Tracy Allen is the wife of a San Francisco billionaire who arrives at Three Rivers in need of a new liver. But complications set in when David and Pam travel to Youngstown, Ohio to pick up one from the donor, a murder victim of highwaymen, a setback occurs when the liver is cancer ridden. As a result, Tracy's husband, John, defies Dr. Jordan's advice and resorts to buying a new liver for her on the black market. Meanwhile, a friend from Andy's criminal past, named Michael, resurfaces who anonymously gives a hearty donation to the hospital for Kuol's heart transplant as a bargaining chip to get Andy to resume his old life of crime before entering med school. Also, Miranda and Andy try to treat a young couple who are infected by an unknown pathogen.