Driving cross-country, Ray and his wife and daughter stop at a highway rest area where his daughter falls and breaks her arm. After a frantic rush to the hospital and a clash with the check-in nurse, Ray is finally able to get her to a doctor. While the wife and daughter go downstairs for an MRI, Ray, exhausted, passes out in a chair in the lobby. Upon waking up, they have no record or knowledge of Ray's family ever being checked in.
Ray is driving home with his wife Joanne and daughter Peri after a Thanksgiving visit to Joanne's parents and argue about the state of their relationship. Peri needs to use the restroom, so they take a break at a gas station. After returning to the car, Peri cannot find her compact mirror. Joanne goes to check the restroom, and Ray searches the back seat. While Ray is distracted, Peri is menaced by a stray dog and starts backing towards an exposed pit. Ray throws a rock to scare the dog, which causes Peri to fall into the hole. Ray dives in after her and hits his head. He comes around in a daze, and a distressed Joanne has climbed down and is checking Peri for injuries. After his head clears, he picks Peri up and decides to bring her to a nearby hospital they passed a few miles back to see to her arm. During the admissions process, they are asked if they would be willing for Peri to be placed on the organ donor register. Peri is seen by a doctor who concludes that her arm is broken but wants her to have a CAT scan in case she has a head injury. Joanne accompanies her to the scanning facility in the basement, while Ray falls asleep in the waiting area. Ray awakens hours later and asks the hospital staff if he can see his wife and daughter, but is told they have no record of them. Most of the doctors have changed shift, and the only nurse still there said that Ray came alone and was treated for a head wound. Ray becomes distressed, is restrained by security and after being given a sedative is locked in a room. He escapes and waves down two police officers to who agree to investigate. More evidence is found in the hospital that his family was never there, and Ray is taken by the police to the gas station. They find a large bloodstain in the pit and attempt to arrest Ray. He takes an officer's gun and locks them in the gas station before returning to the hospital. He reaches the basement, after fighting with security, and finds that Peri is about to have her organs harvested. He drags her out of the operating theatre, along with a drugged Joanne, shooting a doctor as they leave. As they drive away, it is revealed that his family died in the pit; Peri from her fall and Joanne after she was pushed onto a spike by Ray. Their bodies were in the back of the car the whole time and the events of the hospital visit were the result of Ray's psyche trying to deny the reality of what happened. On the back seat, a seriously ill patient who Ray extracted from surgery lies unconscious.
Summary adapted from TMDb and Wikipedia sources.
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