Disgraced Episcopal bishop Rt Rev Heather Cook has been formally indicted by a grand jury on 13 charges.

Cook was driving the car that killed Tom Palermo, 41, as he was cycling in Baltimore on December 27 last year. It subsequently emerged that she had a long-standing alcohol problem including a previous conviction for drink driving, and that she was suspected of being drunk at her own consecration.

The charges include automobile manslaughter, criminally negligent homicide, failing to remain at the scene of the accident, driving while under the influence of alcohol and texting while driving during an accident that results in death or serious bodily injury.

Cook has been released on bail and is undergoing in-patient alcohol dependency treatment. She has been asked to resign from her bishopric but has so far not responded.

The Episcopal Bishop of Maryland has said the diocese is in "deep pain" as a result of her actions.

Eugene Taylor Sutton, Cook's senior, wrote in a pastoral letter earlier this month: "The Diocese of Maryland is in deep pain. Words barely express the depth of our shock and despair over the events and revelations of the past two weeks.

"There are still too many questions for which there are no easy answers, and we are filled with anger, bitterness, pain and tears. Our thoughts and prayers remain with the Palermo family in their bereavement and for ourselves as a diocese in mourning."

Cook could face as many as 20 years in prison if she is convicted.