Nearly 11 years to the day after Laurie Kanyok ran out of her gynecologist’s office in Manhattan and reported him for sexual assault, she stood in front of him in a federal court yet again.

The 4,016 days since she had called the police on June 29, 2012, to tell them about Robert A. Hadden had been measured from hearing to hearing as she told and retold the story of her abuse. They were years “riddled with injustice, confusion and heartache,” she told the court on Wednesday.

“The system has taken over a decade to bring justice to this horrible crime,” she said, telling the federal judge who will decide Mr. Hadden’s punishment that “I have spoken one too many times in court and implore you to make this the last time.”

The sentencing hearing, attended by about two dozen victims, their families and supporters, was the first of the two for the former Manhattan gynecologist; at the second, on July 24, he will be sentenced by the judge, Richard M. Berman. Mr. Hadden was convicted in January of inducing patients to cross state lines for appointments they believed were routine examinations, but were in fact occasions for sexual assault.

On Wednesday, Mr. Hadden, 64, sat at the defense table to the right of the lectern where 11 women spoke. Mr. Hadden’s wife and son, who had sat in the rows behind him during the trial, were absent. Wearing the brown undershirt and tan scrubs of a federal detention center, he sat looking in front of him, sometimes glancing at the women speaking.

Cases against Mr. Hadden, who has lost his medical license and has not worked as a doctor since 2012, have wound through state and federal courts over the past decade. He first admitted to sexual abuse six years ago, but struck a state-court plea agreement that let him avoid serving time.

Mr. Hadden’s case, along with revelations about the treatment of wealthy sex abuser Jeffrey Epstein, led to scrutiny of how the Manhattan prosecutor’s office, then led by Cyrus R. Vance Jr., handled such crimes.

Mr. Hadden, who worked as a gynecologist with Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, was arrested in 2012 after a patient told the police that he had molested her during an exam. He was indicted in 2014 and prosecutors said that over a dozen other women had accused him of similar misconduct during medical appointments, as long ago as the 1990s.

But two years later, prosecutors agreed not to seek prison time for Mr. Hadden and promised not to pursue new sexual abuse allegations against him. Under the agreement, his sex-offender status was to end after 20 years.

Years later, federal prosecutors brought a case against Mr. Hadden, taking a tougher line than the state.

In 2020, federal prosecutors charged him in a case stemming from assaults against four patients who traveled from and through New Jersey, Nevada and Pennsylvania for gynecological and obstetric appointments.

“Hadden acted as a predator in a white coat,” said Audrey Strauss, who was then the acting U.S. attorney in Manhattan.

In recent years, hospitals where he was on staff have reached at least two separate settlements with 226 former patients for a total of about $236 million.

Throughout the proceedings, more than 70 victims testified in court or writing, said Jane Kim, an assistant U.S. attorney.

“Today is about the victims in this case,” she said in court. “This has been a long and painful path for them.”

On Wednesday, the women recounted how Mr. Hadden abused the trust they had in him as a doctor and in the medical institutions he worked for, in order to systematically and repeatedly abuse them.

“We need to do better,” Ms. Kanyok said. “Robert Hadden had a long history of sexual abuse that was concealed until now.”

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