As his victims wept in a Michigan courtroom, disgraced long-time USA Gymnastics team doctor Larry Nassar was sentenced to up to 175 years in prison for abusing young female gymnasts who were entrusted to his care.
"I've signed your death warrant," Ingham County Circuit Court Judge Rosemarie Aquilina told Nassar on Wednesday, following days of accounts from about 160 of his victims.
Spectators and victims cried, applauded and embraced as Nassar, 54, wearing a dark blue jailhouse jumpsuit, was led out of the courtroom.
Rachael Denhollander, the first woman to publicly accuse him in 2016, shared a hug with Angela Povilaitis, the lead prosecutor.
Nassar, who served as the program's physician through four Olympic Games, apologised to his victims during the hearing, telling them, "I will carry your words with me for the rest of my days."
Aquilina dismissed his statement as insincere.
Nassar, who already is serving a 60-year sentence in federal prison for child pornography convictions, also said his accusers fabricated claims to gain money and fame, writing, "Hell hath no fury like a woman scorned."
The prosecution and Aquilina emphasised the broader significance of the sentencing, coming amid a national debate over sexual misconduct prompted by accusations against powerful men from Hollywood to Washington.
"At this particular moment in history, this sentence and hearing will be viewed as a turning point in how our community, our state, our nation, our culture looks at sexual abuse," Povilaitis said.
Aquilina rattled off a series of statistics about the prevalence of sexual abuse before saying, "It stops now."
The sentencing followed an extraordinary week-long hearing that saw Nassar's victims unflinchingly, defiantly tell their stories in raw terms.
The women ranged from famous Olympic gold medalists like Aly Raisman to former gymnasts like Denhollander, now a lawyer.
McKayla Maroney, a gold medalist at the 2012 London Olympics, called Nassar a "monster human being," while a former member of the US national team said his abuse led to depression and an eating disorder.
Another gymnast said she was only six years old when Nassar began molesting her and blamed the doctor for her father's suicide once he realised she had not been lying about the abuse she endured.
In addition to Raisman and Maroney, Olympic gold medalists Simone Biles, Jordyn Wieber and Gabby Douglas went public in recent months with their own accusations against Nassar.
Nassar pleaded guilty in November to seven counts of first-degree sex assault in Ingham County, as well as three charges in Eaton County, where he is due to be sentenced next week.
The scandal's impact is far from over, with prominent gymnasts castigating USA Gymnastics for its handling of the scandal.
After the sentencing on Wednesday Lou Anna Simon, the president of Michigan State University, where Nassar also worked, announced her resignation.
Around 140 victims have filed a lawsuit against Nassar, USA Gymnastics and Michigan State, claiming the institutions knew about allegations of abuse years ago and failed to act.