Superstar fullback Joseph-Aukuso Suaalii was knocked out in the first half as the Reds turned a 14-point deficit into a stirring 28-21 derby win at Allianz Stadium.
Suaalii was wiped out after an accidental knee to the jaw from teammate Andrew Kellaway as the pair collided in a tackle on Reds centre Filipo Daugunu.
Wallabies coach Joe Schmidt was among the concerned onlookers watching as the code-hopping weapon was treated for several minutes before being taken from the field on a medicab.
"It's a head knock that's made him fairly groggy," Waratahs coach Dan McKellar told Stan Sport at halftime.
McKellar was left feeling equally lousy an hour later after his Waratahs suffered their first home defeat of the season to remain anchored in third-last position three games out from the finals.
Adding insult to injury, the friendly fire mishap between Suaalii and Kellaway happened with Queensland on a penalty advantage.
The Reds scored 30 seconds later through hooker Richie Asiata to level the match 14-14 moments before the halftime break.
NSW had made a blazing start, defying driving rain to jump to a 14-0 lead with tries to centre Henry O'Donnell and halfback Jake Gordon in the opening 20 minutes.
Queensland worked their way into the contest when skipper and scrumhalf Tate McDermott danced his way over from a quick tap when the Waratahs were a man down.
Prop Daniel Botha was yellow carded for a tip top tackle on Reds lock Josh Canham.
Tensions had already boiled over between the two fierce rivals, with Waratahs front-rower Angus Bell having to intervene to prevent a scuffle between opposing locks Miles Amatosero and Lukhan Salakaia-Loko.
Canham also found himself yellow-carded early in the second half for a dangerous tackle on returning Waratahs hooker David Porecki.
The Reds also leaked points while a player short, with powerhouse prop Taniela Tupou capping a mighty performance with his first try for the Waratahs that broke the second-half deadlock in the 51st minute.
Tupou's joy didn't last long before he, too, was yellow-carded for a head-on-head clash with Queensland centre Dre Pakeho deemed foul play by the TMO.
Again, the one-man advantage proved profitable as replacement hooker Josh Nasser touched down off a driving maul from the ensuing penalty to lock the game up with 11 minutes remaining.
McKellar could only shake his head in disbelief when Kellaway had the chance to put Darby Lancaster over for a potential match-winner, only to send the pass to the replacement winger's bootlaces.
The coach's anguish turned to downright despair barely a minute later when Reds winger Lachlan Anderson reeled in a pinpoint cross-field kick from Daugunu to score the winner down the other end.
Queensland's victory consolidated their fourth-place standing, maintaining hope of a top-three finish and an all-important home final.
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