For the second match in a row, Cesare Prandelli put out a side ill-suited to the task at hand and Italy paid the price.
For the second match in a row, Mario Balotelli was poor, Claudio Marchisio was worse, and the referee was worse than both put together.
Italy were lined up in a 3-5-2, with Giorgio Chiellini joined in the middle by his Juventus teammates Andrea Barzagli and Leonardo Bonucci. Matteo Darmian and a clearly crocked Mattia De Sciglio were the wingbacks, and the midfield composed of Andrea Pirlo, Marcisio, and Marco Verratti, leaving Italy vulnerable to thrusts through the middle.
It quickly became evident that this wasn't going to work. Uruguay's midfield pinned down Pirlo and Verratti, and there was little the rest of the squad could do to make up for the creative loss. Balotelli was frustrated from the first whistle, and Immobile was stranded without any form of service. It made for an ugly affair for Italy, especially when decision after decision from the referee went against them.
Then Prandelli started making subs, and things went from bad to worse.
First he hauled off Balotelli for Marco Parolo, announcing to the entire world that he intended for Italy to hold out for a scoreless draw to advance rather than go for a goal to force the issue. Parolo offers little going forward, and was mostly anonymous once he came on. Balotelli hadn't been good and was looking likely to pick up a second yellow card, but was still far and away the best chance Italy had to score.
Prandelli's other subs did no more good. Hauling off Immobile for an off-the-pace Antonio Cassano was an idiotic decision at best, as Cassano has offered Italy nothing but turnovers and a complete lack of presence up top since the roster was finalized. Taking of Verratti in the 75th minute was understandable as he'd taken a knock early in the second half that was clearly affecting his play, but putting on Thiago Motta, who has also been a big pile of uselessness in recent international play, was not a helpful move for Italy.
Things went from bad to worse for Italy at the hour mark, as Marchisio was sent off in another questionable decision by the referee. Marchisio hit the shin of Arevalo Rios with a high boot while trying to keep possession of a loose ball, but replays showed that he was clearly trying to avoid contact, actively pulling his foot and his upper body away from Rios, not trying to break his leg or something equally as heinous. He was stupid for putting his boot so high while trying to wrangle the ball, yes, but there was no intent to harm there. The ref didn't see it that way, however, and sent Marchisio off without a second thought.
In the 81st minute, everything that had been cracking apart for Italy finally broke, as Diego Godin got free in the box on a corner and headed the ball in after being left utterly unmarked by any of Italy's defenders. It was a fitting nail in Italy's World Cup coffin, one last big mistake and lapse in concentration sinking any hopes they had left of making the knockout rounds.
The incident that everyone will be talking about for weeks, though, came just a minute before the goal. Uruguay striker Luis Suarez was running in the box with Chiellini, then inexplicably reached over and seemed to bite the defender on the shoulder. Chiellini immediately swung an elbow at Suarez to get him away, then went down holding his shoulder and trying to show the ref the mark that Suarez had left with his teeth. While some initially thought it may have "just" been a headbutt, a later replay clearly showed Chiellini's shirt being pulled away from his shoulder, and there's only one way that happens: Suarez bit him.
It's shocking. Utterly shocking. But somehow from Suarez, this is the third time this has happened. Just fourteen months ago he bit Chelsea defender Branislav Ivanovic under similar circumstances, and several years ago bit another player while he was with Ajax. It's an incomprehensible situation to be in for a player to have bitten another player not once, but three times during the course of his career.*
*ed. note: I'm a Liverpool fan, but I can in no way defend what he did. I've generally avoided it after past incidents, but now there's just no way to come anywhere even close to a defense or explanation.
That incident will take the headlines from this match, but it didn't change the fact that Italy were hideously poor for the second straight match. After playing like this in the group stage, they didn't deserve to go through, and that hurts to say.