RICHMOND, Va. (AP) — A West Virginia doctor should have been allowed to testify at his wife's trial on charges that she obstructed an investigation into his health care fraud, a federal appeals court was told Thursday.

Osteopath Barton Adams of Parkersburg had been deemed mentally incompetent to assist in his own defense, but his wife's attorney said there was no evidence that he remained incompetent when the woman's trial began five months later.

John A. Carr, attorney for Josephine Adams, said the doctor had stated his desire to provide evidence exonerating his wife as late as the evening before her November 2011 trial.

"It was a completely circumstantial evidence case," Carr said. "It would have been critically important to have Dr. Adams present to testify."

Assistant U.S. Attorney Robert H. McWilliams said it was reasonable for U.S. District Judge John Preston Bailey to conclude that the doctor remained incompetent because the court had not received information to the contrary.

"There was no way for Judge Bailey to know at all if or when this witness would be available," McWilliams said.

The appeals court typically takes several weeks or months to rule.

Josephine Adams was convicted of conspiracy and obstruction and was sentenced to three years of probation. Her husband, who owned and operated a Vienna pain clinic, pleaded guilty a year later to health care fraud and tax evasion and was sentenced to 50 months in prison. The federal appeals court upheld his convictions last week.

According to the government, Adams made bogus claims for Medicare and Medicaid payments totaling nearly $4 million. He and his wife hid the money in foreign accounts and lived a lavish lifestyle of international travel and lodging in high-end hotels.

At Thursday's hearing, appeals court Judge Andre Davis sounded troubled that Bailey appeared to rely on a five-month-old psychiatric report in determining that Barton Adams remained incompetent to testify. Davis said the doctor was an important potential witness, and he questioned why Bailey did not postpone Josephine Adams' trial and bring her husband in for a hearing on his mental state.

McWilliams acknowledged that the judge could have done that, but insisted that his decision not to does not warrant reversal. He said judges are supposed to be notified when an incompetent defendant's psychiatric capacity to stand trial is restored, and Bailey had received no such notification.

"It would be great if government bureaucrats did everything they're supposed to do when they're supposed to do it," Davis said. "But we know that's not true."