George Furbank will miss the rest of England's summer internationals after he was withdrawn from the team to face South Africa because of appendicitis.
The full-back, who was set to make his first England appearance in close to two years, was taken to hospital on Friday evening and was replaced in the starting XV by Marcus Smith.
Following the 45-21 mauling at Ellis Park, England boss Steve Borthwick confirmed Furbank will also miss the games against Fiji on July 11 and Argentina on July 18.
Borthwick said: "He went into hospital on Friday evening with abdominal pain, he had surgery on Saturday morning on his appendix and he is still in hospital recovering.
"I spoke with him earlier, he is gutted and he will miss the next couple of weeks. He will be delayed in South Africa to fly back at a later date."
The 29-year-old, who recently joined Harlequins, has battled a succession of injuries, including to his calf, arm and knee, since his last England outing in November 2024.
He earned a recall after helping Northampton Saints to the Prem Rugby title this summer.
Meanwhile, Borthwick defended Tommy Freeman and Guy Pepper, who were both shown yellow cards late on in Saturday's defeat.
Freeman was sent to the sin bin for a dangerous tackle in the 71st minute and a minute later Pepper followed him into the stands for a late challenge.
That meant the tourists were forced to play the final seven minutes of their Nations Championship opener with only 13 men and they leaked tries to Malcolm Marx and BJ Dixon in the closing minutes to complete a harrowing evening in Johannesburg.
However, Borthwick refused to blame either player.
He said: "If you look at the Tommy Freeman one you see a slight timing error, there wasn't anything malicious or reckless there. He was trying to make a tackle and he was apologetic for the tackling height.
"The Guy Pepper one, South Africa put players under pressure because that is the way they play and they are very good.
"We want our execution and decision making to be at a very high level and these young players will learn from this experience of playing against the best in the world."
England have now been hit with 10 yellow cards and one red in their six games in 2026.
The theme of ill-discipline was raised by their post-Six Nations review as an area of concern and Jamie George, who is captaining the side in place of the rested Maro Itoje, admitted that part of their game needs to be better.
He said: "There are some clear things we need to make sure we get better at and as players we have to take a lot more responsibility with regards to our discipline, which let us down.
"Outside of that, there were periods where we put the Springboks under a lot of pressure. Speaking to their guys they know they have been in a Test match.
"We are going to be a significantly better team off the back of this experience with a young team coming here and understanding how we put them under a lot of pressure and also understanding how we let that pressure get to us a little bit.
"This is going to be a great learning experience for us, but we are gutted because we genuinely believed we could come here and win.
"We are going to rally round, stay tight and we are all looking forward to getting to Liverpool and putting in a great performance against Fiji."
Fin Smith also offered an honest appraisal of England's defeat, alleging Borthwick's side were "soft" in defence at Ellis Park.
"We still have to question why we started as poorly as we did," Smith said. "For about 50 minutes of that game you saw how we wanted to play but then, ultimately, they were too good for us in the end.
"I'm actually more frustrated about how we started rather than how it went at the end. At the end, down to 13, we were still fighting against a top side like that.
"It is understandable, 15 against 13, they might get a few but for us to start as poorly as we did was more frustrating.
"We were soft defensively, missed a lot of tackles and ultimately they scored quickly when they got into our 22.
"Deep down I'm probably pretty proud of our efforts, we stuck in it, but we gave ourselves too much to do."
England will now look to bounce back against Fiji at Everton's Hill Dickinson Stadium next Saturday (kick-off 2.10pm).
