Taiwanese actress Barbie Hsu reportedly missed two crucial opportunities for medical intervention before her passing, according to leaked hospital records.

One of these moments occurred when she declined hospitalization due to having already booked return flight tickets.

Sohu reported that Barbie arrived in Japan on January 29 and passed away on February 2 at the age of 49. Her family confirmed the following day that she succumbed to influenza-related pneumonia. Prior to her death, she exhibited serious health warning signs.

Leaked emergency department records from a local hospital—yet to be officially verified by Japanese medical authorities—indicate that Barbie was in critical condition before her passing. Her blood oxygen level had fallen to 89%, and doctors detected moist rales, signaling lung damage. Despite these alarming symptoms, she was only prescribed antipyretic medication. Rather than being admitted to the hospital, Barbie opted to return to her hotel for observation, missing her first chance for proper medical care.

A day before her death, on February 1, medical staff recommended transferring her to Tokyo General Hospital. However, Barbie and her family declined the suggestion, citing their pre-scheduled return flight, thereby missing a second critical opportunity for treatment.

Tragically, on the way back to her hotel, Barbie stopped breathing. She was rushed to a nearby community clinic, where a CT scan revealed that both of her lungs had turned white, indicating severe infection. An ambulance was called, and she was finally admitted to a local medical facility. However, the clinic lacked specialized care, and she ultimately passed away.

Following her hospitalization, a video surfaced of Barbie’s sister Dee and their mother dancing at the hotel, leading to speculation that the family had underestimated the seriousness of her condition. Some believe they mistook her symptoms for a mild cold rather than a life-threatening case of pneumonia.

The authenticity of the leaked medical records remains unverified.

Barbie’s cremation ceremony took place in Japan, and according to TVBS, her husband, South Korean musician DJ Koo, is expected to return to Taiwan with her ashes on February 6.

This was not the first time Barbie had faced severe health crises. In 2016, while giving birth to her second child, she experienced an epileptic seizure, fell into a coma due to oxygen deprivation, and suffered cardiac and respiratory arrest. Her then-husband, Chinese businessman Wang Xiaofei, performed CPR and saved her life. She remained in a coma for ten days before regaining consciousness. Wang later recalled how her face turned purple, her body convulsed, and she became completely unresponsive, prompting him to administer mouth-to-mouth resuscitation and CPR.

In 2017, Barbie fainted and was hospitalized, later revealing that she had chronic mitral valve prolapse. The following year, she collapsed again due to a prolonged cold, triggering another epileptic episode. Her mother also confirmed that Barbie had suffered two miscarriages around that time.

According to Oriental Sunday, Barbie’s perfectionism and commitment to beauty played a role in her fragile health. Since her debut at 17, she had battled epilepsy and heart issues while adhering to extreme dieting habits. Standing at 163 cm, she weighed only 39 kg at one point and maintained 42–44 kg while filming. She often skipped meals after lunch, ate only half the portions prescribed by her nutritionist, and engaged in intense exercise routines.

On film sets, she reportedly consumed lunch boxes containing just two bites of rice and a tiny piece of fermented tofu. On one occasion, she fainted after not eating for three days. During a commercial shoot, she collapsed, and staff discovered that she had tightly bound her waist and abdomen with a corset.

Her obsession with beauty was well-documented. In 2004, she published “Beauty Queen,” a best-selling book detailing skincare techniques, which remained at the top of sales charts for years. Within six weeks, it sold over 200,000 copies, setting a record for beauty publications in Taiwan. In the book, she admitted to using anticoagulants to maintain fair skin, despite the life-threatening risk of internal bleeding.

“I can’t accept not being fair-skinned,” she once confessed on a talk show.

In “Beauty Queen 2,” released in 2007, she promoted intravenous skin whitening treatments, which have since been banned in France due to health risks.

Her relentless pursuit of beauty was described as a “death march” in elite beauty circles. On the show “Amazing Life,” her close friend Aya Liu recalled a trip to New Zealand where Barbie packed three large suitcases filled with beauty devices, oxygen injection machines, and UV sterilizers.

Barbie gained fame through her roles in TV series such as “Meteor Garden,” “Mars,” and “Summer’s Desire.” Her personal life, especially her marriages, was often in the public spotlight.

She was married to Wang Xiaofei from 2011 until their divorce in 2021, and the couple had two children together. Just three months after their split, she married 55-year-old DJ Koo.