Dipak Desai, the Las Vegas doctor blamed for Nevada’s largest-ever hepatitis C virus (HCV) outbreaks has died while in prison custody, a Nevada state corrections official said on April 11. Desai, who was 67 years old, apparently died from a stroke while serving a life sentence for his crimes, the Las Vegas Review-Journal reports

According to court documents, Desai spread the liver virus to his patients by repeatedly violating safe injection protocol at his clinics—for instance, by reusing syringes on patients and double dipping syringes into anesthetic propofol. Although the HCV outbreak eventually linked to Desai occurred in 2007, it didn’t become public until early 2008, after officials notified nearly 63,000 former Desai clinic patients that they should get tested for blood-borne diseases. 

In 2013, Desai was convicted of 27 charges related to the hepatitis C outbreak, including second-degree murder, insurance fraud and criminal neglect. Although Desai was charged with only one murder, he was blamed (though not convicted) for a second one in connection to the outbreak started at his endoscopy clinic in southern Nevada. Since then, local health authorities have linked as many as 114 cases of hepatitis C to Desai clinics.

At the time of his trial, Desai’s attorney insisted that the doctor was unfit to stand trial because of a history of frequent strokes, including one he suffered during court proceedings. However, state and federal prosecutors repeatedly characterized the doctor as a con man who was manipulating his physicians and psychiatrists to avoid the consequences of his crime, which ultimately helped lead to a conviction and sentence of 18 years to life in state prison in 2013.

State corrections officials reported that on April 2, Desai was transferred from the medical facility at Northern Nevada Correctional Center in Carson City. He died late April 10 at Renown Regional Medical Center in Reno. An autopsy showed Desai had suffered from multiple strokes, including the one responsible for his death.