Ex-US Olympic gymnastics team doctor Larry Nassar has been sentenced to 40 to 175 years after testimony from nearly 160 of his victims.
The judge dismissed Nassar's statement as insincere as he attempted to apologise to the court.
Nassar, 54, pleaded guilty to multiple counts of sexual assault against girls and young women, including Olympians.
Judge Rosemarie Aqualina told Nassar during the sentencing he will "be in darkness the rest of his life".
"As much as it was my honour and privilege to hear the sister survivors, it was my honour and privilege to sentence you. Because, sir, you do not deserve to walk outside of a prison ever again," she said.
"You have not owned yet what you did. I wouldn't send my dogs to you, sir," she told the former doctor, adding: "I've just signed your death warrant".
He had already been sentenced to 60 years for possession of child pornography, before pleading guilty to 10 counts of criminal sexual conduct.
Following seven days of emotional testimony from Nassar's victims, he was given an opportunity to address the court.
"What I am feeling pales in comparison to the pain, trauma, and emotional destruction that all of you are feeling," he told the packed courtroom.
"There are no words to describe the depth and breadth of how sorry I am for what has occurred," he added.
A story of survival
Rajini Vaidyanathan, Lansing, Michigan
Sitting in court throughout the seven day hearing, the stories have been strikingly similar - the former USA gymnastics team doctor would call the women in for treatment, but instead of taking away their pain, he stole their innocence. Some were so young they didn't realise until years later that they had been sexually abused.
As Larry Nassar sat in his prison overalls, just metres away from them, survivor after survivor looked him in the eye and reminded him of what he'd done to them. And that's been the most extraordinary thing about this hearing.
While the content of their testimony has been harrowing, it's also been inspiring. For survivors of sexual abuse it's hard to relive the experience, let alone do so in front of your attacker.
Source:BBC