s the film opens, a young woman is recklessly driving a white BMW down a mountain highway. A slow-moving truck impedes her progress, and she attempts to pass it by moving into the oncoming lane of traffic, on a blind curve. Suddenly, a second truck looms in the oncoming lane, and it clips the woman's rear fender. The woman spins and comes to a stop in front of the first truck, which broadsides her car, and she dies on route to the hospital (this whole ordeal is interspersed throughout the movie).



John Quincy Archibald (Denzel Washington) is with his wife Denise (Kimberly Elise) at his son's baseball game. As his son (Daniel E. Smith) runs around the bases and heads to second, he grabs his chest and collapses. After a series of tests at the hospital, John is informed that Michael has an enlarged heart and will need a transplant. However, his health insurance has been changed by the company he works for to a cheaper option and the new policy does not cover the surgery, so they must raise $75,000 (30% of the $250,000 transplant fee) in order to get their son's name on the list of likely recipients of an available heart. The family tries to raise the money by selling some of their possessions and helping out their neighbors, but to no avail. Eventually, the hospital gets tired of waiting for payment and decides to release Michael. John walks into the hospital emergency room and begins a hostage situation. He gathers the hostages and sets his demands: his son's name on the recipient list as soon as possible. The hostage negotiator, Lt. Frank Grimes (Robert Duvall), stands down to let John cool off.



Meanwhile, John and the 11 hostages communicate and learn more about each other. They begin to understand John's situation and support him a little as he ensures each of them receive the treatment they came to the emergency room for. One of them, Miriam (Troy Beyer), is pregnant and her husband Steve (Troy Winbush) is hoping that their first kid is healthy. A young hostage, Julie (Heather Wahlquist), has a broken arm, and she and her boyfriend Mitch (Shawn Hatosy) claim that a car crash caused it, but due to some holes in their story (and the fact that Mitch's only injuries are scratches on his arm) John and another hostage, Lester (Eddie Griffin), are able to conclude that the two are lying and that Mitch had actually beat Julie up.