Disgraced ex-sports doctor Larry Nassar has been sentenced to another 40 to 125 years for sexually abusing girls.
Eaton County Judge Janice Cunningham issued the sentence on Monday. Last week he received 40 to 175 years in jail in a different Michigan county.
“It’s impossible to convey the depth and breadth of how sorry I am to each and every one involved,” he told the court before his final sentencing.
The number of women who accuse Nassar of abuse has grown to more than 250.
The case has rocked the US Olympic Committee, the sport’s governing body USA Gymnastics and Michigan State University, where he also worked as a sports doctor.
Top officials at USA Gymnastics and Michigan State University have resigned in recent weeks amid the fallout, and the case has prompted several investigations into whether complaints against the doctor were ignored.
Monday’s sentencing followed days of emotional testimony from dozens of Nassar’s victims.
More than 200 women in total have delivered impact statements on his abuse in both hearings.
Nassar offered an apology on Monday, but Judge Cunningham said he had suggested in a pre-sentencing interview that he had done nothing wrong.
“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, their families and friends,” she said.
“Clearly you are in denial. You don’t get it.”
Last week Judge Cunningham decided not to formally charge a father of two sexual assault survivors who leapt at Nassar after asking the judge for “five minutes in a locked room with that demon”.
A GoFundMe campaign raised more than $30,000 (£21,000) for the father, Randall Margraves.
However, the judge said that she would not press charges against him.
The campaign said the money would instead go “to a good cause to help victims of sexual abuse”.