Columbia University and a New York City hospital on Monday agreed to a $756 million settlement with 576 victims over a decades-long cover-up of crimes committed by disgraced gynecologist and convicted sex offender Robert Hadden.

The deal was approved Monday in Manhattan Supreme Court, the New York Post reported. It is the largest per-plaintiff civil resolution in U.S. history, averaging $1.3 million per survivor. Approximately $277 million had been secured for Hadden victims in previous settlements against Columbia, bringing the total payouts to just over $1 billion with Monday’s agreement.

“This settlement is not about money — it’s about accountability,” victim Laurie Maldonado, who was a patient of Hadden’s for nearly a decade, told the Post. “Columbia University enabled sadistic abuse, and now, they’ve been forced to face the truth.”

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