Surgeon James Ryan gave his much younger girlfriend Sarah Harris anesthesia drugs to control her, prosecutors say
When Sarah Harris went in for surgery to remove her wisdom teeth in the summer of 2020, she must have thought she was in good hands. The oral surgeon she chose, Dr. James Ryan, had years of training, a good reputation and a thriving practice near her Washington, D.C.-area home. As a new patient at 23, she may never have dreamed he'd allegedly watched her when she was just 14. And Ryan would do more than take out Sarah's teeth. Her family says he would take her self-control and eventually take her life.
On the morning of Jan. 26, 2022, first responders could not revive Sarah after finding her unresponsive on the floor of the house where she lived with Ryan; following the surgery, the two had become romantically involved. Ryan told authorities he'd gone to bed about 10:30 p.m. the night before and discovered her in the morning. He told first responders Sarah had been struggling with drugs and mental health and he suspected an overdose. Authorities on the scene believed Dr. Ryan's account.
But for a while Sarah's mother, Tina Harris, had been suspicious of Ryan. Tina Harris tells "48 Hours" contributor Nikki Battiste that Ryan admitted to her he'd noticed Sarah when he saw her in the park with friends when she was only 14. And Battiste learns from authorities that, when they started dating years later, Ryan had provided Sarah with access to the habit-forming drugs that eventually killed her. It's all in a report titled "Depraved Heart Murder," now streaming on Paramount+.
Tina Harris says she knew Ryan was responsible for her daughter's death from the moment he'd called with the news that morning. She says Sarah had a history of depression and anxiety. Twice in the previous three months, she says she'd discovered Sarah with slurred speech and drug vials and medical paraphernalia nearby, which she'd instructed Sarah's sister Rachel to photograph. Tina Harris says Sarah and Ryan both had claimed he was merely hydrating her and they convinced Tina Harris not to notify police. But she says her suspicion about Sarah having been at risk was affirmed after her daughter's death when authorities discovered Sarah had two powerful surgical anesthetics in her system: propofol and ketamine, the latter of which is also used for depression and made news in the 2023 death of actor Matthew Perry.
During and after high school, Sarah had been a good student, an aspiring model and a beauty pageant winner. She already had a boyfriend. But Tina Harris says Ryan didn't seem to care. She says soon after the medical procedure, his interest in Sarah became more overt. More than twice her age, he'd texted her with smiley face emojis, Tina Harris says, and offered Sarah a job as his surgical assistant. Interested in a medical career, she'd taken the job, and Tina Harris says around that Christmas, he'd left Sarah a diamond necklace in her locker. Ryan was divorced with three grown children and he already had a baby with one of his employees.
"I said, 'OK, he's after you,'" said Tina Harris. "You've gotta put your foot down."
But Tina says in early 2021, Sarah agreed to have a meal with Ryan. Over the coming months, he wore Sarah down, says Tina Harris, by showering her with attention, gifts and travel — even paying travel expenses for the other Harrises too.
"You think he was grooming Sarah?" asked Battiste.
"Yes, yes," Tina Harris responded. "And … I think he was grooming me; I think he was grooming Rachel."
They were all together on a trip to Key West in September 2021, when Tina Harris says a drunk Ryan revealed something to her and Rachel that made them instantly uncomfortable: that he'd noticed Sarah long before ever seeing her as a patient. Tina says Sarah had been just 14.
"'I used to see Sarah walking the neighborhood and playing at the park with her friends,' " Tina Harris says Ryan told her one evening. She says he then added a reference to having thought Sarah was "pretty."
The conversation could not be independently corroborated, but Tina Harris says Ryan kept talking. "'I found out she worked in the toy store across the street at this little shopping area,'" she says he told her. "'So I would take my kids there so I could see her and I remember when she dressed up as Elsa from 'Frozen' and she looked just like Elsa.'"
According to Tina Harris, Ryan later discovered Sarah had a waitressing job.
"'Then I found out she worked at one of these restaurants…and so I would go in there for dinner so I could get her as my server,'" she says Ryan told her.
"It sounds like Dr. Ryan was obsessed with Sarah," Battiste observed.
"He was. He was very much so," Tina Harris said.
Tina Harris says she shared her concerns with Detective Ian Iacoviello of Montgomery County Police weeks after Sarah's death. The specialist in pharmaceutical cases was nearing his 2023 retirement, but first made a case against James Ryan with prosecutors, who charged and tried him.
"I can't imagine as a parent hearing another grown man say that they were watching my child," Iacoviello told us. "There is a problem, um, an infatuation, a — almost a control aspect."
During and after Ryan's initial courtship of Sarah, authorities say he had brought her drugs that he'd removed from his office and controlled her, as evidenced in a slew of texts between them, unearthed by Rachel Harris after her sister Sarah's death.
On Feb. 11, 2021 Ryan wrote: "I can give you an injection … the anxiety will be completely gone in 6 second s (sic) … it will work. Let's try it…" In October, Sarah is asking for the drugs, writing: "Do we have Ketamine here …" In November: "We need syringes … I feel like s***." In December: "I just really need … sleep xan (sic) you bring propofol …"
"He's created an addict," said Iacoviello.
And in at least one case, Ryan appears to have actually administered the drugs to Sarah himself. On Dec. 20, 2021, he'd written "If you wake up … I just went to change, after I gave you Ketamine just now …"
"He's injecting her while she's asleep," Iacoviello told "48 Hours." "No monitoring, no anything."
"She was chemically dependent on him," said social worker Janice Miller, who had testified on behalf of the prosecution at Ryan's trial. From the witness box, Miller had told jurors that dysfunctional relationships can be caused by imbalances, in which one side seeks power over the other and then uses that power for control. And Miller told Battiste that, though she'd never met Ryan, his behavior fit the pattern of an abusive partner and as such, his need for control over Sarah Harris could have started years earlier.
"If Dr. Ryan was attracted to Ms. Harris when she was still a teenager, uh … he didn't really view her as a person," she said in an interview with "48 Hours." "He viewed her as an object … not a person to be in an equal relationship with. And so, if that's true, then he entered into that relationship not with the idea that they could have an equal relationship, but that he could control her."
Ryan may have wanted to control Sarah, but prosecutors making a case against him faced a challenge. They had no conclusive evidence he wanted her to die. So they charged him with drug distribution, intent to distribute and a very uncommon type of murder.
What is "depraved heart murder"?
It's known as "depraved heart murder."
They told us it's a subcategory of second-degree murder — more serious than manslaughter, in which the state must show the defendant has a reckless disregard for human life. Maryland Assistant State's Attorney James Dietrich gave "48 Hours" an example:
"If I ... take a gun and just randomly shoot it into a crowd," Dietrich says, "I may not necessarily want or care that anybody dies. But…that is such a grossly reckless act that someone's likely to die."
And Dietrich says Dr. Ryan's medical training meant he had to know the risks of those drugs he was bringing to Sarah Harris.
Ryan's alleged comments about Sarah at 14 never came up at trial, where the defense team argued that when Ryan and Sarah met as adults, he only wanted to help her and that her own battle with drugs and depression may have played a role in her demise. But, having considered the incriminating texts and photos Rachel had taken at Sarah's house, it took a jury less than three hours to reach a guilty verdict on all the charges.
And James Ryan is not the only doctor to face drug charges in a fatal overdose. Just last summer, federal prosecutors charged two physicians with conspiracy to distribute ketamine in the Matthew Perry case.
At the Ryan sentencing on Jan, 3, 2024, Ryan addressed the court before the judge gave him 45 years in prison.
"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," Ryan said. "And I should have made sure that she never had access to them…I should have never thought I could control her addiction …"
