It took five seconds on Google to find Blake Snell (two time Cy Young winner) threw 43 pitches in a first inning last year. Daniel Norris of the Tigers threw 54 in the first a few years ago. Bartolo Colon once took 61 pitches to get out of the first inning. Steve Trachsel threw 61 pitches in an inning. Those are all major league guys.
Yes, it's rare. But it does happen. And, with the overall game being pretty average, it seems that there were probably other factors that we more of the cause.