The Dominican public health minister said in a radio interview Monday that the Maryland couple found dead last month in a hotel room at a luxury resort had pre-existing health problems and may have died after mixing prescription drugs and alcohol.

In response, the attorney for the couple's families called the minister's claim “absolutely ludicrous.”

Public Health Minister Rafael Sánchez Cárdenas noted more than once during the interview that the couple’s May 30 deaths were extraordinary, given that they died almost “simultaneously” and that there was no sign of violence or foul play.

"The toxicological test will determine if there's alcohol, and narcotics and the amount," Sánchez Cárdenas said. "There's been talk about drug abuse," he added, noting it could be lethal if combined with alcohol. He added that "they had pre-existing health issues."

Sánchez Cárdenas said the bottom line was that there was nothing nefarious about the rash of the U.S. tourist deaths dogging the country since first making headlines in the spring.

"Each one of these involved pre-existing health issues leading up to their deaths," he said. "Every one of these cases can be explained. The autopsies show what happened."

In a text message sent to Fox News, Steven Bullock, the attorney representing the Maryland couple’s families, called the public health minister’s remarks about the two tourists “absolutely ludicrous.”

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Edward Holmes, 63, and Cynthia Day, 49, who were engaged, were found unresponsive in their room at the Grand Bahia Principe La Romana by a resort employee who went to check on them after they failed to check out. The couple, who had been at the resort since May 25, had plans to return to the United States the day they turned up dead.

Edward Holmes and Cynthia Day died last month in the Dominican Republic.

Edward Holmes and Cynthia Day died last month in the Dominican Republic. (Facebook)

Several medications were found in the room, including an anti-inflammatory drug, an opioid and blood-pressure medicine, Dominican officials said at a news conference last Friday. Autopsies for many of the tourists showed pulmonary edema, an accumulation of fluid in the lungs frequently triggered by heart disease. Among nearly a dozen U.S. tourists who have died in the country in the last 18 months, Dominican investigators said most died of a heart attack.

Autopsies for Day and Holmes showed they had enlarged hearts, internal bleeding and pulmonary edema. Day was said to have fluid in the brain. On the radio show, the health minister said that Holmes was "morbidly obese."

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FBI officials have been conducting toxicological tests in their Virginia research center on blood samples from the couple, as well as from a Pennsylvania woman, Miranda Schaup-Werner, who died at the same resort complex five days before. Schaup-Werner's relatives said she collapsed after she had a drink from the minibar. Her autopsy stated she had a heart attack.

The news of Holmes’ and Day’s deaths, made public by their families when they went to the media with concerns about investigators’ preliminary determination that the two died of natural causes, prompted friends and relatives of other U.S. tourists who died in other Dominican resorts to come forward, sharing their suspicions and bewilderment about what killed their loved ones.

Many of the families described their deceased relatives as having been in generally good health right before traveling to the Dominican Republic. They have expressed outrage over what they saw as a concerted effort by Dominican officials to pin the deaths on the people who died. Some families have been arranging for their own autopsies and toxicological tests in the U.S.

The FBI told Fox News last week that the bureau sent a team to the Dominican Republic to help investigate the deaths.

Dominican Republic Public Health Minister Rafael Sanchez Cardenas is seen on the left.

Dominican Republic Public Health Minister Rafael Sanchez Cardenas is seen on the left. (Dominican Republic Public Health Ministry)

Among the questions that relatives and some U.S. public health and epidemiological experts have raised: whether at least some of the deaths might have been caused by counterfeit alcohol or by pesticides or insect-killer chemicals that somehow wound up on drinking glasses or utensils.

As Sánchez Cárdenas was wrapping up the radio interview Monday morning, friends and family of Cynthia Day were gathering at the First Baptist Church of Glenarden in Maryland for her memorial service. Holmes' funeral has been scheduled for Wednesday.

Dominican officials often have emphasized the presence of several prescription medications in the room where Day and Holmes were staying, but only in the last week started saying outright that the meds seemed to have played a role in their deaths.

In the morning radio interview, Sánchez Cárdenas said the couple had a practical "pharmacy" in their room. Last week, Carlos Suero, the spokesman for the Ministry of Public Health, told Fox News in a wide-ranging phone interview that the coverage of the rash of deaths in the popular Caribbean vacation spot as "mysterious" was nothing but fake news. Suero said that in a competitive industry such as tourism, there were people who would try to undermine a top destination such as the Dominican Republic.

Suero laid out many of the arguments and scenarios that Sánchez Cárdenas underscored in the radio interview, speaking about the health issues that some of the tourists allegedly had, and saying that perhaps it wasn't responsible to travel with such health problems.

Suero told Fox News that Holmes died first and Cox died afterward, saying that the shock of seeing Holmes dead next to her could have killed her.

Will Cox and his mother, Leyla Cox, who died in the Dominican Republic.

Will Cox and his mother, Leyla Cox, who died in the Dominican Republic. (Will Cox)

At the funeral service, Bullock told reporters he did not buy the account by Dominican investigators about the cause and circumstances of the deaths of Day and Holmes.

“It’s a mystery,” Bullock told WTOP. “There’s reason for us to pause, and we’re going to investigate this and get this matter resolved.”

Bullock said he was focused on getting more information from U.S. officials and results of toxicology tests before jumping to conclusions.

“We need to find out what’s going on and what happened,” said Meshonn Madison, Day's friend.

Sánchez Cárdenas also singled out the deaths of Joseph Allen, 55, of New Jersey, and Leyla Cox, 53, of New York. He said Allen had unhealthful habits such as smoking and drinking regularly, and a report on his death referred to him as "a ticking timebomb," adding that "his organs were practically destroyed, with a biological age of more than 80 years old. He was extremely obese, weighing more than 400 pounds.”

Allen's family has disputed those conclusions.

The health minister said Cox's autopsy showed she previously had suffered several heart attacks. However, her family and her former supervisor at the New York hospital where she worked as an MRI technician said Cox had never suffered a heart attack.

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Her son, Will Cox, lashed out at Dominican investigators as untrustworthy and said they repeated had put up roadblocks when he tried to get answers and that they tried to rush him into letting them cremate or embalm her. With the intervention of the U.S. Embassy and congressional lawmakers, Cox succeeded in getting Dominican officials to agree to send a vial of his mother's blood to the U.S., where the hospital where she worked would run toxicology tests.

"We’re not talking about a patient who had no medical conditions," the health minister said of Leyla Cox in the radio interview. "A person with hypertension is vulnerable to a heart attack."