My questions would be did the runner go after the fielder and was there intent to injure. If the runner went after the fielder it is an intentional collision and the runner should be called out. If there was intent to injure then the runner is both out and gone. By calling this quickly and loudly you will defuse a potentially nasty situation. It comes down to judgement. Additionally this will occur in adult recreational ball more than anywhere else and adults are bad about it.
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