Post Mortem | The Depraved Heart Murder
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Welcome back to 48 Hours Postmortem. I'm your host, Anne-Marie Green. And this week, we are discussing the doctor who was charged with depraved heart murder in connection with the death of his girlfriend, Sarah Harris. Now, this is a charge that's new to me and perhaps to many listeners as well. So to explain it all, I am joined by 48 Hours producer, Josh Yeager. Josh, thank you so much. Pleasure. Nice to be here.

When Sarah Harris overdosed from a lethal drug cocktail in 2022, Dr. James Ryan was later charged with depraved heart murder. This is a subcategory of second-degree murder that I really had not heard of before. So I'm going to ask you, Josh, just sort of explain it to us. What is it? Have you reported on any other cases like this? Look, I've been doing this job nearly 30 years, and when you've been doing it that long, you tend to feel like you've seen

seen it all when it comes to murder cases. But this is something that I had never seen, and members of the team said the same. And in order to prove this, prosecutors don't have to prove intent. In other words, they don't have to prove you planned or wanted to do this. But what they've got to prove is that you acted with extreme disregard for human life.

So how does that apply in this case? The argument was in court that Dr. James Ryan knew as a physician and as a surgeon, he knew about these particular drugs. He knew how dangerous they could be. And he provided Sarah Harris with access anyway. But Josh, how difficult are depraved heart murder charges to prove at trial?

They are not easy to prove, and prosecutors told us there are a couple of real challenges they face. One of these challenges has to do with the definitions that attach to some of these crimes. We asked about the similarities and differences between depraved heart murder and manslaughter, and the prosecution said that the words in those definitions are different.

similar in a number of instances. Words like reckless disregard for human life versus extreme disregard for human life. And for two crimes that have such similar and comparatively vague definitions,

the punishments are incredibly different. The sentences for manslaughter, the sentencing range, and the sentencing range for second-degree murder are very different. So when you're comparing a crime that may involve words like reckless versus a crime that may involve words like extreme, how is a jury supposed to really compute what those two words mean and how they're different?

Yet, in making the decision between those two crimes, there may be decades of difference in prison time between those two verdicts. And I should point out that that wasn't the only charge that he was facing, right? We should note that in addition to depraved heart murder, prosecutors also charged Ryan with involuntary manslaughter, plus two counts of drug distribution, and then one count of possession with intent to distribute. Right.

I want to talk about, you know, a scene that really kind of struck me. Sarah's mom, Tina, she she's definitely a force. She's the force behind the continued push to find out more.

There is dramatic body cam footage of her screaming at Ryan when she finds out that her daughter is dead and she runs into the house and she is hitting him. My heart went out to her. I mean, what you spoke to her. What was she like? I think this is an extraordinary woman.

In our jobs, we meet victims and surviving family members of victims of these horrific crimes all the time. But I must admit that this particular person made an impression on me that's going to last for some time. And part of that has to do with her larger story. You learn in talking to her that months before Sarah's death, around a year before Sarah's

Another daughter of hers, Rachel Harris, suffered an immense tragedy. Rachel's fiance took his own life in front of her. And that was something that hit very hard across the entire Harris family. Then, as if that's not enough, just, I think it's 18 days before Sarah Harris dies, Tina's son, Christopher, who's in his 30s, died after a heart attack in Montana.

So on the eve of Sarah Harris's death, if you will, Tina is already dealing with two appalling losses in her immediate circle of relatives and soon-to-be relatives. Her strength in talking about it was incredible. And when you see the body cam footage, um,

It's hard to even process what she might be going through at that moment. So when I saw it, I thought just about any reaction you could think of would be understandable because the situation is so inconceivable. So some people are going to wonder why Tina, when she can see that something is really off with this relationship and that her daughter is diminishing, why she didn't just call the police? I think there are a number of reasons. I mean,

first, she does try to convince them to break up. She's not a fan of the relationship, big picture. But there are a number of reasons why I think she does what she does and she doesn't do what she doesn't do. The first is that Tina said Ryan on paper...

looked like a pretty eligible guy for her daughter to be dating. He was pretty impressive. He was highly educated. He had a thriving practice. He seemed to treat her daughter pretty well. And so you can imagine a situation where you have this highly trained, educated person who claims to love your daughter and gives you his opinion on what's going wrong and how he's trying to help. You don't necessarily think you're being lied to. The second is that as Tina discovers

that there's something really wrong with Sarah in Sarah's house, that there's activity going on there that looks suspicious. Sarah and James Ryan plead with her not to go to the authorities. Finally, later on in the second instance where Tina threatens to blow the whistle, her daughter says, if you do that, I will never talk to you again. Look, that puts...

a mother in an excruciating situation. I can't imagine being in that situation. And Tina says she feared for losing the relationship with her daughter. The tragedy is that in the end, she did. Tina also revealed something very unsettling that she says Ryan told her when they were on a trip with Sarah. Tina told you guys that Ryan said that he actually first noticed Sarah around town as a teenager.

a pretty young teenager. Let's just listen to that clip from Tina. And he says, then I found out she worked in the toy store. 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. And then he said, yeah. And 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.

It sounds like Dr. Ryan was obsessed with Sarah. He was. He was very much so. This is a conversation we could not independently corroborate. Having said that, we had no specific reason to doubt what Tina told us. So what we learned...

from Tina about this, that Dr. Ryan noticed Sarah when Sarah was in the park with friends at the age of 14. After that, Tina said, Dr. Ryan discovers that Sarah is working in a toy store. And he says to Tina, I remember going into the toy store and seeing Sarah dressed as Elsa.

He also goes on to detail a situation where Sarah is working at a local restaurant as a waitress and says that he went into that restaurant in order to have Sarah as a server. And while we don't know the exact timing of those second two types of encounter, the toy store and the restaurant, it still tends to indicate that Dr. Ryan has Sarah.

a rather unusual interest in Sarah. And James Ryan is 23 years older than Sarah. So if you take Sarah in her mid-teens, that puts him in his late 30s. That's unusual, and it paints things in a very particular light. ♪

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Sarah's sister, Rachel, is the real hero in many ways here. She broke into Sarah's laptop. She guessed the password and she finds those damning text messages between Sarah and Ryan. How important was this evidence? I think it was critically important. The texts really show three things. First, she complains of sleeplessness and anxiety. And there's a text in which he's saying,

I'm paraphrasing, I can give you an injection that will take care of your anxiety in seconds. After that, we see texts in which Sarah begins asking for these drugs. She's imploring him to bring home

Drugs like ketamine, propofol, which are dangerous and in combination with each other, especially dangerous. And he is bringing them home. That's what the text suggests. And finally, on at least one occasion, there's a text that shows Dr. Ryan actually administering a drug to Sarah. It's a text in which he says, if you wake up, I've just given you ketamine, something to that effect, and now I'm changing.

According to authorities, this shows he's actually administering the drug to her in her sleep. I thought that that text message was the most damning because you obviously can't give permission when you're unconscious. And I have to admit, while I was listening to the hour, like I said earlier, I kept on thinking, but she's a willing participant in this until that text message.

So Sarah's sister, Rachel, she took photos of the surgical drugs in Sarah's house both times that she visited in 2021. Sure. And I'll just say the photos were critically important. Rachel takes photos around the house on two occasions in 2021 where they discover medical paraphernalia. And then there are photographs taken at the so-called crime scene where Sarah is discovered. First responders misinterpret

the scene of Sarah's death. Authorities said they're used to drug overdose cases involving things like heroin, where you find tinfoil, you find burnt spoons, you find shoelaces as tourniquets. That's not what they found around Sarah Harris. She was surrounded by gear that looked like it was from a medical setting.

It was medical grade equipment with plastic wrappers, syringes and vials of surgical anesthesia. First responders aren't typically trained to look for that kind of stuff. That's what we learned. And it took a very particular kind of cop, a cop with expertise in pharmaceutical investigations to look at these photos to see this case in an entirely different way.

He looked at those photos. He sort of read between the pixels, if you will, of these photos. And what he saw was a different kind of drug overdose. And that went a long way, both in making his case with prosecutors and in trying it in front of a jury. So you were talking about Detective Ian Iacovello, who is the expert in pharmaceutical investigations. If he had not been assigned to this case, could Ryan have gotten away with murder?

I think he certainly could have. The investigation, I think we could say, was dormant after first responders talked to Dr. Ryan, who was on the scene, who provided an account of his girlfriend Sarah Harris's life, which included struggles with mental health, struggles with substances, and in fact even included, according to Dr. Ryan, a previous victim

overdose in which Dr. Ryan said he brought Sarah back, was able to resuscitate her. So what he was doing with authorities was essentially establishing an ongoing pattern of certain emotional, mental, psychological struggles Sarah had, problems with substance abuse. And when you have a doctor on the scene of a death telling you in fairly medical terms what he thinks happened, you don't have any glaring evidence, at least not yet, to the contrary of

Police said you tend to take his word for it. So in 2023, Ryan is found guilty of depraved heart murder, as well as involuntary manslaughter and drug charges. Then months later in 2024, a judge sentenced him. And this is I actually gasped because I was thinking, how many years can you really get for this? A judge sentenced him to 45 years, well above the sentencing guidelines for this combination of crimes.

I wondered, was this about sending a message precisely because he was a doctor and he should have known better?

Yes, I think so. First, let's unpack the charges. He got a total of 45 years. About five of those years had to do with the drug charges. So he's left with 40 for depraved heart murder. So this man has a very, very stiff sentence that's handed to him that seemed to us and to experts we talked to clearly to be a sort of a message that the judge is trying to send to the medical community. You cannot...

go rogue and sort of give or sell drugs that your patients shouldn't be taking to them. And if they wind up getting into trouble and die, you are on the, on the hook in a big way. And you don't have to look far, um, around the United States to see this kind of thing happening. Uh, in the headlines very recently, you saw doctors charged in connection with Matthew Perry's death. And in fact, though many of the specifics are not analogous, um,

One of the drugs was ketamine, one of the same drugs that Sarah Harris had in her system. I think increasingly we're seeing, you know, the justice system say, no, wait a minute. There are differences between, you know, conducting surgery and it goes bad or, you know, prescribing a drug that someone has a bad reaction to that is clearly an error versus something a little more malicious. Yeah.

Yeah, it brings up an interesting legal question as well, and that is how well-tailored is the law to situations where someone supplies drugs which wind up being used by someone who dies? And in fact, in Maryland, where this crime occurred, state's attorney's office told us that they have been supporting for some time and trying to get new legislation passed to streamline the laws allowing people

for particular charges in cases where suppliers of drugs that wind up being used in fatal overdoses can be charged more easily so that authorities are not in a position of having to try to take the facts of the case

square peg, fit it into a charge, a pre-existing charge, round hole. Yeah. I mean, I can see in this case, it seems sort of incredibly creative, but it worked. The jury believed the argument. The footage at the end of the episode of Tina at the gravesite of both her son, Christopher, and her daughter, Sarah, it's heartbreaking.

The fact that she buried their ashes together shows just how closely siblings were. As you mentioned earlier, Christopher died just 18 days before Sarah. How did this tight-knit family cope with this tremendous series of losses? Yeah, it was heartbreaking to be there. And it was clear in talking to her that these two children she lost were not only close on the calendar, but they were close emotionally.

And I think she told us that that's why she decided to bury them in the same casket. She visits often, and it's just every bit as brutal as you might expect it to be. I think, as perhaps we've heard in other cases, what the Harris family does, what Tina does, is she tries to look for something constructive in all of this and pin her emotional well-being

She said when she looks back at Sarah's downward spiral in her death, there are real regrets that she has at the way she handled certain things. And she said instead of sort of closing in around those regrets and just suffering increased pain,

She wants to use those regrets and actually highlight them for people in a way that allows people, at least potentially, who might find themselves in a similar situation to avoid making the same mistakes. And to me, that's the definition of strength.

I absolutely agree with you. Over and over in many of these episodes, we see how powerful the love and the strength of a mother can be. That they often drive the investigation. They often demand justice for their children. And she was definitely a perfect example of that. But not just her, the family as well. Rachel was just absolutely key to this. Having suffered her own tragedy, she showed the same kind of strength. Remarkable.

Remarkable indeed. Josh, thank you so much for joining us today. My pleasure. Thanks. So if you like this series, Postmortem, rate and review 48 Hours on Apple Podcasts and follow 48 Hours wherever you get your podcasts. You can also listen ad-free on Amazon Music, Wondery Plus, and in the Wondery app or with a 48 Hours Plus subscription on Apple Podcasts. And thank you again for listening.

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