On this day in 1989 Mr Clean, aka Joseph Ferriola who picked up as the head of the Chicago Outfit after Joey Aiuppa and John Cerone were sent to prison, died after having a second heart transplant at the age of 61. He lead the family from 1985 until 1988 and was quoted as a “cold-blooded terrorist”.

He was also the first mobster to undergo a heart transplant.

On this day, March 11, in 1989, Joseph Ferriola — known throughout the underworld by his fitting nickname "Mr. Clean" — passed away at the age of 61 following complications from a second heart transplant. His death marked the end of a career that had seen him rise through the brutal ranks of the Chicago Outfit to become one of the most feared and powerful mob bosses in the organisation's storied history.

Born in Chicago in 1927, Ferriola spent decades proving his worth to the Outfit, the criminal empire that traced its roots back to the legendary Al Capone. He was a trusted street operator and enforcer long before he ever sat at the top of the table, building a fearsome reputation that earned him the contradictory moniker "Mr. Clean" — a reference not to any moral virtue, but to his ability to handle problems with ruthless efficiency whilst keeping himself insulated from law enforcement. Federal investigators were rather less poetic in their assessment, describing him plainly as a "cold-blooded terrorist."

Ferriola's ascent to the leadership came in 1985 under grim circumstances. The Outfit's reigning bosses, Joey Aiuppa and underboss John Cerone, were among several Chicago mobsters convicted and imprisoned following the landmark Strawman investigation — a wide-ranging FBI operation that exposed the Outfit's hidden control over Las Vegas casinos. With the old guard behind bars, Ferriola stepped up to steer the organisation, taking the helm at a time when mob power across America was under unprecedented federal pressure. Unlike the grand criminal dynasties of New York's Five Families, the Chicago Outfit operated with a leaner, more centralised structure, and Ferriola maintained that tradition during his tenure.

His time as boss, however, was cut short not by rivals or prosecutors, but by his own failing health. He stepped back from active leadership in 1988 and made history of a peculiar kind in the process — becoming the first known mobster to undergo a heart transplant. When that first transplant ultimately failed, a second procedure was attempted, but Ferriola did not survive it. He died on March 11, 1989, with the federal government still actively pursuing cases against him.

Joseph Ferriola's legacy within the Chicago Outfit is that of a hardened, capable operator who kept the organisation functioning through one of its most turbulent periods. He remains a significant, if sometimes overlooked, chapter in the long and violent history of organised crime in America.