapidly fibroblasts will form and at
    what stages?
    Penny asserts, “The clear insinuation from this line of questioning
    was that the prosecutor had recent research studies that undermined
    [Plunkett’s] testimony regarding the fibroblast membrane.” But she
    argues the prosecutor did not produce any such research and none
    exists.
    ¶62         We disagree that the prosecutor committed misconduct
    by suggesting more recent research existed. Plunkett was the first to
    29
    STATE v. WEST
    Opinion of the Court
    bring up the “published literature,” and only at that point did the
    prosecutor ask what that literature consisted of. Based on Plunkett’s
    response, the prosecutor asked generally if more recent research
    existed. And, after Plunkett referred to more recent Japanese
    studies, the prosecutor attempted to clarify the issue. The questions
    were relevant to impeach Plunkett’s testimony about when Emily’s
    brain injury likely occurred. See State v. Burns, 
    237 Ariz. 1
    , ¶ 104, 
    344 P.3d 303
    , 327 (2015).
    ¶63         Next, Penny contends the prosecutor “tried to
    mischaracterize the evidence in order to prejudice the jury” while
    questioning Plunkett about whether Emily’s injury had resulted
    from a “violent force.” Her argument is based on the following
    exchange:
    Q. Your ultimate conclusion as to
    the cause of Emily’s death was that it was, I
    think you said you agreed with [the county
    medical examiner, Dr. Eric Peters,] and that
    it was due to blunt impact?
    A.   Correct.
    Q. And did you agree with Dr.
    Peters’[s] assessment that it was a violent
    force?
    A.   No.
    Q.   So you didn’t agree with Dr.
    Peters?
    A. I don’t recall Dr. Peters ever
    using the term violent force in his report of
    it. Let me take a look. He doesn’t use the
    term violent force. This child’s death is due
    to a non-natural and violent cause.
    Violence is a generic term used to indicate
    30
    STATE v. WEST
    Opinion of the Court
    anything other than natural disease.       He
    does not use the term violent force.
    Q.   Unnatural and violent cause?
    A.   Correct.
    Q. And you don’t believe that in
    any way connotates the level of force it
    would have had to take?
    A. I certainly wouldn’t use that.
    The connotation was there was something
    other than a low velocity impact.
    Q.    Would you agree with me that
    violent cause does not equate to low
    velocity impact?
    A.     Violence, if you look it up in
    the dictionary, does not have a quantitative
    term. Any time you strike somebody in the
    arm, regardless of the force that is used,
    that’s an act of violence.
    ¶64          We disagree that the prosecutor mischaracterized the
    county medical examiner’s conclusion about Emily’s cause of death.
    Even assuming he did, we are satisfied beyond a reasonable doubt
    that the prosecutor’s actions did not contribute to or affect the
    verdict. See Roque, 
    213 Ariz. 193
    , ¶ 152, 
    141 P.3d at 403
    . As the state
    points out, “[t]he prosecutor was attempting to impeach . . . Plunkett
    by using language from the medical examiner’s report to undermine
    his conclusion [Emily] had not been the victim of a crime.” But,
    because Plunkett had the medical examiner’s report with him, he
    was able to cite directly from it and distinguish between the
    prosecutor’s use of “violent force” and the medical examiner’s use of
    “non-natural and violent cause.”          Thus, Plunkett’s testimony
    clarified the medical examiner’s conclusion, and, if his testimony
    had any effect on the verdict, it was in Penny’s favor.
    31
    STATE v. WEST
    Opinion of the Court
    3. Dr. Uscinski
    ¶65          Penny also argues the prosecutor “improperly injected a
    false claim” into the trial while cross-examining Uscinski “by using a
    hypothetical that had no basis in fact.” The prosecutor’s question
    was: “So if for example hypothetically speaking if the caretaker
    says, I lost my cool and I shook the child violently, and you see a
    child with retinal hemorrhages, because you don’t believe shaking
    can cause retinal hemorrhages you would not consider the
    admission the caretaker made to a paramedic about shaking the
    child.”
    ¶66          However, after the prosecutor posed the hypothetical,
    defense counsel objected and the trial court sustained the objection.
    The court also instructed the jury to disregard questions to which it
    had sustained objections.        We assume the jury follows its
    instructions. See State v. Canion, 
    199 Ariz. 227
    , ¶ 43, 
    16 P.3d 788
    , 798
    (App. 2000). Thus, even if the hypothetical was improper, we are
    satisfied beyond a reasonable doubt that the prosecutor’s conduct
    did not contribute to or affect the verdict. See Roque, 
    213 Ariz. 193
    ,
    ¶ 152, 
    141 P.3d at 403
    .
    Violation of Rule 803(18)
    ¶67         Penny next contends the prosecutor introduced hearsay
    evidence during the trial while questioning Scheller, Plunkett, and
    Dr. Patrick Barnes by reading from “articles that w[ere] not
    established as reliable.”       She argues this conduct violated
    Rule 803(18), Ariz. R. Evid., and constituted misconduct.
    ¶68          Rule 803 provides exceptions to the hearsay rule.
    Subsection (18) explains that a “statement contained in a treatise,
    periodical, or pamphlet” is not excluded by the rule against hearsay
    if “the statement is called to the attention of an expert witness on
    cross-examination or relied on by the expert on direct examination”
    and “the publication is established as a reliable authority by the
    expert’s admission or testimony, by another expert’s testimony, or
    by judicial notice.”
    32
    STATE v. WEST
    Opinion of the Court
    1. Dr. Scheller
    ¶69         As to Scheller, Penny appears to challenge the
    prosecutor’s citation to the American Pediatrics Journal, the Journal
    of Neurosurgery, the Journal of Trauma, and the Archives of
    Pediatric and Adolescent Medicine. But, before reading articles
    from each of those journals, the prosecutor asked Scheller if the
    journals were “reputable,” to which Scheller agreed. He also
    confirmed that the latter three were “peer-reviewed.”            The
    prosecutor thus complied with Rule 803(18).
    ¶70            Penny nevertheless seems to suggest that, under
    Rule 803(18), the individual articles, rather than the journals as a
    whole, need to be verified as reliable. We disagree. Rule 803(18)
    specifically provides that “the publication” must be “established as
    . . . reliable.” Establishing the publication—or, in this case, the
    journal—in which the article is printed as reliable provides sufficient
    “guarantees of trustworthiness” to overcome any hearsay concerns.
    Rossell v. Volkswagen of Am., 
    147 Ariz. 160
    , 173, 
    709 P.2d 517
    , 530
    (1985).
    2. Dr. Plunkett
    ¶71          As to Plunkett, Penny challenges the prosecutor’s
    reference to “a great deal of literature . . . in the Journal of Pediatrics,
    the Journal of Neurosurgery that says . . . the most common cause
    for retinal hemorrhages is non-accidental inflicted trauma.” But,
    before Plunkett responded, defense counsel objected and the trial
    court sustained the objection. As previously mentioned, the court
    instructed the jury to disregard such questions, and we assume the
    jury followed its instructions. We are therefore satisfied beyond a
    reasonable doubt that this incident did not contribute to or affect the
    verdict. See Roque, 
    213 Ariz. 193
    , ¶ 152, 
    141 P.3d at 403
    .
    3. Dr. Barnes
    ¶72         Penny challenges the prosecutor’s questioning of Barnes
    about a book chapter he had co-authored with Dr. Paul Kleinman.
    She points out that Barnes “specifically stated that the information in
    33
    STATE v. WEST
    Opinion of the Court
    that text had been updated and . . . that the textbook was no longer
    reliable.” She thus suggests there was no verification of reliability as
    required by Rule 803(18). In response, the state argues that
    “Rule 803(18) was not implicated” because the prosecutor used the
    contents of the book chapter, which was inconsistent with Barnes’s
    trial testimony, for impeachment purposes. It maintains the book
    chapter constituted a prior inconsistent statement, admissible under
    Rule 801(d)(1)(A), Ariz. R. Evid. We agree.
    ¶73          Rule 801(d)(1)(A) provides that a statement is not
    hearsay if “[t]he declarant testifies and is subject to cross-
    examination about a prior statement, and the statement . . . is
    inconsistent with the declarant’s testimony.” This is a “broad
    exception to the hearsay rule” because “[i]t is based upon a belief
    that a jury ordinarily should be permitted to consider a prior
    inconsistent statement in determining credibility.” State v. Carr, 
    154 Ariz. 468
    , 471, 
    743 P.2d 1386
    , 1389 (1987); see also State v. Miller, 
    187 Ariz. 254
    , 257, 
    928 P.2d 678
    , 681 (App. 1996).
    ¶74          Here, Barnes’s testimony and opinions in this case were
    generally inconsistent with the cited portions of the book chapter he
    co-wrote. See State v. Hines, 
    130 Ariz. 68
    , 71, 
    633 P.2d 1384
    , 1387
    (1981) (inconsistency determined by “whole impression or effect of
    what has been said or done”; “absolute oppositeness” not required)
    (citation omitted). Penny nevertheless argues that the contents of
    the book chapter do not qualify as prior inconsistent statements
    because “[Barnes] agreed that the statement[s] w[ere] no longer
    true.” But this argument misses the point of the rule allowing prior
    inconsistent statements, which are typically used for impeachment
    as to the witness’s credibility. See Carr, 
    154 Ariz. at 471
    , 
    743 P.2d at 1389
    . The requirements under Rule 801(d)(1)(A) were met here.
    ¶75            In a related argument, Penny contends the prosecutor
    improperly questioned Barnes about the “unknown opinions” of
    Kleinman, who did not testify at trial. She maintains such
    questioning was “collateral, irrelevant and argumentative and . . . an
    unfair insinuation that . . . Barnes’[s] opinion was in conflict with
    that of . . . Kleinman.” But Penny has not supported her argument.
    See Ariz. R. Crim. P. 31.13(c)(1)(vi); Bolton, 
    182 Ariz. at 298
    , 
    896 P.2d 34
    STATE v. WEST
    Opinion of the Court
    at 838 (failure to argue claim constitutes waiver and abandonment).
    We therefore do not address it further.
    ¶76          Penny has not shown any violation of Rule 801 or
    Rule 803. Accordingly, she also has failed to meet the higher
    standard of showing that any error “‘infected the trial with
    unfairness as to make the resulting conviction a denial of due
    process.’” Hughes, 
    193 Ariz. 72
    , ¶ 26, 
    969 P.2d at 1191
    , quoting
    Donnelly, 
    416 U.S. at 643
    .
    Attack on Defense Counsel
    ¶77          Penny lastly contends the prosecutor unfairly attacked
    “the credibility of defense counsel.” According to Penny, the day
    before Emily’s death, during a scheduled visitation with her
    biological family, Emily fell and hit her head on a changing table,
    but a witness mistakenly reported that she had hit her head on a
    bookshelf. Penny claims she “had cleared the issue up prior to trial”
    but the prosecutor “improperly impugned defense counsel” while
    questioning Plunkett “by suggesting that defense counsel had
    misled the medical examiner regarding this prior incident.”
    ¶78         Penny, however, has failed to provide citations to the
    record showing that the prosecutor in fact knew Emily had hit her
    head on a changing table and not a bookshelf. Consequently, we
    cannot determine whether the prosecutor’s question to Plunkett was
    knowingly improper. We therefore deem the argument waived. See
    Ariz. R. Crim. P. 31.13(c)(1)(vi); Bolton, 
    182 Ariz. at 298
    , 
    896 P.2d at 838
    .
    ¶79          But, even assuming the argument is not waived, we
    agree with the trial court that no prosecutorial misconduct occurred.
    Despite alleging that the prosecutor “persistently” brought this issue
    up, Penny directs us to only one portion of Plunkett’s cross-
    examination. The prosecutor showed Plunkett a letter defense
    counsel had written to him and asked whether he had relied on
    information contained in that letter in forming his opinions in this
    case. Penny takes issue with the following questions:
    35
    STATE v. WEST
    Opinion of the Court
    Q. . . . I will ask specifically as far
    as there was a description of some falls in
    this letter. And under number three of the
    letter, and let me ask you if you recall being
    . . . given information from the defense that
    there was a fall the day prior where Emily
    struck her head on a wooden book shelf?
    A. Well, that letter actually states
    that on the 24th, which was the day that
    Emily collapsed, so that’s wrong. . . .
    Q. Correct. And assuming that is
    just a typographical error, that incident
    occurred on the 23rd, did you take into
    account whether Emily had fallen the day
    previous to her collapse and struck her
    head on a wooden book shelf?
    ¶80          Through this questioning, however, we can discern no
    attempt by the prosecutor to “impugn defense counsel.” Rather, we
    agree with the state that “[t]he obvious thrust of this questioning
    was to impeach . . . Plunkett about the basis of his expert opinion,
    i.e. whether he had considered incomplete or inaccurate information
    when rendering his expert opinion.” The emphasis of the questions
    was that Emily had fallen the day before—not what she had hit
    when she fell—and how that affected Plunkett’s opinion. This was a
    proper topic for impeachment. See Burns, 
    237 Ariz. 1
    , ¶ 104, 344 P.3d
    at 327.
    Cumulative Effect
    ¶81          As to all the incidents above, we have either determined
    that no prosecutorial misconduct occurred or, assuming there was
    some misconduct, it was harmless. Turning to those incidents
    where we assumed some misconduct, we agree with the trial court
    that the prosecutor did not “intentionally engage[] in improper
    conduct . . . ‘with indifference, if not a specific intent, to prejudice
    [Penny].’” Roque, 
    213 Ariz. 193
    , ¶ 155, 
    141 P.3d at 403
    , quoting
    36
    STATE v. WEST
    Opinion of the Court
    Hughes, 
    193 Ariz. 72
    , ¶ 31, 
    969 P.2d at 1192
    . Thus, the cumulative
    effect was not “so pronounced and persistent that it permeate[d] the
    entire atmosphere of the trial.” Hughes, 
    193 Ariz. 72
    , ¶ 26, 
    969 P.2d at 1191
    . And, based on the foregoing, we cannot say the court erred
    in denying Penny’s motion for a mistrial based on prosecutorial
    misconduct. See Anaya, 
    170 Ariz. at 441
    , 
    825 P.2d at 966
    .
    Disposition
    ¶82         For the foregoing reasons, we affirm Penny’s conviction
    and sentence.
    37