Samoa centre George Pisi has been cited over his tip tackle on Tommy Bowe during last Saturday's international against Ireland at the Aviva Stadium.
The incident a minute before half-time was spotted by referee Steve Walsh, who sin-binned the player.
Pisi's hearing will take place in London on Tuesday. Also attending will be Japan number eight Ryu Koliniasi Holani, who was yellow-carded for a dangerous tackle during the defeat to Scotland at Murrayfield on Saturday.