Sunderland defender Patrick van Aanholt ruled out of Tottenham Hotspur clash on medical grounds

Sunderland boss David Moyes has confirmed Patrick van Aanholt was pulled out of the Mackems' 1-0 defeat at Tottenham Hotspur due to medical advice. The 26-year-old Dutchman was named in Moyes' starting line-up but was belatedly withdrawn from the game at White Hart Lane.

Moyes has now revealed he took the decision on advice from cardiologists. The manager – whose last-minute decision left Van Aanholt visibly bemused – has confirmed the defender could return for the EFL Cup match against Queens Park Rangers on Wednesday (21 September).

"He had the statutory checks with the cardiologists," said Moyes, according to the BBC. "The Football Association panel advised us really late that he should not play until further tests had taken place."

Moyes said that van Aanholt, who joined Sunderland from Chelsea in 2014, had subsequently undergone those tests and is now poised to travel with the squad for their game at Loftus Road. He admitted, though, to being surprised at how late the Football Association (FA) contacted him about the issue.

"We are just surprised the FA panel didn't contact me or my doctor until 3.55 on Sunday afternoon," the Sunderland manager said. "I have never in my career been put in a situation like that. It was completely outside our control, but it was in our control because we knew we had to make the correct decision for the player and for the football club."

However, the Football Association has since sought to clarify the situation surrounding van Aanholt. "This cardiac screen was not conducted as part of the FA's cardiac screening programme, therefore, the FA had no involvement in the player's referral, the screening process or the communication of the results with the club," the governing body explained.

The statement continued: "On occasion, clubs may seek independent advice on a player's cardiac health from an expert cardiologist who sits on The FA Consensus Panel. They are hugely respected and vastly experienced specialists who place the patient at the very centre of their care and their only concern will be in regard to the wellbeing of that individual."

Sunderland lost the game at White Hart Lane due to a 59th minute winner from Harry Kane. The game also saw Sunderland's on-loan winger Adnan Januzaj sent off for two bookable offences.