San Francisco 49ers quarterback Alex Smith has not received medical clearance from team medical director Dr. Dan Garza to return from a concussion and will not play against the Chicago Bears on Monday night, ESPN's Chris Mortensen reports.
Smith is believed to have sustained his concussion while attempting a quarterback sneak on a fourth-and-1 play in the second quarter of last Sunday's 24-24 tie with the St. Louis Rams. Smith remained in the game for several plays, completing a 4-yard touchdown pass to Michael Crabtree before exiting the game after displaying symptoms of a concussion.
Smith was able to practice in advance of Monday night's game, but did so on a limited basis, wearing a black, "no-contact" jersey.
With Smith out, the 49ers will start 2011 second-round pick Colin Kaepernick against the Chicago Bears on Monday night and No. 3 quarterback Scott Tolzien will be active in a backup role. Kaepernick completed 11 of 17 pass attempts for 117 yards with eight rushing attempts for 66 yards and a touchdown in the tie against the Rams. On the season, the 6-foot-5, 233-pound Kaepernick has completed 16 of 26 attempts for 206 yards with 177 yards and three rushing touchdowns while playing in 16 percent of the 49ers' offensive snaps.
Kaepernick will be making his first NFL start against the Bears, who will also have a backup under center. Even before the Bears began practices for Monday night's meeting with the 49ers, head coach Lovie Smith ruled Jay Cutler out for the game due to a concussion he sustained in the second quarter of a 13-6 loss to the Houston Texans last Sunday night. Like Smith, Cutler remained in the game for around a half-dozen plays before his concussion was discovered at halftime. Former Washington Redskins and Oakland Raiders quarterback Jason Campbell will make the start for the Bears, who signed veteran Josh McCown to serve as the backup while Cutler works his way through the league's concussion protocol program.
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