Theranos' former chief operating officer Ramesh Balwani sentenced to nearly 13 years in prison for fraud
Balwani, 57, of Fremont was sentenced Wednesday in California to 12 years and 11 months in federal prison for fraud that risked patient health by misrepresenting the accuracy of Theranos blood analysis technology.
Pramod Thomas is a senior correspondent with Asian Media Group since 2020, bringing 19 years of journalism experience across business, politics, sports, communities, and international relations. His career spans both traditional and digital media platforms, with eight years specifically focused on digital journalism. This blend of experience positions him well to navigate the evolving media landscape and deliver content across various formats. He has worked with national and international media organisations, giving him a broad perspective on global news trends and reporting standards.
Theranos former chief operating officer, Indian-origin Ramesh Sunny Balwani, has been sentenced to nearly 13 years in prison for fraud that prosecutors said risked patient health and defrauded the blood testing company's investors of millions of dollars.
Balwani, 57, of Fremont was sentenced Wednesday in California to 12 years and 11 months in federal prison for fraud that risked patient health by misrepresenting the accuracy of Theranos blood analysis technology and that defrauded the company's investors of millions of dollars, US Attorney Stephanie Hinds said.
In addition to the 155 months prison term, US District Judge Edward Davila sentenced Balwani to three years of supervision following release from prison. A hearing to determine the amount of restitution to be paid by Balwani is to be scheduled in the future. Balwani was ordered to surrender on March 15, 2023, to begin serving his prison sentence.
Balwani was employed from September 2009 through July 2016 at the Palo Alto-based blood testing company founded in 2003 by his former girlfriend Elizabeth Holmes, once touted as Silicon Valley's rising star.
Last month, District Judge Davila sentenced Holmes to 11 years and 3 months in federal prison and ordered her to surrender to begin serving her sentence on April 27, 2023. Balwani was 37 when he met then 18-year-old Holmes.
"There is an unfortunate saying in Silicon Valley - fake it till you make it," Attorney Hinds said in a video statement.
Holmes and Balwani "stretched this idea to a place much farther than the law allows and in so doing, put vast amounts of investor dollars at risk," Hinds said adding that with Balwani's sentencing, the court also made clear that his decision to deceive doctors and patients also put the health of patients at risk.
Hinds said that while patient health is the highest priority of the US healthcare system, and Silicon Valley has long been home to healthcare start-ups that enhance the care of patients through technological developments, Balwani, in a desire to become a Silicon Valley titan, valued business success and personal wealth far more than patient safety.
He chose deceit over candour with patients in need of medical care, and he treated his investors no better, Hinds said in a statement.
Trial evidence showed that the fraud brought 'spectacular personal wealth to Balwani, who owned nearly 30 million shares of Theranos over 6 per cent of the company which were worth hundreds of millions of dollars at the peak of the fraud.
Balwani was born in Pakistan but his family is said to have moved to India. He moved to the US from India during the 1980s and studied at the University of Texas.
FBI Special Agent in Charge Robert Tripp said Balwani not only deliberately concealed defects in Theranos' blood-testing technology to mislead investors, he knowingly put patients health at risk.
During his employment at the now defunct Theranos, Balwani held the positions of board member, chief operating officer and president.
Balwani and Holmes, who was chairperson and CEO, claimed Theranos developed a 'revolutionary blood analyzer' that could run any blood test run by conventional labs using only a small blood sample drawn via a fingerstick, rather than the traditional draw from a vein.
Balwani and Holmes asserted that the Theranos proprietary analyzer produced results that were cheaper, more reliable and less variable than existing methods, and obtained results at a speed faster than ever before possible.
However, evidence at trial demonstrated that both Balwani and Holmes knew that the analyzer performed only a few basic tests and was slower than existing devices. They repeatedly resorted to using conventional machines to obtain the blood test results that the Theranos analyzer was supposed to perform, the statement said.
However, they led investors and the public to believe that Theranos was conducting essentially all of its tests using only its Theranos analyzer, it said.
Evidence demonstrated that Balwani and Holmes were aware that the Theranos analyzer's limited capabilities meant it could not compete in the market, but they nevertheless trumpeted false claims and representations about the analyzer's capabilities and conspired to convince patients and investors that the claims were true, the statement said.
Evidence at trial and examples in a sentencing memorandum filed by the government demonstrate the 'dark reality' these misrepresentations created for patients.
In order to portray Theranos as a legitimate enterprise, Theranos eventually offered the blood analyzer to the public to perform a 'full range' of tests, despite internal protests from Theranos employees and even resignations by staff. Prosecutors said because of this, numerous misdiagnoses followed.
Instances presented at trial included that of a pregnant woman who had suffered multiple miscarriages and obtained HCG values from Theranos testing that strongly indicated she was miscarrying again. However, confirmatory tests by conventional methods indicated a viable pregnancy, and the woman went on to deliver a healthy baby.
"This scenario played out with multiple pregnant women who received erroneous HCG results from Theranos tests," prosecutors said.
Prosecutors said that amidst their repeated technology failures, Balwani and Holmes chose to continue deceiving their investor-victims and to proceed with the elaborate investor fraud conspiracy. They induced dozens of investors, many of whom were prominent public figures, to invest hundreds of millions of dollars in Theranos by using consistently glowing but false representations to investors and potential investors about the analyzer's progress and its capabilities.
Balwani and Holmes asserted to investors that the Theranos technology had been comprehensively validated by multiple major pharmaceutical companies and was being used by the Department of Defense to treat wounded soldiers where, it was represented, it actually saved lives in the battlefield. However in truth, pharmaceutical companies did little work with Theranos and did not validate its technology, and the Department of Defense never used Theranos analyzer to clinically treat soldiers, the statement said.
The duo also continued to tout Theranos analyzer as a revolution in healthcare while misrepresenting the dire financial status of the company. Despite Theranos having zero revenue in 2012 and 2013, they represented to investors in late 2013 and 2014 that Theranos had hundreds of millions in revenue from a combination of pharmaceutical companies and the military.
Balwani conspired to induce retail stores Walgreens and Safeway to invest in Theranos based on false pharmaceutical company endorsements and fantastical revenue projections. By March 2015, Theranos raised more than $730 million dollars from investors who invested subsequent to Theranos public relations push in 2013.
Federal criminal charges were initially filed against Balwani and Holmes in June 2018. In July 2020, a federal grand jury returned a superseding indictment charging both with two counts of conspiracy to commit wire fraud and 10 counts of wire fraud. In July this year, Balwani was convicted by a federal jury on all counts after a four month trial.
Balwani was tried separately from Holmes, and in her trial Holmes was not convicted of all counts.
TENSIONS with Pakistan, fluctuating ties with Bangladesh, and growing Chinese influence in Nepal and Sri Lanka have complicated India’s neighbourhood policy, a top foreign policy and security expert has said.
C Raja Mohan, distinguished professor at the Motwani Jodeja Institute for American Studies at OP Jindal Global University, has a new book out, called India and the Rebalancing of Asia.
He also described how India’s engagement with the US, Japan, Australia and Europe has moved from symbolism to one of substance. Raja Mohan said, “After independence, India withdrew from regional security politics, focusing on global issues and non-alignment. But the past decade has seen a reversal. India is now back in the Asian balance of power. The very concept of the ‘Indo-Pacific’ reflects that, putting the ‘Indo’ into the ‘Pacific.’”
The idea, he explained, has deep historical roots: “The British once viewed the Indian and Pacific Oceans as interconnected realms. Now, after decades of separation, those spaces are merging again.”
Narendra Modi with Xi Jinping and (right)Vladimir Putin at last month’s SCO summit in China
While India once aspired to build a “post-Western order” alongside China, those dreams have long since faded, according to the expert.
“Contradictions between India and China have sharpened,” he said, citing territorial disputes, a $100 billion (£75bn) trade deficit, and China’s growing influence among India’s neighbours.
By contrast, India’s ties with the US and Europe have strengthened.
“Where once India shunned security cooperation with Washington, it is now deeply engaged,” he said. Yet he emphasised that India remains an independent actor, “not a traditional ally like Japan or Australia.”
His comments were made during the Adelphi series, hosted by the International Institute for Strategic Studies (IISS) last month. According to the expert, who is also a visiting research professor at the National University of Singapore, the return of India to regional security politics marks a significant change in its foreign policy since independence. Popular discussions about the “rise of Asia” tend to oversimplify what Raja Mohan explained was a deeply uneven transformation. “It’s more accurate to say Asia as a whole is rising,” he said, adding, “but not evenly. China has risen much faster than the rest.”
This imbalance has created internal contradictions within Asia, according to the academic. “China’s sense of entitlement to regional dominance and its territorial claims have provoked reactions from other Asian countries,” he said.
While China’s economic ascent, once “a marriage of Western capital and Chinese labour”, that relationship has strained over the past 15 years as the Asian country grew into a global military and economic powerhouse, according to Raja Mohan.
And the US, which previously nurtured China’s growth, now seeks to restore balance in Asia, shifting from a policy of engagement to one of cautious competition, he said.
Dwelling on India’s rise, he said, “The question is not whether India can match China alone, but whether it can help build coalitions that limit unilateralism. History shows weaker states can play crucial balancing roles, as China once did against the Soviet Union.”
He explored how the US-China and India-China dynamics might evolve, particularly under US president Donald Trump.
“Some believe the US is retrenching to focus on Asia, others think Trump might seek a grand bargain with China,” Raja Mohan said. “Much depends on how Washington manages its ties with Russia and its global posture.”
He also described how India’s engagement with the US, Japan, Australia and Europe has moved from symbolism to one of substance. Raja Mohan said, “After independence, India withdrew from regional security politics, focusing on global issues and non-alignment. But the past decade has seen a reversal. India is now back in the Asian balance of power. The very concept of the ‘Indo-Pacific’ reflects that, putting the ‘Indo’ into the ‘Pacific.’”
The idea, he explained, has deep historical roots: “The British once viewed the Indian and Pacific Oceans as interconnected realms. Now, after decades of separation, those spaces are merging again.”
While India once aspired to build a “post-Western order” alongside China, those dreams have long since faded, according to the expert.
“Contradictions between India and China have sharpened,” he said, citing territorial disputes, a $100 billion (£75bn) trade deficit, and China’s growing influence among India’s neighbours.
By contrast, India’s ties with the US and Europe have strengthened.
“Where once India shunned security cooperation with Washington, it is now deeply engaged,” he said. Yet he emphasised that India remains an independent actor, “not a traditional ally like Japan or Australia.”
His comments were made during the Adelphi series, hosted by the International Institute for Strategic Studies (IISS) last month. According to the expert, who is also a visiting research professor at the National University of Singapore, the return of India to regional security politics marks a significant change in its foreign policy since independence. Popular discussions about the “rise of Asia” tend to oversimplify what Raja Mohan explained was a deeply uneven transformation. “It’s more accurate to say Asia as a whole is rising,” he said, adding, “but not evenly. China has risen much faster than the rest.”
This imbalance has created internal contradictions within Asia, according to the academic. “China’s sense of entitlement to regional dominance and its territorial claims have provoked reactions from other Asian countries,” he said.
While China’s economic ascent, once “a marriage of Western capital and Chinese labour”, that relationship has strained over the past 15 years as the Asian country grew into a global military and economic powerhouse, according to Raja Mohan.
And the US, which previously nurtured China’s growth, now seeks to restore balance in Asia, shifting from a policy of engagement to one of cautious competition, he said.
Dwelling on India’s rise, he said, “The question is not whether India can match China alone, but whether it can help build coalitions that limit unilateralism. History shows weaker states can play crucial balancing roles, as China once did against the Soviet Union.”
He explored how the US-China and India-China dynamics might evolve, particularly under US president Donald Trump.
“Some believe the US is retrenching to focus on Asia, others think Trump might seek a grand bargain with China,” Raja Mohan said. “Much depends on how Washington manages its ties with Russia and its global posture.”
China, he noted, has already toned down its aggressive “wolf warrior” diplomacy, realising that assertiveness has backfired. Yet the underlying structural contradictions between China and both the US and India “are unlikely to disappear.”
Asked about India’s balancing act between the US and Russia, especially after Moscow’s invasion of Ukraine, the expert was pragmatic.
“India has steadily moved closer to the US and the West, but Trump’s trade-first approach has caused turbulence,” Raja Mohan said.
He cited the threats of high tariffs on Indian imports and resentment over trade imbalances with Washington DC.
On Russia, Raja Mohan’s view was that the relationship has been “in slow decline since the 1990s.”
While India’s GDP now outpaces Russia’s, it continues to engage Moscow for practical reasons. “India’s oil purchases from Russia rose from two per cent to forty per cent after 2022. That’s pragmatism, not alignment,” Raja Mohan said.
He added that prime minister Narendra Modi’s recent handshakes with China’s president Xi Jinping and Russia’s president Vladimir Putin at the Shanghai Co-operation Organization (SCO) summit in China were “signals, reminders to the West that India has options.”
Raja Mohan said India was at the cusp of a historic transformation. “India once provided security across Asia - in both world wars, millions of Indian soldiers fought overseas. That history was forgotten when India withdrew from global security,” he said.
“Now we are reclaiming that role. Ideally, the partnership with the US is the best. But if not, India and other Asian powers will have to shoulder the burden themselves.”
“Japan, Korea, India, Australia - all will have to do more on their own,” he said. “We’ll need to pull up our own bootstraps.”
Dr Benjamin Rhode, senior fellow at IISS, chaired the session.
aggressive “wolf warrior” diplomacy, realising that assertiveness has backfired. Yet the underlying structural contradictions between China and both the US and India “are unlikely to disappear.”
Asked about India’s balancing act between the US and Russia, especially after Moscow’s invasion of Ukraine, the expert was pragmatic.
“India has steadily moved closer to the US and the West, but Trump’s trade-first approach has caused turbulence,” Raja Mohan said.
He cited the threats of high tariffs on Indian imports and resentment over trade imbalances with Washington DC.
On Russia, Raja Mohan’s view was that the relationship has been “in slow decline since the 1990s.”
While India’s GDP now outpaces Russia’s, it continues to engage Moscow for practical reasons. “India’s oil purchases from Russia rose from two per cent to forty per cent after 2022. That’s pragmatism, not alignment,” Raja Mohan said.
He added that prime minister Narendra Modi’s recent handshakes with China’s president Xi Jinping and Russia’s president Vladimir Putin at the Shanghai Co-operation Organization (SCO) summit in China were “signals, reminders to the West that India has options.”
Raja Mohan said India was at the cusp of a historic transformation. “India once provided security across Asia - in both world wars, millions of Indian soldiers fought overseas. That history was forgotten when India withdrew from global security,” he said.
“Now we are reclaiming that role. Ideally, the partnership with the US is the best. But if not, India and other Asian powers will have to shoulder the burden themselves.”
“Japan, Korea, India, Australia - all will have to do more on their own,” he said. “We’ll need to pull up our own bootstraps.”
Dr Benjamin Rhode, senior fellow at IISS, chaired the session.
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