CLEVELAND -- The Indians have dealt with their share of injuries this year. With Mike Clevinger already on the 60-day injured list with an upper back strain, the last thing the Tribe needs is to lose another key piece of its starting rotation.

After Carlos Carrasco cruised through three perfect frames, he took a tumble during the fourth inning of Tuesday’s 3-1 loss to the Marlins while covering first base on a ground ball to Carlos Santana, hitting his left knee on the way to the ground after colliding with Neil Walker. Carrasco was pulled from the game after the fourth inning due to left knee discomfort and was sent for a precautionary MRI.

“He kind of bruised it, you know. He fell on it, but he initially felt it in the back,” Indians manager Terry Francona said. “So that’s why medical people felt like let’s just rule everything out and hopefully it’s just being precautionary, but we do want to get him checked out.”

When Carrasco first got back up to his feet from the somersault at first base, the 32-year-old had a bit of a limp. He was looked at by the team’s medical staff on the mound and, after throwing a few warmup pitches, was given the green light to stay in the game. But as the Indians came up to hit, Neil Ramírez began warming in the bullpen and Carrasco was not sent back to the mound to start the fifth inning.

“Well, he threw the first pitch and it didn’t look great, but he goes, ‘I’m fine,’ and I said, ‘Hey, you need to be honest with us,’” Francona said. “And then after that inning he came and said, ‘I’m getting tight,’ so we got him out of there.”

Carrasco has struggled to get into a consistent groove so far this season, pitching solid outings every other start. But Tuesday was setting up to be the first time he would toss consecutive gems all year -- allowing just two hits with four strikeouts through four frames -- and the team could’ve used it. Ramirez gave up a solo home run to Jorge Alfaro on the first pitch he threw after replacing Carrasco, then he allowed two more runs to score in the fifth.

“Obviously, [Carrasco] was pitching really good right there and you’re not expecting to come into the game,” Ramirez said. “But I saw what happened, and when you see him slow to get up, you’re ready as a bullpen guy for something happening, so it’s not an excuse for anything that happened. I had plenty of time to get ready. I just didn’t pitch well.”

In 10 innings this year, Ramirez has a 7.20 ERA, which is the second-worst ERA in the Tribe’s bullpen, better than only Oliver Perez (7.94 ERA).

“I think guys know right now that I’m having a hard time commanding my slider and so I think a lot of guys are just sitting on my fastball,” Ramirez said. “I know [Alfaro is] aggressive. The scouting report says he’s aggressive. I think he’s only seen two or three pitches per plate appearance. I played right into their hand. I just have to be better.”

The Indians’ offense was held hitless through five and scoreless through six by Marlins starter Pablo López, who had gone 0-3 with a 6.14 ERA in his last three starts. The Tribe's lone run of the evening came on a Tyler Naquin single to center field in the seventh, knocking in Carlos Gonzalez. Gonzalez has now hit safely in each of his six games with Cleveland since being called up on April 14. The Indians' three hits gave them their fourth game of the year with three or fewer hits, which is tied for the most in the Majors.

“Oh, man, he’s got a good fastball,” Cleveland catcher Roberto Pérez said of Lopez. “We haven’t seen that guy. It was his night tonight. He attacked us, he got ahead of us and we just couldn’t capitalize with men in scoring position or whenever we had something going. You gotta tip your hat to him and come back ready to play tomorrow.”