Sunderland’s club doctor has resigned following the Patrick van Aanholt saga.

Ishtiaq Rehman handed his notice in earlier this week following the dramatic withdrawal of the Dutch full back from David Moyes’s side to face Tottenham Hotspur only 15 minutes before kick-off.

In the aftermath of the September 18 game at White Hart Lane, which Sunderland lost 1-0, Moyes said he was acting on the advice of a cardiologist from the Football Association cardiology consensus panel when he left out Van Aanholt.

Patrick van Aaholt was initially said to be withdrawn on advice of an FA cardiologist

However the FA then denied their involvement saying the cardiologist was independent

But the FA denied any involvement and insisted the Wearsiders were dealing with an independent specialist.

That lack of communication within the club, which led to the confusion, is not thought to have gone down well. Moyes, whose side sit bottom of the Premier League, revealed Van Aanholt’s late withdrawal had harmed their performance.

‘It affected the team,’ he said. ‘You’ve heard of people going over on an ankle in the warm-up and pulling out, but this was completely different.’

The confusing incident has resulted in club doctor Ishtiaq Rehman resigning from Sunderland

Van Aanholt, 26, has since played 90 minutes in back-to-back matches.

Dr Rehman joined Sunderland in June 2013, according to his LinkedIn profile.

The Van Aanholt situation is not the first time in his short tenure that the club have hit the headlines for medical reasons.

In 2014, Sunderland signed striker Ricky Alvarez on loan from Inter Milan, with an agreement that they would pay around £8million to secure his services if they avoided relegation.

The Van Aanholt saga is said to have negatively affected Sunderland, says Moyes

Despite beating the drop, Sunderland refused to pay up and claimed Inter were in breach of the agreement for stalling over knee surgery on the Argentine midfielder.

FIFA initially found in favour of the Italians but both clubs appealed against the decision and the case is currently with the Court of Arbitration for Sport (CAS).