Every operation I do as a neurosurgeon starts the same way. Before the incision, the whole team stops. We confirm the patient’s name, the procedure, the side, and in spine surgery, the level. Nobody picks up a scalpel or hands over an instrument until everyone in the room agrees. At that moment, anyone can ask any question. It’s encouraged. It stops confusion from developing later in the case when the surgical moments may have more intensity.

College football just showed why pauses like that matter.

On Saturday night in Provo, Utah, No. 8 BYU beat No. 2 Notre Dame 28-24. With four seconds left, CJ Carr’s pass to Jaden Greathouse in the end zone fell incomplete. Several replays showed 0:01 on the clock when the ball hit the ground. The replay booth cleared it anyway. Fans stormed the field, and the game was over.

Hours later, the Big 12 said publicly that “time remained on the clock when the ball hit the ground and the play was incorrectly cleared by the replay officiating crew.” The conference promised “a complete review of the end-of-game officiating process.”

A Notre Dame Fan’s Disclaimer

I am a Notre Dame fan . BYU won. The Cougars made the plays. Notre Dame did not at crucial moments. One extra snap from inside the 10 guarantees nothing. There was also a debate over pass interference on the last throw, but that is a judgment call.

The clock is not a judgment call. It is a fact that can be checked. When a system fails to check a fact in a standard way, that is a process failure. Medicine has spent 25 years learning how to improve those processes.

Michigan Already Ran This Experiment

This is 2026’s second major end-of-game clock error. In Week 1, Michigan trailed Western Michigan 12-7 when Bryce Underwood’s Hail Mary sailed out of the end zone. NBC’s clock showed zeros. The Big Ten replay crew, using a different clock feed, put one second back . Michigan scored on the next snap and won 13-12.

On Sept. 16, the NCAA’s FBS Oversight Committee agreed that replay protocols were not followed and that, had they been, “the outcome of the game would have been different.” It could not overturn the result. Under Rule 1-1-3-b, “When the referee declares that the game is ended, the score is final.”

So in Week 1, replay added a second that should not have been there. In Week 7, the system failed to restore one that should have been. Opposite errors, same root cause.

What The NCAA Rulebook Actually Requires

The 2026 NCAA Instant Replay Case Book tells the booth to “be aware when the clock runs out and whether time should be restored.” At the end of a half, the booth must “confirm with the on-field officiating crew that replay has cleared the last play.”

Awareness is not verification. Under collaborative replay, a command center official confirms the booth’s decision to clear “scores and turnovers.” The end-of-game clock is not on that list.

What is missing is a required, independent read of the clock before the referee declares the game over.

The NFL is not a model either. Since 2016, the game clock has been reviewable . But at the end of a half, a timing error counts only when “more than one second should be put on the clock.” Even the NFL could let a 0:01 miss stand.

Surgical Time-Out Is A Hard Stop

Checklists started in aviation, after Boeing’s Model 299 crashed in 1935. In a 2009 New England Journal of Medicine study , the WHO Surgical Safety Checklist cut inpatient deaths from 1.5% to 0.8%. The Joint Commission’s Universal Protocol requires a final time-out before incision with the whole team taking part. The procedure does not start until every question is resolved.

A football booth checklist would be short:

  • Freeze the frame when the ball is dead and read the official embedded clock.
  • Two independent reads. The replay official and the command center each confirm the time.
  • Read-back to the referee before anyone declares the game over.
  • No final whistle until it is done. But can a field rush can wait 20 seconds?

This is the real question. In medicine, accountability has a name. The attending surgeon is the captain of the ship and owns the outcome. The time-out is led by a named person and documented in the chart. Anyone in the room, including the newest nurse, can stop the line.

When something goes wrong, the error is reported and presented at morbidity and mortality conference, where surgeons review their own complications before peers.

College football generates billions.

So, who really owns the clock and outcome in Provo? Is it the replay official? The communicator? The command center? The referee who declared it final? What role does the Big 12 have other than saying they made a mistake that can’t be undone? Today the honest answer is basically some shade of everyone, which means no one.

College football needs to fix that.

Accountability does not mean scapegoating one official. Medicine uses a just culture , which AHRQ describes as fixing the system issues behind errors while keeping “zero tolerance for reckless behavior.”

The Big 12 deserves credit for admitting the error overnight. In a twist Michigan fans will appreciate, the University of Michigan Health System moved from “deny and defend” to full disclosure, and a 2010 study found that claims, lawsuits and liability costs all fell. Honesty built trust.

Notre Dame fans will get over this one as long as they beat Miami... The real question is whether college football treats two game-changing clock errors in seven weeks as bad luck or as a warning for their structure overall. Surgeons learned that answer the hard way. Football doesn’t have to.