"Anytime you get behind in the count, any professional hitter, it's never a good start," said Matusz, who threw two balls to Sands to start things off. "To follow it up with a fastball right down the middle, you put yourself in trouble."
But the loss wasn't solely on Matusz's shoulders. The Orioles squandered another quality start -- this time from lefty Wei-Yin Chen -- as the offense continues to struggle to manufacture runs, with three of Monday's four scores coming via the home run. A group widely speculated as one of the best lineups in baseball this spring has hit . 217 with runners in scoring position over the past 11 games, as the Orioles have gone 5-6 over that span despite getting 10 quality starts.
"I don't live in that world," manager Buck Showalter said of his club not being able to cash in on offensive opportunities. "It is what it is. You can go back and find some really good things you did. You can dwell on the negativity. You can't in the locker room. I know there's a certain reality to some of it. We pitched well and I think if we continue to pitch well, it will work certainly to our favor."
After Chen recorded the first two outs of the seventh, Darren O'Day issued a leadoff walk and recorded a pair of quick outs in the eighth before turning the ball over to Matusz. Rays manager Joe Maddon, who had originally penciled in David DeJesus to pinch-hit, switched him with Sands after Matusz took the ball.
"I didn't know what he was going to do," Maddon said. "I swear I didn't. But if he didn't [make a move], then we have DeJesus on him. And if he did, we had Sands on the other guy."
The Orioles also got some pop off their bench, with pinch-hitter Delmon Young homering to bring the O's within a run in the ninth, but it wasn't enough.
Down 3-2, the Orioles tied it up in the eighth after loading the bases, but couldn't break the game open. Nick Markakis and Manny Machado opened with a pair of singles off reliever Grant Balfour, and after Adam Jones grounded out, Maddon brought on lefty Jake McGee.
Chris Davis worked a bases-loading walk and slugger Nelson Cruz bounced a ball to third baseman Evan Longoria, who was playing deep enough to allow Cruz to reach with an infield single, tying the game at 3. But J.J. Hardy struck out, then pinch-hitter Steve Pearce -- after smoking a ball just foul -- grounded out to keep the game tied.
"It's such a fine line," Showalter said. "Stevie's ball barely misses the chalk line there. Of course, McGee is one of the better relief pitchers in the league. But our guys have been doing a good job out of the 'pen, too, so it's frustrating."
The Orioles, who had just one hit off Rays starter Jake Odorizzi over the first five innings, got on the board courtesy of Jones' second consecutive game with a homer. After Markakis doubled to start the sixth, Jones went deep one out later to chase Odorizzi from the game.
Chen outlasted his mound counterpart, giving the Orioles their eighth consecutive quality outing with a solid 106-pitch start. The lefty allowed a pair of homers, resulting in three runs, over 6 2/3 innings.
"In the first few innings, there was something that I could have controlled [with my location], but I didn't do it well so the opposing hitters hit a lot of foul balls and drove my pitch count up," Chen said through his interpreter. "And I also allowed two home runs and those home runs lead to the three runs allowed, so those are mistakes that I made. So, I have to take responsibility of those pitches."
Chen allowed a homer to Yunel Escobar in the first and a two-out, two-run shot to Ryan Hanigan in fourth, but limited Tampa Bay to just four hits outside of that. At 99 pitches to start the seventh, Chen exited in favor of right-hander O'Day after striking out Kevin Kiermaier.
"Wei-Yin, he wasn't as efficient with his pitches as you'd like to see, but I think Tampa had something to do with that too," Showalter said. "But he got us to the point where we had a chance to win the game. That's usually what you want out of your starting pitching."