Larry Nassar, the former USA Gymnastics doctor who was accused of molesting professional and Olympic-level gymnasts for decades, was sentenced to an additional 40 to 125 years in prison Monday. Nassar, accused of sexually assaulting at least 265 girls and women under the pretenses of medical examinations, apologized to his victims in Eaton County Court. He said the victim impact statements he heard over nine days of hearings “impacted [him] to [his] innermost core.”

Judge Janice Cunningham, however, did not believe he was remorseful. “I am not convinced that you truly understand that what you did was wrong and the devastating impact that you have had on the victims, families and friends,” Judge Cunningham said. “Clearly you are in denial, you don’t get it, and I do not believe there is a likelihood you could be reformed.” Monday’s proceeding is the presumed end of the criminal saga against Nassar, aside from an unexpected appeals process. Over 200 of Nassar’s ex-patients delivered written and verbal testimony over nine days of hearings during the trial.

Despite Nassar’s conviction, the growing scandal facing the US Olympic committee and associated governing bodies is poised to continue. Questions surround the US Olympic Committee, USA Gymnastics, and Michigan State University, where Nassar was employed for close to two decades, regarding whether credible allegations against Nassar were ignored or covered up.

Victims have allegedly come forward as early as 1997, and the two decades wait for justice was described as a “wake-up call” by Judge Cunningham. ‘”It is unfathomable to think about the number of victims that would have been spared had authorities acted upon the complaints they received years ago.”

Nassar’s sentencing follows the plea agreements made by Nassar’s attorney late last year, following previous convictions in Ingham County for child molestation and a federal conviction for possession of child pornography. Together, Nassar faces between 140 and 360 years in prison in all cases. The most recent conviction in Eaton county originates from abuse performed by Nassar at Twistar’s gym, were promising gymnasts trained.

The first public accusations against Nassar surfaced in September 2016 after an investigation by the Indianapolis Star. Initially, Nassar denied all charges brought in the Star’s article, but was found to be in possession of more than 37,000 images and videos of child pornography later that year. Nassar later pleaded guilty in both cases.

During plea proceedings, Nassar complained to Ingham County Court Judge Rosemarie Aquilina about having to listen to his victim’s testimonies, although he later apologized during sentencing. Despite Nassar’s apology, one of his lawyers appeared on a local radio program and said she did not believe many of the girls’ testimonies – and that Nassar used “legitimate medical techniques” that his victims described as molestation. Nassar later disavowed his lawyer’s remarks through a statement issued by his defense team.

Judge Cunningham sealed Nassar’s case with a blistering assessment of Nassar’s legacy: “You have lived an idolized life. You were a prominent doctor in our society. You were the member of an Olympic team. You have been pampered and lived a high-class lifestyle… the result will be spending rest of your life in a small prison cell. I’m sure that is unthinkable to you. But you will be left to sit there with only the memories of destroying your own family. And I do not believe you will have the ability to shut out the words of the children and the young women and the adults who trusted you, and you let down.”