The Chicago outfit was known for being extremely violent and sadistic,even by Mob standards. I would say Sam was a perfect fit as an enforcer and killer.
Because of the fact that he was absolutely n-u-t-z,the Outfit never took a chance on making him,but he was widely feared and respected nonetheless.
As I understand it,the goofy courtroom antics,and the bullhorn horsesh*t were good for a few laughs,since they occurred during fairly minor cases,but after Sam and a couple of his guys were indicted for the Foreman homicide,and it looked like he was going to continue the sideshow,the writing was on the wall.
The top brass feared that Sam could harm the cases of his co-defendants, so the order was given and "The Ant" went into damage control mode,giving Mad Sam a couple of rounds of buckshot.