Both benches emptied, but before the smoke of heated emotions cleared, it happened again, after Cleveland starter Jeanmar Gomez hit Mike Moustakas in the buttocks with a pitch in the bottom of the third. This time, two Indians players, Gomez and third baseman Jack Hannahan, and manager Manny Acta were ejected.
Both sides agreed that Sanchez had no malicious intent.
"I know he didn't hit me on purpose," said Choo, who now has been hit three times already this season. "But still, I have a memory of last year."
Last June 24 at San Francisco, Sanchez was pitching for the Giants in an Interleague game against the Indians when he broke Choo's left thumb with a delivery. The injury required surgery and Choo spent 6 1/2 weeks on the disabled list.
"I hit him twice and I don't have anything against him," Sanchez said. "But if I'm going to miss, I'm going to miss in -- I'm not going to miss over the plate, and that's what happened both times."
Acta was asked if he thought Sanchez hit Choo on purpose.
"I doubt it, but he was the guy who broke his thumb last year. So, I know that Choo is a little sensitive about that," Acta said.
So when Sanchez drilled Choo in the right knee, the Indians' slugger shouted at the pitcher and gestured toward the plate.
"I said, 'Throw it over the plate,'" Choo said.
Within moments, the Indians, led by Hannahan, were running onto the field and the Royals' dugout also emptied. Players from both bullpens also raced onto the field. There was a bit of pushing and shoving with Hannahan grabbing Sanchez for a moment -- "He was just holding me back and that was it," Sanchez said -- plus a lot of milling around. But the umpires and less-agitated players and coaches quickly restored order.
That didn't last long, after the Indians scored five times in the third for a 5-0 lead.
Moustakas then led off for the Royals, and Gomez threw a low, inside pitch for ball one and then hit Moustakas.
"That's part of the game," Choo said. "We take care of each other on the team."
Moustakas really didn't expect to get hit.
"The guy hadn't given up a hit all day and they're up five runs. If he's going to hit me and put me on first, that's fine," Moustakas said. "So I really didn't think ... but after the first one on the inner half I said, 'All right, there's a pretty good chance I'm getting it,' and I ended up getting another one."
For his part, Gomez said he was just trying to pitch in and the ball moved too much.
At any rate, plate umpire Gary Darling immediately ejected Gomez. After Choo was hit, Darling had issued a warning against further mischief, but Gomez said he didn't get the message.
"I believe he's trying to protect his teammate," Acta said. "He went overboard a little bit on that one. First of all, there was a warning in place. Once you hit a guy, you're going to be thrown out of the game. That early in the game, it really taxes your bullpen."
True enough, the Indians used seven relievers in the game as the Royals eventually wiped out a 9-2 deficit and only Dan Wheeler remained in the Tribe's bullpen.
"I thought it came back to bite 'em because, obviously, we came all the way back in the game and they burned their whole bullpen almost," the Royals' Billy Butler said. "I feel like that's the last thing you want to do when you're down by five is awaken the beast and make him mad."
With Gomez thumbed out, emotions were re-ignited and players rushed into the center of the infield with Hannahan again in the middle of the action. This time, there was a scrum of players scuffling near first base with Royals manager Ned Yost grappling with Hannahan in the midst of it. Acta succeeded in pulling Hannahan away from Yost as a peace-maker.
"I got nose-to-nose with Hannahan," Yost said. "In those situations, my job's not to fight. My job's to break it up. Hannahan was there, and I just grabbed him. That was it."
Order was again restored, albeit not quite so quickly, and the umpires also ejected Hannahan. Josh Tomlin came in to replace Gomez and, as play was about to resume, the umpires noticed Acta was still in the Indians' dugout and told him that he also was ejected.
If there was any satisfaction in all this for Choo and the Indians, it was that they turned the third into a five-running inning and knocked Sanchez out of the game.
This was the third time that Choo had been hit by a pitch this season and he'd also approached the mound after ducking out of the way of a pitch from Toronto's Luis Perez. So the Indians' slugger is, as Acta said, sensitive about such matters.
"I didn't think he was going to act that way. We're professionals, you know," Sanchez said. "If he knew the situation; I've got a guy on first, how am I'm going to hit somebody? You've got to act like a professional and take the base, it's not like I hit him on purpose."
In the end, beyond clearing the benches and causing some unpleasantness, the incidents sparked no pitched battle.
"Everybody did a good job of keeping their heads and composed and really realizing that, at the end of the day, baseball's the most important thing," Moustakas said.
Choo got the final say on the matter. After the Royals rallied to tie the game at 9 on Yuniesky Betancourt's home run in the eighth inning, Choo smacked a two-run double in the 10th for an 11-9 Indians win.
Dick Kaegel is a reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.