Season synopsis
Contains spoilers for this season and earlier seasons.
The final season opens with the aftermath of the ambulance explosion: Pratt has catastrophic injuries, and despite surgery he dies after his brother Chaz arrives. Cate Banfield becomes ER chief. Luka and Abby leave County with Joe for Boston, while Neela and Ray reconnect when he returns on Halloween with prosthetic legs after months of rehabilitation. Carter also returns to County for unpaid shifts, concealing how sick he is. His kidney failure is caused by amyloidosis that developed from schistosomiasis, damaging his remaining kidney; he is already receiving dialysis when he collapses at work.
Carter needs a transplant, and Benton, now working at Northwestern, stays beside him through the operation. Doug and Carol arrange a donor kidney without knowing it is for Carter; he undergoes successful surgery under Benton’s supervision. Neela faces a malpractice suit after a patient dies, but the family later drops the case. She and Brenner begin a relationship, then break up when his past comes to light. After Neela decides to leave County, she takes a position at Le Chatelier Medical Center in Baton Rouge, where Ray works at a physical rehabilitation center, joining him there after her final shift.
In the series finale, Carter opens the Joshua Carter Center, a clinic for people who cannot afford care. Kem attends, but the loss of their son remains between them; she leaves after agreeing to call him. Rachel Greene visits as a prospective medical student and interviews for the teaching program. When an industrial explosion sends casualties to County, Carter returns to emergency work and invites Rachel to observe and assist with a patient, calling her “Dr. Greene.” The series closes with County treating the injured.