The hit led to a stoppage in action while Stewart, with blood streaming down his face, had to be held back multiple times by Detroit personnel as he tried to confront James. The incident occurred with 9:18 remaining in the third quarter and the Lakers trailing 79-67.
Stewart was initially whistled for a loose ball foul on the play. Following an official review, James was assessed a flagrant foul 2 and ejected, Stewart was assessed two technical fouls and ejected and Lakers guard Russell Westbrook was called for a technical foul.
After the game, crew chief Scott Foster said Westbrook was deemed to be "an escalator and not a peacemaker" as the reason for the technical foul. Foster also said Stewart was assessed two technical fouls for "multiple unsportsmanlike acts during the altercation." Foster explained that James' penalty stemmed from "unnecessary and excessive contact above the shoulder."
"Everyone in the league knows LeBron's not a dirty guy," Lakers big man Anthony Davis said. "In fact, when he knew he hit him, as soon as he did it, he looked back at him like, 'Oh, my bad. I didn't try to do it.'"
Lakers coach Frank Vogel said Stewart initiated the contact but did not object to James' ejection.
"[James] had an elbow [from Stewart] to the rib cage, which was a foul and he was trying to shed the contact," Vogel said. "And had incidental contact that was obviously enough for a flagrant 2."
Stewart and James did not speak to reporters after the game.
"It was a tough play with Isaiah," Pistons coach Dwane Casey said. "His eye got cracked all the way open, and he was upset for a reason. So, I don't think James is a dirty player, but again, it got them going."
James finished with 10 points in 21 minutes, extending his double-digit scoring streak to 1,048 games -- the best in league history.
Davis was surprised by the retaliatory measures attempted by the Pistons' second-year center, who required five stitches after the game.
"I don't know what he was trying to do," Davis said. "But I know nobody on our team, 1 through 15, was having it. We're going to protect our brother. I've never, in 10 years, seen a player try to do that as long as I've been playing. ... It's uncalled for. You got a cut above your eye, accidental-like, it wasn't on purpose. And we weren't going to allow him to keep charging our brother like that. I don't know what he was trying to do, but we wasn't going to allow that."
Stewart attempted to bull-rush the Lakers' scrum at least three times before retreating through a tunnel behind the Pistons' bench. Detroit guard Cory Joseph positioned himself near the Lakers' bench to stop Stewart should he have emerged from an adjacent tunnel that would have led him back by the Lakers' group.
While Lakers players took exception to Joseph's presence in the moment, Foster credited him for his instincts.
"Cory was anticipating he may come around the back of house and enter the Laker bench from the opposite side," Foster said, in the pool report. "So, he was going to intercept him. I actually told Cory that would be good."
Westbrook first heard of his technical foul when asked about it by a reporter during his postgame news conference.
"Why'd I get a tech? I didn't know I had a tech. Wow. That's interesting," he said. "Well, you know, that's just being Russell, I guess. When you're Russell Westbrook, they just try to do anything, apparently. Well, whatever. ... They had to put it on somebody. I'm the easiest person to throw s--- on. Why not me?"
Westbrook could be seen squaring up in Stewart's direction while being pulled away by a member of the Lakers' security team in a screengrab from the incident that went viral.
Davis said he was reminded of the infamous "Malice at the Palace" incident between the Pistons and the Indiana Pacers that occurred nearly 17 years to the day before Sunday's fracas. The Pistons' public address announcer repeatedly urged fans to stay in their seats and stay off the court or risk being arrested as Sunday's events unfolded.
"We're back in Detroit too. So, flashbacks," Davis said. "But, yeah, I mean, the NBA security, their security, our security, coaching staff, even some players did a good job of trying to de-escalate the situation."
Los Angeles entered the fourth quarter down by 15 points but mounted a comeback to improve to 9-9 on the season. Westbrook had 15 of his 26 points and six of his 10 assists in the fourth, and Davis finished with 30 points, 10 rebounds, six assists, five blocks and four steals. The Lakers' five-game road trip continues with games on Tuesday against the New York Knicks and on Wednesday against the Pacers.
"The altercation, it could have done two things: It could have made us unravel. Or it could have brought us together, and I think it did just that. It brought us together," Lakers center DeAndre Jordan said. "We were down, we could have easily folded, let go of the rope, but we didn't. We continued to fight, and we knew, obviously, with LeBron out we had to all step it up even more."
Should James face disciplinary action from the ejection, he could miss the Lakers' lone trip to Madison Square Garden this season.
Vogel believed the win could springboard his listless Lakers team.
"To me, it's one of those things that can change the momentum of your season," he said. "To see guys rally around a teammate that just got ejected like that in a strange circumstance. Played with incredible guts."