Hull Kingston Rovers prop James Green has been charged with making a reckless shoulder strike on Gene Ormsby.
The incident took place in the second half of the Robins' 26-18 win over Warrington Wolves in the Challenge Cup semi-final on Saturday.
Green, who does not have the option of submitting an early guilty plea, will now appear before an independent disciplinary tribunal on Tuesday evening.
Meanwhile, Hull teammate Kris Welham has himself been issued a formal warning after making what was perceived to be a dangerous throw on Anthony England during the same fixture.
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