On Monday, the U.S. State Department confirmed that back in April, an American tourist named Robert Wallace died under mysterious circumstances at the Hard Rock Hotel and Casino in Punta Cana. According to his niece, Wallace, 67, was last seen having a Scotch from the hotel mini bar before he fell ill.

“He started feeling very sick, he had blood in his urine and stool right afterward,” Wallace’s niece, Chloe Arnold, said. He died in a local hospital three days later.

Wallace’s death, while strange, wouldn’t be considered all that unusual, if not for the fact that it is the latest in a string of recent mysterious deaths of American tourists in the Dominican Republic. Most recently, an American couple was found dead at the Grand Bahía Principe La Romana in the Dominican Republic, with investigators saying that while no cause of death has yet been determined, no signs of violence were reported on the scene. Last month, a 41-year-old tourist from Pennsylvania was found dead in the same hotel, reportedly also after having a drink from the minibar.

The FBI is working with Dominican Republic officials to determine whether there’s any link between the deaths, but toxicology report results aren’t expected for at least a month. In the meantime, here’s what’s been going on in the Dominican Republic, and what we know about the tourist deaths so far.

How many tourists have died under mysterious circumstances in the Dominican Republic?
According to the State Department, Wallace’s death marks the fourth mysterious death of an American tourist in the Dominican Republic. But according to CBS News, there have been at least six tourist deaths in the Dominican Republic in the past year alone. Two of the deaths have been at the Hard Rock Hotel and Casino in Punta Cana, while four took place at Bahia Principe hotels. (In a statement to Rolling Stone, a representative for the Hard Rock Hotel & Casino Punta Cana said that “the safety and health of our guests is now, and has always been our highest priority,” and that they have protocols to ensure the safety of their guests, including daily inspections of their mini bars. Representatives for Grand Bahía did not respond to a request for comment, but in a post on Twitter on June 7th, the resort disputed recent media reports about the deaths of American tourists, saying that it “completely disagree[d] with the dissemination of false information issued publicly which threatens the image and reputation of the company,” adding that the hotel chain “would like to express our deep respect to the authorities and the ongoing investigations. We reiterate our firm commitment to collaborating completely with the authorities and the ongoing investigations.”)

In addition to Wallace, a Pennsylvania psychotherapist named Miranda Schaup-Werner, 41, was found dead in her hotel room on May 25th. She was staying at the Luxury Bahia Principe Bouganville hotel, an adults-only hotel in the town of San Pedro de Maconis. A preliminary autopsy report found that she had died of a heart attack, and the resort told CNN that her husband said she had a history of heart conditions. She also had fluid in her lungs and respiratory failure, according to the report. Curiously, Schaup-Werner also fell ill after having a drink from the minibar, though she was staying at a different resort than Wallace.

On May 30th, a mere few days after Schaup-Werner was found dead, employees at the same resort found Maryland couple Edward Nathaniel Holmes, 63, and Cynthia Ann Day, 49, dead in their hotel room after they missed their checkout time. They had been staying at the Bahia Principe La Romana, another hotel at the same resort.

Like Schaup-Werner, Day and Holmes were found to have fluid in their lungs and evidence of respiratory failure, according to a statement issued by the Dominican Republic National Police following a preliminary autopsy report. Also like Schaup-Werner, there was evidence that one of them had a preexisting condition. Holmes’ autopsy indicated that he had an enlarged heart and signs of cirrhosis of the liver, and blood pressure medication and a bottle of oxycodone were found in their hotel room.

Tourism Minister Francisco Garcia initially denied that the deaths were connected, insisting that the country was still safe to visit. But following the discovery of Day and Holmes, as well as reports that the three tourists had fluid in their lungs at the time of their deaths, investigators started to investigate whether there was a link between the three tourists’ deaths.

In addition to the deaths of Wallace, Schaup-Werner, Day, and Holmes, which all took place within a two-month period, at least two other tourists have died under mysterious circumstances in the Dominican Republic in the last year, CBS News reports — also at Bahia Principe hotels. Yvette Monique Sport, 51, died of a heart attack at the Bahia Principe in Punta Cana in June 2018, reportedly after she too had a drink from the minibar. And David Harrison, 45, also died of a heart attack and pulmonary edema during his stay at the Punta Cana Hard Rock Hotel and Casino last year — the same hotel where Wallace died last April.

“We went down there as a happy family, and we came home a broken family,” his widow, Dawn McCoy, told Maryland news station WTOP. “I came home a widow and my 12-year-old son came home fatherless.”

There have also been nearly 70 reports of tourists reporting symptoms of food-borne illness in the Dominican Republic since March alone, according to the website IWasPoisoned.com. More than half of these reports came from tourists who stayed at the Hard Rock Hotel and Casino in Punta Cana.

One couple from Colorado has also reported becoming violently ill after staying at the Grand Bahia Principe La Romana Resort, where Holmes and Day were found dead. They told KMGH/CNN that their doctor told them they had likely suffered the effects of “organo-phosphate poisoning,” or poisoning from chemicals used in some pesticides. They are suing the hotel and seeking $1 million in damages.

Is the Dominican Republic safe?
For now, it appears that the answer is a tentative yes. Although the U.S. State Department issued a level 2 travel advisory warning for tourists visiting the island back in April (for reference, there are four levels of advisory warnings, with a level 2 urging visitors to “exercise increased caution”), it appeared to be due to concerns about “violent crime, including armed robbery, homicide, and sexual assault” and not illness.

Tourism Minister Francisco Garcia has denied that the deaths were connected, referring to them as “isolated incidents” and insisting that the country was still safe to visit. And security experts seem to agree with this assessment. “It’s not an overly dangerous place,” Matthew Bradley, the director of security organization International SOS, told Time. “I would still consider the Dominican Republic a safe place to go.”

Tourism is an incredibly popular industry in the Dominican Republic: the island attracts nearly two million American visitors per year, and tourism accounts for about 17% of the country’s GDP,  according to one 2014 paper.

This story has been updated to include comment from the Hard Rock Hotel & Casino Punta Cana. 

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