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Red Sox seeking more compensation for Mookie Betts as Brusdar Graterol’s medical issues hold up trade

Brusdar Graterol, 21, already has had Tommy John surgery and was limited by a shoulder impingement last year.
Brusdar Graterol, 21, already has had Tommy John surgery and was limited by a shoulder impingement last year.Carlos Osorio/AP/Associated Press

When the dust settles, it’s still expected that Mookie Betts and David Price will end up in Los Angeles and outfielder Alex Verdugo will be a Red Sox. It’s even possible that righthander Brusdar Graterol will head across Fort Myers, from the spring training home of the Twins to the Red Sox, and that starter Dodgers starter Kenta Maeda will end up in Minnesota.

But nearly two days after the Red Sox agreed in principle to a blockbuster three-team deal with the Dodgers and Twins, it has yet to be finalized after concerns related to the medical evaluation of Graterol, major league sources confirmed. Ken Rosenthal of The Athletic was first to report that the Red Sox’ review of the 21-year-old’s medical records led the Sox to conclude that he is less likely than anticipated to project as a starting pitcher.

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With that conclusion, according to sources confirming the report, the Sox are seeking additional compensation in the deal. Initially, the Sox seemed to seek an additional prospect, but it’s possible the Sox could seek a different player (or players) to replace Graterol in the deal. As of Thursday night, the matter of the back end of the deal — specifically, the status of Graterol — was viewed as a matter between the Red Sox and Twins.

If the Twins and Red Sox can’t find common ground about how to respond to Boston’s medical concerns about Graterol, it’s possible the Sox and Dodgers could replace Graterol in the deal through direct negotiations, or that the teams could cut out the Twins and seek a different third team to round out the deal. Despite what one major league source characterized as the “moving parts” of the deal, sources from the Red Sox and Dodgers still believe that the framework of the trade isn’t in jeopardy.

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Graterol has an electric arm, throwing a sinker that regularly exceeds 100 miles per hour, along with a slider with a chance to be a true weapon. His changeup remains a work in progress.

Based on the profile of his pitches alone, multiple evaluators see the righthander as having at least a chance to be a big league starter – potentially a mid-rotation contributor or better. One NL evaluator saw Graterol as having perhaps a 20-30 percent chance of a future in a rotation. An AL evaluator said that while the righthander’s future is “probably” in the bullpen, he would first want to exhaust the possibility of developing the righthander as a starter.

If he can stay healthy, Brusdar Graterol has the potential to be a big-league starter, evaluators say.
If he can stay healthy, Brusdar Graterol has the potential to be a big-league starter, evaluators say.EMILEE CHINN/Getty Images

“I wouldn’t want to give up on [Graterol starting],” he said, “and I wouldn’t want to bet on it.”

The Twins, according to a recent look at Graterol in the Star Tribune, saw the righthander (who pitched just over 70 innings combined in the minor leagues and big leagues last year) as a potential big league bullpen option coming out of spring training, though the team hadn’t closed the door to him as a starter — presumably with further development time in the minors to build his workload.

However, even before the exchange of medical information, injury risk was a known part of Graterol’s profile — and part of the reason many view the bullpen as perhaps a likelier path than starting. He underwent Tommy John surgery in 2015, and didn’t pitch at all in 2016. In May 2018, he dealt with back spasms, followed by shoulder impingement syndrome in 2019. Now, a medical issue concerning Graterol may be keeping the trade from becoming official.

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“It would not stun me,” one American League scout said. “He’s had issues in the past.”

The shoulder impingement limited Graterol’s innings last season, and resulted in a late-season move from the Double-A rotation to the bullpen. That said, when he returned from more than two months on the injured list, he showed his typical premium velocity on his sinker.

Though Price (elbow) and Verdugo (back) both have had their own past health issues, neither was flagged in the review of medical records. Only Graterol’s status is in question.

It’s still possible Graterol ends up a member of the Red Sox. Regardless, even if Graterol ends up not going to Boston, it remains difficult to imagine the genie being rebottled on the rest of the deal.

One of the other players in the deal, Alex Verdugo, is expected to join the Red Sox in spring training.
One of the other players in the deal, Alex Verdugo, is expected to join the Red Sox in spring training.ELISE AMENDOLA/Associated Press

Alex Speier can be reached at alex.speier@globe.com. Follow him on Twitter at @alexspeier. Julian McWilliams of the Globe staff contributed to this report.