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WERNERSVILLE, Pa. (AP) — The pastor of a fundamentalist congregation that eschews modern medicine will stand trial on a charge he should have alerted authorities when his 2-year-old granddaughter was dying of pneumonia last year, a Pennsylvania judge ruled Wednesday.

District Judge Ann Young said prosecutors put on enough evidence to send the case against Rowland Foster to the Berks County Courthouse for trial, reversing a different judge’s decision in April to throw out the charge of failure to properly report suspected child abuse.

Young called the death of Ella Foster “tragic, sad, beyond belief,” and told Foster she was not questioning his religious beliefs.

Her decision came after watching a video of state police questioning the elder Foster, but Young said an important part of her decision was testimony at the previous preliminary hearing by Dr. Neil Hoffman, a forensic pathologist.

Hoffman did not testify Wednesday, but Young drew from the transcript of the earlier hearing in which he said the girl’s condition would have been easily treatable and that if she had been, she almost certainly would have survived.

Young called Hoffman’s testimony “clear, convincing and compelling.”

Rowland Foster, 72, of Lebanon, ignored questions as he left the hearing, but his defense attorney, Chris Ferro, said prosecutors will have difficulty getting a conviction at trial, which will require a more stringent level of proof than was needed before Young.

“I think the commonwealth is going to be unable to prove the charge beyond a reasonable doubt,” Ferro said.

Prosecutor Jonathan Kurland argued to the judge that Ella Foster had been subjected to child abuse, and that her grandfather, as a pastor, was required by law to report suspected abuse and willfully failed to do so.

“Dr. Hoffman testified (that) in the morning before she died, it would have been apparent to a reasonable person that Ella was in need of medical care and medical intervention,” Kurland said.

He said Rowland Foster’s comment to a detective that he has never been to a doctor was evidence of “rationalization and justification and awareness.”

Ferro called his client “a grieving grandfather, not a criminal” and said Ella Foster’s death was “a crater in the heart of the community.”

Ella Foster was being cared for before she died, Ferro said, including being given food and liquids.

“This is not a mandatory reporter who is turning his blind eye to child abuse,” Ferro said.

Ella’s parents, Jonathan and Grace Foster, await trial on involuntary manslaughter charges.

Rowland Foster leads the Faith Tabernacle Congregation, which instructs members to avoid doctors and pharmaceutical drugs. An advocacy group that tracks faith-based medical neglect says the church’s position has resulted in the deaths of dozens of children from preventable or treatable conditions.