CLEVELAND, Ohio (CNN/WKYC) -- An emergency room physician accused of murdering his wife with cyanide pleaded not guilty on Wednesday, nearly four years after her death.
Rosemarie DiPuccio Essa's family say they want "justice for Rosie."
A judge set bail for Yazeed Essa at $75 million at a hearing attended by members of his slain wife's family.
Police say Rosemarie DiPuccio Essa, 36, weakened by cyanide poisoning, died in a car wreck on February 24, 2005.
Yazeed Essa left the United States in March 2005, shortly after being questioned by police about his wife's death. He was indicted by a Cuyahoga County grand jury in February 2007.
"This man lied to us," said Dominic DiPuccio, brother of Rosemarie Essa, outside the arraignment courtroom at the Justice Center in Cleveland.
"Right after my sister Rosie was murdered," DiPuccio said, "Yazeed Essa swore to us on the heads of his two little children that he had nothing to do with her death. Now we know the truth and can't wait for him to face justice."
Choking back tears as they waited for the case to be called, the DiPuccio family said they've been waiting almost four years for Essa to return to Cleveland and face the charge of aggravated murder.
Police investigators said Yazeed Essa initially said his wife was taking calcium supplements. But when Essa turned over his wife's pill vial to detectives, tests revealed that several pills contained deadly potassium cyanide rather than calcium.
Potassium cyanide, used in electroplating gold and euthanizing insects for collections, looks like sugar and can smell like almonds. It can be dissolved in water and hidden in food or medications.
Moments before she died, Rosemarie Essa called a friend on her cell phone and said her husband had insisted she take a calcium pill before leaving home, officials said.
A few weeks later, Yazeed Essa went to Beirut, Lebanon, and spent 19 months in the Middle East. He was taken into custody in Nicosia, Cyprus, when officials discovered his identity. He was extradited late last week.
Essa "fled the United States because he did not believe he could get a fair trial, since he is an Arab-American," defense attorney Steven Bradley said.
"Since the election of Barack Obama as president, Essa now believes the political climate has changed enough that he was willing to return and now get a fair trial," Bradley said.
Bradley and his co-counsel, Mark Marein, said they were not shocked that Judge Joan Synenberg set bail at $75 million.
"Our client is fully prepared to remain in jail until the time of his trial. He says he is an innocent man."
Essa's late wife's family takes a different view.
"We have absolutely no doubt that he is a killer," DiPuccio said. "It's been really tough for all of us and we're glad this day has finally come. Maybe we can get some justice for Rosie."
Rosemarie Essa's mother, Gigi DiPuccio, held the hands of her husband, Rocco, and said, "I think about my daughter every day."
As her eyes filled with tears, she said, "Now we just want to get justice for Rosie and the kids and our family so we can start to heal. We're at the first step right now. We need to get through this and we will as a family."
If convicted of aggravated murder, Yazeed Essa faces a life sentence, with parole eligibility after 20 years in prison.