The court refused fallen Theranos CEO Elizabeth Holmes in her appeal to be out of federal prison while she pleads her conviction for the scam she instigated while in control of a blood-testing rip-off that bared Silicon Valley’s shady side.

In an 11-page ruling issued, U.S. District Judge Edward Davila concluded there wasn’t compelling enough evidence to allow Holmes to remain free on bail while her lawyers try to persuade an appeals court that alleged misconduct during her four-month trial led to an unjust verdict.

Elizabeth Holmes

The judge’s decision implies that Holmes, 39, will have to submit to authorities on April 27 to begin the over 11-year prison sentence that Davila levied in November.

The punishment came 10 months after a jury found her guilty on four counts of fraud and conspiracy against the Theranos investors who believed in her promises to revolutionize the healthcare industry.

Holmes could still file another appeal of Davila’s latest ruling, a maneuver her co-conspirator at Theranos — Ramesh “Sunny” Balwani — successfully used to delay his scheduled March 16 date to begin a nearly 13-year prison sentence. But the Ninth Circuit Court of Appeals last week rejected that appeal, and Balwani is now scheduled to report to a Southern California prison on April 20.

Davila has recommended Holmes serve her sentence in a Bryan, Texas, prison. It hasn’t yet been publicly confirmed if that will be the facility where she reports.

Unless she can find a way to stay free, Holmes will be separated from the two children she had leading up to the trial and after her conviction.

Theranos Blood-Testing

Although they had separate trials, Elizabeth Holmes and Balwani were accused of essentially the same crimes centered on a ruse touting Theranos’ blood-testing system as a breakthrough in health care. The claims helped the company become a Silicon Valley sensation that raised nearly $1 billion from investors and smoothed Holmes with a $4.5 billion fortune.

But Theranos’ technology never came close to what Holmes and Balwani bragged about, leading to the company’s shocking downfall and to the criminal case that highlighted Silicon Valley’s greed and shady dealings that hid in plain sight.

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