On Wednesday, the doctor was arrested for their deaths.

A Clay County grand jury indicted Nagareddy, known in the media widely as “Dr. Death,” on three counts of murder, and 59 additional counts of unauthorized distribution of pain prescriptions, reported the Atlanta Journal-Constitution.

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Nagareddy has denied the allegations from the outset, according to news reports. “Unequivocally, we will be ready to defend this matter,” Steve Frey, Nagareddy’s attorney, told the Journal-Constitution after the indictment Wednesday. “He is innocent of all of these charges.”

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It’s the latest development in a years-long investigation into Nagareddy’s medical practice.

A probation officer was among the first to flag Nagareddy after she noticed that three people in her caseload who had died were patients of the doctor, according to an AJC investigation. She reported the pattern to the Drug Enforcement Administration, which worked with local law enforcement to build a case that led to Nagareddy’s initial arrest in January.

He was charged with violating the Georgia Controlled Substances Act by allegedly prescribing medications that had no legitimate purpose. Nagareddy was later released on a $100,000 bond, the Journal-Constitution reported.

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One month after his January arrest, the Georgia Composite Medical Board voted to suspend Nagareddy’s license.

Ruth Carr, the mother of Audrey Austin, told several news outlets she was relieved by the new charges, but continued to grieve the loss of her daughter.

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“It doesn’t get better with time. And I think that it’s been long overdue with the doctor,” Carr told WSB-TV 2. “I knew he was doing (it) with people other (than) my daughter and I knew she wasn’t the only one.”

Nagareddy is accused in court documents of giving refillable painkiller prescriptions, taboo in the medical community because patients can fill the prescriptions prematurely. Former patients told investigators that Nagareddy was known around town for prescribing pills for pain, and that he rarely if ever gave physical examinations before writing prescriptions, documents show.

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“You just tell him what you want and you get it,” one former patient said.

Court documents allege that 36 of Nagareddy’s patients died while he was allegedly prescribing them controlled substances — hydrocodone, oxycodone, methadone, fentanyl and amphetamine salts — and autopsies confirmed that 12 of those patients died of prescription drug overdoses. His patients were often battling addiction, anxiety and depression.

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Investigators interviewed the program director of a methadone clinic in Atlanta, who was not identified by name in court documents but was quoted saying: “Dr. Nagareddy is very generous with scripts.” The medical director of the clinic, also unnamed, told investigators that patients “get anything they want” from the doctor and that he “has a bad reputation.”

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On Vitals and RateMDs, some former patients praised the doctor’s bedside manner, credited him with saving their lives and claimed he was the only physician who would accept them without insurance.

Others, however, bashed Nagareddy, calling him a “drug pusher” and posting warnings about the doctor as early as 2010.

People in those comment threads and in documents said the waiting room at Nagareddy’s office was often packed with dazed patients.

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“I’d see a lot of zombied-out people,” Rebecca Gray, the sister of another patient who overdosed, told the Journal-Constitution. “You could tell a lot of them were junkies.”

At a news conference Wednesday, District Attorney Tracy Graham Lawson told reporters that at least 11 of the new counts Nagareddy faces include his negligence to sign or date his prescriptions, the McDonough, Ga.-based Henry Herald reported. According to the newspaper, the doctor could face additional charges for at least 30 other alleged overdose deaths.

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“What it means is there will no longer be prescriptions issued by Dr. Nagareddy that result in the deaths of any innocent people,” Lawson told reporters.