A Hilo doctor at the center of a federal prosecution accusing his office workers of illegally obtaining and selling powerful prescription painkillers has dementia and had been treating himself for the disease since 2014, according to the report of a court-appointed psychiatrist.

The report concludes that Dr. Ernest Bade is not mentally competent to stand trial on federal drug distribution and conspiracy charges.

Senior U.S. District Judge Helen Gillmor accepted the psychiatrist’s evaluation and conclusions Thursday, which she said are supported by the doctors who have been treating Bade, and deemed the 80-year-old doctor unable to stand trial.

Such a finding requires the court to have the government place the defendant in a hospital for treatment to improve his mental condition. But because there is no known cure for dementia or treatment to slow or stop its progress, Gillmor did not place Bade in the government’s custody.

Assistant U.S. Attorney Michael Albanese told Gillmor he will file papers to dismiss all charges against Bade.

Charges in which Bade is not named as a defendant will remain against Marie Benevides, Yvonne Caitano, Sheena Strong and Theresa Saltus.

Benevides, 80, is Caitano’s mother and Strong’s grandmother. She pleaded guilty last month to conspiracy to obtain a controlled substance through fraud. In exchange for her guilty plea, the government promised to drop the other charges against her and recommend probation at sentencing in September.

Caitano, Strong and Saltus are scheduled to stand trial in October.

A federal grand jury returned an indictment in October charging Bade and the four women, who worked in his office and were also his patients, with conspiring to distribute and dispense a controlled substance, conspiring to distribute and possess with intent to distribute a controlled substance and conspiring to acquire and obtain possession of a controlled substance by misrepresentation, fraud, forgery, deception and subterfuge.

The indictment also charges Bade with 40 counts of unlawfully distributing and dispensing controlled substances.

The U.S. Drug Enforcement Administration says Benevides, Caitano, Strong and Saltus got prescriptions from Bade for large quantities of painkillers, including oxycodone, hydrocodone, fentanyl and morphine, and prescription steroids, muscle relaxers and sedatives.

The women traveled to Maui to get the drugs because pharmacies in Hilo grew suspicious and stopped filling their prescriptions. The government says Caitano sold the drugs at her home. The DEA said Caitano and Benevides had a 14-year-old girl collect money from customers who drove up to their house, then deliver the drugs to them in their cars. Strong went after customers who didn’t pay enough.