WATCH: Circus Elephant's Fall in O.C. Stirs Hot Debate

Two days after tumbling off a ramp leading to a train car in Orange County, Sarah the elephant seemed calm while grazing with her pack in a portable circus pen in Ontario.

Officials with Ringling Bros. and Barnum & Bailey Circus said the 54-year-old pachyderm suffered only minor scrapes in the incident that prompted Animal Defenders International to call for the animal to be removed from the road and examined.

ADI filed a complaint with the USDA, which monitors the health and welfare of animals in the entertainment business. The group says Sarah fell because she is sick.

Ringling Bros. said the Asian elephant is healthy but simply stumbled.

The fall happened shortly after the elephant performed Sunday in Anaheim and was boarding a train headed to Ontario.

Sarah walked up the ramp and “got into a little bit of a bad angle,” said Brian French, elephant manager with Ringling Bros. “So she had to back up to reset herself, and as she was backing down the ramp, she misstepped with her foot and went off the side a short step. But it was in the gravel, so she lost her footing and had to go down on her knees.”

Earlier this year, the USDA cited Ringling Bros. for failing to adequately treat Sarah for a pus-like discharge present during urination, a violation of the Animal Welfare Act, reports Sign On San Diego. Official USDA documentation alleges that despite diagnosis by a senior veteranarian for Sarah's infection, animal handlers ignored the recommended treatment and insisted that her problems stemmed from a chronic (yet undocumented) fistula that was under control.

ADI said several eyewitnesses reported the elephant was having trouble walking.

According to a witness account ADI forwarded in its complaint to the USDA, “I walked with the elephants the whole way, and the elephant who fell was last in line, her back legs didn’t seem to be moving right, she looked weak, like she had arthritis or pain that she was dealing with and she was walking funny the whole time."

“It’s undeniable that she fell,” said Matt Rossell, campaign director for Animals Defender International. “The question is what caused it.”

Rossell pointed to the USDA report citing the circus for not properly treating the animal.

Ringling Bros. disputes the USDA report. Circus attorneys are reviewing the report and will produce evidence showing that caretakers have been treating the condition, said Chris Reichert, West Coast public relations manager.

A veterinarian regularly checks Sarah, he said. After the fall, two vets checked her, officials said. French said he spent the next few days with Sarah to make sure she was not seriously injured.

“She has been eating and drinking normally,” said Ringling Bros. vet tech Jessica Hyman. “She’s not exhibiting any signs of pain or lameness or illness of any sort. She looks great.”