The first time was in Week 1. Newton was recovering from fractured ribs and the Panthers opted in a game-time decision to go with backup Derek Anderson to give the injury another week to heal.
That's probably the best -- and maybe only -- option for Sunday's game, too.
Newton suffered two transverse process fractures in his lower back on Tuesday when he was involved in a car accident in which his vehicle rolled multiple times. The injury is similar to the one Dallas quarterback Tony Romo suffered earlier this season in a Monday night game against Washington.
Romo didn't play the following week against Arizona. Panthers team officials didn't sound optimistic that Newton would be ready this week.
Where this is significantly different from Romo's situation is that Newton is a running quarterback. He has taken more than twice as many hits as any other quarterback since coming into the league in 2011. The read-option is a big part of his game and Carolina's game plan with him.
Newton ran 12 times, 10 on designed plays, for 83 yards in Sunday's 41-10 victory over New Orleans in which the Panthers ended a seven-game winless streak. It's hard to imagine putting that many -- if any -- designed runs into a game plan against Tampa Bay with a quarterback in Newton's condition.
There might not be that option. Newton is being kept overnight at Carolinas Medical Center for observations after undergoing tests. Nobody knows how sore he will be on Wednesday morning or in the days to come.
Nobody knows for sure when he will be released from the hospital.
The Panthers can't wait days. Despite a 4-8-1 record, they are only a half-game behind Atlanta (5-8) and New Orleans (5-8) for the NFC South lead with three games to play. They have to begin putting in the game plan as though Newton won't play.
Anderson is more than capable. He completed 24 of 34 pass attempts for 230 yards and two touchdowns in the opener at Tampa. He knows the system and knows the Bucs (2-11), who trailed 17-0 until midway through the fourth quarter of that game.
The Panthers need to win out to have a shot at the playoffs. They need their franchise quarterback, who was coming off his best game of what has been his worst season.
But they need Newton more for the long haul, just as they indicated before the opener.