An American tourist died of respiratory failure in her Dominican Republic hotel room just days before a Maryland couple was found dead of the same cause at the same resort, according to the woman's family.
Miranda Schaup-Werner, 41, a psychotherapist from Allentown, Pennsylvania, died May 25 from respiratory failure and pulmonary edema, according to a spokesperson for the family. Schaup-Werner and her husband were staying at the adults-only Bahia Principe Bouganville in La Romana, a city on the southern end of the island.
Five days later, Nathaniel Holmes, 63, and Cynthia Day, 50, an engaged couple from Maryland, were found dead in their room at another hotel on the same property.
The Bahia Principe responded on Wednesday with a statement that disputes 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."
A spokesperson for the attorney general of the Dominican Republic said she did not understand why the hotel is ruling on a manner of death when the investigation is not complete.
The statement provided by Bahia Principe also said that the deaths of Holmes and Day remain under investigation, with toxicology and histopathological test results still pending, and that the causes of their deaths has not yet been determined.
According to the Dominican Republic National Police, an autopsy performed on Day and Holmes determined they also died of respiratory failure and pulmonary edema.
The Bahia Principe further emphasized the lack of any "indications of any correlation between these two unfortunate incidents."
The U.S. Department of State confirmed the death of Schaup-Werner but didn't identify a cause. In a statement, the department said they are not aware of any connection between the deaths.
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 relatives of all three U.S. citizens are raising questions about the deaths. McDonald told NBC he's not convinced a "healthy 41-year-old suddenly dies like this," noting that officials in the Dominican Republic did not do a toxicology report, nor did they test Schaup-Werner's glass and drink as part of the cause of death investigation.
In his statement, McDonald asked, “Why didn’t the deaths of the Maryland couple (Cynthia Day and Nathaniel Holmes) trigger an investigation, following so closely on Mrs. Schaup-Werner’s death? Have there been other deaths?”
Day and Holmes had been staying at the vacation spot since May 25 and were scheduled to fly back home May 30. The bodies showed “no signs of violence,” according to The Dominican Today.
According to police, investigators are looking at the possibility carbon monoxide poisoning is to blame for Holmes' and Day's deaths. Police in the Dominican Republic did not confirm whether the couple's room had a carbon monoxide detector.
Sonya Jackson, Day’s sister, said the family is having a hard time believing respiratory issues caused the couple's deaths.
"What happened to them?" she asked. "My sister is a perfectly healthy person."
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.
Correction (1:02 p.m. June 5, 2019): This article has been updated to reflect that the two hotels are on the same resort property.