OAKLAND, Calif. -- Red Sox slugger David Ortiz was scheduled to leave the team Tuesday and return to Boston to be examined again for an irregular heartbeat.

Jon Lester
Lester

David Ortiz
Ortiz

Big Papi was a late scratch for Boston's game Monday night at Oakland for what was first thought to be the flu. Ortiz, who on Sunday hit his major league-leading 47th home run at Seattle, already spent time in a Boston hospital earlier this month for the condition.

He said he thought it was caused by fatigue.

"He will get a clean bill of health before he plays again," manager Terry Francona said. "The games are important, but we have a responsibility to do what's right."

Said Sox reliever Mike Timlin: "It's not good. This game is nothing compared to someone's health or family. We don't play games with people's lives. I don't know any of the details. All I can do is pray for him."

Ortiz wasn't the only problem for the beat up Red Sox. Before Monday's game they placed rookie left-hander Jon Lester on the 15-day disabled list and sent him back to Boston for further evaluation of his troublesome back.

Then the Sox sent pitcher Kyle Snyder back to the hotel because of the bug that has been going around the clubhouse.

And All-Star left fielder Manny Ramirez was out of the starting lineup for the fourth time in five games with a sore right knee. Francona doesn't expect him to play again until the team returns home later this week.

The A's took advantage, getting homers from Frank Thomas and Nick Swisher in a 9-0 rout.

Ortiz was scheduled to be seen by Dr. Larry Roman.

Francona, general manager Theo Epstein and trainer Paul Lessard met with Ortiz just more than an hour before game time.

"We honestly think he's OK, but he can't play like that," Francona said. "We can't do it."

Lester, one of four rookies on the Red Sox pitching staff, originally was slated to start Monday's series opener at Oakland, but Kason Gabbard took his place in the rotation. The move is retroactive to Thursday.

Lester almost didn't take the mound Wednesday night against the Angels in Anaheim, where he beat Kelvim Escobar and threw 96 pitches over five innings.

"He came out of that start the other day with his back grabbing at him," said Francona, whose reeling Red Sox were coming off a three-game sweep by the Mariners in Seattle. "We just kind of felt we'd send him back to Boston and get him thoroughly checked. He's a big part of our future. We've asked a lot of him already. We're a little concerned."

Lester is 7-2 with a 4.76 ERA in 15 starts this year. Shutting him down for the rest of the season is not being considered at this point, though Francona will monitor him closely over the season's final month.

"He'll get a clean bill of health and we'll all feel better," Francona said. "We don't want to hurt this kid. ... If we had to shut him down, we would."

Boston purchased the contract of first baseman Carlos Pena from Triple-A Pawtucket to take Lester's roster spot and transferred Adam Stern to the 60-day DL with a hamstring injury.

Pena started at first base and on one play dived over the short padded wall along the first-base line and fell awkwardly into the crowd before getting up unharmed.

Even Francona, who has been taking blood-thinning medication for several years, was spitting out blood only hours before game time -- as well as during Sunday's game at Safeco Field. He had bitten a chunk out of the inside of his left cheek, causing the excessive bleeding.

When the team gets back to Boston, catcher Jason Varitek and right fielder Trot Nixon both will be close to rejoining the team.

Varitek had arthroscopic surgery on his left knee Aug. 3, while Nixon has been on the 15-day DL since July 31 with a strained right biceps. Varitek will probably only play four or five innings when he first returns.

"We have to use some common sense," Francona said. "We have to try to find a way to survive and win games. Right now, we're not the team we were a month ago. We're beat up and playing different guys."

Copyright 2006 by The Associated Press

----------------------------------------------------------------------

Could any of this be brought on by growth abuse?