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The 20-year-old, the youngest member of Great Britain's cycling team, seemed set to win Paralympic gold on his Games debut, leading Slovakia's Jozef Metelka by a wide margin and looking to add to his world championship title.
However, with just 500 meters remaining, Atkinson began to show signs of fatigue. He lost his balance on a corner and fell off his bike. The impact caused the bike to hit the back of his head as he fell at high speed.
He had to be assisted off the track in front of a shocked crowd at the Paris velodrome. BBC Sport has been informed that while Atkinson will be evaluated by the British Cycling medical team, he has not sustained any serious injuries.
"I think I'm okay," Atkinson told Channel 4. "I can see and I'm all in one piece, so I'm happy. I've never pushed myself that hard before, and it showed. I just ran out of energy and went down."
The day before, Atkinson had competed in the men’s C4-5 1,000m time trial, finishing in fifth place.
Earlier on Saturday, the Cheshire rider had delivered an exceptional performance in qualifying, shattering the world record with a time of 4:17.700—five seconds faster than the previous record.
He had beaten Metelka in the qualifier, but in the final, it was the Slovakian who secured the gold by maintaining his position and riding past the fallen Atkinson in the final moments.
Atkinson was awarded silver for reaching the final, despite not finishing the race, and he was well enough to collect his medal on the podium and wave to the cheering crowd.
"It's been amazing," he said. "It feels a bit unreal. I’m very proud and happy. A Paralympic record and a silver medal—I wouldn’t have believed it in my wildest dreams."
Gatien le Rousseau won bronze for France, defeating compatriot Kevin le Cunff.
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"Heartbroken" Van Gass Criticizes Factoring System
Jaco van Gass faced disappointment after failing to win a medal in the men’s C1-3 1,000m time trial, despite setting two new world records.
Van Gass broke the C3 record with a time of 1:04.825 in the final, surpassing his own morning session benchmark. However, due to the classification system used at the Paralympics, he was competing against riders from the C1 and C2 categories as well. Three of these riders recorded faster times in the final.
Li Zhangyu and Liang Weicong secured a one-two finish for China, with Zhangyu taking gold and Liang silver. France’s Alexandre Leaute earned bronze, marking his second medal of the Games.
Li and Liang are C1 riders, classified by the UCI as having the most severe disabilities, while Leaute is C2, and van Gass is C3. The final times of the Chinese riders represented 92.01% of the time it would take them in the C3 category, while Leaute’s was 94.5%.
Van Gass’s time remained unchanged. Had all riders’ times been applied without factoring, Van Gass would have won gold.
He has called on the UCI to review the Paralympic classification and factoring system as he voiced his disappointment at missing out on a medal.
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BBC Sport has reached out to the UCI for a comment.
Van Gass still has the mixed team relay on Sunday and the road race events next week.
"I need a good recovery," he said. "I didn’t get much sleep last night because I was too excited. I need a good night’s sleep and maybe a massage before we go again with the other two events."
The 36-year-old British Army veteran won the men’s C3 3,000m individual pursuit final on Friday, just a week after his participation in the Games was in doubt due to being hit by a car during training.
Earlier, GB’s former C1 world champion Fran Brown failed to advance from qualifying in the women’s C1-3 500m time trial. Making her Paralympic debut, Brown finished eighth fastest, with only the top six moving on to the medal races.
It was also disappointing for Blaine Hunt, who couldn’t follow up on his C4-5 time trial silver from Friday. Hunt, 35, did not reach the medal races in the C5 4,000m pursuit, finishing seventh in qualifying.