In a sexual abuse scandal that has reverberated across the American sports scene, former Olympic team doctor Larry Nassar was sentenced Wednesday to 40 to 175 years in prison for molesting young gymnasts and other athletes.
The punishment was handed down in a Michigan courtroom where Judge Rosemarie Aquilina had spent days listening to impassioned, angry statements from about 150 women — including Olympic champions — who had been victimized by Nassar.
"I've just signed your death warrant," Aquilina told Nassar, noting that he would also be imprisoned 60 years for separate child pornography crimes.
The 54-year-old sat with his head bowed during much of the morning's proceedings, standing at one point to give a brief statement.
"Your words these past several days," he said, turning toward victims in the gallery, "have had a significant emotional effect on myself and have shaken me to my core."
For years, Nassar treated gymnasts and other athletes in an official capacity for USA Gymnastics, Michigan State University and a private gymnastics club. Victims have criticized those organizations and the U.S. Olympic Committee for ignoring initial complaints about him.
Olympic gymnast Mc-Kayla Maroney has claimed the USOC covered up its knowledge of Nassar's misconduct, stating in papers filed for a civil lawsuit in Los Angeles that officials established a "culture and atmosphere that conceals known and suspected sexual abusers."
Aquilina echoed such concerns, saying: "There has to be a massive investigation as to why there was inaction, why there was silence."
Within hours of the sentencing, the USOC announced that it would hire an independent third party to investigate when complaints were first brought and why Nassar's actions went unaddressed for so long.
The probe will include USA Gymnastics and its results will be made public, officials said.
The Nassar scandal has drawn sports into a larger national debate over men, especially in politics and the entertainment industry, who have used their positions of authority to mistreat women.
Angela Povilaitis, a Michigan assistant attorney general, asked the court: "What does it say about our society that victims of sexual abuse have to hide their pain for years when they did nothing wrong?"
Nassar, who accepted a plea deal, has pleaded guilty to other counts in separate proceedings beyond the child pornography case. His accusers have said he molested them under the guise of conducting medical treatments.
Athletes who came under his care — including such other Olympians as Simone Biles, Aly Raisman and Gabby Douglas — were told that when he improperly touched and penetrated them, he was adhering to a proven method for addressing sports injuries.
"The reality is, you caused me a great deal of physical, mental and emotional pain," Raisman said to Nassar in court. "You never healed me."
Later on Wednesday, Michigan State president Lou Anna Simon announced her resignation, stating: "As tragedies are politicized, blame is inevitable. As president, it is only natural that I am the focus of this anger."
There were other key developments earlier this week as USA Gymnastics announced the suspension of a well-known Olympic coach and the resignation of three board members.
Coach John Geddert, who led the U.S. women's team to a gold medal at the 2012 London Olympics, had long-standing ties to Nassar and owns a Michigan gym where some of the molestations occurred. He also worked directly with Jordyn Wieber, an Olympian who last week confronted Nassar in court.
Hours before Geddert's suspension, USA Gymnastics chairman Paul Parilla, vice chairman Jay Binder and treasurer Bitsy Kelley tendered their resignations.
"We believe this step will allow us to more effectively move forward in implementing change within our organization," new President and Chief Executive Kerry Perry said.
"As the board identifies its next chair and fills the vacant board positions, we remain focused on working every day to ensure that our culture, policies and actions reflect our commitment to those we serve."
The governing body previously severed its relationship with the famed Karolyi Ranch, run by the husband-and-wife coaching duo of Bela and Martha Karolyi. The Huntsville, Texas, facility, which had long served as a national training center, was another site where Nassar is accused of sexual abuse.
Aquilina's lengthy comments Wednesday included more information about a letter Nassar recently sent to the judge asking that his presence not be required during victim impact statements that stretched on for days.
Though the Michigan case focused on seven victims, many others who said they had been molested by Nassar were allowed to speak.
The judge refused to make Nassar's letter public but read passages in which he complained about the severity of his punishment in the federal pornography case, which he said prompted him to accept the deal with Michigan prosecutors.
"What I did in the state case was medical, not sexual," he wrote. "But because of the porn, I lost all support."
Observers in court gasped when Aquilina revealed that Nassar wrote: "Hell hath no fury like a woman scorned."
When Aquilina asked him if he was guilty, Nassar replied: "I accept my plea."
Nassar knew about his predatory tendencies even before he became a doctor and should have sought help before launching into decades of criminal behavior, Aquilina stated. The letter, she added, factored into her sentence.
"You don't get it," she said. "You're dangerous. You remain a danger."
There was applause in the courtroom when the hearing ended.
Among those in attendance was Rachael Denhollander, a former gymnast who triggered the case by alerting reporters at the Indianapolis Star to Nassar's criminal activity in the summer of 2016.
"The number of sexual assault victims Larry had was plain to me," she told reporters in the courtroom. "I am very grateful for Judge Aquilina."
10:50 a.m.: This article was updated with more details from the sentencing and about changes at USA Gymnastics.
10 a.m.: This article was updated throughout with Los Angeles Times staff reporting.