SAN JOSE, Calif. — Elizabeth Holmes, the former chief executive of the blood-testing startup Theranos, was sentenced on Friday to more than 11 years in federal prison for her role in defrauding investors out of hundreds of millions of dollars.

Holmes, once seen as a Silicon Valley wunderkind, was ordered to begin her prison sentence on April 27, 2023, in a case U.S. District Judge Edward Davila described as "troubling on so many levels."

Before Davila handed down his sentence, a sobbing Holmes stood up and addressed the judge directly.

"Looking back, there are so many things I would do differently if I had the chance. I regret my failings with every cell of my body," she said, as her voice cracked.

Holmes' defense lawyers had hoped for a short prison sentence, or even home confinement. Now Holmes, 38 and pregnant with her second child, is expected to report to prison in five months. After her release, she is to spend three years under supervision.

"The tragedy of this case is that Ms. Holmes is brilliant," Davila said before his pronouncement. But he concluded that she was motivated by avarice and greed to lead investors into believing that her company could do far more than she knew was possible. He also saw her actions as symptomatic of the worst of Silicon Valley.

The tech industry "finds vectors with financial and personal gain that clouds the good judgement of individuals," Davila said. "Was there a loss of moral compass here? Was it hubris? Was it intoxication with the fame," said Davila of Holmes.

When Theranos was at its peak, Holmes and Ramesh "Sunny" Balwani, her then-boyfriend and No. 2 at Theranos, lived in a $15 million mansion. They traveled in a private jet. They had dinners at the White House.

If Holmes wasn't in pursuit of a lavish lifestyle, the judge asked, "What was it then?"

In one of the more surprising moments of the hearing, Davila asked if any victims were in the audience and wanted to speak. One man shot his hand up. His name was Alex Shultz, the son of former secretary of state George Shultz, who was on the Theranos Board of Directors.

He stood in front of the judge in what appeared to be an improvised speech and said somewhat haltingly that Holmes "took advantage of my dad," and that she had "figured out his weakness."

Alex Shultz said his son, Tyler Shultz, a former Theranos employee who became a key whistleblower, dealt with private investigators hired by Holmes to follow Tyler Shultz.

His son was so spooked by the ordeal that he began sleeping with a knife under his pillow.

"It was a grueling experience," he said. "My family home was desecrated by Elizabeth," he said.

A promise of easy blood tests too good to be true

In January, a jury convicted Holmes on four wire fraud-related counts for her role in deceiving investors about a supposedly groundbreaking technology that could scan for hundreds of conditions with just a few drops of blood. It is a feat laboratory scientists around the world for years have tried to accomplish, but Holmes, a Stanford dropout, claimed she had perfected it.

She drummed up nearly $1 billion in investment based on the premise that her proprietary blood-testing devices would revolutionize health care, but prosecutors argued during the trial that Holmes fudged test results, flagrantly lied about the capabilities of her tests and tried to cover it up when whistleblowers and journalists began to draw scrutiny to what was really going on at the company.

"She knew that they were investing in Theranos based on a false premise," prosecutor John Bostic told the judge on Friday. "She was aware of the mismatch between what she was presenting to investors and reality."

It is nearly unheard of in Silicon Valley for an executive to face criminal prosecution in the wake of a business collapse. But legal experts said the egregiousness of Holmes' lies, the sheer dollar amount of loss and the fact that she was operating in the highly-regulated health care world, made the Theranos case exceptional.

Still, Holmes' prosecution stirred debate in tech circles about possible sexism, with some wondering why men who led tech startups that failed after unrealized promises have never faced criminal charges.

There appears to be more scrutiny on high-flying tech startups now, however.

The Justice Department is reportedly investigating the now-bankrupt FTX, an exchange for trading crypto. Its recent implosion wiped out former CEO Sam Bankman-Fried's wealth of $16 billion, which Bloomberg called "one of history's greatest-ever destructions of wealth."

Federal investigators are probing the unwinding of the company, with the specter of possible criminal charges being discussed among legal experts.

In the Theranos case, Balwani, who was convicted in a separate trial in the same fraud scheme as Holmes, is set to be sentenced Dec. 7.