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Miami quarterback Tua Tagovailoa was concussed again as the Dolphins lost 31-10 against the Buffalo Bills.
The 26-year-old went into the 'fencing position' that usually signifies concussion following a tackle by Damar Hamlin.
Tagovailoa has a history of concussions and was diagnosed minutes after leaving the field.
In the 2022 season he suffered three separate concussions including in successive weeks.
Bills running back James Cook scored three touchdowns to take their record for the season to 2-0.
Before being forced off, Tagovailoa completed 17 of his 25 attempted passes for 145 yards - including a touchdown for De'Von Achane - but had three passes intercepted.
Wide receiver Tyreek Hill, who was detained by police before the Dolphins' season-opening win against the Jacksonville Jaguars last Sunday, played in the Dolphins' defeat.
Following the incident, which took place hours before scoring a touchdown in the 20-17 win against the Jaguars, Hill called for the police officer who detained and handcuffed him to be fired.