A U.S. Senate panel led by Sen. Bernie Sanders voted Thursday in favor of holding Steward Health Care CEO Ralph de la Torre in civil and criminal contempt after he refused to appear at a hearing last week in defiance of a congressional subpoena.

The Senate Health, Education, Labor, and Pensions (HELP) Committee passed the contempt resolutions in a near-unanimous vote, with Sen. Rand Paul (R-Ky.) abstaining.

The vote marked “the first time in modern American history that the HELP Committee has issued a civil or criminal contempt resolution,” according to Sanders’ office.

The approval of the two resolutions, which now head to the full Senate for consideration, could mean jail time for de la Torre, who has come under fire for purchasing two yachts as his private equity-backed company faced financial turmoil. De la Torre was paid a salary of nearly $4 million the year before Steward ultimately filed for bankruptcy.

A lawyer for de la Torre insisted in a letter to Sanders (I-Vt.) on Wednesday that the CEO “lacks the authority to speak on behalf of Steward with respect to the ongoing bankruptcy proceedings and he is prohibited by a federal court order from doing so.”

Ahead of Thursday’s vote, Sanders said de la Torre’s decision not to comply with the Senate HELP Committee’s subpoena was “unfortunate and unacceptable.”

“For months, this committee has invited Dr. de la Torre to testify about the financial mismanagement and what occurred at Steward Health Care. Time after time he has arrogantly refused to appear,” said Sanders. “Dr. de la Torre has given us no choice but to move forward this morning on two resolutions to enforce the subpoena and to hold him accountable for his actions.”

“Even though Dr. de la Torre may be worth hundreds of millions of dollars, even though he may be able to own fancy yachts and private jets and luxurious accommodations throughout the world, even though he may be able to afford some of the most expensive lawyers in America—no, Dr. de la Torre is not above the law,” Sanders added.

Sen. Ed Markey (D-Mass.), a member of the Senate panel, said in a statement that “as a physician and as the CEO of Steward from its founding, there is no one who understood the potential consequences of Steward’s failures more than Dr. Ralph de la Torre.”

“Dr. de la Torre led Steward when it sold out hospital real estate to Medical Properties Trust and allowed [the private equity firm] Cerberus to extract over $800 million in profit,” said Markey. “Dr. de la Torre led Steward as eight hospitals closed, 2,000 patients were endangered, and at least 15 patients died. Dr. de la Torre led Steward as it filed for bankruptcy.”

“We are making clear to Dr. de la Torre, the Steward Board of Directors and senior leadership, and other CEOs, private equity investors, and corporate executives who treat the healthcare system like their piggy bank: Your millions do not shield you from accountability to a legal order issued by the United States Senate,” Markey added.

The Senate panel’s passage of the two resolutions comes a week after Steward nurses told the committee—in de la Torre’s absence—that Steward-owned hospitals were disastrous for patients and healthcare workers. A report published by the Senate HELP Committee earlier this month found that “death rates for certain conditions at some Steward-owned hospitals increased as death rates for those same conditions held steady or decreased across the country.”

Lisa Gilbert, co-president of the consumer advocacy group Public Citizen, said in a statement Thursday that the Senate panel’s “actions today are an important reminder that no one is above the law.”

“Congress and the American people deserve answers on what happened under Dr. de la Torre’s watch at Steward, as his damaging actions had real consequences for patient health,” said Gilbert. “Dr. de la Torre and others like him should not be able to ignore congressional subpoenas without accountability.”

If the full Senate approves the criminal contempt resolution, it would “refer the matter to the U.S. Attorney for the District of Columbia to criminally prosecute Dr. de la Torre for failing to comply with the subpoena,” Sanders’ office said.