I'm looking for a book with a character named Punchinello.?

The book was about a family of bakers that received a prophesy that 5 bad dates were going to come to one of the family members. There was also a lot to do with a clown that went on a rampage at a hospital. The clown named his son Punchinello, who also went on a rampage in the story. The main character's name might have been Rudy, but I'm not sure. I think that's wrong, I'm drawing a blank. I definitely remember punchinello though. I can't remember the title of author, but it was a really good book.