Bills running back C.J. Spiller was carted off the field in Cleveland after suffering an apparent shoulder injury in the first quarter.
Spiller caught a short pass from quarterback Ryan Fitzpatrick and was injured at the end of a 25-yard play.
With Fred Jackson already out with a knee injury, Tashard Choice assumed the feature back role for the Bills. Spiller, who entered Week 3 averaging 10.1 yards per carry, left the game with four carries for 16 yards and two receptions for 42 yards and a touchdown.