Former USA Gymnastics Doctor Larry Nassar molested young athletes for over two decades and had his “death warrant” signed by Judge Rosemarie Aquilina on January 24.

Nassar began working with USA gymnastics in 1986 as an athletic trainer and his first reported abuse of an Olympic athlete was in 1994. Two years later, he was appointed the National Medical Coordinator for USA Gymnastics and began a primary sports medicine fellowship at Michigan State University in 1997. In 2012, Nassar was inducted into the USA Gymnastics Region 5 Hall of Fame.

On August 29, 2016 Rachael Denhollander filed a report stating that Nassar abused her in 2000 and within the next few months, 80 other victims came forward to MSU police. Now, after the week-long trial, over 150 women have testified in the courtroom of Judge Rosemarie Aquilina. Rachael Denhollander was the first victim to come forward and had the last words at his hearing, saying, “Larry is the most dangerous type of abuser.” Denhollander was joined by Olympic gymnasts Aly Raisman, Gabby Douglas and McKayla Maroney.

After listening to the victims’ stories and reading a six page letter from Nassar complaining that it was detrimental to his mental health to listen to them, Judge Aquilina sentenced Nassar to 40 to 175 years in prison. In the wake of the scandal, Lou Anna Simon, president of Michigan State University and the entire USA Gymnastics board, resigned. The board’s announcement came after a letter from the United States Olympic Committee that threatened to decertify the organization if they did not comply.

Many of the victims, such as Rachael Denhollander, Aly Raisman and Simone Biles, criticized the organization during their testimonies and statements on social media. Denhollander asked the executive officers to resign last August, but the board remained intact. Raisman’s entire testimony landed a full page in the New York Times in which she stated that the organization is “rotting from the inside.” Raisman also tweeted at USA Gymnastics in early January, saying, “You are 100% responsible. It was mandatory to get ‘treatment by Nassar.’” Biles added to her teammates’ comments about the organization wondering why she had to continue training at the Karolyi Ranch where Nassar abused her earlier in her career. After this critique, USA Gymnastics ended its relationship with the ranch.

John Manly, an attorney who represents 107 women in civil lawsuits targeting USA Gymnastics and Michigan State University, has accused both organizations of hiding Nassar’s misconduct. These lawsuits are just the beginning of the fallout from this case, and USA Gymnastics will be next in the courtroom.