US artistic swimmer Anita Alvarez, who was dramatically rescued from the bottom of the pool after fainting in her solo routine, was omitted from the team event on Friday at the request of governing body FINA.
"That was a decision FINA had made," said Selina Shah, US artistic swimming's team doctor.
"In my opinion she could have competed, I am very confident," Shah said.
FINA said it had organised a medical examination on Friday morning that included three representatives of its medical committee, its executive director, Dr. Shah and US team officials.
"Following these discussions, FINA determined that Anita Alvarez should not compete today," FINA said in a statement.
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"The health and safety of athletes must always come first. While FINA understands why this decision will have been disappointing to the athlete, it was a decision that was made with her best interests in mind.
The governing body said it was "delighted" that Alvarez had made "such a strong recovery" and looked forward to seeing her in competition again soon.
Shah said she did not know how FINA had reached its conclusion that Alvarez should not compete.
"I'm not aware of their decision making process."
Alvarez fainted and dropped to the bottom at the end of her individual routine on Wednesday and was saved by her quick-thinking coach, Andrea Fuentes.
'A great athlete'
Alvarez had been entered in the team event on Friday and was on every official startlist until just before the event was scheduled to begin when she was replaced on the eight-woman team by Yujin Chang.
Standing in the warm-up area before the event, as the US swimmers made their final preparations behind her, Shah said she was sure Alvarez would be cheering the team on.
"I think she is very excited for the team to compete and she's a great athlete and she's going to be there supporting them."
The US team finished ninth out of 12 in an event won by China.
On Wednesday, AFP's underwater robot camera captured astonishing images as Alvarez sank and her coach, Andrea Fuentes, dived to the bottom of the pool and dragged the swimmer to the surface.
"I think she was at least two minutes without breathing because her lungs were full of water," said Fuentes, a four-time Olympic artistic swimming medallist, adding that the swimmer's heart was beating.
The USA artistic team released a statement on Thursday saying Alvarez had fainted due to her effort during the routine.
"This happened to her once last year at the Olympic Qualification Tournament when competing her duet," an US spokeswoman added.
On Friday, Shah said the doctors were still searching for a definitive explanation.
"We are going to look into what happened and do some additional extensive programmes with consultants and make another determination as to an actual cause," Shah said.
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