Former Theranos President Ramesh ‘Sunny’ Balwani Begins His Defense

“Sunny Balwani did not start Theranos, he did not control Theranos,” said Mr. Cazares. “Elizabeth Holmes, not Sunny, founded Theranos and built Theranos.”

By the time Mr. Balwani joined Theranos in 2009 as president and chief operating officer, Ms. Holmes had spent six years building “a small but sophisticated company,” said Mr. Cazares. His knowledge of the company was largely based on what Ms. Holmes, who was also his girlfriend, and Theranos scientists told him, Mr. Cazares said.

Mr. Balwani, 56 years old, faces a dozen counts of wire fraud and conspiracy to commit fraud for allegedly lying to investors and patients about the blood-testing startup’s technology. Mr. Balwani helped run the company from 2009 to 2016 alongside Ms. Holmes, and helped finance it by underwriting a $13 million loan and buying $5 million in stock. The two had a romantic relationship that spanned more than a decade and was intertwined with their co-leadership of the company, according to evidence in the case.

Ms. Holmes was found guilty of wire fraud and conspiracy in January in a separate criminal trial.

Ms. Holmes and Mr. Balwani were indicted together in June 2018, but U.S. District Judge

Edward Davila

agreed in March 2020 to Mr. Balwani’s request to sever the trials so they would have separate court appearances. Judge Davila presided over Ms. Holmes’s trial and is also overseeing Mr. Balwani’s proceedings; the same assistant U.S. attorneys who brought Ms. Holmes’s case are also prosecuting Mr. Balwani’s case.

Mr. Balwani’s trial had faced delays due to a prolonged jury selection and the Covid-19 pandemic, and because Ms. Holmes gave birth to a baby boy last year, which postponed her own trial.

The government has accused Mr. Balwani, like Ms. Holmes, of misleading investors, business partners and patients about the capabilities of Theranos’s technology and its finances. Theranos claimed it could test for more than 200 health conditions using just a few drops of blood from a finger prick. Prosecutors have alleged and witnesses in Ms. Holmes’s trial testified that the company used its proprietary device for just 12 types of patient tests, and those tests could be inaccurate. Theranos relied on commercial blood analyzers for the majority of its tests, lawyers for both sides have said.

Mr. Cazares said that Theranos used investor money as it promised—to build the company. When Mr. Balwani left in May 2016, Theranos had hundreds of millions of dollars in the bank, patents and hundreds of blood tests developed by Theranos scientists, Mr. Cazares said.

“The money was there, the business was there,” said Mr. Cazares. And Mr. Balwani, whose stake in Theranos was worth as much as $500 million on paper, walked away from Theranos without selling any stock.

By the time Mr. Balwani left in 2016, Theranos was struggling with unreliable and inaccurate blood tests, deteriorating retail partnerships, unhappy investors and regulatory scrutiny, The Wall Street Journal has reported. Regulators had uncovered major deficiencies in the lab he oversaw. The company dissolved in 2018 following civil lawsuits, a settlement with the Securities and Exchange Commission over fraud charges in which Theranos didn’t admit or deny wrongdoing but paid a penalty, and the federal indictment.

The government’s indictment alleges fraud spanning from 2010 to 2016, during which Mr. Balwani was at the company. In Ms. Holmes’s trial, she described Mr. Balwani as her closest business mentor who had influence over how she ran the business—though he wasn’t the ultimate decision maker.

The government’s opening statements gave a preview of a case that echoed the one against Ms. Holmes.

“This is a case about fraud. About lying and cheating to obtain money and property,” said Assistant U.S. Attorney

Robert Leach.

Mr. Balwani “did this to get money from investors, and he did this to get money and business from paying patients who were counting on Theranos to deliver accurate and reliable blood tests so that they could make important medical decisions.”

Mr. Leach said Mr. Balwani was responsible for what he described as false financial projections that were given to investors. Mr. Leach said Mr. Balwani told investors to expect Theranos would have $990 million in revenue in 2015, when in fact the company had less than $2 million in sales, among other projections Mr. Leach said were misleading.

Mr. Cazares countered that allegation, saying Mr. Balwani accurately portrayed the company’s expected revenue growth based on an agreement from

Walgreens Boots Alliance Inc.

to put Theranos blood-testing devices in thousands of retail pharmacies.

Mr. Balwani is an entrepreneur and immigrant from a family of farmers, who became wealthy from his own success in tech startups before going to work at Theranos, Mr. Cazares said. Mr. Balwani had worked as a software engineer and had a business degree when he went to the blood-testing company, where he was put in charge of the lab despite having no medical or laboratory experience.

Mr. Cazares took issue with the government for charging Mr. Balwani without reviewing a database that contained all of Theranos’s lab testing data, including 9 million patient test results.

The database is a thorny issue. The government subpoenaed a copy of Theranos’s proprietary lab-result database, but in August 2018, just days after the government received a copy on an external hard drive, Theranos officials destroyed the entire database, the Journal has reported. The government later learned that a passcode needed to make use of their hard drives was missing.

Before Mr. Balwani’s lawyers outlined the broad strokes of his defense, prosecutors on Tuesday described Mr. Balwani as one-half of a business duo that lied to cheat investors and patients out of money. “They were partners in everything, including their crimes,” said Mr. Leach.

Mr. Balwani was a full participant in the lies Theranos spread, Mr. Leach said, driven by its dwindling cash reserves and unreliable technology. The company went years without revenue and its cash had diminished to $6.9 million by 2013, he said.

For a time, said Mr. Leach, their fraud scheme was enormously successful: They raised hundreds of millions of dollars from investors, and it “brought them fame and adoration.”

Mr. Leach told the jury that they would soon see text message exchanges Mr. Balwani and Ms. Holmes shared during their yearslong personal relationship, which was largely hidden from Theranos investors, employees and board directors. Prosecutors also introduced hundreds of these messages during Ms. Holmes’s trial, showing the two worked in tandem as the top officers of a multibillion-dollar company and as romantic partners.

“They candidly explained to each other how bad things were inside Theranos at the time they were touting Theranos as a revolution in healthcare,” said Mr. Leach.

Write to Heather Somerville at Heather.Somerville@wsj.com