Elizabeth Holmes, the co-founder of defunct blood-testing startup Theranos, has lost her bid to avoid prison and has been ordered to pay a $452 million restitution bill. Holmes was convicted of fraud in March 2021 after lying to investors and patients about the accuracy of Theranos’ blood-testing technology.

The verdict marks the culmination of a years-long legal battle that began after a Wall Street Journal investigation exposed Theranos’ fraudulent practices in 2015. Holmes and her former partner, Sunny Balwani, were indicted in 2018 on multiple counts of fraud, with prosecutors alleging that they had deceived investors and patients in order to obtain funding for the company.

Holmes had argued that she was not aware that the technology was not functional and that she had been misled by Balwani, but the jury did not buy her defense. She now faces up to 20 years in prison, although it is unlikely that she will receive the maximum sentence.

In addition to the prison sentence, Holmes has been ordered to pay $452 million in restitution to investors and patients who were affected by Theranos‘ fraudulent practices. The sum is likely to be difficult for Holmes to pay, as she has reportedly been living off loans from her partner, William “Billy” Evans.

The case has captivated the attention of Silicon Valley and has raised questions about the culture of hype and deception in the tech industry. Many have criticized Holmes for portraying herself as a visionary entrepreneur while deceiving investors and patients, and have called for stricter regulations to prevent similar scandals from occurring in the future.