Frustrated by the slow progress of the case, a judge said Monday that a doctor and two nurses accused of killing four desperately ill patients after Hurricane Katrina should be formally charged or exonerated.

"With all due respect, I'm tired of this case," District Judge Calvin Johnson said during a hearing on whether documents in the matter should be made public. "This case needs to either go forward or end."

He said he was frustrated by the length of time he has spent dealing with the case, since neither Dr. Anna Pou nor nurses Cheri Landry and Lori Budo have been indicted.

The women were arrested on July 18 and later released. Their attorneys maintain their clients are innocent.

The three are accused of using morphine and sedatives to kill four patients, ages 62 to 90, who would have otherwise survived the sweltering, chaotic conditions at Memorial Medical Center after the storm hit New Orleans on Aug. 29, 2005.

Dalton Savwoir, a spokesman for District Attorney Eddie Jordan, said a grand jury has not been convened yet; one will probably be convened early next year.

Jordan and Attorney General Charles Foti defended the delay in the case, saying the charges are complicated, involving multiple victims. "We can't be hurried by any court," Jordan said.

Johnson's frustration comes at a time when criminal cases in New Orleans remain backlogged because of a shortage of public defenders and other problems created when Katrina's floodwaters destroyed evidence and shutdown the court system.