Everton midfielder Andre Gomes suffered a serious ankle injury which left Tottenham's Son Heung-min in tears and overshadowed the home side scoring a 97th-minute equaliser to earn a vital point.
Gomes, 26, was tackled from behind by Son and appeared to be injured by an awkward fall which prompted an anguished reaction from players and fans close to the incident.
Son was sent off by referee Martin Atkinson as Portugal international Gomes received extensive treatment in a lengthy delay and was eventually taken off on a stretcher.
Former Everton winger Pat Nevin, who was the analyst for BBC Radio 5 Live at Goodison Park on Sunday, described the incident as "horrible".
"Players looked devastated and there was utter confusion - players with their heads in their hands," the former Scotland international said.
"Son was distraught before he was sent off, and Serge Aurier couldn't watch and was praying.
"Gomes was led straight to the corner to the ambulance to take him to hospital."
The atmosphere around Goodison Park darkened as the football became secondary to Gomes' plight, until the mood was lifted by substitute Cenk Tosun heading in from close range.
Earlier, Spurs midfielder Dele Alli's clinical finish had livened up a dull game where the video assistant referee again proved a controversial talking point when Everton were denied what looked like a penalty.
Spurs, without a league win on the road since January, seemed set to take all three points when Alli punished a loose pass from Everton's Alex Iwobi to fire in.
Moments later, Alli looked to have handled in the Everton box but, after a three-minute delay peppered with boos from supporters, a penalty was not given by VAR.
Everton eventually equalised deep into the 12 minutes of stoppage time following Gomes' injury, with the draw moving Marco Silva's side three points clear of the relegation zone.
Spurs were set to move eighth with a rare away win, but instead are 11th in the middle of a pack of 13 teams separated by just six points.
Tottenham manager Mauricio Pochettino sent his "best wishes" to Gomes, adding "the most important thing is he recovers quickly".
Son initially looked set to be given a yellow card for the challenge before referee Atkinson changed his mind and reduced Spurs to 10 men for the rest of the match.
Pochettino said it was "not important" whether Son should have been sent off or not, although added he did think his player was given a red card because of the "consequence" of the challenge.
"It was a normal action with the bad luck that Andre was injured," he told BBC Sport.
For the first hour of the match, there was very little to talk about as both teams illustrated why they are struggling in the bottom half despite each holding much loftier ambitions.
So it was once again left to the farcical nature of VAR to give fans leaving Goodison Park something to complain about.
Shortly after Alli put Tottenham ahead, the Spurs midfielder looked to have handled in his own box when jumping to challenge Yerry Mina at an Everton corner.
Initially it looked innocuous - and certainly accidental - but replays suggested a penalty would be given as, judging by the letter of the law, his arm was raised above his head.
Loud boos were heard from the Goodison crowd as VAR watched 26 replays in a wait lasting almost three minutes.
Eventually it was decided that the original 'no penalty' decision should stand, leaving the players, managers, supporters at the ground and television viewers alike confused.
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