The verdict against once-respected oral surgeon James Ryan was devastating: guilty of depraved-heart murder, a Maryland jury declared in August. For months, the jurors had been told, Ryan had supplied his girlfriend with addictive anesthesia solutions administered through IVs at their home, until she died of an overdose.
On Wednesday, a Montgomery County judge is scheduled to sentence the 50-year-old defendant.
Prosecutors are seeking a 55-year term, the maximum allowable, arguing in new court filings that Ryan kept giving Sarah Harris, 25, drugs that he stole from his office even as her weight dropped to 83 pounds. “She was helpless, hooked, and trapped,” they wrote.
Ryan’s attorneys said they will seek a far shorter term that would give their client a chance at parole by age 60. Their court filings invoke the Oct. 28 death of “Friends” TV star Matthew Perry from the acute effects of ketamine, which he had reportedly taken in the past for depression. The drug was one of several that Ryan gave to Harris.
“This is not a man who made choices with a depraved heart,” Ryan’s attorneys wrote. “This was a man who desperately wanted to alleviate the pain of the woman he loved, but made the wrong decisions.”
Ryan formerly ran Evolution Oral Surgery on the third floor of a medical office building in the county’s Germantown area. Starting in 2021, he provided Harris — a former beauty queen he met when she came to him as a patient — with drugs that included propofol, an anesthesia solution that contributed to the 2009 death of pop icon Michael Jackson.
Ryan’s sentencing hearing, which is expected to last several hours, is likely to include emotional testimony from both sides. “This is a very difficult circumstance for everyone,” Circuit Court Judge Cheryl McCally recently said in court.
Harris died in early 2022 of “ketamine, propofol and diazepam intoxication,” according to a report by Maryland’s Office of the Chief Medical Examiner. The manner of death — possibilities that include homicide, suicide, accidental or natural — could not be determined, according to the report.
Prosecutors have long said that while Ryan didn’t necessarily set out to kill Harris, he knew how deadly the drugs could be — especially when administered inside a house, sometimes by Harris herself. In their new filings, prosecutors note that Ryan had told police that a month before Harris’s death, he had to perform CPR at their home to revive her from an overdose of ketamine. Such “extreme indifference” to her life, prosecutors say, amounted to second-degree murder.
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In their new filings, Ryan’s lawyers stressed that one of three drugs found in Harris’s body — diazepam — comes in a pill form and was taken by Harris herself. They said during Ryan’s trial that prosecutors discounted the possibility that Harris took her own life.
Ryan spent at least part of his childhood in Arizona, went to college in Long Island and received dental surgery training at New York University, graduating with honors in 2006. He is a divorced father of four, according to court filings.
Ryan practiced at several locations before starting his practice in Germantown. “Our philosophy really is [to] treat patients the way that we want to be treated ourselves,” Ryan once told prospective patients in a video on the firm’s website. “Connections and making a difference — that’s the point of everything. So it feels really good to be able to do that.”
As for Harris, she received good grades in school while struggling with mental health issues in her mid-teens, then graduated from Montgomery’s Quince Orchard High School and earned a scholarship to Montgomery College, according to her family.
Harris also participated in beauty contests for Miss Maryland and Miss Maryland Petite, which she won in 2020, according to her family. That same year, after going to see Ryan for dental work, she took a job at his practice. The two began dating and eventually moved in together.
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On Feb. 11, 2021, Ryan introduced Harris to drugs from his practice, according to text messages later obtained by investigators and cited in court filings. “I can give you an injection,” he wrote. “The anxiety will be completely gone in 6 seconds.”
As Harris’s drug use expanded, the two regularly communicated about specific kinds — including Versed, a brand name for the drug midazolam — as well as IV poles, saline bags, gauze, tape and 20-gauge needles.
“Can you get more Versed and ketamine,” Harris wrote on Aug. 27, 2021. “And also IV catheter.”
Ryan wrote to Harris about his own use of Versed: “I’m trying not to do so much. And taper to nothing. Hard in this stupid area.”
The text messages — often written by Harris from their home and Ryan at the office — detailed the drugs’ effects on Harris. “I just woke up. I feel like I got actual sleep,” she wrote on Sept. 28, 2021. “I feel very out of it, though.”
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“I’m glad you got actual sleep,” Ryan responded. “I think the ketamine works well for you. Drink lots of water and you will not feel so out of it. Need to get the k out of your system.”
In their court filings, prosecutors urged the judge to view such advice in the context of the dentist’s standing in his girlfriend’s life.
“The defendant made Sarah dependent on drugs that only he could provide,” wrote Assistant State’s Attorneys James Dietrich, Jennifer Harrison and Kimberly Cissel.
They will have to persuade Judge McCally to go beyond Maryland sentencing guidelines, which, while not mandatory, suggest a term of 10 to 25 years, according to calculations by attorneys in the case.
Defense attorneys stress that Ryan was trying to treat Harris’s anxiety while keeping her off street drugs and that his own judgment was clouded by drug abuse and mental health struggles.
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“Dr. Ryan was, and is, a deeply flawed individual, but he had no desire to kill Ms. Harris,” wrote attorneys Paul Kemp and Aindrea Conroy. “To the contrary, he loved Ms. Harris deeply and wanted their relationship to grow and for her to be healthy.”
The text messages also reveal what prosecutors describe as Harris’s deteriorating condition.
“You slept all night and every time you woke up you were sobbing,” Ryan wrote to her on Dec. 21, 2021. “I couldn’t understand what you were saying because of the ketamine. I just hugged you. Just a reminder they were just bad dreams.”
In their new filings, Ryan’s attorneys draw attention to the death of 54-year-old Perry, who was found in the pool of his Los Angeles home. In addition to listing the acute effects of ketamine as the principal cause, an autopsy report cited several “contributing factors,” including drowning, coronary artery disease and the effects of buprenorphine. His death was ruled accidental.
“Even in light of this tragedy,” Ryan’s attorneys wrote, citing media coverage of Perry’s death, “it is reported that people should not be dissuaded from being treated with ketamine under the supervision of a medical professional.”
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They also urged the judge to consider Harris’s role in her heightened drug use. “As Ms. Harris’ use of those drugs became out of control,” they wrote, “Dr. Ryan did try to restrict her access to those drugs, but was ultimately and tragically unsuccessful.”
But he kept bringing her the dangerous drugs even after her near-fatal overdose, the prosecutors said. And on the day before Harris was found dead in their home, prosecutors told the judge, the two had been discussing drug use.
“Is it possible to bring home ketamine when you come,” Harris wrote on Jan. 25, 2022.
“Yes I will bring some home,” Ryan replied. “I love you baby.”
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