An accused mass shooter has managed to avoid a death penalty trial by refusing to take his medicine.

Jesse James Warren has been charged with killing four people and seriously wounding a fifth at the Penske truck-leasing facility in Kennesaw on Jan. 12, 2010. Psychiatrists have deemed him incompetent to stand trial and said he refuses to take medication to control his schizophrenia and delusions. The state tried to forcibly medicate him to restore his competency, but the Georgia Supreme Court put a stop to that effort in 2015.

Seven years of attempts to prosecute Warren ended Tuesday with a court order committing him to a state prison hospital indefinitely, Cobb County District Attorney Vic Reynolds announced.