“I’ve just signed your death warrant,” Ingham County Circuit Court Judge Rosemarie Aquilina said as she announced Nassar’s sentence and delivered a searing rebuke of his years as an abuser.

Aquilina also scoffed at the apology Nassar offered his victims and said he will be required to make restitution to them.

Some victims dabbed their eyes after Aquilina spoke, while Rachael Denhollander, the first woman to come forward publicly in 2016, smiled. Spectators applauded when the hearing ended and Nassar, wearing a dark blue jail house jumpsuit, was led out of the court.

Nassar, 54, pleaded guilty in November to seven counts of first-degree sex assault in Ingham County, as well as three additional charges in Eaton County, where he will be sentenced next week. He is already serving a 60-year sentence in federal prison for child pornography convictions.

Nassar, who served as the USA Gymnastics physician through four Olympic Games, apologized to his victims before the sentencing, telling them, “I will carry your words with me for the rest of my days.”

But Aquilina dismissed his statement as insincere, reading aloud from a letter he wrote to her in which he claimed he was a good doctor who was “manipulated” into pleading guilty, drawing gasps from courtroom spectators. Nassar also claimed his accusers fabricated claims to gain money and fame and wrote, “Hell hath no fury like a woman scorned.”

“This letter tells me you still do not own what you did,” Aquilina said, after angrily tossing the sheet of paper aside. “I wouldn’t send my dogs to you, sir.”

Changing view

Michigan Assistant Attorney General Angela Povilaitis said the conclusion of Nassar’s case takes the victims’ shame and puts it “where it belongs, right on him.”

“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,” she said.

The sentencing followed an extraordinary weeklong hearing that saw a parade of Nassar victims tell their stories in raw and unflinching terms, describing how he used medical treatments as a cover to justify penetrating their bodies with his fingers.

Although Nassar only admitted to seven instances of abuse in the case, Aquilina allowed other victims to speak at his sentencing. Throughout much of the proceedings, the bespectacled Nassar sat with his head bowed, rarely making eye contact with his victims.

His accusers ranged from famous Olympic gold medalists like Aly Raisman to women like Denhollander, who was the last of the victims to speak on Wednesday and whom Aquilina described as “the bravest person I have ever had in my courtroom.”

Several victims said the doctor employed manipulative tricks, including offering kind words and candy their coaches had forbidden, to gain their trust.

In addition to his work with Olympic teams, Nassar also was the team physician for the Michigan State University gymnastics and women’s crew teams, as well as an associate professor at MSU’s College of Osteopathic Medicine.

The National Collegiate Athletic Association said on Tuesday it had opened an investigation into Michigan State’s handling of the case. In her statement on Wednesday, Denhollander criticized the school for failing to adequately investigate complaints against Nassar dating back years.

In addition to Raisman, Olympic gold medalists Simone Biles, Gabby Douglas and McKayla Maroney have gone public in recent months, saying they were assaulted by Nassar while undergoing treatment.

Victims and others have criticized USA Gymnastics for ignoring their complaints and have accused the federation of suppressing their accounts in a bid to avoid bad publicity.

On Monday, three top board members resigned in the wake of the scandal, following the exit last March of the federation’s president and chief executive.

Several companies have announced they would not continue to sponsor the federation, including AT&T Inc on Tuesday.