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The upcoming Toxic episode 3 on Investigation Discovery explores the case of Sarah Harris, a 25-year-old Maryland woman who died from a fatal combination of anesthetic drugs in January 2022. A former beauty pageant winner and aspiring medical professional, Sarah had once been a patient at Dr. James Ryan’s oral surgery practice.
Their relationship evolved after he offered her a job, eventually leading to them living together. Authorities later discovered that Ryan, who was twice her age, had been supplying Sarah with powerful drugs from his clinic.
According to a CBS News report dated May 11, 2025, these substances, typically reserved for surgical settings, were administered at home without safety protocols. Prosecutors alleged that Ryan showed a reckless disregard for Sarah’s life, leading to his conviction for second-degree depraved-heart murder. As per the NBC Washington report dated January 3, 2024, he was sentenced to 45 years in prison.
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Toxic episode 3, titled The Depraved Heart, will air on Monday, May 19, 2025, at 10 pm ET/PT on Investigation Discovery.
Sarah Harris, a 25-year-old beauty queen and surgical assistant, died from a lethal mix of anesthetic drugs in January 2022
In January 2022, Sarah Harris was discovered unconscious at the Maryland residence she shared with her partner and boss, oral surgeon Dr. James Ryan. Her death was attributed to a combination of ketamine, diazepam, and propofol, powerful anesthetic agents typically used under professional supervision in operating rooms.
According to a Fox News report dated August 28, 2023, investigators discovered medical paraphernalia throughout the home, including syringes, tourniquets, and IV bags. These findings led to Ryan being charged and later convicted of depraved-heart second-degree murder.
Toxic episode 3, titled The Depraved Heart, set to air on May 19, 2025, at 10 pm ET, revisits this case. The episode explores the events through interviews with Sarah Harris’ family and investigators, focusing on the gradual erosion of her independence under Ryan’s influence.
A relationship defined by control and drugs
Sarah Harris first met Ryan in 2020 during a routine oral surgery appointment. Weeks after the procedure, he contacted her about a job opening. According to a CBS News report dated May 11, 2025, she accepted a position as a surgical technician at his Germantown practice.
By early 2021, they began dating, and later that year, she moved into his home. Over time, Harris’s physical and emotional state began to decline. Her family, including sister Rachel and mother Tina, became alarmed by her rapid weight loss and erratic behavior.
Text messages retrieved from Sarah Harris’ devices revealed that she frequently requested drugs from Ryan and discussed administration methods with him. These exchanges showed Sarah asking for ketamine and propofol, and Ryan agreeing to bring them home or advising her on usage.
“If you wake up … I just went [to] change after I gave you ketamine. Just now,” Ryan wrote in one such text message, as cited in the NBC Washington report dated January 3, 2024.
Detective Ian Iacoviello of Montgomery County, who reviewed the evidence submitted by Rachel Harris, described the messages as a timeline of Sarah Harris’s decline.
“You could see ... Sarah die,” Iacoviello said, according to CBS News.
He noted that the drugs Ryan provided, meant for monitored use in medical facilities, were being administered in a domestic setting with no safeguards.
A legal conviction and a family’s pursuit of justice
In August 2023, after a two-week trial and just three hours of deliberation, a Maryland jury convicted James Ryan of depraved-heart murder, involuntary manslaughter, and drug distribution charges. Prosecutors argued Ryan’s actions reflected “extreme indifference" to Sarah’s life, satisfying the requirements of Maryland’s depraved-heart murder statute.
“Every time he gave her those drugs… a little bit of Sarah died,” Assistant State’s Attorney Jennifer Harrison told jurors, as per the Law & Crime report dated August 26, 2023.
As per the CBS News report dated May 11, 2025, during sentencing, Ryan accepted partial responsibility.
“While I did not administer the drugs to Sarah, and I’m not exactly sure when she got them, those drugs were absolutely my responsibility,” he said.
He received a 45-year prison sentence. Sarah Harris’ story, as detailed in Toxic episode 3, underscores the dangers of unchecked power dynamics in personal and professional relationships.
Stay tuned for more updates.
