The Ninth Circuit upheld Elizabeth Holmes’s and Ramesh “Sunny” Balwani’s fraud convictions, prison sentences and joint restitution order. The court’s amended opinion, filed December 22, 2025, left its affirmance in place. Separately, the Supreme Court denied Balwani’s petition for review on October 5, 2026; Holmes was not a party to that petition.
What the Ninth Circuit decided
On February 24, 2025, the U.S. Court of Appeals for the Ninth Circuit affirmed the judgments against Holmes and Balwani after reviewing challenges to trial rulings, convictions, sentencing findings and restitution. On December 22, 2025, it amended its opinion and denied Balwani’s requests for panel and en banc rehearing, while continuing to affirm the judgments. The court concluded its opinion with the words, “We affirm.” Ninth Circuit opinion
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The case concerned Theranos’s claims that it could run fast, accurate and affordable blood tests using a finger-prick sample. The court said the company’s device did not deliver results that were faster and more accurate than conventional technology. The defendants’ cases involved representations to investors about the company’s technology, finances and business relationships.
Holmes and Balwani had separate trials and different verdicts
Their convictions should not be described as identical: the defendants were tried separately, and the juries reached different results.
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| Defendant | Trial verdict | Original sentence |
|---|---|---|
| Elizabeth Holmes | Convicted of investor-related conspiracy and three investor wire-fraud counts. The jury acquitted her on patient-related counts and could not reach a verdict on three other investor counts. | 135 months in prison and three years of supervised release, according to the U.S. Attorney’s Office for the Northern District of California (2022). |
| Ramesh “Sunny” Balwani | Convicted on all counts, including investor- and patient-related fraud counts. | 155 months in prison and three years of supervised release, according to the U.S. Attorney’s Office for the Northern District of California (2022). |
The Ninth Circuit affirmed both defendants’ convictions and sentences. The sentences above are the original sentences reported by the U.S. Attorney’s Office; the sources cited here do not establish a later sentence modification or custody-status change. U.S. Attorney’s Office case summary
Why the appeals failed
Former employees’ testimony
The court said some former employees’ testimony crossed into expert territory. It nevertheless found any error harmless, so that issue did not warrant reversing the judgments.
Rank #2
CMS report in Holmes’s case
The Ninth Circuit held that the CMS report was relevant to Holmes’s knowledge, intent or state of mind. It found that the district court had not abused its discretion by admitting the report.
Balwani’s indictment challenge
Balwani argued that the indictment had been constructively amended. The court rejected that claim, reasoning that the indictment gave him notice of the charged misrepresentations about patient-test accuracy regardless of which type of device ran the tests.
Rank #3
Sentencing and restitution challenges
The court also rejected challenges to sentencing findings and restitution. The defendants argued that residual share value should have been credited against victims’ losses. The panel concluded that any error on this point was harmless in light of the district court’s findings about those losses.
The affirmed restitution order was $452 million
The district court ordered Holmes and Balwani to pay $452 million in restitution jointly and severally, and the Ninth Circuit affirmed that order. Joint and several liability means the obligation is shared: the order does not require each defendant to pay $452 million separately. The court’s ruling upheld the case-specific amount; it is not a general measure of fraud losses.
Rank #4
What happened after the Ninth Circuit ruling
After the Ninth Circuit denied rehearing in its December 22, 2025 amended opinion and order, Balwani sought Supreme Court review. The Supreme Court docket records that he filed his petition for a writ of certiorari on May 21, 2026, and that the Court denied it on October 5, 2026. The docket identifies Balwani as the petitioner, not Holmes. Supreme Court docket
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