As the Eagles-Patriots game kicked off, a fan was dying in the stands. Could EMTs have helped sooner?

In the shadow of Lincoln Financial Field, Joe Nocero threw a football in Lot P. He ate empanadas and played cornhole. He and his crew of longtime season ticket holders enjoyed their time together on the afternoon of Nov. 17, wanting to make the most of the sunny, late-fall tailgate before the 4:25 p.m. Eagles-Patriots game, a much-anticipated Super Bowl rematch.

When they got inside the stadium, Nocero yelled to his friends, encouraging them to hustle to get to their seats by kickoff. They made their way through the sellout crowd, then hiked the concrete steps to the top row of Section 236, which faces away from the city skyline.

Nocero sat down. His body started moving oddly, and he became unresponsive. As soon as the group noticed, someone ran for help. A security guard and a police officer arrived several minutes later, his friend Conrad Muth said, and the officer began working on Nocero. But the EMTs took longer, according to Muth’s account.

“I was screaming to the security guard: ‘Where are the EMTs?’ ” Muth said. “I was just really angry with how long it took them to get to him.”

Nocero suffered some kind of fatal cardiac event that afternoon. His official cause of death was later determined to be a type of heart disease. The 41-year-old Eagles fan never saw kickoff.

While small armies wait to tend to injured players on NFL sidelines, and concussion spotters watch for potential head trauma on the field, the medical response in the stands is more opaque. Locally, sports franchises refused to discuss medical emergencies, even in a broad context, citing confidentiality policies.

The Eagles declined to comment on Nocero’s death or to provide information regarding emergency preparedness and response protocols at Lincoln Financial Field.

“As an organization we place a priority on the safety of our fans,” a spokesperson said in an email, “but do not discuss that type of information publicly.”

National Event Services, the crowd-management company that provides EMS staffing for the Eagles, Flyers, Phillies, and a host of other clients, did not respond to several requests for comment.

It is difficult to gauge how often fans die as a result of medical emergencies and accidents suffered inside stadiums. Researchers at the University of Southern Mississippi’s National Center for Spectator Sports Safety and Security said they weren’t aware of any public data on the topic.

Last month, Mike Kahler, a 30-year-old Ravens fan, died after slipping and falling during a playoff game at M&T Bank Stadium in Baltimore. Two years ago, in an incident that intensified discussions about protecting baseball fans at ballparks, Linda Goldbloom, 79, died after getting hit in the head by a foul ball at a Los Angeles Dodgers game. This fall at the Linc, 38-year-old Marco Bianchi died after suffering a heart attack in Section 131 during the Lions game on Sept. 22.

In October 2001, Anthony DiGiovanni arrived at Veterans Stadium for a 1 p.m. Eagles-Cardinals game. Less than half an hour before kickoff, his 69-year-old father, a retired police officer with whom he shared a name, wasn’t in his seat. DiGiovanni knew something was horribly wrong — his dad had missed only one Eagles home game from 1971 to 2001. He would later learn his father had been standing in the back of their section when he suffered a fatal heart attack.

On a Thursday night in September 2013, Steve Kearney Jr. was walking into the Linc for the famous “Andy Reid game” between the Chiefs and the Eagles when his father had a heart attack in the concourse. He said EMTs quickly tended to 58-year-old Steve Kearney Sr., using a defibrillator and then transporting him to a medical facility under the stadium. He later died.

Researchers have studied whether sports spectators have an increased risk of cardiac emergencies, with mixed results. A 2017 study in the Canadian Journal of Cardiology found watching an exciting hockey game could trigger a heart attack in fans who were already at risk.

But the study also notes: “Life is full of triggers, large and small, good and bad. Avoiding all triggers equates to avoiding life itself and is not a viable strategy.”

Responding to such a wide range of medical emergencies and accidents is undoubtedly challenging in the congested, chaotic space of a big-time sporting event, where tens of thousands of fans pack into tight seats, clog concourses and aisles, and sometimes — including in Nocero’s case — watch a game from the stadium’s top row, a place accessible only by a steep set of stairs.

Conrad Muth and three other friends had season tickets with Nocero for nearly a decade. Game days began early. For afternoon games, they often got to South Philly in the early morning to set up their tailgate along the fence in Lot P, across from Citizens Bank Park.

Nocero would bring down steak or chicken for another friend to grill. They’d have coolers of beer and Henry’s Hard Grape Soda, which Nocero had introduced to the group and got everybody hooked on. Nocero, an active guy, loved to get up and throw the football, and play tailgate games, especially cornhole.

Over the years, the game-day group had evolved, as friends grew up, got married, and had children. But Nocero seemed to balance it all — fatherhood, marriage, a successful career with a national mortgage lender, and an Eagles obsession, his friends said. He was always the life of the party, smiling, laughing, relishing the moment, and reminding those around him to do the same.

Nov. 17 began the same way so many other game days had — before he left, Nocero had even done the laundry and picked up coffee for his wife and breakfast for his son.

The day ended, however, with terrifying moments that will forever replay in the minds of his friends.

In Section 236, Muth said he watched Nocero become unresponsive in front of him, in the same spot where for years they had cheered and screamed and danced and cried over football, something that now seemed so insignificant.

Muth called another friend, Jeremy Collinson, who’d known Nocero for 20 years and was watching the game from a club box at midfield. Collinson said he had a clear view of the panic in Nocero’s section.

“It took a long time for [EMTs] to come up there,” Collinson said. “It felt like an eternity.”

In Jamison, Bucks County, 35 miles from the Linc, Melissa Nocero was wondering why she hadn’t gotten a call from her husband. He had made it a habit to FaceTime her and their 5-year-old son, Nico, before every game, so his boy could feel like he was there for kickoff or the flyover.

She made cookies, and helped Nico set up a Mickey Mouse board game. Her cell phone rang a few times with numbers she didn’t recognize. She didn’t answer. Then, her husband’s friends called, frantic.

Yes, Joe Nocero spent his final moments doing what he loved, and that brings some peace to his loved ones. But the emotion is more complicated, especially for his fellow season ticket holders who will retrace his final steps into the stadium for years to come. In an instant, their Sunday pastime became forever linked to grief and loss, sadness and frustration.

His friends said they want to know more about the time it took medical personnel to respond and why they never saw the EMTs use an automated external defibrillator, commonly called an AED, a device that shocks the heart.

Quick response time, early CPR, and rapid defibrillation can increase survival rates in people experiencing cardiac emergencies. With each minute that passes without defibrillation, a person’s chance of survival decreases by 7 to 10%, according to the American Heart Association.

Melissa Nocero recently retained Matt Casey, of the Center City law firm, Ross Feller Casey LLP, to look into the circumstances surrounding her husband’s death (No legal action had been taken at the time of publication).

She has tried to avoid going down an angry path, she said, instead focusing her energy on Nico, who has endured his own struggles. He was born with his esophagus connected to his lungs instead of his stomach, and as a baby he often stopped breathing. Twice, she said, her husband gave him CPR and revived him.

“I always say, Joe saved his life,” she said, “and Nico’s going to save mine.”

The morning after her husband died, she called Nico to the kitchen table. He bounded down the stairs, stuffed animals in hand.

“Remember when Daddy went to the Eagles game?” she told him. “Well, during the game, he went to heaven.”

“What?” she recalled Nico responding. “So I’ll never see him again?”

“You’ll see him in your dreams,” Melissa said she replied. “He’ll still be watching over you.”

Throughout the day, Nico periodically tapped her on the shoulder, saying “I really miss Daddy.”

Friends and family flocked to their home. A friend, Bill Lodge, set up a GoFundMe to support Melissa and Nico. Days later, thousands of people showed up to Joe’s funeral. His cell phone pinged constantly, Melissa said, with messages of gratitude from those he impacted in life, whether old friends or people he had helped buy their first homes through his work as a loan officer with Movement Mortgage.

For the friends who were at his last game, they mulled a difficult question: Could they return to the Linc the next week?

On that Saturday night, hours before the Eagles played the Seahawks, Melissa said she texted the group: “Hey, listen, if you were contemplating if it was the right thing to go to the game or not, I just want you to know Joe would totally want you to go.”

Muth couldn’t return to their seats, but others did. They placed Joe’s favorite white Brian Dawkins jersey on his empty chair.

For some, just watching the game on TV brought back memories.

“One of the reasons I had the love for the Eagles was for Joe,” Lodge said.

DiGiovanni and Kearney, who both watched their fathers suffer fatal heart attacks at Eagles games years ago, said they still have season tickets and go to games often.

DiGiovanni, now 55, isn’t as religious about the Eagles as his dad was. He doesn’t go to night games much anymore, he said, and he’s often contemplated selling his tickets. But he can’t bring himself to do it.

“I used to say, ‘The only reason I go to games is because it’s a day with my dad,’ ” DiGiovanni said. “Now, the only reason I go is because it’s a day with my son.”

Kearney, now 37, thinks his father would haunt him if he ever sold his tickets, he said with a laugh.

Returning to the Linc wasn’t as difficult as he thought it would be, but to this day, he said, “every time I walk past the spot in the concourse where it happened, it takes me back.”

On a December Monday, rain poured as Melissa and Nico Nocero stood on the Lincoln Financial Field sideline and watched the players warm up before the Eagles-Giants game. It was the first time they’d returned since Joe died.

She and her husband’s friends said they’ve been happy with the Eagles’ response in the months since his death. The organization made a donation to his favorite charity, the SuperHero Project — which supports families with children in the neonatal intensive care unit, where Nico once was a patient — and gave the family a football with the words “Joe Nocero, Forever an Eagle” printed on the side. During the Giants game, they displayed a similar message on the big screen. and provided Joe’s friends and family with seats.

As kickoff approached, Melissa carried Nico up to a covered area in the first level, where a dozen of her husband’s friends were waiting to watch the game with them.

The group laughed and talked with each other, drank beer and snacked. They cheered for the Eagles and thought about the fan who wasn’t there, the person whose seat they could see across the stadium.

Since the Seahawks game a week after Joe’s death, none of his friends have returned to Section 236. The Eagles arranged for them to sit elsewhere for the rest of the home games. But come September, the crew will be back up there, Muth said, in honor of all the memories they shared with their friend.

Joe Nocero’s friends called him “Joey Knows,” Collinson said, and if there was one thing he knew best, it was how to embrace life and celebrate the big and small moments all the same.

The Giants game “was almost cathartic,” Collinson said through tears. “It felt like a celebration … Some part of me was like ‘It’s time to let go.’ ”

On the field, the Eagles trailed early. At halftime, they were losing 17-3. But they came back in the fourth quarter and with two minutes left, tied the score at 17 — one of Joe Nocero’s favorite numbers, his wife said.

It was after 11 p.m. as the game headed to overtime, and Melissa and Nico said their goodbyes and made their way to the parking lot. As they were walking out, headed for home, fireworks exploded into the rainy night sky.

For the first time since Joe Nocero died, the Eagles won.