Born on August 23 (year unknown)
Presumed dead after jumping from a bridge [March 8, 2019; revealed to be alive May 14, 2019]
"Cry-baby" (mother's nickname)
Former DVX agent
Pentonville Prison (628 Fairfax Rd, Pentonville, NY 16543)
Formerly Jerome penthouse (979 Carlyle, Port Charles, NY)
Formerly Metro Court Hotel, Port Charles, NY
Formerly Collins residence, Port Charles, NY
Unknown during decades working for DVX
Formerly an unknown asylum for the criminally insane
Formerly Pentonville (held in isolation)
Formerly Lighthouse, Port Charles, NY
Gloria Chamberlain (wife; murdered)
Victor Collins (father)
Melanie Chamberlain (mother)
Kevin Collins (twin brother)
Livvie Locke (niece)
*On January 30, 2013 Kevin denied having a daughter named Livvie and claimed that Livvie was a part of Lucy's fantasy world
Linda Walker (engaged; murdered)
Felicia Jones (Scorpio) [engaged; early 1992]
Stalked Felicia Jones (Scorpio) [1992 until 1995]
Attempted murder: Audrey Hardy [May 28, 1993]
Attempted murder: Steve Hardy [May 28, 1993]
Kidnapped Maxie Jones [Jun 1993]
Kidnapped Felicia Jones (Scorpio) 
Attempted murder: Felicia Jones (Scorpio) 
False imprisonment: had Felicia Jones (Scorpio) committed to sanitarium 
Attempted murder: Felicia Jones (Scorpio) 
Held Felicia Jones (Scorpio) hostage 
Assaulted Mac Scorpio 
Detonated bomb 
Escaped sanitarium [Mar 1995]
Kidnapped Georgie Jones [Mar 1995]
Assaulted Kevin Collins [Mar 24, 1995]
Faked his death [Mar 24, 1995]
Worked for the DVX [March 1995 until May 2018]
Escaped Ferncliff and assumed Kevin Collins' identity [Aug 28, 2018]
Practicing psychiatry without a license; treated Kevin Collins' patients [Sep 2018 until Mar 2019]
Impersonated Kevin Collins [Sep 2018 until Mar 2019]
Framed Carly Corinthos for murder [Nov 2018]
Insinuated himself in the murder investigation to mislead police [Nov 2018 until Mar 2019]
Framed Griffin Munro for murder [Nov 26, 2018]
Attempted murder: stabbed Lulu Falconeri [Jan 21, 2019]
Attempted murder: tried to smother Lulu Falconeri [Jan 28, 2019]
Withheld medical treatment from Kevin Collins when Kevin was struck blind [Jan 30, 2019]
Framed Franco Baldwin for murder [Jan/Feb 2019]
Altered Lulu Falconeri's memories of her attack through hypnosis [Feb 5, 2019]
Lured Griffin Munro to hospital rooftop with intention to push him to his death [Feb 8, 2019]
Injected Laura Collins with a sedative [Feb 18, 2019]
Kidnapped Laura Collins and locked her in a basement with Kevin Collins [Feb 19, 2019]
Kidnapped Carly Corinthos [Mar 2019]
Left Carly Corinthos to die at bottom of a ravine [Mar 2019]
Attempted murder: pulled Ava Jerome over the side of a bridge [Mar 8, 2019]
Knocked Curtis Ashford unconscious and held captive [May 15, 2019]
Physically assaulted Laura Collins and held captive [May 15, 2019]
Attempted murder: rigged cabin to explode with Curtis Ashford and Laura Collins inside [May 15 to 17, 2019]
Knocked out Kevin Collins and left him hanging from the rafters [May 21 and 22, 2019]
Knocked out Scott Baldwin [May 22, 2019]
Threatened to kill Ava Jerome with a knife [May 23, 2019]
Sexually abused by his mother [throughout childhood]
Stabbed by Felicia Jones as she defended herself 
Minor injuries in fall from cliff [Aug 1993]
Cut wrists in a staged suicide attempt [Sep 1993]
Diagnosed by Dr. Kevin Collins as a sociopath [Dec 1993]
Assaulted by Mac Scorpio defending Felicia Jones 
Sustained minor injuries in an explosion [Mar 24, 1995]
Determined to be in deep psychosis [May 2018]
Underwent electroconvulsive therapy [Jun until Jul 2018]
Overmedicated with sedatives [Jun until Jul 2018]
Went temporarily blind from exposure to designer virus decades earlier [Jan 21 to 25, 2019]
Attacked in self-defense by Franco Baldwin [Feb 27, 2019]
Inflicted deep cut to hand to frame Franco Baldwin [Feb 27, 2019]
Shot in shoulder [Mar 8, 2019]
Presumed dead after leaping from bridge [Mar 8, 2019]
Severed his right hand as proof of his "death" [revealed Apr 5, 2019]
Knife plunged into his back by Ava Jerome [May 24, 2019]
Injected with seizure inducing drug by Dr. Hamilton Finn [Jun 3, 2019; revealed Jun 12, 2019]
Kidney removed without his consent [Jun 6 and 7, 2019]
In June 1992, Felicia Jones met a handsome young pediatrician named Ryan Chamberlain who had recently taken a job at General Hospital. They hit it off and began to date, but Felicia was troubled by distressing visions and a mystery stalker. By August, Ryan sensed that he was losing Felicia, so he whisked her away on a romantic getaway with the intention of eloping. As Felicia and Ryan embarked on the trip, Felicia's memories from her time in Texas a few months earlier returned in horrific detail. Felicia realized that she was with a killer named Todd Wilson, but she was forced to pretend that she had no idea until she could escape Ryan's clutches. Stranded at the cabin, Felicia reminded Ryan that they had to get back to Port Charles for her daughter's birthday party, but Ryan claimed that they couldn't leave until his Jeep was repaired.
When Ryan slipped out to fetch some wood for a fire, Felicia found a spare key to the Jeep. She tried to start it, but it had been disabled. Desperate, she searched the Jeep until she found a cell phone hidden in the center console. She called Mac at the Outback to warn him that Todd Wilson was Ryan Chamberlain, but the connection was bad. She was forced to end the call when she heard Ryan call out to her. As she and Ryan returned to the cabin, Felicia held out hope that Mac had heard her, but she continued to look for an opportunity to escape. Eventually, Ryan realized that Felicia was onto him, and the two struggled. Felicia managed to wound Ryan, which allowed her to escape.
Later, Felicia recounted to Sean Donely and Mac Scorpio that she had met Todd Wilson during her visit to Texas. One afternoon, Felicia had taken Maxie for a picnic in the park, and Todd had been there, collecting plants and herbs for research. Felicia had found Todd charming, and she'd been fascinated with his work. Maxie had also taken to Todd, which had made dating him easy. However, within a month, Todd had declared his love for Felicia, and he had proposed marriage. He had wanted to take her to Mexico, but Felicia had asked him to be patient because it had been too soon after her divorce.
Next, Felicia recalled getting a knock on the door. It had been Todd's wife, Gloria. Gloria had been furious because she'd been watching Felicia and "Ryan" for days. She demanded that Felicia back off and leave "Ryan" alone, but Felicia had no idea who "Ryan" was. That was when Gloria had revealed that Felicia had known Ryan as Todd Wilson, then Gloria had added, "His name is Ryan Chamberlain, and he is my husband!"
Felicia had gone to "Todd's" office to end things. She had been afraid because she hadn't been able to bear hurting him, but when she'd opened the door, she'd been horrified to see "Todd" repeatedly stab his wife. Terrified, Felicia had run for her life. After she had reported the murder to the police, Felicia had collected Maxie then boarded the first flight back to Port Charles. Felicia recalled arriving at the brownstone and unpacking the car when someone had approached her from behind and pressed something to her nose and mouth that had knocked her out and wiped away her memory. Felicia hadn't seen who it had been, but she was certain that it had been Ryan.
Felicia's troubles with Ryan were not behind her. Ryan managed to turn things around by pretending that he'd been the victim. Assistant District Attorney Jessica Holmes believed Ryan's claims and charged Felicia. Felicia was convicted of attempted murder then sentenced to a psychiatric facility for treatment, but Sean was able to persuade Jessica that Ryan had lied. Jessica reluctantly agreed to go along with Sean and Mac's plan to stage Felicia's death.
In May 1993, Ryan attended Felicia's funeral. After he left, Felicia's close loved ones were filled in on the ruse. The next phase of the plan involved Felicia pretending to be a ghost. With the help of various people around town, Felicia began to haunt Ryan. She called him at work and appeared as a ghostly apparition until she slowly wore him down. After she lured him to a lecture hall in the hospital, Ryan tearfully confessed to Felicia's "ghost" that he had loved her and that he had never meant to hurt her or Maxie.
Felicia recorded the confession as Ryan spoke about his mother and how she had constantly criticized him. He had never been good enough for his mother, and he had hated what his mother had made him do. Ryan admitted that he'd felt clean after he'd killed the women, and he confessed that all he had ever wanted was to be loved. Felicia asked about the initials of the women they'd found his in diary, "S.V. and M.P.," as well as the other victims. Ryan admitted that he'd killed, "Sylvia V," "M.P.," and the rest of the women. Satisfied that she had everything necessary to put Ryan away, Felicia tried to flee.
Ryan realized that he'd been duped, and he gave chase. He caught up with Felicia in the morgue. Mac arrived before Ryan could harm Felicia, but Ryan managed to escape. He made his way to Audrey and Steve Hardy's home, believing that Audrey was his mother. Audrey tried to play along, but things turned violent when Steve arrived home. Ryan despised Steve for taking the only picture that Ryan had had of his mother. Mac took Felicia into hiding until Ryan was captured, but in June, Ryan kidnapped Maxie to draw Felicia out.
The plot worked. Felicia promised Ryan that she wasn't like his mother and that she wouldn't hurt him. She pretended to love Ryan and to want a future with him and Maxie. Nearby, Mac and Sean prepared to rescue Felicia. When the men confronted Ryan, he grabbed Felicia to use as a human shield. Felicia realized that he wouldn't tell her where her daughter was, and she broke free. Ryan stumbled backwards and fell from the edge of the cliff. Moments later, a police officer arrived with Maxie. Maxie had been left in a motel room, so she had called the operator for help. Meanwhile, Mac and Sean rappelled to the bottom of the canyon. Ryan had been banged up but not seriously injured.
In August 1993, Ryan threatened Jessica Holmes for her role in making him believe that Felicia had died. Ryan staged a suicide attempt to get himself transferred to GH, where he had found a way to slip in and out of the hospital without being detected. One night, Ryan escaped, murdered Jessica, then let Sean take the fall. During Ryan's second excursion from GH, Ryan was captured then questioned about Jessica's murder. Instead, Ryan spoke about killing Linda Walker, whose body he'd left on the side of the road. He recalled feeling sad when he had seen the look on her face once she had realized what was happening.
Ryan claimed that he had loved Linda, but he had never felt as if he'd measured up to her expectations, in part because she had wanted a career as a singer in a nightclub rather than being content to be a doctor's wife. He recalled that he'd once planned a romantic dinner for Linda before their wedding, but she had complained. He suddenly realized that Magi had been the one who had complained about the dinner then admitted that he sometimes got his victims confused because of their constant criticisms.
Ryan admitted that his victims were all the same in the end: disembodied voices telling him that he was not good enough. "Except for that idiot Lauren," Ryan recalled. He shared that he hadn't been able to pry her off with a crowbar, which had led her "insipid friend" Michelle Blake to play detective and blackmail him. Ryan also confessed that he had hidden everything that he would need to escape from GH in a radiator during his time working in the hospital. His staged suicide attempt had been a ploy to gain access to the hospital room where his tools had been hidden.
Ryan revealed that he'd been lying in wait when Jessica had arrived home. He'd watched her pour a glass of water and check the mail before he had silently slipped out of the closet, picked up a heavy candlestick, and approached her. Jessica had cried out as he had bludgeoned her. Ryan insisted that it had been the perfect crime, and it hadn't mattered to him whether Sean or Tiffany had been blamed for Jessica's death. Sean took comfort in knowing that Ryan had been stopped.
In December 1993, Ryan spoke to a psychiatrist about his mother. He admitted that she had been "cold and unfeeling and impossible to please." He claimed that he had once considered going into psychiatry, but he had realized that it would have been redundant, since he'd likely end up on the cover of a psychiatric magazine, anyway. Ryan made it clear that it was pointless to try to get into his head because the doctor would never learn anything that Ryan didn't want him to. When the doctor informed Ryan that his brother wanted to talk to him, Ryan insisted that he didn't have a brother.
Moments later, Kevin Collins entered the room. Ryan was shocked to see his identical twin, and he continued to deny that they were brothers. Kevin acknowledged that it had been 30 years since they'd last seen each other, but Ryan flew into a rage and attacked Kevin until a couple of orderlies pulled Ryan off. Kevin's reception in Port Charles was equally challenging. He was forced to explain that his parents had divorced when Kevin and Ryan had been four years old. Kevin had moved to Europe with their father, and Ryan had remained with their mother. Kevin explained that his mother, Melanie, had been determined to eradicate all traces of Victor and Kevin because they had ceased to exist for her.
Kevin also revealed that he was a psychiatrist and that he had read about his brother's case in several psychiatric journals. Kevin admitted that he wanted to learn about Ryan's case because Kevin shared the same genetic makeup as a serial killer.
A few weeks later, Felicia and Kevin discussed the psychological profile that the police had on Ryan. Felicia shared that Ryan was attracted to women who resembled the mother that Ryan could never please. All of Ryan's relationships had been intense, but they had invariably left him feeling as if he'd let his partner down, which had driven Ryan to kill them. Kevin diagnosed Ryan as a sociopath, but he wondered if Ryan's illness had been the result of nature or nurture. Kevin didn't recall much about his mother, but he'd seen pictures of her and confirmed that Felicia looked a lot like her.
Kevin remembered that his mother had never held him, and he'd always been slightly afraid of her. According to Kevin's father, she had been cold, critical, and very domineering.
In January 1994, Kevin paid Ryan a visit at the facility where Ryan had been imprisoned. They discussed their mother when Ryan confessed to fantasizing about strangling Felicia to death even though he loved her. Ryan had the same thoughts about his mother. Ryan admitted that he loved his mother, and he had tried to make her happy, but nothing had ever satisfied her. Kevin was curious if "Mother" had ever been violent with Ryan, but Ryan claimed that "Mother" had never touched him in any way.
Later that year, Ryan escaped when he learned that Mac and Felicia had planned to marry. The wedding was ruined, but Ryan was captured. Mac and Felicia set a new wedding date and tried to move on with their lives.
In March 1995, Ryan seduced his therapist, Connie Cooper, and persuaded her to help him escape. Once he was free, he broke her neck using a scarf. Next, Ryan kidnapped Felicia's newborn daughter, Georgie. Mac, Felicia, and Kevin followed Ryan to Canada. A witness spotted Ryan and the baby on the side the of road, close to an amusement park. Mac and Kevin agreed that it was the most logical place for Ryan to go. Ryan briefly captured both Felicia and Lucy, but Mac found the ladies and freed them. Kevin caught up with his brother, and Ryan was surprised to notice that Kevin had a tattoo of a swordfish on his inner right wrist.
Lucy's return offered Ryan an opportunity to slip out of the funhouse. Felicia and Mac found Georgie safe in her carrier on the carousel while Kevin went after his brother. Back in the funhouse, Kevin tried to persuade Ryan to surrender by promising to help Ryan. Ryan continued to play games by making Kevin chase him around the funhouse. At one point, the brothers struggled and knocked a gas line loose. Kevin urged his brother to leave with him, but Ryan refused because he wanted to die with his brother. Kevin ran out while Ryan remained behind then flipped a switch to turn on the lights, which triggered a massive explosion. Ryan was presumed dead.
In June 2018, Carly Corinthos was sent to Ferncliff for treatment after she had been found guilty of attempted murder by reason of insanity. A patient in the room next to Carly's tapped out an S.O.S. message in Morse Code on the wall. She was repeatedly warned by the staff and by her doctor, Kevin Collins, not to have any communication with the patient because the patient was a dangerous homicidal maniac. Carly remained intrigued with the patient, fearing that he had been held against his will as she felt that she had been. In July, a heavily sedated Carly was taken for electroconvulsive therapy. She was confused when she saw a patient who looked exactly like Kevin being wheeled out of the treatment room.
On August 23, Kevin visited the mystery patient known as "Wilson Ritter." It was his twin brother, Ryan Chamberlain. Ryan was confined to a straitjacket and subdued as Kevin lit a candle on a cupcake then wished his twin a happy birthday. When Kevin wasn't around, Ryan took the opportunity to befriend a male nurse named Gordan. Ryan insisted that he was the real Kevin Collins, but Gordan knew better. On August 28, Kevin checked in on Ryan. Kevin assumed that his brother was safely confined to the straitjacket, and he turned his back on Ryan to check his phone. Ryan, who had loosened the straitjacket, peeled it off then knocked Kevin unconscious.
Later, Kevin woke up and discovered that Ryan had traded places with him. Ryan instructed Gordan to drug the patient then left. As Ryan had planned, Gordan didn't believe Kevin's pleas for help or his claims that he was the real Kevin Collins. Ryan returned to Port Charles and sought out Felicia, who had married Mac Scorpio and owned the Floating Rib with her husband. However, Ryan's plans hit a snag when Kevin's wife, Laura, returned home from an extended trip. Ryan feigned illness and worked long hours to avoid intimacy with her.
Ryan also found himself drawn to Ava Jerome. He saw in her a kindred spirit because of her darker impulses. On October 30, Ryan spotted Mary Pat Ingles, the ex-head nurse at Ferncliff during his days as a patient. He approached her at the bar as she nursed a drink, but Mary Pat wasn't surprised to see "Kevin." She knew his secret and was willing to sell it to the highest bidder. "Kevin" asked Mary Pat to meet him on the piers to discuss a mutually beneficial deal.
On the piers, Mary Pat made it clear that she wanted an easy desk job at GH and a steady income from "Kevin," or she would sell her story to the Invader. She was confident that "Kevin" wouldn't want people to know that he'd been hiding his homicidal twin under their noses. After Mary Pat walked away, Ryan picked up a longshoreman's hook then followed her. Later, Mary Pat's decapitated head was found floating in a barrel of apples during a Halloween charity event at the Floating Rib. Mary Pat's body had been displayed at the Jerome Gallery with a pumpkin perched on its shoulders. The autopsy revealed that Mary Pat had been killed instantly with a single stab that had allowed the wound to bleed out internally.
Ryan's attempt to frame Carly for the murder failed, but he managed to insinuate himself in the murder investigation by offering to share his professional insights into the killer. Ryan realized that he could not continue to remain married to Laura because she would eventually realize that he was not Kevin. Plus, Ryan had fallen in love with Ava. Ava was flattered by "Kevin's" attention and stunned when he left Laura to be free to date Ava. Unfortunately for Ava, Kevin had targeted his next victim -- Ava's daughter.
Ava and Kiki were estranged because Kiki had started dating Ava's ex-lover as soon as Griffin Munro and Ava had split. Ava was furious and often complained to "Kevin" about her daughter. Determined to break Kiki and Griffin up, Ava set Griffin up to make it appear that he had slept with Kiki's newfound sister, Sasha. The plot failed when Kiki realized that Sasha had been drugged and that Griffin had been knocked unconscious. Ava unwittingly sealed her daughter's fate when Ava confessed to "Kevin" that she and Kiki would be better off if Ava wasn't in town -- or if Kiki wasn't.
On November 26, "Kevin" knocked on Kiki's door. She smiled as she welcomed the trusted doctor into her apartment. Ryan murdered Kiki with a single plunge of his knife to her abdomen. He displayed her body in the honeymoon suite on the Haunted Star as guests gathered for Curtis and Jordan Ashford's wedding. Among the guests was Griffin, who had been waiting for Kiki's arrival. Ryan retuned to Ava's apartment then made love to her for the first time. Ava later provided "Kevin" with an alibi when the police questioned his whereabouts for the time of Kiki's murder.
To Ryan's surprise, Ava was devastated by Kiki's murder. He was also annoyed when his effort to frame Griffin for the murder failed. Further complicating matters was Laura's certainty that "Kevin" had suffered some kind of breakdown. Laura was reluctant to divorce her husband, and she questioned how he could have been drawn to someone like Ava. During that time, Lulu Falconeri decided to write a series on the Ryan Chamberlain murders to mark the anniversary of Ryan's death. Ryan was delighted by the series because he saw it as a celebration of his genius, but the spotlight on the murders also drew unwanted attention.
A television producer decided to make a documentary about the Ryan Chamberlain murders. Ryan was impressed with Peyton Mills's work, but things took a turn when Peyton confided to "Kevin" that he intended to end the documentary with the suggestion that Ryan had survived the blast at the funhouse. Ryan couldn't take the risk, so he killed Peyton with a stab to the abdomen then displayed Peyton's body among the holiday decorations at Metro Court Restaurant. The police realized that they had a possible copycat serial killer on their hands, and their attention turned to Franco Baldwin.
Ava leaned heavily on "Kevin" as she tried to deal with her grief. Her love for him grew, and "Kevin" suggested that they run away together and start over somewhere else. Ava refused to leave her daughter Avery behind. She knew that Avery's father, Sonny Corinthos, would never allow Avery to visit Ava for extended periods of time.
On January 21, 2019, Lulu became Ryan's next victim. Lulu was surprised when her mother mentioned seeing a list of Ryan's "nine victims" on Kevin's desk. According to Laura, "Kevin" had included Felicia, even though Felicia had survived. Lulu knew of only "seven victims" that Ryan had killed prior to his "death" in 1995, so she called "Kevin." Ryan had been plotting to murder Sonny and Carly to free Avery up to travel with Ava, but he changed his plans to deal with Lulu.
Lulu welcomed "Kevin" into her office at the Invader then told him that she had questions about the list of Ryan's victims. Ryan listed his murder victims, but Lulu hadn't had Suzanne Smith or Deborah Jones's names on her list, prompting Ryan to reveal that those murders remained unsolved. Lulu's eyes rounded with horror as she realized who "Kevin" really was. She attempted to flee, but Ryan attacked. However, luck was on Lulu's side because Ryan suffered an intense migraine that briefly knocked him out. When he woke up, he was blind.
Gravely injured, Lulu made her way to the restaurant, but she collapsed before she could name her attacker. Meanwhile, Ryan managed to stagger to the elevator. He was found and rushed to the hospital, but no one seemed to realize that "Kevin" had attacked Lulu. "Kevin" was told that he'd been part of a twin experiment conducted by the DVX and that the blindness was the result of a designer virus he'd been exposed to decades earlier. Dr. Hamilton Finn assured "Kevin" that the blindness could be reversed with surgery. As Ryan recovered from the surgery, he learned that Lulu had survived the attack but remained unconscious.
Determined to finish what he had started, Ryan slipped into Lulu's hospital room and started to smother her, but he had to abort the plan when he heard visitors approach her door. To Ryan's delight, Jordan suggested that Lulu undergo hypnotherapy to try to recover her memory, and Jordan wanted "Kevin" to do it. Laura was uncomfortable with the idea of "Kevin" putting Lulu under hypnosis, but "Kevin" assured Laura that he would take good care of Lulu, despite the tension between him and Laura. Laura relented when Lulu promised her mother that she trusted "Kevin."
Under hypnosis, Ryan planted the suggestion that Franco had attacked Lulu. When Lulu woke up, she was certain that Franco had tried to kill her. To bolster Lulu's claim, Ryan parted with a portion of his prized "trophy" collection -- the driver's licenses of each of his recent victims. Ryan planted the evidence in Franco's art room at the hospital. Ryan also paid Kevin a visit and discovered that his brother had also been struck blind, but he forbade the head nurse from transferring Kevin to a nearby hospital for treatment.
Kevin decided to trick Ryan by informing him that Kevin and Laura had signed a prenuptial agreement that might impact the divorce. Ryan was eager to get his hands on the money, so he made a point of asking Laura's divorce attorney, Alexis Davis, about the prenuptial agreement. Alexis told him that she would get back to him because Laura hadn't mentioned it.
On February 8, Franco was arrested and charged with attacking Lulu and murdering Kiki, Peyton, and Mary Pat. Ava insisted that it wasn't possible because Franco had loved Kiki like a daughter. A few days later, Ryan saw Ava and Griffin talking. Fearing that Ava would start developing feelings for Griffin again, Ryan lured Griffin to the rooftop with the intention of pushing him off the ledge to make it appear like a suicide. His plans were thwarted when Ava, looking for "Kevin," appeared on the rooftop.
Ryan realized that he'd been mistaken about Ava's feelings for Griffin. A few days later, Ryan paid Kevin a visit at Ferncliff to confront Kevin for lying about the prenuptial agreement. Ryan realized too late that Laura had followed him. Laura was shocked when she saw Kevin locked in a room at Ferncliff, but Ryan injected her with a sedative before she had an opportunity to call for help. Ryan locked Laura and Kevin in a basement room then forced Laura to sign divorce papers so that he would be free to marry Ava.
On February 26, Ryan surprised Ava with an engagement ring then persuaded her to elope with him to Niagara Falls. Ava happily agreed, but Ryan's plans hit a snag when Franco confessed to Ryan's recent murders in a televised interview. Furious, Ryan went to Ferncliff to confront Franco about the lies. He demanded to know why Franco had taken credit for Ryan's crimes. Franco was stunned when he realized that "Kevin" was Ryan Chamberlain.
Ryan stabbed Franco, but Franco cried out for help. The head nurse appeared at the door, prompting Ryan to claim that Franco had attacked him. The nurse believed "Dr. Collins" and called for security. Franco knocked Ryan down then slipped out the door, locking Ryan in the room. Ryan sliced his hand to make it appear that he'd been injured when Franco had attacked.
At GH, "Kevin" gave a statement as his hand was stitched up. Later, he encountered Carly in the parking lot as he prepared to leave to pick up Ava for their trip. Carly questioned "Kevin" about the patient at Ferncliff, named Wilson Ritter, because she suspected that it had been an alias for "Kevin's" twin brother. Ryan realized that Carly was close to exposing him, so he knocked her out then stashed her in the trunk of his car. Later, Ryan picked up Ava, and they drove to Niagara Falls. They checked into a motel for the night and made plans to marry in the morning.
Ava discovered "Kevin's" secret when she went to the car to fetch the shoes for her wedding dress. Ava was shocked when she saw Carly unconscious in the car's trunk, with her feet and hands bound. She panicked when she heard "Kevin" approach, but he asked Ava to return to the room while he handled everything. Later, "Kevin" returned to the room and informed Ava that he'd dropped Carly off a few miles down the road. Ava was worried about Carly, but she realized that she needed to tread carefully with "Kevin."
"Kevin" decided that it was time for him and Ava to get married, so he dragged her out of the motel and across the footbridge to Canada. However, Laura had found a way out of Ferncliff and had joined forces with Jason. Jason and Laura caught up with Ryan on the footbridge, and Jason fired a shot at Ryan's shoulder. Stunned, Ava demanded to know what was going on, but Ryan refused to let her learn the truth from Jason and Laura. Ryan grabbed Ava then threw himself over the bridge. Jason managed to grab Ava's hand at the last second and hoisted her to safety.
Ryan's body was not recovered from the frigid rushing waters. He was presumed dead by the Canadian police, but those who knew him best feared that Ryan had survived the fall. When Laura returned to Port Charles, she asked how Ryan had ended up in Ferncliff. Kevin explained that he had received a call from the DVX in May 2018 about a problem operative who had been hallucinating and howling. Kevin had been stunned to discover the operative had been Ryan, and the DVX had intended to "eliminate" Ryan if Kevin had refused to take him off their hands.
Kevin admitted that he had placed Ryan in Ferncliff, and he'd found a combination of drugs that had seemed to help. On March 22, Ava received a call from an unknown number. The caller didn't speak, but Ava feared that it might have been Ryan. A few weeks later, Ryan's right hand washed ashore, but it was quickly determined that the limb had been cleanly severed from a living donor. All agreed that it was within the realm of possibility that Ryan had amputated his hand in an effort to make it appear that he had died.
Ava received some help from Mac, Felicia, Laura, Kevin, and Lulu to set a trap for Ryan. Laura and Kevin pretended to break up, then Kevin pretended to take comfort in Ava's arms. Lulu printed stories and pictures of the couple in the Invader, and several public confrontations with people like Lucy Coe and Julian Jerome -- who had no idea what Kevin and Ava were up to -- helped give the "relationship" some credibility.
Meanwhile, Laura and Curtis worked together to track down a lead in Canada that they were certain would lead them to Ryan. As they closed in on Ryan, a nurse named April Tremblay was murder. April had helped Ryan during his recovery. Soon, both Laura and Curtis found themselves in a fight for their lives when Ryan managed to turn the tables and abduct them. Laura and Curtis worked together to free themselves from the ropes that Ryan had secured them with as gas filled the cabin. They made it out in the nick of time, and only suffered cuts, bruises, and minor smoke inhalation from the blast.
In Port Charles, Ryan made his way to the Nurses Ball. After knocking out Scott Baldwin and Kevin, Ryan tied his twin's unconscious body to a rope then hoisted it up to the rafters. Afterwards, Ryan followed Ava to a remote cabin. Ava greeted Ryan like a long lost love, and she managed to get him to drop his guard until she pulled out a gun to confront him about what he had done to Kiki. Ryan claimed that Kiki's last words had been a cry for her "Mommy." Ava nearly pulled the trigger, but Curtis arrived in time to stop her because they needed Ryan alive to donate a kidney to Jordan. Kevin had been deemed a match, but a health issue had precluded him from being a transplant donor.
Ryan smiled with satisfaction as the police handcuffed him. He leaned close to taunt Ava for not having had it in her to kill him, so she reached for a knife then plunged it into Ryan's back. Ryan survived, as did his brother. While in the hospital, Ryan offered to donate his kidney to Jordan in exchange for his freedom. His victims had other ideas. Several banded together to take the kidney and make it appear that Ryan had given consent by having Kevin pose as Ryan right up until the surgery. Ryan had been kept sedated and hidden in the art room. After the surgery, Ryan slipped into a coma.
On June 12, Ryan woke up in Pentonville's prison infirmary wondering how he had gotten there. Dr. Hamilton Finn and Detective Valerie Spencer revealed that he was recovering in his new home from kidney surgery. Ryan looked down at the incision on his abdomen in stunned disbelief. He accused Finn of stealing the kidney, but Ryan's outrage fell on deaf ears as Finn and Valerie left. Later, Nelle Hayes entered the infirmary to pick up the dirty linen. Ryan and Nelle bonded right away over the injustice of having their kidney taken against their will.