American Woman Died at Same Dominican Republic Hotel That Maryland Couple Died In

Published: 6/4/2019, 1:38:47 PM EDT

American Woman Died at Same Dominican Republic Hotel That Maryland Couple Died In — The Bahia Principe hotel in the Dominican Republic. (Screenshot/Google Maps)

An American woman died at the same Dominican Republic hotel where a Maryland couple was found dead five days before on May 30.

Cynthia Day, 49, and her fiance, Nathaniel Holmes, 63, were found dead in their room at the Bahia Principe hotel inside the Playa Nueva Romana resort. Officials said in an update that the couple's cause of death was respiratory failure and pulmonary edema, which is caused by excess fluid in the lungs.

A Pennsylvania woman, Miranda Schaup-Werner, 41, died at the same hotel on May 25 after collapsing while drinking in her hotel room, a relative told Fox News.

Schaup-Werner was a psychotherapist who lived in Whitehall, according to her Facebook page.

Nathaniel Holmes and Cynthia Day in a file photo. (Cynthia Day/Facebook) — Nathaniel Holmes and Cynthia Day in a file photo. Cynthia Day/Facebook

The U.S. State Department on Tuesday confirmed the death in a statement: "We can confirm the death of a U.S. citizen in the Dominican Republic. We offer our sincerest condolences to the family for their loss. We are in close contact with local authorities regarding their investigation into the cause of death. We stand ready to provide all appropriate consular assistance."

"The U.S. Department of State and our embassies and consulates abroad have no greater responsibility than the protection of U.S. citizens overseas. Out of respect to the family during this difficult time, we have no further comment," the agency added.

Schaup-Werner's cause of death was also listed as respiratory failure and pulmonary edema.

“It was very quick,” Jay McDonald, who is acting as the family spokesman for his brother-in-law, Daniel Werner, Schaup-Werner’s husband, told Fox. “Daniel and all of us are in a state of disbelief, we are shocked. She was perfectly content, everything seemed fine.”

Schaup-Werner had a drink before sitting down and snapping a selfie, McDonald said. She stood up and then collapsed.

“She started shrieking and she dropped to the floor. He attempted to do CPR, he tried to resuscitate her," he said. Paramedics rushed to the room and injected her with epinephrine, a treatment for allergies, before declaring her dead.

Authorities “did a very cursory [look] into determining the cause of death," he added.

The cause of death listed for all three Americans was analyzed by a doctor.

“It most likely indicates that there was some type of lung injury that led to basically leaking of the fluid on portions of the lungs that should be filled with air,” Dr. Robert Shesser, chair of the department of emergency medicine at George Washington University, told NBC. “When that happens, people don’t get enough oxygen and can die.”

Police said carbon monoxide poisoning may have killed them.

An illustration showing ways to prevent carbon monoxide poisoning. (Centers for Disease Control and Prevention) — An illustration showing ways to prevent carbon monoxide poisoning. Centers for Disease Control and Prevention

“Anything that decreases the amount of oxygen could lead to leakage in the lungs,” Shesser said. “The way carbon monoxide works is it basically poisons the cells, so even though there is enough oxygen around, it’s not being used properly.”

Sonya Jackson, Day’s sister, said that the family doesn't think respiratory issues caused the death of Day and Holmes and said they're planning on having a second autopsy done when the body is flown back to the United States.

The U.S. State Department currently has a level 2 travel advisory for the Dominican Republic, which sits on an island in the Caribbean bordering Haiti.

“Violent crime, including armed robbery, homicide, and sexual assault is a concern throughout the Dominican Republic. The development of a professional tourist police corps, institution of a 911 system in many parts of the country, and a concentration of resources in resort areas means these tend to be better policed than urban areas like Santo Domingo," the State Department stated.

"The wide availability of weapons, the use and trade of illicit drugs, and a weak criminal justice system contribute to the high level of criminality on the broader scale."