Following Egan Bernal's abandon of the Criterium du Dauphine before the start, an early crash during stage 4 forced Emanuel Buchmann (Bora-Hansgrohe) and Steven Kruijswijk (Jumbo-Visma) to also quit the race.
Bora-Hansgrohe also lost Gregor Muhlberger, who went down hard in the same crash on the descent of the Col de Plan Bois after just 29km of racing. Thibaut Pinot (Groupama-FDJ) was also caught up in the crash but continued in the race.
The loss of Bernal, Buchmann and Kruijswijk means that three of the top four finishers of last year's Tour de France have been forced to quit the Criterium du Dauphine, with concerns about how their injuries will affect their form for this year's Tour de France which is due start in exactly two weeks on August 29 in Nice.
Jumbo-Visma revealed that Kruijswijk suffered a dislocated shoulder. Photographs from the race showed him holding hid left arm in pain a race sat with him. He also suffered a deep cut on his left elbow.
Buchmann was helped to his feet by a member of the Bora-Hansgrohe team staff, while Muhlberger sat in a field before also getting to his feet.
Geraint Thomas revealed that Bernal had decided to abandon the Dauphine due to a back problem.
"He's got a bit of a bad back and the best thing for him is to just take it easy. It's such a short turn around to the Tour that it's important he gets it 100 per cent right and be good then," Thomas said before the start of the mountain stage to Megeve.
"I don't think it's a major issue; it's just better to be on the side of caution. He's had two races before this as well, so he's got the racing that he needs. It's just about making sure that everything is 100 per cent there and that there are no issues."
More to follow.