It could be a month before the toxicology reports on a Maryland couple found dead at a Dominican Republic resort last week are available.
Nathaniel Holmes, 63, and Cynthia Day, 50, an engaged couple from Prince George's County, were found dead in their room in a resort hotel in La Romana May 30. Miranda Schaup-Werner, 41, a psychotherapist from Allentown, Pennsylvania, died in another hotel at the same resort five days earlier.
The attorney general for the Domincan Republic revealed preliminary results of the autopsies of Holmes and Day Thursday, including a long list of medical notes. But the results confirm earlier reports the couple suffered respiratory failure and pulmonary edema.
NBC Medical Correspondent Dr. John Torres reported a combination of the pain medications found in their room could have caused the pulmonary edema — a buildup of fluid in the lungs — but so could other types of poisons.
The minister of tourism said no official judgment can be made until the investigation, including the toxicology report, is finished.
“The doctors … have told us that it takes about a month,” said Paola Rainieri de Diaz, president of the Hotel and Tourism Association of the Dominican Republic.
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Foul play has not been ruled out, but Dominican police confirmed earlier reports there were no signs of violence.
A spokesperson for her family said Schaup-Werner died May 25 from respiratory failure and pulmonary edema like Holmes and Day. She and her husband were staying at the adults-only Bahia Principe Bouganville in La Romana on the southern end of the island.
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The Bahia Principe responded Wednesday with a statement that disputing some details reported by multiple news outlets. In the statement, the Bahia Principe said that the hotel's medical team was contacted after Schaup-Werner was found unresponsive in her hotel room. The team was in the process of transferring her to a hospital when she died, according to the statement. The Bahia Principe also stated that "Schaup-Werner's cause of death was determined to be a heart attack" and that her husband "confirmed she had a history of heart conditions."
The Bahia Principe further emphasized the lack of any "indications of any correlation between these two unfortunate incidents."
Schaup-Werner's brother-in-law, Jay McDonald, said in a written statement she had “a drink from the in-room minibar. Her husband, Dr. Daniel Werner, was with her when she abruptly experienced acute physical distress and collapsed.”
She reportedly had been in good health, and the couple was visiting the island to celebrate their ninth wedding anniversary, McDonald told NBC News.
The families of Day and Holmes plan on having autopsies conducted once the bodies are returned to the U.S.
The U.S. Embassy is actively monitoring the investigations by Dominican authorities.
