Now, with Ryan’s trial set to start Wednesday in Montgomery County Circuit Court, his defense is taking an aggressive posture. Ryan didn’t kill Sarah Harris, his attorneys are expected to assert, but rather she took her own life.
“This is a very personal situation for everybody involved here — everybody,” Judge Cheryl McCally said at a recent hearing, addressing Harris’s relatives in the gallery and alerting them to the painful testimony and arguments ahead. “And there are going to be lots of references to information that is particularly difficult for her family, also for Dr. Ryan.”
McCally scheduled two days for jury selection, starting Monday, followed by 10 days of trial. Jurors will hear about the abuse of medical-grade drugs that Ryan, 50, is accused of swiping from his dental office in Germantown and helping administer to Harris, who was 25 when she died in early 2022. The substances in question include ketamine, propofol, and midazolam, all designed to be used during surgery. Abusing them is less common than abuse of other drugs, according to medical literature, but it does happen.
Much of the prosecutors’ case, according to recent court filings and hearings, will be presented through nearly a year’s worth of text messages between Ryan and Harris — many exchanged while she was at their home and he was at the office.
“I think the ketamine works well for you,” Ryan wrote in September 2021 to Harris, who responded that she felt disoriented, according to court evidence submitted in the case.
“Is it hard to walk?” Ryan wrote.
“No,” she texted back, “just feel like I’m kinda floating.”
In asking jurors to convict Ryan of “depraved heart,” second-degree murder, prosecutors do not have to prove that he premeditatedly killed Harris. They instead will try to show that, as an oral and maxillofacial surgeon well-versed in anesthesia, he knew how dangerous the drugs were and knew of Harris’s worsening addiction. She was just 86 pounds at her death and had been seen a short time before with needle marks and bruises covering her arms. As such, prosecutors will stress, Ryan showed an “extreme disregard” for Harris’s life by introducing her to the drugs, setting up the home-delivery system and fostering her addiction.
The case is complicated by indefinite autopsy results. The Maryland Office of the Chief Medical Examiner ruled the cause of Harris’s death was “ketamine, propofol and diazepam intoxication,” according to court records, but the manner of how that happened could not be determined.
In court hearings, Ryan’s attorney, Thomas DeGonia, has described Harris as suicidal and indicated that he would question prosecution witnesses about whether Harris could have taken her own life. DeGonia and co-counsel Aindrea Conroy have messages they can use as well.
“I’ve been in a bad place,” Harris wrote over Instagram to a friend a month before her death, according to court filings, adding, “I just want peace again.”
Ryan formerly ran Evolution Oral Surgery, which operated from the third floor of a medical office building. “Our philosophy really is treat patients the way that we want to be treated ourselves,” he said on a promotional video.
Harris appears to have met him first as a patient. In October, 2020, according to court records, she took a job at his office. Several months later they started dating and she later moved into his home. Their text messages discussed drugs and administration equipment.
“Can you get more Versed and ketamine,” Harris wrote on Aug. 27, 2021. “And also IV catheter.”
Two weeks later, Ryan wrote to Harris about his own use of Versed, a brand name for midazolam. “I’m trying not to do so much. And taper to nothing. Hard in this stupid area.”
Detectives also described Ryan’s drug abuse at work, alleging in court papers that his employees found him asleep in his office once and needed ammonia smelling salts to wake him up.
On Oct. 28, 2021, two of Harris’s relatives went to Ryan’s home and found Harris “in a totally altered state,” prosecutors wrote in a recent court filing, adding that they also found vials of drugs, saline bags and other medical supplies. They returned later to a similar scene and confronted Ryan about providing Harris with drugs.
“He promised to never let it happen again,” wrote Assistant State’s Attorneys James Dietrich, Kimberly Cissel and Jennifer Harrison.
Then one of Harris’s sisters accessed her iCloud account, retrieved text messages between her and Ryan, and gave them to investigators.
“The text messages revealed that defendant was in fact stealing ketamine, propofol and midazolam from his practice and providing them to the victim,” prosecutors wrote. “In various text messages, [the] defendant tells [the] victim he is bringing the drugs home, that he will give her an IV, and he often instructs her on how to administer the drugs herself. He tells her he will bring home fluids, IV bags, needles and other supplies for the injections. He even tells her on one occasion he gave her more ketamine while she was sleeping. She describes for him in detail the disorienting, anesthetic effects of the drugs, to the point where she urinates on herself while she is unconscious on the couch. It becomes clear through the messages she is growing more addicted over time.”
“Do you have the key card to the office?” she texted him on Oct. 2, 2021, when he was out to dinner. “I’m gonna go when you get back … I was going to get propofol if that’s okay.”
But Ryan wrote back that he was at the office and would bring her home propofol and fluids.
On Jan. 25, 2022, the day before Harris was found dead, text messages filed in court show this exchange.
Harris: “Is it possible to bring home ketamine?”
Ryan: “Yes. I will bring some home. I love you baby.”
Harris: “Don’t forget a needle please.”
Ryan: “Will do.”
“We don’t have any evidence that Dr. Ryan administered the fatal dose of drugs to Sarah Harris,” Dietrich said in court on June 16, asserting instead that for a full year Ryan increasingly put Harris’s life in grave danger. “He provided the drugs that led to her overdose.”
