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Toxic episode 3, titled The Depraved Heart, airing May 19, 2025, on Investigation Discovery at 10 pm ET/PT, examines the events that led to the death of 25-year-old Sarah Harris and the legal fallout that followed.
Toxic episode 3 investigates how a routine dental procedure with Dr. James Ryan, an established oral surgeon in Maryland, spiraled into a fatal relationship involving medical-grade drugs and alleged coercive control.
According to a CBS News report dated May 11, 2025, Harris began working for Ryan shortly after her surgery in 2020. Over the following year, their professional connection turned romantic, and prosecutors later argued that Ryan used his position to supply Harris with anesthetics like ketamine and diazepam.
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As detailed by the Law & Crime report dated August 26, 2023, text messages revealed Ryan had administered drugs to Harris at home, even while she slept. Toxic episode 3 reconstructs these findings through interviews with investigators and Harris’ family, offering a close look at the case that resulted in Ryan’s conviction for depraved-heart second-degree murder.
Toxic episode 3 case overview: The Sarah Harris tragedy is explored in depth
Toxic episode 3, titled The Depraved Heart, airs on May 19, 2025, at 10 pm ET/PT on Investigation Discovery. The episode focuses on the death of Sarah Harris, a 25-year-old Maryland woman whose relationship with her employer, oral surgeon Dr. James Ryan, ended in tragedy.
The story, explored in detail in Toxic episode 3, traces how a routine dental procedure evolved into a toxic relationship marked by dependency, drug misuse, and ultimately a fatal overdose.
Sarah Harris met Ryan in 2020 during a wisdom tooth extraction at his Germantown, Maryland, clinic. Months later, Ryan hired her as a surgical assistant, and by 2021, the two had moved in together. Prosecutors later alleged that Ryan, more than twice Sarah’s age, used his professional access to clinical anesthetics to control her through drugs.
According to a CBS News report dated May 11, 2025, authorities found Sarah dead in their Clarksburg home in January 2022, with syringes and surgical-grade drugs including ketamine and diazepam nearby.
Prosecutors said Ryan 'watched her deteriorate'
Toxic episode 3 lays out how Ryan was ultimately convicted of second-degree depraved-heart murder. The charge, rarely used, implies that while there may not have been intent to kill, there was clear disregard for the victim’s life. As per a Washington Post quote cited by a Fox News report dated August 28, 2023, Assistant State’s Attorney Jennifer Harrison said during the trial,
“Dr. James Ryan — a well-trained oral surgeon, skilled in what he did, an expert in his field continuously provided these dangerous, deadly anesthetic drugs to Sarah Harris… even as he watched her deteriorate before his eyes.”
Authorities alleged that Ryan administered or instructed Sarah to self-administer clinical drugs in their home without safety precautions, despite knowing the risks. Text messages recovered by Sarah’s sister, Rachel, revealed conversations where Harris requested specific drugs and Ryan complied. As per the CBS News report dated May 11, 2025, one message from December 2021 read,
“If you wake up… I just went [sic] change after I gave you ketamine. Just now.…”
Such texts suggested that Ryan may have injected Sarah while she was asleep.
Tina Harris, Sarah's mother, told 48 Hours that her daughter had visible needle marks on her arms and looked physically diminished. Rachel Harris, who later compiled photos, texts, and evidence into a binder, became instrumental in helping law enforcement reopen the case.
Detective Ian Iacoviello, an expert in pharmaceutical crimes, reviewed the evidence and described the text messages as reading, like watching a murder in slow motion, stating,
"You could see … Sarah die."
The court’s verdict and aftermath
A jury in Montgomery County reached a verdict in under three hours, finding Ryan guilty of second-degree depraved-heart murder, involuntary manslaughter, and multiple drug-related offenses. He was sentenced to 45 years behind bars on January 3, 2024.
Prosecutors argued that Ryan's medical knowledge made his actions especially dangerous. According to the NBC Washington report dated January 3, 2024, Montgomery County State’s Attorney John McCarthy said,
“These drugs were drugs, except for one of them, that were used uniquely and exclusively in operating rooms,”
Yet Ryan supplied them for at-home use without any safeguards. Toxic episode 3 will explore Sarah Harris' story, also shedding light on the misuse of medical authority and the blurred lines between care and control.
Stay tuned for more updates.
