John Quincy Archibald takes a hospital emergency room hostage when his insurance won't cover his son's heart transplant.
John Quincy Archibald's son Michael collapses while playing baseball as a result of heart failure. John rushes Michael to a hospital emergency room where he is informed that Michael's only hope is a transplant. Unfortunately, John's insurance won't cover his son's transplant. Out of options, John Q. takes the emergency room staff and patients hostage until hospital doctors agree to do the transplant.—Anonymous
The films begins somewhere in Canada where a young woman is driving dangerously into oncoming traffic, as she attempts to pass a semi she is clipped by another semi which cause her to spin and stalls, then right into the path of the first semi that slams into the side of her car killing her instantly. A few weeks earlier in Chicago, Illinois John Quincy Archibald (Denzel Washington) and his wife Denise (Kimberly Elise) are getting behind with their payments. One day after witnessing their young son Michael (Daniel E. Smith) collapse at his baseball game. After a series of tests at the hospital, John is informed by Dr. Raymond Turner (James Woods) and Rebecca Payne (Anne Heche), a hospital administrator, that Michael has an enlarged heart and will need a transplant.
Because the company he works for dropped John from full-time to part-time, his health insurance has been changed, and the new policy does not cover the surgery, leaving them to raise $250,000 to get their son's name on the donor list. The family tries to raise the money (they sell everything of value they have and even try and approach TV show hosts to run special interest pieces for the family) but are only able to come up with a third of the necessary payment. The hospital uses the money to clear their current dues and demands the full $250K for the transplant procedure.The hospital tires of waiting and releases Michael; Denise shouts at John to do something or else Michael dies. Unwilling to let his child die, John walks into the hospital ER with a handgun, gathers hostages, and sets 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 eleven hostages 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 child 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. Due to holes in their story, John and another hostage, Lester (Eddie Griffin), conclude the two are lying and that Mitch beat up Julie. After a while, John agrees to release some hostages to have his son's name added to the list an hour afterward. He releases Steve, Miriam, and a hostage named Rosa (Martha Chaves) with her baby.
Meanwhile Frank and Rebeca talk to Denise and tell her that the hospital is putting Michael on the list of donors and will cover all expenses. Frank knows this is a lie and that the plan is to use Denise to misguide John into thinking that Michael is on the list when he is not.
The Chicago Chief of Police, Gus Monroe (Ray Liotta) is a sadistic sob and doesn't agree with Franks's tactics (he wants to bring down the hostage taker asap for the TV audiences and his own personal ratings with the Mayor's office), gives a SWAT unit permission to insert a sniper into the building via an air shaft. John is shot while he is distracted talking to Denise, but ends up receiving only a minor wound, which is treated right away. After taking the shot, the sniper's leg falls through the ceiling tiles. Outraged, John pulls him out of the air shaft and beats him up.Meanwhile Rebecca is moved listening to John's conversation with his son and decides to put him on the list right away, which nobody else knows.
Using the bound SWAT policeman as a human shield, he steps outside to the sight of dozens of policemen pointing weapons at him and a large, supportive crowd. John demands that his son be brought to the emergency room. The police agree to his demand in exchange for the SWAT sniper.
Once his son arrives, John reveals to the hostages his intention to commit suicide so his heart can be used to save his son. He persuades Dr. Turner to perform the operation, and two of his hostages bear witness to a will stating his last request. John says his last good-byes to Michael and enters the operating room. He loads a single bullet into the gun and pulls the trigger, but the safety is on. As he prepares to end his life a second time, his wife learns about an organ donor of the woman who died in a car accident has been flown to the hospital for organ recovery. She runs to the emergency room and stops John from shooting himself, and John allows the hostages to go free. Michael is given the life-saving operation and, after watching the procedure with Denise, John is taken into police custody after the operation is a success John became a nationwide hit.
Three months later at his trial, all of the witnesses speak on his behalf. He is later acquitted of charges of attempted murder and armed criminal action but is found guilty of kidnapping. It is never revealed what his sentence for the crime will be, but his lawyer is overheard saying that no judge will give him "more than three to five (years)" and that she will try and get it reduced to two.
