BERLIN — The oft-delayed trial of a former SS medic who served at the Auschwitz death camp opened Monday in Germany, amid lingering questions about whether the 95-year-old is fit enough for the proceedings to continue.

The trial of Hubert Zafke, scheduled to start in February at the Neubrandenburg state court in northeastern Germany, had been postponed three times after presiding Judge Klaus Kabisch determined Zafke wasn’t well enough to participate, based on a doctor’s assessment.

Among other things, the retired farmer suffered from stress and high blood pressure and had suicidal thoughts, the court was told. Already in 2015, the Neubrandenburg court ruled against bringing the case to trial due to Zafke’s health, but a higher court overturned that, saying that the trial could go ahead if the sessions were limited.

Zafke was examined again Monday morning ahead of the court session, and Kabisch decided to proceed.

Zafke was pushed into court in a wheelchair, holding a wooden cane in his hand, and made no comment as the charges against him were read, saying only “yes” that he had understood them, the dpa news agency reported.

As the trial opened, prosecutors and attorneys representing Auschwitz victims who are co-plaintiffs both filed motions accusing Kabisch of bias for his previous rulings on Zafke’s health, asking for his removal.

Prosecutors argued in their motion that Kabisch never intended for the trial to start, noting — among other things — that no Auschwitz survivors had been invited to testify, as is common in such proceedings, dpa reported.

Monday’s session was ended after two hours when a medic noted that Zafke’s blood pressure had risen to an elevated 160:90.

“Fitness to stand trial is an imperative according to the rule of law,” Kabisch told the court.

Kabisch told the court the motions for his removal would now have to be heard before he could schedule another session in the trial. A court spokesman said it is not clear how long it will take for the motions to be resolved.

Zafke is charged with 3,681 counts of accessory to murder for allegedly helping the Auschwitz death camp in Nazi-occupied Poland function.

The charges stem from a one-month period in 1944 and involve the deaths of Jews who arrived in 14 train transports, among them one that brought Anne Frank and her family to the camp. Frank died later at Bergen-Belsen, and Zafke is not charged over her death.

Prosecutors allege that Zafke’s unit was involved in putting gas into gas chambers to kill Jews and others, screening blood and other samples from hospitalized women prisoners, and otherwise helping the camp run by treating SS guard personnel.

They say the unit was also involved in auxiliary guard duties.

Zafke’s attorney insists his client was just a medic who did nothing criminal at Auschwitz.