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Family looks for answers after popular musician struck down by blood clot

Daniel Di Giacomo died in the early morning of Feb. 21, struggling for breath on the kitchen floor as his incredulous father looked on. He was 31 years old.

The bassist for the up-and-coming country band the River Town Saints, Di Giacomo was a fun-loving bear of a man who had suffered a broken lower leg and dislocated ankle about seven weeks earlier.

His family believes the break prompted a fatal chain of events. They’re looking for answers.

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“No one should got through what we have been going through,” said Di Giacomo’s mother, Janet.

The cause of death is believed to be a thrombosis, or blood clot, that had traveLled to his lung, causing a pulmonary embolism. Di Giacomo’s family says that if they had known a blood clot was a potentially fatal risk, they would have asked more questions.

“Six days before he died, he had clear symptoms of a blood clot, but we didn’t know what it was,” said his sister, Cristina.

Di Giacomo’s father, Mike, says an embolism wasn’t even on his radar. “We didn’t know what the warning signs were.”

Janet said her attempts to get answers form Queensway Carleton Hospital about whether her son should have been sent home after his surgery with a list of warning signs and a prescription for blood thinners have been unsuccessful.

The hospital’s chief of staff, Dr. Sanjay Acharya, wrote to Janet in an email dated March 22 that he has directed the department chief to review current practice relating to her concerns.

“We have already asked our risk managers to review the consents and how/if they need to be updated,” Acharya wrote.

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“This is part of our internal review and what we would do after any critical incident. It would be our normal practice to invite you and your family to participate in any way you feel appropriate when we have gathered the basic information we need to make analysis.”

Di Giacomo broke his leg just before noon Dec. 31 while delivering a television on an icy day. While he spent the summers touring with the River Town Saints, Di Giacomo worked a day job in the winter months.

He went first to the Almonte General Hospital and was transferred to Queensway Carleton. It took him 12 hours to see specialist. As was his way, he never breathed a word of impatience, said Janet.

Di Giacomo could not be scheduled for surgery the next day and went home. He had day surgery on Jan. 3, and was sent home with seven pages of instructions, including two pages for using crutches, a prescription for painkillers and a knee walker, a scooter-like device that allowed him to get around without putting weight on his ankle.

He left the instructions on the coffee table of his west-end home, but Janet read every one of them. There was no mention of thrombosis or the risks around it or the suggestion that the patient should follow an exercise regime, she says.

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“The only mention was about wiggling his toes.”

Daniel was the fourth of five children born to Janet and Mike. The family is musical. Janet played the guitar and piano and taught the boys to play. Di Giamcomo joined his first band at Bell High School, and was self-taught on the bass.

“He loved being the centre of attention. Not in an offensive way. If you were in a room with Dan, he was the loudest guy and everyone would be laughing,”  said bandmate Jeremy Bortot.

Dan Di Giacomo was the bassist with the Ottawa band the River Town Saints. Photo by Sean Sisk PhotographyPhoto by SEAN SISK /jpg

Di Giamoco was also a deeply religious person and had studied at Bible college and spent two and a half years at a Los Angeles mission for the homeless called the Dream Center.

“Dan had really strong beliefs. What people found super-cool about him was that he was pragmatic about it,” says Bertot. “He knew his theology, but he lived his life according to his beliefs. He was a good guy to other people. He was just kind.”

The band criss-crossed the country in a 1988 Chevy van nicknamed Ron Burgundy and opened for a better-known acts. Di Giacomo’s bandmates joked that he got his own room on tour because he snored like a grizzly bear sucking on a shop vac.

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The Saints played at every major country music festival in Eastern Canada and toured with country music stars Kip Moore and Dean Brody. The Saints’ singles Bonfire and Cherry Bomb got significant radio play and band was nominated for the Canadian Country Music Association award in the rising star category in 2016.

Chris McComb, Dan Di Giacomo, Jeremy Bortot of the River Town Saints.Photo by Sean Sisk PhotographyPhoto by Sean Sisk /jpg

“It’s hard to make a living from music. You have to work so hard. If you’re just doing it for the money, you would be disappointed,” said Bortot. “It can’t be about the destination; it has to be about the ride. And it was such a great ride. If you saw Dan on stage, you would see someone who loved what he did.”

In the second week of February, Di Giacomo’s recovery appeared to be slow. The band and its lead singer had parted ways last fall and was auditioning new singers in Bortot’s basement on Feb. 14, 15 and 16.

Di Giacomo still couldn’t put any weight on his ankle. He had to sit while he played bass. He complained  of fatigue, nausea and dizziness. When he returned home, it took 20 minutes  to get him into the house. He later texted his friends that he still didn’t feel back to normal and asked if future auditions could be spaced out.

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“He was exhausted. We just thought he was healing. He couldn’t do that much,” says Janet.

The Sunday before he died, Di Giacomo gave his father a scare when he complained of chest pains. Mike gave him an aspirin and the pain subsided.

Di Giacomo told his parents he thought he over-exerted himself.

“He wasn’t the kind who abused the medical system,” said Janet. “A couple of people urged him to go to the hospital, but he probably didn’t want to be packed up and sent home again.”

On the night of Feb. 20, Di Giacomo spoke to his mother, who was in Pennsylvania, and spent his last few hours texting friends. It appears he got up for a glass of water in the early morning of Feb. 21.

His father woke up shortly after 2 a.m. and heard Di Giacomo calling for help. Mike found his son sitting on the kitchen floor, struggling for breath and semi-coherent. Mike called 911.

One paramedic team came and called for backup. Di Giacomo was hooked up to a monitor. His father, sitting on the stairs across the hall, said he saw his son’s heartbeat flatline.  Paramedics continued to administer CPR and rushed Di Gimacomo to the hospital with Mike following.

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When Mike saw the doctor’s face, he knew his son was dead.

Shortly after, Mike spoke to a coroner who asked a few questions, including whether Daniel was taking blood thinners. Di Giacomo didn’t hide anything from his family, and as far as Mike knew, his son wasn’t taking blood thinners. That question got the wheels turning for Mike.

“That begged the question — if it was a known risk, why was he not prescribed blood thinners? My son just died. I was hearing a suggestion that it didn’t have to happen,” he said. “If the risk was there, why didn’t we know about it? That’s what we want to know.”

March was Deep Vein Thrombosis Awareness Month. According to a survey commissioned by Thrombosis Canada last fall, only 43 per cent of Canadians know about the condition and only 25 per cent are concerned about it even though it can kill quickly. Vein blood blots affect about 100,000 Canadians and cause 10,000 deaths.

Thrombosis Canada launched a campaign last month about the most common symptoms, which include chest pain, being lightheaded and out of breath, leg tenderness and leg swelling.

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A spokeswoman for the Queensway Carleton said the hospital can’t comment on the specifics of Di Giacomo’s case, but its standard processes include discussing potential side effects, like blood clots or infections. Patients deemed to be at a higher risk are supported and treated on an individual basis.

For a patient who has had ankle surgery, the post-operative kit would include an information sheet indicating that “some pain is normal for the first seven to 10 days,” and urging the patient to call his or her surgeon or go to the nearest emergency department if there is severe pain not relieved with pain medication or if there is pain for more than seven to 10 days.

The standard information package includes things to watch for, like pain, swelling, and changes in colour, said the spokeswoman. “Some of these symptoms may indicate a blood clot or other issue. But the general package does not go into more details.”

Blood clots are not a standard medical concern for ankle surgery, she said. “Blood clots can be a general concern, depending on the type of surgery. Our largest at-risk surgery population is our total joint replacement patients — given the significant mobility challenges.”

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Janet believes that the risk of a post-operative embolism should have been made clear by the hospital, and it should have been in the handout package, along with instructions for an exercise regimen.

“I want to know if patients are getting this information. And if not, why? Never in our worst nightmares did we know that it could be a fatal risk. We didn’t even question it. We would have acted very differently,” said Janet.

“It’s just another paragraph or two. Let people know,” said Mike. “Daniel was taken away at 31 years of age. It’s not the parents that are supposed to bury their children.”


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