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James Ryan, a Maryland oral surgeon, was sentenced to 45 years in prison for supplying his girlfriend and former patient, Sarah Harris, with dangerous anesthesia drugs that ultimately led to her death in January 2022. Authorities found Harris unresponsive in the Clarksburg home they shared, surrounded by clinical drug vials, syringes, and IV equipment typically used in operating rooms.
The autopsy determined that Sarah Harris died from a combination of ketamine and diazepam toxicity. James Ryan had been providing Harris with controlled substances for over a year, with texts revealing he instructed her on how to use them and sometimes administered them himself.
The latest episode of Toxic on Investigation Discovery, titled The Depraved Heart, airing on May 19, 2025, at 10:00 PM ET/PT, delves into the case. Prosecutors argued that despite his medical training, James Ryan repeatedly ignored the fatal risk his actions posed. The episode focuses on Harris’ family and the ongoing impact of her death.
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5 key details about James Ryan's crimes explored
Airing on May 19, 2025, Toxic episode 3, titled The Depraved Heart, examines the troubling case of Dr. James Ryan. Here are the five key details of his crimes.
1) Sarah Harris went from patient to partner under James Ryan’s influence
According to the NBC Washington report dated August 28, 2023, Sarah Harris first met James Ryan during a routine dental procedure in 2020. A few weeks later, Ryan offered her a job at his practice. By early 2021, they began a romantic relationship despite a significant age gap- he was 50; she was 25. Harris moved into Ryan’s home in Clarksburg, Maryland, by the summer of 2021.
Ryan's relationship with Harris allegedly crossed professional boundaries. Per a CBS News report dated May 11, 2025, Tina Harris, Sarah’s mother, said Ryan admitted he had noticed Sarah years earlier when she was just 14, watching her at the park and visiting her workplace without her knowledge. This early interest and subsequent involvement raised concerns among Harris’s family.
2) Ryan supplied powerful anesthetics from his clinic to Sarah Harris
Prosecutors said James Ryan used his position to gain access to drugs typically restricted to operating rooms. As per a Fox News report dated August 28, 2023, He continuously provided these dangerous, deadly anesthetic drugs to Sarah Harris over time, even as he watched her deteriorate before his eyes. The drugs included ketamine, diazepam, and propofol.
Text messages recovered during the investigation showed that Harris would request specific drugs and paraphernalia, and Ryan would comply. According to the Law & Crime report dated August 26, 2023, Ryan then told Harris how to use the drugs he provided, often including instructions to intensify the effects.
3) The overdose death scene showed signs of prolonged drug abuse
On January 26, 2022, Harris was found dead in the living room of the house she shared with James Ryan. Authorities recovered used syringes, drug vials, and IV supplies.
As per CBS News, Ryan told police it appeared to be an overdose and that Harris had previously struggled with mental health. However, the autopsy confirmed that she died from a combination of ketamine and diazepam intoxication.
4) Sarah's sister uncovered key evidence that reignited the case
Though initial responders treated the scene as a suicide or accidental overdose, Sarah's sister, Rachel Harris, discovered hundreds of text messages, photos of drug paraphernalia, and screenshots.
She compiled these into a binder and submitted them to Montgomery County police. This evidence prompted a deeper pharmaceutical investigation. Detective Iacoviello reviewed the binder and concluded that Ryan had created an addiction and maintained control through a steady supply of sedatives.
5) Ryan was convicted of depraved-heart murder and sentenced to 45 years
James Ryan was arrested in March 2022 and later convicted in August 2023 of second-degree depraved-heart murder, involuntary manslaughter, and drug distribution. Prosecutors did not argue that Ryan intended to kill Harris but claimed he acted with extreme disregard for her life.
As per CBS News, Prosecutor Jennifer Harrison told jurors,
“The act of giving her the drugs is... him handing her a loaded gun.”
On January 3, 2024, Ryan was sentenced to 45 years in prison, with the judge opting for a term beyond the standard guidelines. Toxic episode 3 examines the emotional and legal fallout from James Ryan’s actions and highlights the systemic issues surrounding healthcare abuse and personal vulnerability.
Stay tuned for more updates.
