In the top of the seventh inning, Carmona gave up a two-run homer to Detroit's Miguel Cabrera. One out later, the Cleveland pitcher hit Sheffield in the left arm with a pitch. The Tigers' designated hitter walked slowly to first base, carrying his bat with him, glaring at Carmona and exchanging words with the right-hander.
When Carmona threw over to first on a pickoff attempt, Sheffield motioned and yelled at him to throw the ball to the plate. Carmona took a step toward first base, yelled, and Sheffield charged the mound.
Both Carmona and Sheffield threw punches before the pitcher got Sheffield in a headlock and began landing punches. Players and coaches from both dugouts and bullpens ran onto the field, but no other punches appeared to be thrown before order was restored.
Cleveland catcher Victor Martinez was restrained by Indians hitting coach Derek Shelton as he kept waving to Sheffield, challenging him to continue the fight. Fellow Venezuelans Magglio Ordonez and Cabrera also came over to calm Martinez.
Sheffield and Carmona were ejected, along with Martinez and Tigers second baseman Placido Polanco.
Carmona also hit Sheffield with a pitch on April 17 in a game that included five hit batters.
Kelly Shoppach replaced Martinez at catcher, and Edward Mujica came on to replace Carmona. Jeff Larish ran for Sheffield and was caught stealing to end the inning. In the bottom half, Edgar Renteria came on to play shortstop with Ramon Santiago moving over to replace Polanco at second.