Full opinion text
MEMORANDUM OPINION AND ORDER CASTILLO, District Judge. This case arises out of the tragic death of Norman L. Smith, Jr., (“Smith”) while he was in the custody of the Cook County Department of Corrections (“CCDOC” or “Cook County Jail”). On Friday, April 23, 2004, Smith was arrested and charged with possession of a controlled substance. Smith’s mother claims that he died seven days later at Cook County Jail because the sheriffs officers and medical staff at the Jail ignored his obvious symptoms of meningitis and the repeated requests of Smith and his fellow inmates for medical help. Plaintiff Marlita E. Thomas (“Thomas” or “Plaintiff’), as Smith’s mother and the independent administrator of his estate, brings this suit under 42 U.S.C. § 1983; the Illinois Wrongful Death Act, 740 ILCS 180/1 (2005); the Illinois Survival Act, 755 ILCS 5/27-6 (2005); and Illinois common law against Cook County, the Sheriff of Cook County Michael F. Sheahan (“Sheriff’) in his official capacity, the President of the Cook County Board John Stroger, Jr. (“Stroger”) in his official capacity, Sergeant James Monczynski (“Monczynski”), Officer Alex Sanchez (“Sanchez”), Officer Donetta Davis (“Davis”), Officer Terrence Toomey (“Toomey”), Officer Douglas Johnson (“Johnson”), Officer Louis Thiemecke (“Thiemecke”), Officer Darryl Houston (“Houston”), Officer Jesus Facundo (“Fa-cundo”), Sergeant Gerald Dew (“Dew”), Sergeant Steven Stroner (“Stroner”), Lieutenant Raymond Krzyzowski (“Krzy-zowski”), Sergeant Ivan Hernandez (“Hernandez”), and Peggy Westbrook (“West-brook”) (collectively, “Defendants”). At issue is Plaintiffs Fifth Amended Complaint (“Complaint”). (R. 150.) Defendants have joined in three separate motions for summary judgment, filed by the individual defendants (R. 260), Hernandez (R. 286), and Cook County (R. 324). MOTIONS TO STRIKE Defendants also filed a motion to strike the following documents: (1) Plaintiffs Rule Local Rule 56.1(b)(3)(B) statement of additional facts; (2) Plaintiffs combined response to Defendants’ Local Rule 56.1(a)(3) statement of undisputed facts; (3) Plaintiffs combined response to Defendants’ motions for summary judgment in their entirety or in part; and (4) Plaintiffs exhibits 3, 8, 14, 23, 66, and 74. (R. 352, Defs.’ Mot. to Strike.) Hernandez filed an additional motion to strike, essentially repeating certain claims in the joint motion to strike (R. 373, Hernandez Mot. to Strike); accordingly, this Court will address only the joint motion to strike and will address Hernandez’s motion specifically where it deviates from the joint motion. Defendants argue that Plaintiff violated the local rules and thus should be given the ultimate sanction of striking Plaintiffs statement of additional facts and her responses to Defendants’ statements of fact. Local Rule 56.1 requires that statements of facts contain allegations of material fact, and the factual allegations must be supported by admissible record evidence. Malee v. Sanford, 191 F.R.D. 581, 582-83 (N.D.Ill.2000). Courts in this district have broad discretion to enforce Local Rule 56.1, and the Seventh Circuit regularly upholds its strict enforcement. See, e.g., Koszola v. Bd. of Ed. of City of Chi, 385 F.3d 1104, 1109 (7th Cir.2004); Midwest Imps., Ltd. v. Coval, 71 F.3d 1311, 1316 (7th Cir.1995). Defendants complain that Plaintiff filed 140 numbered paragraphs in her joint statement of additional facts, even though under Local Rule 56.1(b)(3)(C), plaintiff needed prior leave of Court to file more than 40 paragraphs. (R. 352, Defs.’ Mot. to Strike at 3.) Plaintiff, however, had to respond to three separate summary-judgment motions from Cook County, Hernandez, and the remaining Defendants. While Defendants concede that perhaps Plaintiff could have filed 120 paragraphs total (40 paragraphs per motion), they quibble over the remaining 20. (Id. at 3.) This Court admonishes Plaintiff for not following the local rules, but we find that the factual complexity in this case warrants the relaxation of the 40-paragraph limit. See Local Rule 56.1, Committee Comment (“A party may seek leave to file more asserted statements of fact or additional fact, upon a showing that the complexity of the case requires a relaxation of the 80 or 40 statement limit”.) Defendants also complain that Plaintiffs statement of facts should be stricken because it is not “concise,” but the more appropriate action would be for this Court to simply disregard any extraneous facts Plaintiff includes. (R. 352, Defs.’ Mot. to Strike at 6.) Defendants next argue that Plaintiff violates Local Rule 56.1(b)(3)(C)— which requires a statement “consisting of short numbered paragraphs” — by imper-missibly combining six to ten statements of fact into a single numbered paragraph. (Id. at 3.) Not only do Defendants do the same thing in their statements of fact (see, e.g., R. 262, Defs.’ Facts ¶¶ 10-74), but they compound the problem by responding to Plaintiffs numerous factual statements as merely “Disputed” despite that certain fact statements are incontrovertibly undisputed. (See, e.g., R. 368, Defs.’ Resp. to PL’s Facts ¶ 109.) In addition, Defendants do not provide a list to this Court of the allegedly problematic paragraphs beyond a reference by example to Plaintiffs paragraphs 53 to 57. We also note that both parties improperly include some legal conclusions, hearsay, and speculation in their statements of fact, which this Court will not consider. Malee, 191 F.R.D. at 583. Because of the mutual responsibility the parties share for their unwieldy statements of fact, this Court will not sanction Plaintiff. First, a movant’s 56.1(a) statement should contain only factual allegations. It is inappropriate to allege legal conclusions in a 56.1(a) statement on the off-chance that one’s opponent might not file a correct response. Defendants next request that this Court strike affidavits from and any references to Smith’s fellow inmates: Titus Haynes, George Robotis, Darius Parker, and Alan Robinson. Defendants argue that Plaintiff never disclosed them as witnesses or individuals with relevant information before the September 15, 2006 discovery cut-off, and thus Defendants did not have the opportunity to depose them. (R. 352, Defs.’ Mot. to Strike at 6-7.) Defendants also ask for the draconian remedy of striking all of Plaintiffs summary judgment submissions. (Id. at 7-8.) In her response, however, Plaintiff attached a copy of a 2004 fax that her counsel sent to counsel for the individual Defendants which included Robinson, Robotis, and Haynes as potential witnesses. (R. 361, Resp. to Mot. to Strike, Ex. 1, Fax.) Then, in 2006, before the close of discovery, Plaintiffs attorney disclosed the addresses for these witnesses to Defendants’ counsel. (Id., Exs. 2-5.) The Sheriff himself raised the possibility of Parker’s testimony in his Rule 26(a)(1) supplemental disclosures, as the Sheriff stated that any of the names listed on a “Group Grievance” document, submitted by Parker, may have information relevant to medical requests on Smith’s behalf. (Id., Exs. 6-7.) Furthermore, Plaintiffs counsel disclosed Parker’s address in a letter dated August 25, 2006. (Id., Ex. 8.) Because Plaintiff disclosed these witnesses prior to the discovery cutoff, we will not strike her summary judgment submissions. Defendants also rfequest that this Court strike Plaintiffs Exhibit 23, Addendum to Dr. Katz’s Expert Opinion Report, because it was disclosed for the first time on or about November 7, 2006, after the close of discovery and after Dr. Katz’s deposition had already been taken. (Id. at 8-9.) The one-page addendum addresses the deposition testimony of Smith’s cellmate, Cory Mitchell, which occurred after Dr. Katz’s deposition. The addendum is proper for this purpose. We' grant Defendants’ motion to strike only as to paragraph 139 of Plaintiffs statement of facts, in which Plaintiff attempts to incorporate by reference all facts submitted and answered and all supporting materials filed in the case of Addie McCall v. Sheahan, 03 C 5948, 2003 WL 23801014 (N.D.Ill. filed Aug. 22, 2003), in which Judge Holderman granted summary judgment to the Sheriff on the plaintiffs policy claims. In addition to far exceeding the Local Rule’s limit on statements of fact, Plaintiff does not attempt to demonstrate the relevance, probative value, and admissibility of these materials beyond a cursory summary of that case. Malec, 191 F.R.D. at 583 (“the 56.1(a) statement should be limited to material facts.”) It is not this Court’s job to weed through the stack of additional evidence Plaintiff wishes to admit. Accordingly, this Court will strike the portion of Plaintiffs Rule 56.1(b)(3)(B) statement of additional facts adopting and incorporating by reference the materials filed in Addie McCall v. Sheahan, et al., 03 C 5948, 2003 WL 23801014 (N.D.Ill.). Hernandez’s motion to strike added one argument: that this Court should not consider the portion of Plaintiffs response brief that exceeds 15 pages because Plaintiff did not seek leave of court to file an oversized brief. (R. 373, Hernandez Mot. to Strike at 4.) Plaintiffs 28 page brief, however, was in response to: (1) Hernandez’s 15 page memorandum in support of his motion for summary judgment (R. 290); (2) Defendant Cook County’s 7 page memorandum in support of its motion for summary judgment (R. 325); and (3) the remaining Defendants’ 15 page memorandum in support of their motion for summary judgment (R. 261). Plaintiffs 28 page response brief is much less than the total 45 pages she would have been entitled to had she filed three separate responses. Accordingly, Hernandez’s motion is denied. UNDISPUTED FACTS I. The Parties Smith was arrested on April 23, 2004, and taken to Division V, Tier 1-M, of Cook County Jail. Despite inmate testimony that Smith had requested medical attention and was obviously very sick, it is undisputed that none of the officers or medical staff on duty during Smith’s incarceration, except Officer Toomey, have any memory of Smith before he was found convulsing and comatose in his Cook County Jail cell in the early morning of April 30, 2004. Defendants Monczynski, Sanchez, Davis, Too-mey, Johnson, Thiemecke, Houston, Fa-cundo, Hernandez, Dew, Stroner, and Krzyzowski were assigned as correctional officers or supervisory correctional personnel at Division 5, Tier 1-M at the Cook County Jail during various shifts between April 24 and April 30, 2004, where Smith’s jail cell was located. (R. 262, Defs.’ Facts ¶ 2.) The Sheriff is the Jail’s warden. (Id.) Cook County finances the Jail and subcontracts with Cermak Health Services (“Cer-mak”) to provide medical care to detainees. (Id. ¶ 3.) Defendant Westbrook is employed by Cermak as a Correctional Medical Technician (“CMT”). (Id. ¶6.) She was on duty for Division 5, Tier 1-M during various shifts the last week of April 2004. (Id.) II. Cermak Cermak is located on Cook County Jail grounds, with its emergency room (“ER”) located in its own building. (R. 349, Pl.’s Resp. to Defs.’ Mot. for Summ. J., Ex. 32, Myvett Dep. at 66.) Cermak has a dispensary, or clinic, in each jail division. (Id. at 67.) During the day shift, the CMTs rotate their responsibilities of working in the clinic and dispensing medication on the tier. (Id. at 68.) The clinic closes at 3 p.m.; after that, the Cermak receiving center handles inmate complaints, and at night, the ER handles complaints. (Id. at 32-33.) Between April 24 and April 30, 2004, CMTs Westbrook, Bradley, Lacy, and Patton were assigned to Division 5, Tier 1-M. Myvett was one of two CMTs on duty in the Cermak ER in the early morning of April 30, 2004. A. Tier Visits Cermak policy mandates that its personnel make daily visits to the tiers of Cook County Jail. (R. 368, Defs.’ Resp. to Pl.’s Facts ¶¶ 98, 109.) Cermak staff are required to turn in “Daily Encounter Forms” each day which document their tier visits and contact with inmates. (Id. ¶ 132.) The correctional officers’ Living Unit Logs (or “tier logs”) also may reflect medical visits to a tier. (R. 368, Defs.’ Resp. to Pl.’s Facts ¶ 130.) It is disputed, however, if the officer or the CMT is supposed to sign the tier log, and whether the tier logs get signed at all when a CMT arrives on the tier. (Id., Ex. 18, Davis Dep. at 58-59; id., Ex. 19, Dew Dep. at 79; R. 349, PL’s Resp. to Defs.’ Mot. for Summ. J., PI. Ex. 15, Bradley Dep. at 38; id., Ex. 71, Ki-riazes Dep. at 51, 112; id., Ex. 45, Lacy Dep. at 57.) Generally, CMTs do not go inside the tier to dispense medications; rather, they stand in the interlock — the locked area on the tier where the officers stay when they are not doing security checks. (R. 368, Defs.’ Resp. to Pl.’s Facts ¶ 106.) The officer opens the interlock door, the CMT calls the inmates’ names, and the inmates come to the door to get their medication. (R. 349, Pl.’s Resp. to Defs.’ Mot. for Summ. J., Ex. 65, Westbrook Dep. at 28-29; id., Ex. 32, Myvett Dep. at 68-69.) The CMT cannot see into any inmate’s cell from the tier door. (Id., Ex. 65, West-brook Dep. at 29.) CMT Westbrook estimates that it takes 2 to 3 hours to dispense the medications. (Id. at 31.) Cermak personnel cannot .access the jail cells unless there is a lockdown, where the inmates are all locked into their cells. (Id., Ex. 71, Kiriazes Dep. at 135.) Nevertheless, Woodrow Winfrey (“Winfrey”) — the Cermak Health Administration supervisor for Division V in April 2004— testified that CMTs sometimes fail to make their daily tier rounds, and he is aware of multiple inmate grievances to that effect. (R. 368, Defs.’ Resp. to Pl.’s Facts ¶ 113; R. 349, Pl.’s Resp. to Defs.’ Mot. for Summ. J., Ex. 68, Winfrey Dep. at 29, 46.) He stated that in general, some CMTs do not make their tier visits because no officer was present on the tier to let them in. (R. 349, PL’s Resp. to Defs.’ Mot. for Summ. J., Ex. 68, Winfrey Dep. at 90.) CMT Lacy testified that he has “frequently” gone to a tier to dispense medications but that there was no officer on the tier; he then finds an officer on another tier to assist him. (Id., Ex. 45, Lacy Dep. at 68-69.) Sergeant Stroner agrees that Cer-mak staff did not go to each tier on a daily basis. (Id., Ex. 37, Stroner Dep. at 18, 42.) Both Winfrey and Howard Hradek (“Hradek”), the Cermak supervisor and CMT interim director in April 2004, specifically recall two group inmate grievances (in July 2003 and in December 2000) against CMT Patton for failing to make tier rounds and dispense medications. (R. 368, Defs.’ Resp. to PL’s Facts ¶ 108.) Hradek and Winfrey disciplined Patton more than once for his repeated failures to perform daily tier visits. (R. 349, PL’s Resp. to Defs.’ Mot. for Summ. J., Ex. 68, Winfrey Dep. at 64.) Nevertheless, Hra-dek — who had the authority to set up training for CMTs — never instituted training on the importance of daily tier visits. (R. 368, Defs.’ Resp. to PL’s Facts ¶ 138; PL’s Ex. 68, Winfrey Dep. at 28, 46, 62.) B. Requests for Medical Attention Detainees can request medical attention through written medical request forms which Cermak personnel are required to retrieve each day. (R. 368, Defs.’ Resp. to PL’s Facts ¶¶ 98,109,123.) A locked black box (the “request box”) is used to collect the written requests. (Id. ¶ 119.) The box is attached to the wall of the interlock, an area of the tier not accessible to detainees. (Id.) It is not possible to see inside the locked box. (Id., Ex. 18, Davis Dep. at 58.) Blank detainee medical request forms are kept alongside the box. (R. 262, Defs.’ Facts ¶ 46; R. 344, PL’s Resp. to Defs.’ Facts ¶ 46.) Officers do not have a key to the locked request box. (R. 368, Defs.’ Resp. to PL’s Facts ¶ 119.) Sometimes detainees would leave completed medical request forms in the sleeve outside the locked box where the blank forms were kept, or would hand the form directly to a Cermak staffer. (R. 349, PL’s Resp. to Defs.’ Mot. for Summ. J, Ex. 45, Lacy Dep. at 25-26; id., Ex. 71, Kiriazes Dep. at 53.) One key will open all of the medical request boxes, and all CMTs are issued keys to open the request boxes. (R. 349, PL’s Resp. to Defs.’ Mot. for Summ. J, Ex. 68, Winfrey Dep. at 40-41; id., Ex. 67, Hradek Dep. at 50-51.) Although Winfrey and Hradek have keys to the locked boxes, they know that some CMTs in Division 5 do not have keys. (Id.) Of the four CMTs working in Division 5 the last week of April 2004, only Patton had a key to the request box. (R. 349, PL’s Resp. to Defs.’ Mot. for Summ. J., Ex. 73, Patton Dep. at 31-32.) CMTs Bradley, Myvett, and Lacy were not aware if any CMTs had a key. (Id., Ex. 72, Bradley Dep. at 16; id., Ex. 32, Myvett Dep. at 76; id., Ex. 45, Lacy Dep. at 24.) Between 5 and 10 years have passed since any memoranda have been distributed to CMTs informing them how to access keys to open the locked medical request boxes. (R. 368, Defs.’ Resp. to PL’s Facts ¶ 125.) CMTs may not have access to the medical request box if no officer is on the tier. (Id., Ex. 68, Winfrey Dep. at 97-98) Jean Kiriazes (“Kiriazes”), the director of Continuous Quality Improvement and Risk Management at Cermak, has heard at least ten complaints from CMTs of lack of access to detainee medical requests. (R. 368, Defs.’ Resp. to PL’s Facts ¶¶ 116-17.) In 2004, 2005, and 2006, CMT Lacy heard a number of complaints that medical request forms were not being picked up. (R. 349, PL’s Resp. to Defs.’ Mot. for Summ. J., Ex. 45, Lacy Dep. at 92.) Inmate Parker, a clean-up worker during his incarceration in Division 5, swore in his affidavit that he often saw medical request slips in the interlock garbage, and that he had put in five unanswered medical request forms himself. (R. 368, Defs.’ Resp. to PL’s Facts ¶ 64; R. 349, Ex. 14, Parker Aff. ¶¶ 5, 7.) Parker also attested that he often saw CMTs unable to gain access to Tier 1-M because the guard was watching another tier. (Id. ¶ 8.) On April 19, 2004, he filed a grievance on behalf of 52 Division V inmates (Tier 2-D) complaining that CMTs did not properly administer basic medications and requesting that medical request slips be picked up properly. (Id., Ex. 14, Parker Dep., Dep. Ex 1.) Director Kiriazes signed the April 2004 group grievance form and responded on April 28, 2004, that medication is properly administered. (Id., Ex. 14, Parker Dep., Dep. Ex 2.) Parker appealed this response, claiming that even when inmates show severe signs of sickness, no medication is given and service is delayed. (Id.) The Appeal Board denied the appeal, stating that the issues were addressed on April 29, 2004. (Id.) Inmates could also make verbal requests to CMTs or officers for medical care. (R. 349, PL’s Resp. to Defs.’ Mot. for Summ. J., Ex. 45, Lacy Dep. at 29-30; id., Ex. 32, Myvett Dep. at 70.) Cermak policy is for a CMT to evaluate an inmate as if his claim of sickness is the whole truth, regardless of what the officer may say. (Id., Ex. 70, Raba Dep. at 80.) There is no training for recognizing drug withdrawal or meningitis symptoms. (Id., Ex. 45, Lacy Dep. at 45). Westbrook testified that if an inmate was too sick to come out of the cell, she would go to him (with a guard) if he screamed out from his cell or if she was notified by another inmate of an immobile sick inmate. (Id., Ex. 65, West-brook Dep. at 32-33, 62.) Westbrook testified that the CMT decides whether to call the doctor, and the doctor decides whether the officer should bring the inmate to see him. (Id., Ex. 65, Westbrook Dep. at 34-35.) If the tier was on lockdown, West-brook testified that a guard was always available to go with her to every cell. (Id. at 38, 63.) CMTs should note all inmate contact even if it does not result in a medical referral. (Id. at 39.) III. Cook County Correctional Officers A. Security Checks Sheriff department policy requires that correctional officers perform security checks to monitor detainee living units, or jail cells, every thirty minutes. (R. 368, Defs.’ Resp. to PI. Facts ¶ 67.) To perform security checks, officers are supposed to physically walk through the tier and look into each area of the tier, including the cells, dayrooms, and catwalks (hallways). (Id) When an officer walks into the tier, there must be a back-up officer in the interlock. (Id, Ex. 18, Davis Dep. at 14; id, Ex. 28, Hernandez Dep. at 80; id, Ex. 20, Toomey Dep. at 66; id, Ex. 21, Off. Johnson Dep. at 24; id, Ex. 22, Houston Dep. at 17.) Policy allows one officer to watch two tiers at the same time (“cross-watching”) is allowed if there is a clear sightline between the two tiers and they are close together. (Id ¶ 65.) As area supervisors, sergeants have a duty to conduct checks of Tier 1-M at least twice per shift and review the officers’ daily Living Unit Logs. (R. 368, Defs.’ Resp. to Pl.’s Facts ¶ 55; R. 262, Defs.’ Facts ¶¶ 36-37.) The area supervisors are responsible for staffing correctional officers on the tier, and thus know when Tier 1-M officers are cross-watching both tiers 1-M and 1L, which was a common occurrence in April 2004. (R. 368, Defs.’ Resp. to PL’s Facts ¶ 54.) The detainees are in the day room for approximately 5.5 hours of the afternoon/evening shift (3 p.m. to 11 p.m.). (R. 262, Defs.’ Facts ¶ 41; R. 344, Pl.’s Resp. to Defs.’ Facts ¶ 41.) Cell doors are unlocked at the same time from the interlock to allow the detainees out, but the officer must enter the tier to re-lock each cell individually. (Id ¶ 42; R. 368, Defs.’ Resp. to PL’s Facts, Ex. 21, Johnson Dep. at 58.) When the inmates go to bed (at approximately 9:00 p.m.) the process of individually opening and locking the cell doors is repeated. (Id) During most of the night shift, the inmates are confined to their cells. (R. 262, Defs.’ Facts ¶ 49.) Inmates may bang on the cell doors to alert officers to problems during the night shift. (Id ¶ 50.) Although the cell doors are unlocked in the early morning for breakfast, not all inmates get breakfast. (R. 368, Defs.’ Resp. to PL’s Facts, Ex. 21, Johnson Dep. at 67.) Despite the policy that officers should make physical security checks of the jail tier, Defendant officers and supervisors testified that correctional officers are not always required to actually walk around the tier for a security check. Officer Hernandez stated that officers can stay in the interlock and do a visual security check unless they see something suspicious. (Id, Ex. 28, Hernandez Dep. at 98-101). Sergeant Monczynski believes officers need not do a physical security check if inmates are in the day room. (Id, Ex. 23, Monczynski Dep. at 150.) Officer Davis testified that she occasionally does her security check through the interlock window; Officer Toomey does security checks through the window if no back-up is available or sometimes if he is watching two tiers at the same time. (Id, Ex. 18, Davis Dep. at 14; id., Ex. 20, Toomey Dep. at 56-58.) Sergeants Dew and Monczynski agree that in the absence of back-up, officers do a visual security check from the interlock. (Id, Ex. 19, Dew Dep. at 53-54; id, Ex. 23, Monczyn-ski Dep. at 40.) Officer Facundo, however, stated that he would do a physical security check even without back-up. (Id, Ex. 16, Facundo Dep. at 48.) Officer Thiemecke testified that if no officer or supervisor were immediately available for backup, he could find another backup. (Id, Ex. 24, Thiemecke Dep. at 49.) Officer Sanchez did not believe that back-up was mandatory to enter the tier in April 2004. (Id, Ex. 14, Sanchez Dep. at 111-12.) With a visual security check through the glass, the officer cannot see every area in the tier where prisoners could be, including the stairs going down to the cells and the hallways by the cells. (Id., Ex. 37, Stroner Dep. at 47-48.) Officers also cannot see into cells or areas in the dayroom or the stairwells from the glass in the interlock. (Id., Ex. 19, Dew Dep. at 54-55; id., Ex. 20, Toomey Dep. at 57.) Thiemecke testified that an officer cannot see inmates in the day room who are blocked by the stairs. (Id., Ex. 24, Thiemecke Dep. at 33) Inmates often lay down in the walkways outside of the cells or sleep on the day-room floor. (Id., Ex. 14, Sanchez Dep. at 123-24.) Facundo testified that it was common for inmates to sleep in the day-room, and in the catwalks next to the cells. (Id., Ex. 16, Facundo Dep. at 25, 67-68.) An inmate can refuse to go out for recreation and stay in to rest if he is sick or if he cannot walk. (Id., Ex. 28, Hernandez Dep. at 131-32). When detainees are sleeping in the day room or catwalks or cells, officers should wake them during security checks to make sure they are alive. (Id., Ex. 16, Facundo Dep. at 70.) Defendant officers also testified that if they are “cross-watching”, they may make security checks through the television monitor of the other tier, and through the interlock glass of the tier where the officer is. (Id. at 58; id., Ex. 26, Stroner Dep. at 46-47, 53.) The monitor shows the day room area, but not the cells or the walkways outside of the cells. (Id., Ex. 26, Stroner Dep. at 54; id., Ex. 14, Sanchez Dep. at 114, 124.) Sergeant Stroner testified that in April 2004, it was routine for several monitors to be broken every day, sometimes for more than a day or two. (Id., Ex. 26, Stroner Dep. at 61, 63.) Stroner would only note a broken monitor in his sergeant’s log if all the monitors were broken at the same time for a long period of time. (Id.) If the 1-M monitor in Tier 1-L is not working, the officer cannot see into 1-M if cross-watching from 1-L. (Id., Ex. 16, Facundo Dep. at 23) There is no clear sightline between tiers 1-M and 1-L. (Id. ¶ 66.) Noise does not easily permeate through the glass that separates the tiers. (Id.) An officer in 1L could not hear an inmate in his cell in 1M. (Id., Ex. 26, Stroner Dep. at 70-72.) Lieutenant Krzy-zowski testified that understaffing at the jail is a chronic problem that he has discussed with his supervisors. (R. 262, Defs.’ Facts ¶ 38.) During the night while inmates are sleeping, officers are still required to do security checks every thirty minutes. (R. 262, Defs.’ Facts ¶33; R. 344, Pl.’s Resp. to Defs.’ Facts ¶ 33.) Each cell door has a ehuckhole, or opening, that the officer could (with the aid of a flashlight) peer into to view inmates. (Id.) Inmates frequently stuff things in chuckholes for privacy or other reasons, such as obstructing air drafts, but officers are supposed to remove the obstruction if they cannot see through the ehuckhole. (Id., Ex. 19, Dew Dep. at 136; id., Ex. 23, Monczynski Dep. at 131; id., Ex. 26, Stroner Dep. at 108-09; id., Ex. 28, Hernandez Dep. at 127; id., Ex. 21, Johnson Dep. at 26-27.) Officers Houston, Sanchez, and Johnson stated that they would look into the cell with a flashlight and check for movement to make sure the inmates were alive. (Id., Ex. 21, Johnson Dep. at 24; id., Ex. 22, Houston Dep. at 11; id., Ex. 14, Sanchez Dep. at 12-13.) There may be a blind spot in some corner cells. (Id., Stroner Dep. at 69-70.) It takes five to ten minutes to do a security check. (Id, Ex. 18, Davis Dep. at 45; id., Ex. 24, Thiemecke Dep. at 119; id., Ex. 21, Johnson Dep. at 26.) All of the officer Living Unit Logs from April 24 to April 30, 2004, state that the Division 5, Tier 1-M officer — even when cross-watching — performed every required security check. B. Requests for Medical Attention Officers are trained to contact their supervisor whenever they come into contact with an inmate who appears or claims to be sick, and the supervisor determines whether Cermak should be called. (R. 344, Pl.’s Resp. to Defs.’ Facts ¶35; R. 368, Defs.’ Resp. to Pl.’s Facts ¶¶ 53, 56.) Monezynski, Thiemecke, and Krzyzowski testified, however, that in emergency situations or when a supervisor is not available, an officer does not need a sergeant’s approval to call Cermak when an inmate is sick. (R. 368, Defs.’ Resp. to Pl.’s Facts, Ex. 24, Thiemecke Dep. at 139; id., Ex. 23, Monezynski Dep. at 31; id., Ex. 31, Krzy-zowski Dep. at 52.) The defendant officers disagree on the extent of evaluation they may make of an inmate requesting medical attention. Officers are not trained to recognize illnesses. (Id. ¶ 97.) Sergeant Dew claims that if an inmate makes a verbal medical request to an officer, the officer will evaluate the seriousness of the claim before contacting their supervisor to assess the situation. (Id., Ex. 19, Dew Dep. at 29-30.) He testified: “If you know inmates, inmates tend to lie.” (Id. at 127.) By contrast, Stroner and Davis testified that they always contact Cermak if an inmate looks sick or requests medical assistance, whether they believed the inmate was sick or not. (Id., Ex. 26, Stroner Dep. at 11-12, 120; id., Ex. 18, Davis Dep. at 42.) If one inmate requested medical attention on behalf of another inmate, the officer would have a duty to talk to the sick inmate or the sergeant. (Id., Ex. 26, Stroner Dep. at 40; id., Ex. 18, Davis Dep. at 38; id., Ex. 21, Johnson Dep. at 16.) If the officer was in the interlock while the inmates were in their cells, he would not know if there was a problem in a cell unless a cellmate got the officer’s attention by hollering or banging on doors. (Id., Ex. 22, Houston Dep. at 45.) The smell of vomit would not necessarily tip off the officers that an inmate was sick. Sergeant Dew testified that he would not know if an inmate threw up in his cell because “you smell vomit a lot in the jail. Doesn’t mean somebody threw up. That place stinks.” (Id., Ex. 19, Dew Dep. at 63-64.) If an inmate threw up in the day room, inmate workers would probably clean it up, and if an inmate threw up in his cell, he or his cellmates would probably clean it up. (Id., Ex. 18, Davis Dep. at 47-48; id., Ex. 21, Johnson Dep. at 65.) To obtain a medical request form, the detainee would have to knock on the interlock door where the medical request forms are kept in an open slot on the side of the locked request box. (Id., Ex. 21, Johnson Dep. at 66.) Stroner testified that when an officer hands out a medical request form, he should instruct the detainee to give the form to the officer when he was finished filling it out. (Id., Ex. 26, Stroner Dep. at 10.) An officer may receive a medical request form from an inmate directly or the inmate may slip them under the interlock door. (Id., Ex. 18, Davis Dep. at 16-17.) Most of the officers do not read the forms, they just put them in the medical request box after they are filled out. (Id.; id., Ex. 21, Johnson Dep. at 66; id., Ex. 16, Facundo Dep. at 67-81; id., Ex. 14, Sanchez Dep. at 29; id., Ex. 26, Stroner Dep. at 36-38; id., Ex. 22, Houston Dep. at 72.) Thiemecke, however, puts the completed medical request forms right back in the side pocket of the box with the blank forms or lays them on top of the box. (Id., Ex. 24, Thiemecke Dep. at 135.) Officers do not have keys to the locked medical request box. (R. 262, Defs.’ Facts ¶ 36.) Callie Baird, the executive director of the CCDOC from 2003 until November 2004, testified that in response to inmate complaints regarding access to medical care, she tried to improve Cermak’s response time, better ensure their daily tier visits, and improve documentation of requested and received medical attention. (R. 369, Defs.’ Supp’l Ex. 32, Baird Dep. at 42-43, 70-71.) Furthermore, the CCDOC stressed to officers that they are not medical personnel and should not make any diagnosis, just call for medical attention. (Id. at 75.) IV. The Events of April 24 through April 30, 2004 A. April 23, 2004 On Friday, April 23, 2004, Smith was arrested and charged with possession of a controlled substance. (R. 344, Pl.’s Resp. to Defs.’ Facts ¶ 9.) Smith was arrested at the home of his friend Darius Williams. (R. 368, Defs.’ Resp. to Pl.’s Facts, Ex. 7, Williams Dep. at 27.) Williams saw Smith the day before his arrest, and he thought that Smith looked normal. {Id.) B. April 24, 2004 On Saturday, April 24, 2004, Cermak gave Smith the customary general health examination for incoming detainees which included, among other things, a chest X-ray, a blood pressure screening, and the taking of medical history from Smith. (R. 344, Pl.’s Resp. to Defs.’ Facts ¶ 10.) Cer-mak’s Medical Intake Form for Smith indicates that Smith was on medicine for high blood pressure, and that he used tobacco and alcohol. (R. 348, Ex. 22, Katz Dep., 4/24/04 Intake Form.) The Form indicated that Smith did not need methadone (used for drug withdrawal). {Id.) After being booked and processed, Smith was placed within the general prison population in Division 5, Tier 1-M. (R. 344, Pl.’s Resp. to Defs.’ Facts ¶ 10.) On that day, Facundo was the officer assigned to monitor both Tier 1-M and Tier 1-L during the day shift (7 a.m. to 3 p.m.). {Id. ¶¶ 81-82.) Facundo’s log stated that he performed sixteen security checks for each tier. {Id.) Sergeant Dew was the area supervisor for Tier 1-M and Tier 1-L. {Id.) Facundo noted on his log that cross-watching was a “major safety and security risk!” {Id.) There were no medical staff visits to Tier 1-M during the day shift on April 24. {Id.) CMTs Lacy and Bradley were on duty, and Westbrook and Patton were off that day. (R. 368, Defs.’ Resp. to Pl.’s Facts, Ex. 45, Lacy Dep. at 46-47.) Detainees Cory Mitchell (“Mitchell”) and Carlos Matías (“Matías”) became Smith’s cellmates in Division V, Tier 1-M. (R. 368, Defs.’ Resp. to Pl.’s Facts ¶ 3.) According to Mitchell, when Smith first arrived at their cell, he had a cough and runny nose, but was otherwise talkative and did not complain of illness. {Id. ¶ 66.) Matías testified in his deposition that Smith was brought into his cell at approximately 3:00 p.m., during the start of the afternoon shift (3:00 p.m. to 11:00 p.m.), “walking like dizzy ... kind of walking like sick,” and “he started throwing up.” {Id., Ex. 13, Matías Dep. at 10-12.) Matías testified that he asked Smith if he was “dopesick” {ie., was suffering from drug withdrawal), and Smith responded that he “don’t mess around with no dope.” (Id.) Matías testified that he and Smith also told an African-American female nurse that Smith was sick and throwing up, but she did not help. (Id. at 21, 26-27.) Matías claims that the nurse dismissed Smith’s symptoms as drug withdrawal. (Id.) Officer Vasquez was assigned to monitor both Tier 1-M and Tier 1-L during the night shift — 11 p.m. April 24, 2004 to 7 a.m. April 25, 2004. (R. 368, Defs.’ Resp. to PI. Facts ¶¶ 79-80.) Sergeant Monc-zynski was the area supervisor responsible for Tier 1-M and 1-L during this shift. (Id.) Vasquez indicated on his 1-M and 1-L logs that cross-watching tiers 1-M and 1-L posed a security risk. (Id.) C. April 25, 2004 On Sunday, April 25, Officer Ruzanski was assigned to monitor both Tier 1-M and Tier 1-L during the afternoon shift. (R. 368, Defs.’ Resp. to PI. Facts ¶¶ 83-84.) His log stated that he performed 17 security checks for both Tier 1-M and 1-L and that cross-watching tiers 1-M and 1-L posed a security risk. (Id.) No medical staff visits occurred during that shift. (R. 348, Ex. 56, 4/25/04 1-M Tier Log.) Officer Thiemecke covered for Ruzanski during his break from 5 p.m. to 6 p.m., and wrote down that the cross-watching was a security risk. (Id., Ex. 57, 4/25/04 1-L Tier Log.) That day, CMTs Lacy and Bradley were on duty. (Id., Ex. 45, Lacy Dep. at 49.) Matías testified that on April 25, Smith “was doing worse, throwing up and throwing up more and more.” (R. 368, Defs.’ Resp. to Pl.’s Facts, Ex. 13, Matías Dep. at 29.) He saw Smith laying down on the floor in the day room and going to the bathroom to throw up. (Id.) Matías said Smith sometimes would not make it to the bathroom, and Matías would clean up the vomit. (Id. at 29-30.) Matías stated that he tried to get help for Smith from the officers, but when he asked Ruzanski to let Smith back in the tier so Matías would not have to clean up his vomit anymore, Ru-zanski locked Matías in his cell. (Id. at 32-35.) D. April 26, 2004 Officer Davis was assigned to Tier 1-M and Sergeant Dew was the area supervisor during the day shift (7:00 a.m. to 3:00 p.m.) on Monday April 26, 2004. (R. 348, Ex. 4, 4/26/04 Tier Log.) No Cermak personnel visited Tier 1-M during that shift. (Id.) Davis testified in her deposition that she does not remember Smith. (R. 344, Pl.’s Resp. to Defs.’ Facts ¶ 12.) CMT West-brook was on duty that day. (R. 348, Ex. 45, Lacy Dep. at 49-50.) On this date, the video monitor for Tier 1-M in the Tier L-l interlock was inoperable. (R. 262, Defs.’ Facts ¶ 39.) Officer Toomey was assigned to monitor both Tier 1-M and Tier 1-L during the afternoon shift (3 p.m. to 11 p.m.), and the area supervisor was Sergeant Stroner. (R. 368, Defs.’ Resp. to Pl. Facts ¶¶ 87-88.) Too-mey’s log states that he performed 16 security checks for both tiers. (Id.) Too-mey indicated on the Tier Log that he could not be on two tiers at same time. (Id.) He also noted that the “video monitor for 1M does not work!” (R. 348, Ex. 36, 4/26/04 Tier Log.) No medical staff visited during this shift. (Id.) Officer Williams was assigned to monitor Tier 1-M and Tier 1-L during the night shift on April 26, 2004. (R. 368, Defs.’ Resp. to PI. Facts ¶¶ 85-86.) His log states he performed 16 security checks for both tiers. (Id.) While Williams’ Tier Log states that he took a break from 1 a.m. to 2 a.m., it does not indicate whether there was a relieving officer. (R. 348, Ex. 58, 4/26/04 1-M night shift Tier Log.) Officer Williams was supervised by Sergeant Gradowski. (Id.) E. April 27, 2004 Officer Davis was assigned to Tier 1-M during the day shift on Tuesday, April 27, 2004, supervised by Dew. (R. 368, Defs.’ Resp. to Pl.’s Facts ¶¶ 33, 55.) Dew testified that he has no memory of Smith. (R. 344, Pl.’s Resp. to Defs.’ Facts ¶ 20.) The Officer’s Living Unit Log stated that Davis cross-watched another tier from 10:00 a.m. to 11:00 a.m., and from 1:05 p.m. to 2:00 p.m., and that this was a “Major security risk.” CMT Westbrook visited the tier 1-M during the day shift. (Id.) CMTs Lacy and Patton were also on duty that day. (Ex. 45, Lacy Dep. at 52.) That morning, Smith appeared in the Circuit Court of Cook County for the Fifth Municipal District located in Bridgeview, Illinois, for a violation of bail bond hearing. (Id. ¶ 11. R. 369; Defs.’ Supp’l Ex. 1, Pl.’s Resp. to Cook County’s Requests to Admit ¶ 1.) Smith left the jail at 5:30 a.m., and returned at 1:30 p.m. (Id., Ex. 35, Division 5 Movement Log.) During the hearing, Smith did not state on the record that he had health problems or was being denied medical care. (Id. ¶ 11. R. 369; Defs.’ Supp’l Ex. 1, Pl.’s Resp. to Cook County’s Requests to Admit ¶¶ 5-6.) Donna Norton, the assistant state’s attorney at the court proceedings, testified that the hearing probably lasted at most two minutes. (Id., Ex. 5, Norton Dep. at 15.) While Smith was in court, Darius Williams and Smith’s girlfriend, Teshana Malone, stopped by the jail to visit him. (Id., Ex. 7, Williams Dep. at 64-65.) Around lunchtime, detainee Mitchell testified that he spoke to a Cook County Jail guard in the Tier 1-M dayroom about Smith’s illness, but the guard denied Mitchell’s request for medical assistance for Smith. (R. 344, PL’s Resp. to Defs.’ Facts ¶ 12.) Mitchell also heard other detainees tell a guard that Smith was sick and had been lying on the floor all week. (Id. ¶ 68; R. 348, Ex. 1, Mitchell Dep. at 85-86.) According to Mitchell, Smith told him that he was either asleep or he otherwise missed Cermak personnel when they came to the tier. (Id.) Mitchell observed that Smith was visibly ill and getting progressively worse, including vomiting, shaking, and not moving very much, often with a blanket pulled over him. (R. 368, Defs.’ Resp. to Pl.’s Facts ¶ 66; see also, id., Ex. 3, Haynes Aff-¶ 2 (Smith visibly ill).) Smith shivered, smelled sickly, gave his meals away to other detainees, could not keep conversations with people, and could not move well. (R. 348, Ex. 1, Mitchell Dep. at 63, 68, 100-02.) In the mornings, Smith did not get up until the guard forced him to leave his cell. (Id. at 106.) Other detainees helped Smith walk by letting him lean on them and by carrying his things. (Id. at 109.) Sometimes, Smith would just lay on the dayroom floor and other detainees would walk around him. (Id. at 59-60, 63-64; see also, id., Ex. 3, Haynes Aff. ¶¶ 2-3.) Smith’s cellmates — Mitchell and Matías — as well as Tier 1-M detainees Titus Haynes and Alan Robinson, testified that they helped Smith fill out and submit medical request forms. (Id. at 64, 69; id., Ex. 3, Haynes Aff. ¶ 3; id., Ex. 66, Robinson Aff.; id., Ex. 1, Mati-as Dep. at 43-45.) Detainee Robinson further attested that he complained about Smith’s condition to CMT Westbrook, including his loss of energy, inability to eat, serious weight loss, and constant vomiting. (Id., Ex. 66, Robinson Aff.) Officer Toomey worked 3 p.m. to 11 p.m. on Tier 1-M on April 27, 2004, supervised by Stroner. (R. 368, Defs.’ Resp. to Pl.’s Facts ¶ 35.) The video monitor for Tier 1-M in the Tier 1-L interlock was still inoperable. (R. 262, Defs.’ Facts ¶ 39.) The officer relieving Toomey during his break from 5 p.m. to 7 p.m. noted that he was cross-watching Tiers 1-M and 1-L, and that the video monitor for 1-M was still not working, and Toomey cross-watched both tiers from 7 p.m. until the end of his shift. (R. 348, Ex. 27, 4/27/04 Tier Log.) Toomey testified that before lock-up, Smith had been laying on the floor next to his cell. (R. 368, Defs.’ Resp. to PL Facts Ex. 20, Toomey Dep.) When Toomey told Smith it was time to lock up, Smith stood up, picked up his blanket, and walked into his cell without assistance. (Id. at 114-15.) Toomey did not think Smith appeared to be sick. (Id. at 21,115.) Toomey testified that he never saw Smith vomit, and no one asked him to summon medical assistance for Smith. (Id. at 21, 116.) That evening, Maurice Merritt, Smith’s cousin, and Darius Williams came to visit Smith at 8:15 p.m. and stayed until 8:50 p.m. (R. 369, Defs.’ Supp’l Ex. 6, 4/27/04 Division 5 Visitor Log.) Williams testified that Smith looked sick, “really bad, like he had lost like 10 to 20 pounds in two days,” and Smith said that he felt really sick, but that the guards would not take him to the doctor because they thought he was “BS’ing.” (Id., Ex. 7, Williams Dep. at 33-34, 45-46.) Smith’s face looked like it was sunken in and he was shaking, and Smith told Williams that he felt “like I’m going to die in here.” (Id. at 36-37.) Williams testified that Smith told him he had put in a request for medical attention. (Id. at 39) Teshana Malone, Smith’s girlfriend, testified that she talked with Smith on the telephone that evening, and that he also told her he did not feel well. (R. 262, Defs.’ Facts ¶ 72.) ' That night, Office Lazinek was assigned to both Tier 1-M and 1-L in Division 5 during the night shift, and Lt. Krzyzowski was the area supervisor. Lazinek was the officer assigned to monitor Tier 1-M during the night shift. (R. 368, Defs.’ Resp. to PL Facts ¶¶ 89-90.) The Log stated that Lazinek performed 16 security checks on both tiers every half hour. (Id.) Lazinek wrote that it was a “major security risk” for the officer to be in two places at one time. (Id.) In addition, the tier 1-L video monitor, which permits officers to monitor part of the tier 1-M dayroom while the officers check tier 1-L, was inoperable. (Id.; R. 262, Defs.’ Facts ¶ 29.) F. April 28, 2004 On Wednesday, April 28, Davis worked the day shift in Tier 1-M, Division V, and Hernandez was the Area Supervisor. (R. 368, Defs.’ Resp. to PL’s Facts ¶¶ 36, 56.) CMT Westbrook visited Tier 1-M during the day shift and dispensed medications. (R. 368, Defs.’ Resp. to PL’s Facts ¶¶ 4-5, 37, 131.) She has no recollection of Smith. The Officer Living Unit Log states that all Tier 1-M inmates moved without incident to recreation (to the day room). (R. 368, Defs.’ Reply Ex. 9, Off. Living Unit Log from 4-28-04, 7 a.m. to 3 p.m.) That day, CMTs Westbrook, Patton, and Bradley were on duty. (R. 348, Ex. 45, Lacy Dep. at 52) In his affidavit, detainee George Robotis attested that on April 28th, 2004, he saw Matías give a female nurse at least two medical request forms on Smith’s behalf. The nurse replied with words to the effect of, “That’s what you get for using drugs.” (R. 348, Ex. 8, Robotis aff. ¶ 2.) In his affidavit, Robotis also attested that on that day, he personally complained to the nurse that visited Tier 1-M about Smith’s condition. (Id. ¶ 6.) Detainee Haynes attested that he and other detainees complained to Officers Toomey and Davis about Smith’s illness on April 28, and April 29, 2004, during both the day and evening shift. (Id., Pl.’s Ex. 3, Haynes Aff. ¶ 3.) Officer Thiemecke worked the afternoon/evening shift (3 p.m. to 11 p.m.) in Tier 1-M, Division V on April 28, and Stroner was the Area Supervisor. (R. 368, Defs.’ Resp. to Pl.’s Facts ¶¶ 36, 53.) Thiemecke noted in the Tier Log that he cross-watched Tiers 1-L and 1-M from 4:08 p.m. to 5:00 p.m., and again from 6:00 p.m. to 8:20 p.m., and that this was a security risk. (R. 348, Ex. 19, 4/28/04 evening Tier Log.) In addition, Thiemecke wrote that he submitted two forms stating that the video monitor for Tier 1-M in the Tier 1-L interlock was still not operable. (Id.; R. 262, Defs.’ Facts ¶ 48.) Hernandez did not personally observe any inmate exhibiting symptoms of serious illness. (R. 346, Pl.’s Resp. to Cook County’s Rule 56.1 Statement ¶ 8.) Thiemecke testified that he did not hear any inmates coughing or vomiting during the afternoon shift on the 28th, and he did not receive any complaints from any inmate about chest pains. (Defs.’ Ex. N to Mot. for Summ. J at 114.) That evening Smith called his sister, Shania Stubbs, to patch in his friend Darius Williams on a three-way call. (R. 369, Defs.’ Supp’l Ex. 7, Williams Dep. at 31, 41-42.) Williams testified that Smith told him he was feeling really sick, and that he repeatedly told the guards he was sick, but they would not take Smith to the hospital. (Id. at 42-43.) Stubbs does not recall Smith saying he was sick during that conversation. (R. 262, Defs.’ Facts ¶ 73.) Smith’s cellmate Matías testified that by April 28, 2004, Smith could barely even walk. (R. 368, Defs.’ Resp. to PL’s Facts, Ex. 13, Matías Dep. at 61.) Matías dragged Smith outside of the cell into the hallway when he could not do it himself. (Id. 167-68.) Matías testified that officers saw Smith during the day shift when they come to unlock the cell doors, and they knew he was sick. (Id. at 61-62.) Matías further testified that while he was in Cer-mak getting his methadone treatment, he brought with him a written request form for Smith. (Id. at 78.) He either gave the form to the guard or to an African-American Cermak nurse. (Id. at 78, 80-81.) He testified that he also spoke with an Indian Cermak staff member about Smith and gave the medical person Smith’s name and cell number. (Id. at 79.) On April 28, 2004, Officer Houston was assigned to monitor Division 5, Tier 1-M between the hours of 11:00 p.m. and 7:00 a.m., supervised by Sergeant Monczynski. (R. 262, Defs.’ Facts ¶ 49.) Houston does not remember Smith or any inmate appearing lethargic, lying around, or vomiting that night. (R. 368, Defs.’ Resp., Ex. 22, Houston Dep. at 72.) G. April 29, 2004 On Thursday, April 29, 2004, the video monitor for Tier 1-M in the Tier L-l interlock was still inoperable. (R. 262, Defs.’ Facts ¶ 39.) Facundo was the officer assigned to monitor both Tier 1-M and Tier 1-L during the day shift, and Hernandez was the area supervisor. (R. 368, Defs.’ Resp. to Pl.’s Facts ¶¶ 93-94.) Fa-cundo stated on the tier log that cross-watching Tiers 1-M and 1-M was a “Major Safety and Security Risk!” (R. 348, PL’s Ex. 7, 4/29/04 day shift tier log.) His log represents he performed 16 security checks on both tiers during his shift. (Id.) There is no record of any medical person visiting Tier 1-M on April 29, 2004. (R. 368, Defs.’ Resp. to PL’s Facts ¶ 130.) No daily encounter forms for Division Y, Tier 1-M on April 29, 2004, have been found. (R. 368, Defs.’ Resp. to PL’s Facts ¶ 129.) On April 29, 2004, only CMT Bradley was present from the regular Division 5 Cer-mak staff. (Ex. 45, Lacy Dep. at 53.) Detainee Robotis attested that on April 29, 2004, he complained to every guard on Tier 1-M that Smith was sick, and he recalls several other detainees doing the same during the day and evening shifts. (R. 348, PL’s Ex. 8, Robotis Aff. ¶¶ 3, 6.) Cellmate Matías recalls asking Officer Fa-cundo for medical request forms and filling them out for Smith. (R. 368, Defs.’ Resp. to PL’s Facts, Ex. 13, Matías Dep. at 18-19.) Matías testified that he accompanied Smith when he slid his completed medical request form through the interlock door. (Id. at 19-20.) Matías remembers Facun-do because “he is always trying to help people.” (Id. at 15-16.) The morning of April 29, Matías testified that he also told a social worker that Smith was very sick and throwing up, but no one came to check on Smith or take him to the dispensary. (Id. at 48-50.) Toomey was assigned to Division 5, Tier 1-M for the 3:00 p.m. to 11:00 p.m. shift., and Stroner was the area supervisor. (R. 348, Ex. 7, afternoon shift 4/29/04 Tier Log.) No medical staff visited during the afternoon shift. (Id.) Toomey noted that the “Yideo monitor for 1M does not work,” and that he was cross watching 1L and 1M from 6:00 p.m. to 7:00 p.m. and from 10 p.m. to 11:00 p.m. (Id.) Two detainees were moved into or out of Cermak that afternoon. (Id.) Toomey recalls locking Smith back up in his cell before the end of his shift on April 29, 2004, but he never saw Smith vomit, and he does not remember whether Smith was coughing or sneezing that evening. (R. 262, Defs.’ Facts ¶¶ 27-28.) Detainee Gilbert Yorke became Smith’s and Matias’s cellmate in Division V, Tier 1-M during the afternoon shift on April 29, 2004, after cellmate Mitchell was discharged around 6:30 p.m. (R. 368, Defs.’ Resp. to PL’s Facts ¶3; R. 262, Defs.’ Facts ¶ 70.) When Yorke first entered the cell, Smith was laying on the mattress on the floor. (R. 368, Defs.’ Resp. to PL’s Facts ¶ 22.) Yorke testified that Smith appeared sick and coughing. (R. 369, Def.’s Supp’l Ex. 12, Yorke Dep. at 18.) Smith was covered in his blanket the whole time. (Id.) Yorke did not see Smith vomit, moan, or groan. (R. 262, Defs.’ Facts ¶ 71.) Smith’s sister spoke with him again by telephone on April 29. Stubbs testified that during that call, Smith told her he had not been feeling well, and that he had been asking to go to the hospital all week and was hoping to go the next day. (R. 369, Defs.’ Supp’l Ex. 10, Stubbs Dep. at 29, 36.) Smith said he felt like he had the flu or a very bad cold. (Id. at 37.) Smith also spoke with his girlfriend and Darius Williams that night and informed them that he was still ill. (Id. at 31-32.) The record contains a Detainee Health Service Request Form, dated April 29, 2004, and filled out by, or on behalf of Smith. (R. 348, Ex. 30, Smith Med. Request.) The form states that Smith’s problems are: “fever, bad cough, chest hurts when I breath in, problem sleeping, vomiting,” and had been occurring for two weeks. (Id.) The Sheriffs Incident Report states that the medical request form for Smith was found in Tier 1-M’s interlock medical box. (R. 348, Ex. 18, Sheriffs Report.) Furthermore, in his interview for the Sheriffs report, Matías stated that Smith had complained of not seeing the paramedics or doctors, and Matías had helped Smith fill out a detainee medical form on April 29 and put it in the interlock medical request box. (Id.) Dr. Raba, chief medical officer at Cermak in April 2004, testified in his deposition that Matías showed Raba a sick call request he had helped Smith fill out, but had not submitted it yet. (Ex. 70, Raba Dep. at 110.) H. April 29, 2004 (night shift) to early morning April 30, 2004 Matías testified that by the night of April 29, Smith was not even talking. Ma-tías dragged Smith back into the cell when it was time to be locked up for the night, and Smith just laid down on his mattress on the cell floor “like he was dead.” (R. 368, Defs.’ Resp. to Pl.’s Facts, Ex. 13, Matías Dep. at 56-57.) Sanchez was assigned to monitor Division 5, Tier 1-M between the hours of 11:00 p.m. and 7:00 a.m. that night. (R. 262, Defs.’ Facts ¶ 58.) Monczynski was the area supervisor. (Id.) When Officer Sanchez’s shift began at 11:00 p.m., the inmates were already locked in their cells. (Id.) That evening, Smith was sleeping on a mattress or cot on his cell floor. (Id.) The Tier Log stated that Sanchez was assigned to cross-watch Tiers 1-L and 1-M, and that he performed a security check every half-hour on both tiers. (R. 348, Ex. 24, 4/29/04 night shift tier log.) Sanchez noted that cross-watching was a “ ^security risk* ” and that the monitor for 1-M was not operating. (Id.) Sanchez took a break from 1:00 a.m. to 2:00 a.m., and Officer Burks relieved him. (Id.) From 11:00 p.m. to 3:00 a.m., Sanchez testified that he did not hear any screaming, moaning, or gurgling sounds, or recall any inmate disturbances. (R. 368, Defs.’ Resp. to Pl.’s Facts, Ex. 14, Sanchez Dep. at 46.) Sanchez testified that he performed his security checks and that he recalls shining his flashlight on Smith at 3:00 a.m. and seeing Smith stir. (Id. at 80.)’ Sanchez clarified that Smith must have moved when he shined his flashlight because otherwise, Sanchez would not have “gone by him.” (Id. at 14-15.) That night, as on other nights, Matías had placed a cookie box in the peephole in the cell door after the doors were locked at night. (R. 368, Defs.’ Resp. to PL’s Facts, Ex. 13, Matías Dep. at 70.) When the officers do their rounds counting inmates at night, they poke out the cookie box to look inside the peephole. (Id.) However, when Matías woke up the morning of April 30, 2004, the cookie box was still in the peephole. (Id.) At approximately 3:35 a.m. on April 30, 2004, the cell doors were unlocked (via a control panel in the interlock) for breakfast. (R. 262, Defs.’ Facts ¶ 60.) At that time, no inmate approached Sanchez to report that Smith was ill. (Id.) After the inmates were all out of their cells, at approximately 3:40 a.m., Sanchez began the process of re-locking all the cell doors one at a time. (Id. ¶ 61.) Minutes later, an inmate allegedly approached Sanchez and told him that there was something wrong with another inmate. (Id.) Matías claims that he had tried to get the officer’s attention before the doors were unlocked for breakfast by kicking the cell door, but Sanchez was sleeping in the interlock with his legs on the deck and did not wake up until Matías started screaming. (Id. at 57-58, 60, 70.) When Sanchez arrived at Smith’s cell, he found Smith on the floor flanked by his two cellmates. (R. 262, Defs.’ Facts ¶ 61.) Smith’s eyes were wide open; he was breathing, but was non-responsive and twitching. (Id. ¶ 62.) Matías said Smith was “shaking, and his eyes went back to the head.... You could just see white.” (R. 368, Defs.’ Resp. to Pl.’s Facts, Ex. 13, Matías Dep. at 56-57.) When Yorke woke up for breakfast around 4:00 a.m., he heard Smith moaning, and Smith appeared to be having seizures. (R. 368, Defs.’ Resp. to PL’s Facts ¶ 24; R. 348, Ex. 18, Sheriff incident report.) Sanchez contacted his supervisor, Sergeant Monczynski, via radio at about 3:50 a.m. or 3:55 a.m. (R. 262, Defs.’ Facts ¶ 62; R. 348, Ex. 18, Sheriffs Report.) Although Sanchez did not tell him it was an emergency, Monczynski arrived at Smith’s cell within minutes. (R. 262, Defs.’ Facts ¶ 62; R. 368, Defs.’ Resp. to PL’s Facts, Ex. 23, Monczynski Dep. at 85.) At 3:55 a.m., upon seeing Smith, Monczynski went to the interlock and called Cermak. (Id. ¶ 63; R. 368, Defs.’ Resp. to PL’s Facts, Ex. 23, Monczynski Dep. at 92.) He returned to Smith’s cell and noted that Smith was still twitching, but not groaning or making any other noises. (Id.) Monc-zynski returned to the interlock and called Cermak again and told them to send someone. (Id.; R. 368, Defs.’ Resp. to PL’s Facts, Ex. 23, Monczynski Dep. at 94,145.) CMT Myvett received the call informing him of a sick inmate. (R. 368, Def.’s Resp. to PL’s Facts ¶ 26.) Myvett stated that the call came at approximately 4:06 a.m., and the caller stated that the detainee was conscious. (R. 348, Ex. 18, 5/5/04 Supp’l Sheriffs Report.) According to the Sheriffs incident report, it took Myvett 15-20 minutes to arrive after the Sergeant called them. (Id., Sheriffs Report.) Myvett stated that he arrived at 4:09 a.m. (Id., 5/5/04 Supp’l Sheriffs Report.) Myvett arrived at the cell without a medical bag and attempted, without success, to get Smith to respond. (R. 262, Defs.’ Facts ¶ 64; R. 348, Ex. 18, Sheriffs Report.) Myvett stated that he checked Smith’s vitals with medical equipment he had in his fannie bag. (Id., 5/5/04 Supp’l Sheriffs Report.) Monczynski told the Sheriffs investigator that he wanted Myvett to call 911, but Myvett said there was no need. (Id.; R. 348, Ex. 18, Sheriffs Report.) Lieutenant Germany, Monczynski’s supervisor, or Myvett, called for a gurney to be brought to Tier 1-M. (Id.) A female paramedic arrived with the gurney 10 minutes later. (Id.) Smith was transferred from Cook County Jail to Cermak at approximately 4:27 a.m., arriving at 4:35 a.m. (Id.) The Sheriffs Report stated that Smith was unresponsive upon arrival in the Cermak emergency room. (Id.) He had a fever of 104, high blood pressure (176/100), and a pulse of 116. (Id.) Cermak notified Chicago paramedics of Smith’s condition at 4:55 a.m., and at about 5:05 a.m., Smith began having difficulty breathing. (Id.) He went into respiratory arrest, before leaving the ER. (R. 348, Ex. 22., Katz Dep., Ex. 12, ER note by Dr. Anaglate.) Smith was transported from Cermak to Mt. Sinai Hospital at 5:10 a.m. (Id., Ex. 18, Sheriffs Report.) The Chicago Fire Department pre-hos-pital care report from April 30, 2004, stated that there was a delay transporting Smith from the Jail to the hospital because no escort was available. (Id., Ex. 21, Pre-Hospital Report.) Smith became pulseless and stopped breathing while waiting for information from Cermak, but Cermak staff did not know how long Smith was unresponsive before they found him. (Id.) The ambulance crew intubated him, but Smith remained unresponsive while CPR continued en route to the hospital. (Id.) Smith arrived at Mt. Sinai Hospital at approximately 5:20 a.m. with no response. (R. 348, Ex. 18, Sheriffs Report.) Smith was pronounced dead at the hospital at 5:40 a.m. (Id.) At Smith’s autopsy on April 30, 2004, the doctor determined that Smith died of meningitis and pneumonia. (Id., 5/5/04 Supp’l Sheriffs Report.) Smith’s death certificate states that he was “D.O.A.”, or dead on arrival, at Mount Sinai. (Id., Ex. 25, Death Cert.) V. Investigation into Smith’s Death After Smith died, Dr. Anaglate, a Cer-mak ER doctor who worked on Smith, stated that he had “heard that inmate Smith had been complaining of being sick, and he seemed to be in a coma state and was not responsive to anything.” (R. 348, Ex. 18, Sheriffs Report.) Detainee Yorke testified that after Smith died, inmates were discussing whether any officers would get into trouble for ignoring Smith’s medical requests. (R. 369, Def.’s Supp’l Ex. 12, Yorke Dep. at 43.) In investigating Smith’s death, Dr. Raba interviewed only one detainee: Matías. (R. 368, Defs.’ Resp. to Pl.’s Facts ¶ 135.) Matías told investigators that Smith had been sick a lot lately; he could not get up, was sleeping a lot, not eating, and vomited three times. (R. 348, Ex. 18, Sheriffs Report.) In his first of two meetings with Matías, Raba testified that Matías was mainly concerned about his own health— fearing that he had contracted meningitis — but he indicated tha