Carlos Huertas has been ruled out of the 99th running of the Indianapolis 500 with an inner ear condition.

The 23-year old Colombian had been scheduled to start from the outside of row six in Sunday's event, but IndyCar medical consultant Dr Terry Trammell ruled that he would have to undergo further evaluation before being cleared to return to competition after the ear complication was detected.

Huertas, who was to have driven the #18 Dale Coyne Racing entry, will now miss the remainder of the 500's on-track activities, including today's Coors Light Carb Day practice and the race itself on 24 May.

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The Coyne team is expected to announce Huertas' replacement shortly, but the #18 car will be moved to the last row of the 33-car field, starting 32nd based on entrant points.

Already lining up at the back is the second Dale Coyne Racing car, the #19 entry, which has also been demoted as a result of a driver change.

James Davison will be at the wheel of that car for the race, but a prior commitment to the Nissan Motorsports GT-R GT3 car in the Pirelli World Challenge race in Mosport, Canada last weekend meant that he was unavailable for qualifying and so the team brought in French driver Tristan Vautier to make sure the car made the race.

The problem for the team is that with so little time left they need someone with current IndyCar experience at IMS as there is no time for refresher or familiarisation programs for whoever steps in. Only Vautier or Buddy Lazier (who tried to qualify for the race by failed to make it onto the 33-car grid in the final 'bump' session last Sunday) seem viable options at this point.

Vautier was still present at Indianapolis Motor Speedway on Friday, dubbed 'Carb Day', the last opportunity for teams to shakedown the cars on the track before Sunday's race. He was seen heading to a morning meeting with Dale Coyne Racing representatives, even though it had previously been understood that he had a prior commitment in Europe racing a Ferrari 458 Italia GT3 for the Akka-ASP team in the Blancpain Endurance Series.

UPDATE: Vautier will take part in Friday's Carb Day practice session and is included in the latest revised starting grid released by race officials at 10.50am local time (3.50pm BST). No further confirmation has yet been given by the team.

Vautier was one of the names suggested as a stand-in for James Hinchcliffe who is ruled out of competition after surgery earlier this week for upper left thigh and pelvic injuries sustained in a violent practice crash on Monday. Hinchcliffe is now out of intensive care and expected to make a full recovery.

Hinchcliffe's seat will now be taken by Australia's Ryan Briscoe, who will also start from the back row of the grid on Sunday in what had been one of the most fluid and unpredictable starting grids seen in recent years for the greatest spectacle of motorsports.