Namibia number eight Renaldo Bothma has been cited for a dangerous tackle by independent Citing Commissioner Maurizio Vancini.
Bothma was cited for an alleged act of foul play contrary to Law 10.4(e) during the Rugby World Cup Pool C match against Georgia in Exeter.
The incident in question was the subject of a yellow card during the match.
The hearing will take place at 10:00 on Friday, 9 October at the offices of RWC 2015 official law firm Clifford Chance in London.
The case will be heard by independent Judicial Officer Alan Hudson (Canada).