Simon gave up three home runs and recorded just four outs before elbow discomfort ended his night, and the bullpen had to carry the rest of the game in a 7-5 extra-inning win over Texas.
Center fielder Adam Jones helped relieve the embattled bullpen by driving a two-run homer off Eddie Guardado in the 10th, and Luke Scott added a two-run double. Closer George Sherrill, who pitched a stressful inning Monday, managed to close down the Rangers (3-5) despite some shaky moments.
"I would say that's probably one of the better games I've seen as far as a team in a long time," said Baltimore manager Dave Trembley of the victory. "I'm real proud of what happened tonight. Unfortunate situation with Simon -- but other people had to step up and get it done.
"We asked an awful lot of those guys in the bullpen tonight. [We had] guys coming back on short rest, guys having to throw more pitches [and] more innings than they've thrown."
In Sherrill's case, the strain showed. Baltimore's relief ace came into a four-run game and allowed four straight hits, giving the Rangers a chance to take control. And with the potential tying run standing on first base, Sherrill gave up two straight warning track fly balls that almost ended the game decisively.
The first, by designated hitter Hank Blalock, sent right fielder Nick Markakis all the way back to the wall. The second, by right fielder Nelson Cruz, sent Jones back to a foot in front of the track. After the game, Jones said that he thought both the Blalock and the Cruz balls had a chance of leaving the park.
"I was like, 'Maybe,' because you never know with this ballpark," said Jones of the Blalock shot. "In the summer, I'm pretty sure that might get out. I think both of them might get out, but good thing we played here in April."
"The Cruz ball, I thought was gone," added Sherrill of the twin deep fly balls. "Blalock, I thought he got under it too much. But luckily, Cruz hit it to the biggest part of the park -- or one of them."
Simon gave up a home run to Michael Young, the second batter he faced. He also served up homers to Cruz and Chris Davis in the second inning, causing shortstop Cesar Izturis to summon Trembley and for the trainers to consult and call for Simon's removal.
"I saw him throwing in the first inning and I saw his velocity down," said Trembley. "After he gave up the home run, the next pitch I kind of saw him reach for his arm. Izturis motioned me out, and when I went out there, I asked him, 'Is it your elbow?' And he said, 'Yeah.'
"He just wasn't throwing like I've seen. Usually, the guy is throwing 94 or 95 [mph] and he was throwing 88 or 89 [mph]. Obviously, there's a problem there and we'll have to get it checked out."
Dennis Sarfate took the ball from Simon and pitched into the fifth inning, allowing just one hit. Chris Ray got four outs and Jamie Walker got three, setting up Jim Johnson to take care of the eighth and ninth.
When Sherrill entered the game with a four-run lead, Danys Baez and Brian Bass -- who threw 65 pitches on Sunday -- were the only relievers left in the 'pen. Trembley said that he intended on staying off Baez at all costs and that he never considered scratching Mark Hendrickson from Wednesday's start.
"I was saving Bass in case the game went extra innings," Trembley said. "We were playing for nine innings. I was kind of flip-flopping back and forth, trying to save Walker when those lefties were coming up. I was really looking at the lineup to see when I could get Ray in if I was going to save Walker. Johnson really helped a lot because he got 11 pitches in that one inning, so I could send him back out."
Aubrey Huff and Scott homered for the Orioles, who never led until the final inning. Baltimore (6-2) didn't push a runner into scoring position from the fifth through the ninth, notching two hits and drawing five walks. And in the end, all that mattered was a resilient evening from an exhausted bullpen.
"That's our job. We're there to pick up each other," said Sarfate, who earned his first win. "Last night it was Danys [and] tonight it was me. Bass had to do it the other day, threw 60 pitches or whatever. ... I hate to see Simon go down, but that's our job. We're here to pick up innings and eat up innings."
Spencer Fordin is a reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.