A Copa America referee refused to shake hands with United States captain Christian Pulisic after the 1-0 defeat to Uruguay.
Matias Oliveira scored the only goal of the game in the second half at the Arrowhead Stadium in Kansas City, Missouri.
It was a third win out of three for Marcelo Bielsa's Uruguay, who have emerged as one of the favourites for the tournament.
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The United States crashed out of the competition at the group stage following the loss.
There were a series of bizarre refereeing decisions from, Kevin Ortega, the man in the middle.
He appeared to give Crystal Palace defender Chris Richards a yellow card for a foul yet also allowed a quick free-kick to be played in the same phase of play, much to the confusion of the US players.
He did not play an advantage later on when Pulisic had the ball.
There was also a suspicion of offside for the winning goal, scored by Oliveira.
At one point Pulisic was seen screaming in the face of the official and then at the end of the game, appeared to sarcastically imply they should be celebrating with the opposition.
Still absolutely seething, the AC Milan winger went over to the officials and offered a handshake but Ortega, refereeing just his eighth international fixture, refused.
His two assistants did shake Pulisic's hand but Ortega kept his arms behind his back and was unmoved while the former Chelsea star extended a handshake.
The hosts are out and there have been calls for manager Gregg Berhalter to be replaced.
He believes he is still the right man to take the nation forward despite the shortcomings.
"We're going to do a review of the whole tournament and then see where we fell short," Berhalter said, as per Yahoo Sport.
"It's obvious that the Panama game hurt us, put us behind the eight ball. I think collectively the staff, the players, the sporting department, we need to look at where do we improve? How do we do better?
"It's not the aspirations that we have as a group. We know it's a talented team with big potential and we didn't show it in this tournament."
Topics: Copa America, United States, Uruguay
Josh Lawless