American Simone Biles fell out of medal contention in the women’s artistic gymnastics balance beam final on Monday at the Paris Olympics.

Italy’s Alice D’Amato finished a solid routine to earn a score 14.366, with a difficulty score of 5.800 and an execution score of 8.566, for her first Olympic gold medal.

China’s Zhou Yaqin earned silver thanks to a strong finish. She started off the competition with a clean routine, adding many connecting elements to boost her difficulty score.

The 18-year-old gymnast lost her balance at one point, but she was able to stay on the beam to earn her a 14.100.

Zhou finished a close second behind Biles at the World Championships in Antwerp.

Another Italian gymnast, Manila Esposito, completed the podium in Paris with a score of 14.000.

Biles slipped and fell off the apparatus at the end of her acrobatic series, unable to complete the last flip.

She was able to finish her routine and stick the landing, and the 27-year-old was tied for fourth.