San Francisco police officer and widowed father Andy García Frank Conner is in a frantic race against time to find a compatible bone marrow donor for his leukemia-stricken son, Matt. In a desperate bid, he breaches FBI headquarters and discovers a perfect match in Michael Keaton Peter McCabe, a sociopath serving a life sentence for a string of murders. McCabe’s long history of brutality—violence inside Pelican Bay State Prison, failed escape attempts, and the brutal way he treats guards and inmates—hangs over him, and he must be kept under heavy restraints when outside the supermax unit.
Inside Pelican Bay, Tracey Walter portrays a Medical Inmate as the prison’s volatile atmosphere surrounds McCabe, whose talent for manipulation becomes clear even before his transfer is considered. McCabe initially shows little interest in helping Conner, but a chance to turn the situation to his advantage gradually reveals itself as he seeks a challenge worthy of Garry Kasparov or Deep Blue. Meanwhile, Conner—which also involves Brian Cox Captain Jeremiah Cassidy and Marcia Gay Harden Dr. Samantha Hawkins—heads toward a plan to move McCabe to the hospital for the transplant, hoping for Matt’s survival.
At the hospital, McCabe is given a sedative. With help from a counteracting drug he obtained from a fellow inmate, he slips free of his restraints, launches a brutal assault on guards and surgeons, and aims to escape. Conner and a fellow officer corner him, but McCabe presses a scalpel to Hawkins’ throat, forcing Conner to lower his guard. The situation spirals when another officer is shot by McCabe, who has seen through Conner’s attempt to stop him. Hawkins warns that if McCabe dies, Matt’s bone marrow would be useless, and Conner positions himself between the dangerous man and the others, a choice that costs him.
Word of the chaos reaches Cassidy, who orders Conner to step back. Undeterred, Conner slips away to hunt McCabe himself. McCabe confirms his control by detonating propane tanks to trigger an explosion, seizing the hospital’s adjacent wing, taking guards hostage, and forcing a lockdown across the building. Conner and Hawkins push forward, convincing McCabe to let them inside so Hawkins can attend to Matt. From the hospital’s security feeds, McCabe studies Conner and begins to respect a man who loves his son enough to risk everything.
Conner intervenes when McCabe is about to ambush Cassidy and his SWAT team with cyclopropane-filled tanks. The clash between loyalty and cunning escalates as Cassidy furies at Conner for aiding the escaped convict, while McCabe seethes at Conner’s persistent interference. He kidnaps Matt and moves deeper into the building’s lower levels. Matt, showing a stubborn grit of his own, tries to wound McCabe to give Conner a better chance; McCabe, however, spares him and leaves him for Conner to find.
McCabe escapes into the city, steals a car, and a high-stakes chase surges toward a bridge. Cassidy’s team arrives by helicopter, and a SWAT sniper opens fire. In a tense reversal, Conner shields McCabe and is wounded in the arm. McCabe, cornered but still dangerous, fights for escape until Conner mortally wounds him, sending him off the bridge and into the bay. Conner dives after him, pulling McCabe from certain death and ensuring the transplant can proceed for Matt.
Back at the hospital, a severely wounded McCabe agrees to proceed with the transplant, saving Matt’s life. Though Conner’s career is over, he is overwhelmed with joy that his son will live. As the surgery continues, a guard delivers the unsettling detail that the operation is a success. In the final moment, while a hospital bed tilts upward, McCabe—the captive who nearly derailed everything—is unmasked in a quiet, chilling moment as a guard realizes his gun is missing. McCabe looks at the guard and, with a sly grin, asks:
> What kind of car do you have?
