Ireland captain Brian O'Driscoll has been ruled out of the remainder of the British & Irish Lions' tour of New Zealand with a dislocated shoulder.
Welsh centre Tom Shanklin will also play no further part on medical advice because of inflammation in a knee injury, while Richard Hill's tour is almost certainly over after a knee injury suffered in Saturday's 21-3 defeat to the All Blacks in the first Test in Christchurch.
Skipper and star midfielder O'Driscoll dislocated his left shoulder during the first 90 seconds. The Irishman was carried off on a stretcher and taken to hospital, but the Lions management are now awaiting tapes of the incident to assess exactly how it happened.
The Lions never recovered from his departure as they crashed to defeat and O'Driscoll was furious at the manner in which he was forced out of the tour.
"I am in no doubt whatever that it was deliberate foul play, a double spearing. It was a cheap shot which has put me out of the tour,'' he said.
"But the truth is it could have been an awful lot worse because they could have quite easily broken my neck. I was turned upside down, in the air and speared into the ground.
"I tackled one of their players and then a ruck formed. I was pushing against Jerry Collins and two guys came in, they had a leg each, I got turned around in the air and speared into the ground. I knew straight away that it was serious.
"I had this searing pain that just wouldn't go away, I have never had a dislocated shoulder before so I did not know that is what it was, but I knew instantly that I was out of the game.
"I can hardly believe that I put so much into this and just got over a minute of play in a Test match.
"I have worked so hard for so long to get to this and to have it taken away by such a cheap shot leaves a really nasty feeling. I am really shocked that Umaga did that.
"It is very hard to describe any emotion at the moment. I just cannot put it into words. I am angry because it was such a cheap shot. It was one of the most dangerous things that you can do in our game. It is why spear tackling is banned.''
Manager Sir Clive Woodward added: "It has been a bad day. Richard Hill has got a serious knee problem, and Tom Shanklin is out of the trip on medical advice."
Woodward has yet to decide on any replacements for the latest injured players, and no decision will be made on O'Driscoll's replacement as captain until the selection is decided for next Saturday's second Test in Wellington.
England's preparations for the Autumn International series were potentially dealt a further blow as Maro Itoje was forced to undergo an x-ray after Saracens' European victory over Scarlets on Saturday night.