I used to argue with my D&D buddies that die rolls only appear random to us because we lack the ability to calculate all of the variables included. It is not truly random, just unpredictable.
It always ended up with us all in a 3 hour argument about the definition of random!
While true quantum randomness would percolate up to the macroscopic all the time, thanks to the butterfly effect, for any given dice roll, it would not make a difference. That's just classical ignorance, which is to say, limited knowledge of initial conditions. I haven't run the numbers, but I doubt any quantum events could possibly affect any particular dice roll in the space of the few seconds it takes to do.
The butterfly effect takes time -- time for the "billiard balls" of the universe, atoms, to bounce around, angles deviate, and eventually the weather itself is different, people are copulating at different times, different sperm are fertilizing different eggs, and poof, the entire population of the planet is different from what it otherwise would be.
Of course, you could have a ridiculously unlikely event, like half the protons in the die (or table where it hits, or your muscle) suddenly degenerate, changing the composition, weight balance, mass, and so on, enough to change the outcome (to say nothing of the die suddenly turning into a doll-sized microwave oven).
