Marlita Thomas v. Cook County Sheriff

In the

United States Court of Appeals

For the Seventh Circuit

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948

M ARLITA T HOMAS,

Plaintiff-Appellee,

v.

C OOK C OUNTY S HERIFF’S D EPARTMENT,

A LEX S ANCHEZ, JESUS F ACUNDO,

T ERRENCE T OOMEY, and C OOK C OUNTY,

Defendants-Appellants.

Appeals from the United States District Court

for the Northern District of Illinois, Eastern Division.

No. 04 C 3563—Ruben Castillo, Judge.

A RGUED D ECEMBER 9, 2008—D ECIDED D ECEMBER 1, 2009

Before F LAUM, W OOD , and W ILLIAMS, Circuit Judges.

W ILLIAMS, Circuit Judge. Norman Smith, a thirty-two

year-old pretrial detainee, arrived at Cook County Jail on

April 24, 2004, and died less than a week later from

pneumococcal meningitis. His mother, Marlita Thomas,

sued Cook County, the Cook County Sheriff, and a

number of correctional employees, under 42 U.S.C. § 1983,

2 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

alleging that the defendants violated her son’s constitu-

tional rights by failing to respond to his serious medical

needs. At trial, a number of Smith’s fellow inmates

testified that Smith’s condition rapidly deteriorated

while prison officials turned a blind eye. The jury

agreed with this assessment. It returned a verdict in

Thomas’s favor and awarded damages in the amount of

$4,450,000 against Cook County, the Sheriff, and three

individual officers. The district court denied the defen-

dants’ motion for judgment as a matter of law and the

defendants now appeal. Specifically, they challenge the

sufficiency of the evidence supporting each of the jury’s

liability determinations, the trial court’s evidentiary

rulings, and the jury’s compensatory damages calculation.

We conclude that the jury had sufficient evidence to

impose liability against the officers for their deliberate

indifference to Smith’s medical needs. The same is true

for Cook County, as the evidence against it was suf-

ficient for a reasonable jury to conclude that the County

had a widespread policy of disregarding detainees’

medical requests. We do not find sufficient evidence,

however, to hold the Sheriff liable. The causal connection

between the Sheriff’s policies and practices and Smith’s

death is tenuous in light of the jury’s finding that individ-

ual correctional officers deliberately disregarded Smith’s

medical needs. Nonetheless, the Sheriff’s absence as a

liable party does not affect the jury’s compensatory

damage award. The parties are jointly and severally

liable for the entire award, which measures the amount

required to compensate the plaintiff for her indivisible

harm, and the Sheriff only added an additional source

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 3

from whom the plaintiff could collect. That the Sheriff is

no longer liable does not limit the amount of damages

to which the plaintiff is entitled.

Nor is the amount affected by the jury’s improper

allocation among defendants. Because we presume that

jurors follow the instructions given, we must interpret

the jury verdict to be consistent whenever possible. As

a result, we interpret the jury’s allocation in this case

as an attempt to split the total damages among the defen-

dants, rather than an effort to issue duplicate awards

for the same injury. We also do not find a $4,000,000-plus

damage award for constitutional violations that resulted

in death to be excessive.

Finally, none of the defendants’ evidentiary challenges

warrant a reversal. Although we are somewhat troubled

that the jury only heard the deposition testimony of a

key witness and did not have the opportunity to assess

his credibility on the witness stand, the district court’s

decision to admit the testimony was not an abuse of dis-

cretion. And even if it was, corroborating live testimony

from other witnesses, along with the defendants’ opportu-

nity to cross-examine during the deposition, render its

admission harmless. Therefore, we affirm the district

court’s order denying the officers and Cook County’s

motions for judgment as a matter of law and for a new

trial. But we reverse its judgment denying the Sheriff’s

motion, and remand with instructions to enter judg-

ment in the Sheriff’s favor.

4 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

I. BACKGROUND

The Cook County Department of Corrections (“CCDOC”)

maintains a procedure for examining inmates’ health and

a system designed to ensure that inmates receive appro-

priate medical care while incarcerated. Upon arrival at

Cook County Jail, each inmate must undergo a medical

examination conducted by medical personnel from

Cermak Health Services of Cook County (“Cermak”),

which runs the health service for detainees at Cook County

Jail. Beyond the initial intake procedure, Cermak provides

additional medical services to inmates as needed. Each

day, a Cermak medical technician is required to visit

the tiers, where the inmates reside, and dispense med-

ication, respond to inmate complaints, and collect

medical request forms. The technicians then record, in

daily contact sheets, the medications dispensed during

their rounds, the medical request forms collected, and any

other pertinent information, including reports of inmate

sickness. In addition, Cermak maintains an infirmary,

mental health facility, lab, pharmacy, and emergency

room staffed by physicians, all onsite and within close

proximity to the inmates.

For a number of reasons, this system did not always

function as it should. First, the Supervisor for Cermak’s

medical technicians (“CMTs”) acknowledged that Cermak

had experienced problems with CMTs not picking up

medical request forms every day. Some CMTs did not

have the keys to access the lockbox where inmates de-

posited their completed medical request forms.

Others simply failed to fill out or turn in their daily

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 5

contact sheets. Further, a number of correctional officers

reported that Cook County Jail was severely under-staffed.

The officers, who were employed by the Cook County

Sheriff, kept daily logs in which they often made refer-

ences to the dangers associated with cross-watching—a

practice that required one officer to watch two tiers at

the same time. One officer noted that cross-watching

created a “major security risk.” Another complained

that he “[could] not be on both tiers at [the] same time.”

As a result of the under-staffing and cross-watching in

Cook County Jail, officers could not perform physical

security checks with the frequency required by Sheriff

department policy. Also, with fewer officers on duty,

CMTs were, at times, unable to gain access to the tiers

to complete their rounds.

The plaintiff alleged that her son, Norman Smith, fell

through the cracks created by the systemic problems in

CCDOC. Smith’s tragic story began on April 23, 2004

when Chicago police officers arrested him for possession

of a controlled substance. The next day, he arrived at

Cook County Jail, the facility where he was to remain

until his trial date. Smith underwent the typical intake

routine, which included a chest X-ray, blood pressure

screening, psychological screening, and a review of his

medical history. Those tests only revealed elevated

blood pressure, for which Smith received a week’s

supply of medication. However, according to Smith’s cell

mate, Carlos Matias, Smith demonstrated symptoms of

illness on the first day he arrived. Matias testified in

his deposition that Smith appeared to be dizzy, began

vomiting, and asked Matias to initiate a medical request

for him.

6 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

Other detainees, along with Matias, testified to

the rapid deterioration in Smith’s condition through

the week. For instance, Smith’s other cell mate, Tyrrell

Mitchell, testified that Smith was vomiting for three to

four days before Mitchell was released Thursday, April 29,

2004, and that he wasn’t able to hold down any food or

maintain conversations with his cell mates. Matias also

testified that by Wednesday, April 28, 2009, Smith could

no longer walk on his own. Instead, Matias would drag

Smith outside of his cell where he remained on the

floor. Several inmates claimed to have filled out medical

request forms on Smith’s behalf. Others testified that

they complained directly to correctional officers and

medical technicians on duty at the time, and a few even

witnessed or helped Smith fill out his own medical

request forms. None of the inmates received a response

to these requests.

Early Friday morning, April 30, 2004, Matias awoke to

find Smith convulsing on the floor in his cell. He alerted

Alex Sanchez, who was the officer on duty at the time,

and Sanchez contacted his supervisor, Sergeant James

Monczynski. However, the plaintiff contended that sig-

nificant delays prevented him from receiving immediate

care. First, Sergeant Monczynski did not arrive at the

cell until about a half hour after Officer Sanchez notified

him of Smith’s condition. Next, Sergeant Monczynski

contacted a Cermak paramedic, who was located in

an adjacent building connected by a courtyard, and the

plaintiff alleged that it took another half hour for the

paramedic to arrive. The plaintiff also claimed that the

paramedic spent a half hour in the tier office looking

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 7

for Smith’s I.D. before he called the other Cermak para-

medics.

The delays allegedly continued as the paramedics

did not have the manpower to lift Smith up the stairs in

a gurney. So they waited at the top of the stairs. Fortu-

nately, a few inmates intervened, carried Smith to the

gurney, and the paramedics wheeled him out. Smith

died later that morning. The Cook County medical exam-

iner determined that he suffered from pneumococcal

meningitis, a particularly deadly form of the disease.

Based on these events, Marlita Thomas, Smith’s

mother, sued a number of individual correctional em-

ployees, the Cook County Sheriff, and Cook County

under 42 U.S.C. § 1983 for violating Smith’s constitutional

rights by ignoring his serious medical needs, along with

other state law claims. After a two-week trial, the jury

returned a verdict against Cook County, the Sheriff, and

Officers Facundo, Sanchez, and Toomey for a total of

$4,450,000 in compensatory damages. On the verdict

forms, the jury allocated $3,000,000 of the damage

award against Cook County, $1,000,000 against the

Sheriff, $150,000 against the individual defendants col-

lectively for the § 1983 claim, and $300,000 against the

individual defendants collectively for the wrongful

death and survival claims. The district court ordered a

remittitur of the award from $4,450,000 to $4,300,000,

but denied the defendants’ motions for judgment as a

matter of law or for a new trial. The defendants appeal

these denials and also challenge the damage award.

8 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

II. ANALYSIS

Following the jury verdict, the defendants filed a

motion for judgment as a matter of law under Federal

Rule of Civil Procedure 50(b), or, in the alternative, for

a new trial under Rule 59. In that motion, the defendants

argued that the evidence was insufficient to support

both individual and municipal liability under Monell v.

Department of Social Services of New York, 436 U.S. 658 (1978).

We review de novo the district court’s denial of

judgment as a matter of law, but we do not weigh

evidence or assess the credibility of witnesses. Walker v. Bd.

of Regents of Univ. of Wis. Sys., 410 F.3d 387, 393-94 (7th

Cir. 2005). Instead, we draw all reasonable inferences in

favor of the nonmoving party. Tart v. Ill. Power Co., 366

F.3d 461, 478 (7th Cir. 2004). “Our job is to assure that the

jury had a legally sufficient evidentiary basis for its

verdict,” Houskins v. Sheahan, 549 F.3d 480, 493 (7th Cir.

2008) (quoting Filipovich v. K & R Express Sys., Inc., 391

F.3d 859, 863 (7th Cir. 2004)), and the “verdict must stand

unless the officers can show that no rational jury could

have brought in a verdict against [them].” Von der Ruhr v.

Immtech Intern., Inc., 570 F.3d 858, 866 (7th Cir. 2009)

(internal quotation marks omitted).

A. Verdict Against Individual Officers

The individual defendants, Officers Facundo, Toomey,

and Sanchez, first challenge the jury verdict finding

them liable under 42 U.S.C. § 1983 for violating Smith’s

constitutional rights. The officers argue that the verdict

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 9

was not supported by evidence or law because the offi-

cers’ actions represent “inadvertence” at the most. Relying

on Palmer v. Marion County, 327 F.3d 588, 592 (7th

Cir. 2003), the officers claim that the plaintiff must dem-

onstrate both subjective knowledge and intentional

disregard of the risk to the inmate’s safety. See also

Collins v. Seeman, 462 F.3d 757, 761 (7th Cir. 2006).

A prison official violates a prisoner’s Eighth Amend-

ment rights, and, in this case, due process rights, when he

displays deliberate indifference to a serious medical

need.1 Hayes v. Snyder, 546 F.3d 516, 522 (7th Cir. 2008)

(citing Greeno v. Daley, 414 F.3d 645, 652 (7th Cir. 2005)). To

establish such a violation, the plaintiff must first demon-

strate that the condition was objectively serious. Hayes,

546 F.3d at 522. An objectively serious medical condition

is one that “has been diagnosed by a physician as man-

dating treatment or one that is so obvious that even a

lay person would perceive the need for a doctor’s atten-

tion.” Id. Next, the plaintiff must show that the official

“acted with a sufficiently culpable state of mind.” Id. This

inquiry has two components. The official must have

1

The inmate in this case was a pretrial detainee. The Eighth

Amendment, which prohibits cruel and unusual punishment,

only applies to convicted prisoners, but we have held that

pretrial detainees are entitled, under the Fourteenth Amend-

ment’s due process clause, to the same basic protection. Williams

v. Rodriguez, 509 F.3d 392, 401 (7th Cir. 2007). As a result, we

apply the same legal standard to a claim alleging deliberate

indifference to an inmate’s medical needs, whether filed

under the Eighth or Fourteenth Amendment. Id.

10 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

subjective knowledge of the risk to the inmate’s health

and also must disregard that risk. Collins, 462 F.3d at 761.

The officers do not contest that Smith suffered from a

serious medical condition. Instead, they argue that the

evidence was insufficient to establish that they both

knew of and disregarded the risk of harm.

A brief overview of the record reveals testimony describ-

ing in detail Smith’s condition on the days leading up

to his death. A number of witnesses reported that Smith

was vomiting, coughing and exhibiting other signs of

serious illness including nausea and lethargy. A fellow

inmate reported that on April 29, 2004, the day when

all three officer defendants were working, Smith was

“coughing a lot, running back and forth to the bathroom,

throwing up, just laying on the floor, not moving, not

eating . . . .” . Another inmate reported that Smith was

lying on the floor in front of the cell—which would

have placed him in the direct path of the officials when

performing their rounds. Inmates testified that they

complained or heard others complain to officers about

Smith’s condition during all three shifts: 7a.m.-3p.m.,

3p.m-11p.m., and 11p.m.-7a.m., that were covered by

Officers Facundo, Toomey, and Sanchez respectively.

Finally, Officer Toomey testified that he saw Smith

that day, and, at one point, saw him lying in front of

his cell.

Circumstantial evidence can be used to establish sub-

jective awareness and deliberate indifference, Hayes, 546

F.3d at 524, and the examples above are just a few

excerpts of testimony that placed a visibly ill Smith

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 11

within plain view of the officers on duty the day before

he died. The evidence suggests that the officers were

aware of the risk to Smith’s health, either from the in-

mates’ complaints, or from his visible symptoms, Farmer

v. Brennan, 511 U.S. 825, 522 (1970) (“[A] factfinder

may conclude that a prison official knew of a sub-

stantial risk from the very fact that the risk was obvi-

ous.”), and their failure to act could have led a jury to

find that they ignored this risk.

As we stated earlier, we do not reweigh the evidence

nor do we substitute our own credibility determinations,

so we cannot accept the officers’ invitation to ignore

the inmates’ testimony. The officers do not explain why

the evidence, which clearly supports a finding of sub-

jective knowledge, is legally insufficient. They only

argue that it is “conflicting and specious.” This is an

argument better suited for cross-examination and closing

statements than appellate review. When faced with

conflicting, or even inconsistent testimony, the jury is

free to believe one side over another. See Taylor v.

Bradley, 448 F.3d 942, 951 (7th Cir. 2006); Allen v. Chi.

Transit Auth., 317 F.3d 696, 703 (7th Cir. 2003). And when

the plaintiff’s witnesses here provided conflicting testi-

mony, the officers had the opportunity to, and did, bring

it to the jury’s attention. Ultimately, the inconsistencies

the officers press seem slightly exaggerated as most of the

inmates presented the same basic story: Smith was very

ill, the three guards on duty on April 29 knew about it,

12 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

and they did nothing.2 As such, we find no error in the

district court’s decision to deny the officers’ motion

for judgment as a matter of law.

B. Verdict Against Cook County

At trial, the plaintiff alleged that the following

unofficial customs or practices caused the constitutional

harm and subsequent death of her son: the failure to

have a system in place to allow for prompt review of

inmates’ medical requests, the practice of severely under-

staffing correctional officers, and the failure to fix the

broken video monitors in Cook County Jail. The jury

ruled in the plaintiff’s favor and entered a verdict

against both Cook County and the Sheriff. Any one of the

alleged policies or practices may support a judgment

against a governing body. Cook County, however, con-

tends that the verdict cannot stand as a matter of law. It

argues that the district court should have directed a

verdict in its favor after all of its employees were

acquitted, and that it cannot be held liable for the

actions of the Sheriff’s officers. The Sheriff and the

County also dispute whether the evidence supports the

grounds upon which the jury found them liable. So the

questions we address are whether the plaintiff presented

2

For example, Smith’s cell mate, Tyrrell Mitchell, testified

that Smith was vomiting for three to four days before his

release and that he was not able to hold down any food or

maintain conversations.

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 13

sufficient evidence of a widespread custom or practice,

and, if so, whether the County can be held liable.

A local governing body may be liable for monetary

damages under § 1983 if the unconstitutional act com-

plained of is caused by: (1) an official policy adopted and

promulgated by its officers; (2) a governmental practice

or custom that, although not officially authorized, is

widespread and well settled; or (3) an official with

final policy-making authority. Monell, 436 U.S. at 690;

Valentino v. Vill. of S. Chi. Heights, 575 F.3d 664, 674 (7th

Cir. 2009). To demonstrate that the County is liable for

a harmful custom or practice, the plaintiff must show

that County policymakers were “deliberately indifferent

as to [the] known or obvious consequences.” Gable v. City

of Chi., 296 F.3d 531, 537 (7th Cir. 2002). In other words,

they must have been aware of the risk created by the

custom or practice and must have failed to take appro-

priate steps to protect the plaintiff. Id. Therefore, in situa-

tions where rules or regulations are required to remedy

a potentially dangerous practice, the County’s failure

to make a policy is also actionable. See Sims v. Mulcahy,

902 F.2d 524, 543 (7th Cir. 1990) (quoting Jones v. City of

Chi., 787 F.2d 200, 204-05 (7th Cir. 1986)).

We do not adopt any bright-line rules defining a “wide-

spread custom or practice.” As we stated in Cosby v.

Ward, there is no clear consensus as to how frequently

such conduct must occur to impose Monell liability,

“except that it must be more than one instance,” 843

F.2d 967, 983 (7th Cir. 1988), or even three, Gable, 296

F.3d at 538 (“[T]hree incidents where vehicle owners

14 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

were erroneously told that their vehicles were not at

Lot 6 do not amount to a persistent and widespread

practice.”) (internal quotation marks omitted). But the

plaintiff must demonstrate that there is a policy at issue

rather than a random event. This may take the form of

an implicit policy or a gap in expressed policies, Phelan v.

Cook County, 463 F.3d 773, 790 (7th Cir. 2006) (citing

Calhoun v. Ramsey, 408 F.3d 375, 380 (7th Cir. 2005)), or

“a series of violations to lay the premise of deliberate

indifference.” Palmer, 327 F.3d at 596 (citation omitted).

Beyond these threshold requirements, the jury must make

a factual determination: whether the evidence demon-

strates that the County had a widespread practice that

caused the alleged constitutional harm. See Woodward v.

Corr. Med. Serv. of Ill., Inc., 368 F.3d 917, 928 (7th Cir. 2004).

The plaintiff presented evidence to identify the wide-

spread Cook County customs or practices that caused

Smith’s death. Beginning with the widespread practice

of failing to review inmates’ timely filed medical

requests, the supervisor for Cermak’s CMTs, Woodroe

Winfrey, testified that medical request forms were not

collected every day. The request forms were placed in a

locked box, to which, at the time of Smith’s death,

many CMTs did not have keys. Further testimony sug-

gested that many CMTs had not been told how to

obtain keys to the lockboxes, that some CMTs were not

turning in their daily encounter forms (which would

disclose whether they collected medical request forms),

and that Cermak did not have a reporting system for

informing supervisors when CMTs failed to make their

daily rounds. Jean Kiriazes, Cermak’s director of con-

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 15

tinuous quality improvement and risk management,

testified that she was aware the medical request forms

were not collected each day, partly because guards were

not available to allow the CMTs on the tier. A number

of Cermak employees testified to, and other evidence

corroborated, the practice of not retrieving medical re-

quests on a daily basis, including on April 29, 2004, the

day before Smith died. We are not dealing with an

isolated act of an individual employee, which would be

insufficient to establish a widespread custom or prac-

tice. Monell, 436 U.S. at 691-94. Instead, the jury heard

a number of County employees, some of whom

were policymakers, testify about a practice that went

on for an extended period of time. The dangers of

delayed responses to medical requests are readily ap-

parent, and the former director of Cermak seemed to

acknowledge as much in his testimony.

The trial testimony also established a link between the

failure to check medical requests and Smith’s death.

Fellow inmate George Robotis testified that on April 28,

2004, he filed a medical request form on Smith’s behalf,

which he submitted directly to an officer working the

tier that morning. On the form, he wrote that because

Smith could not move, he was writing on Smith’s behalf,

and that Smith was not eating, could not get out of bed,

was throwing up, and was very ill. Tyrrell Mitchell,

who shared a cell with Smith for a short period, testified

that he saw Smith fill out a medical request form

(although he didn’t remember if Smith submitted it to

the guard). Alan Robinson, another inmate, testified that

he completed a medical request form for Smith “at

16 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

least three times,” in which he reported that Smith was

dizzy, nauseous, vomiting, and that he had seen others

submitting written requests for Smith. And the list goes

on. Two doctors further testified that pneumococcal

meningitis is almost always fatal if not treated, but mortal-

ity is no more than 30% if treated. And the plaintiff’s

expert, Dr. Ben Katz, testified that Smith would have

exhibited symptoms of meningitis (vomiting, nausea,

fever) by the evening of April 27, 2004. The testimony

at trial leads us to conclude that the jury had a sufficient

basis to find a widespread practice of CMTs failing to

collect medical request forms, and that this failure

caused Smith’s death.

Furthermore, we find unpersuasive the County’s argu-

ment that it cannot be held liable under Monell because

none of its employees were found to have violated

Smith’s constitutional rights. In support of its argument,

the County cites Los Angeles v. Heller, 475 U.S. 796 (1986).

The Supreme Court in that case determined that a munici-

pality could not be held liable for constitutional viola-

tions based on the actions of one of its police officers

after the jury found that the individual officer did not

inflict any constitutional harm. Id. at 799. The Court

reached this conclusion, however, under different

factual circumstances and for different reasons which

do not apply here.

The plaintiff in Heller sued the City of Los Angeles and

individual members of the police force for damages

under § 1983, alleging that the officers arrested him

without probable cause and used excessive force in

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 17

making the arrest. Id. at 797. On the constitutional

claims, the jury returned a verdict for the individual

officer, and the Supreme Court agreed that the

district court properly dismissed the claim against the

City. Id. at 798-99. The Court noted that the jurors

were not instructed on any affirmative defenses that the

individual officer may have asserted, nor were they

presented with any qualified immunity issues. Id. at 798.

The absence of these defenses is significant. If, for

instance, the officer had pled an affirmative defense

such as good faith, then the jury might have found that

the plaintiff’s constitutional rights were indeed violated,

but that the officer could not be held liable. In that

case, one can still argue that the City’s policies caused

the harm, even if the officer was not individually culpa-

ble. Without any affirmative defenses, a verdict in favor

of the officer necessarily meant that the jury did not

believe the officer violated the plaintiff’s constitutional

rights. And since the City’s liability was based on the

officer’s actions, it too was entitled to a verdict in its favor.

The County, in this case, appears to push for a rule

that requires individual officer liability before a munic-

ipality can ever be held liable for damages under Monell.

This is an unreasonable extension of Heller. What if the

plaintiff here had only sued the County, or didn’t know,

because of some breakdown in recording shifts, who

the CMTs on duty were? The actual rule, as we interpret

it, is much narrower: a municipality can be held liable

under Monell, even when its officers are not, unless such

a finding would create an inconsistent verdict. See Heller,

475 U.S. at 798-99; see also id. at 801 (Stevens, J., dissenting).

18 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

So, to determine whether the County’s liability is depend-

ent on its officers, we look to the nature of the constitu-

tional violation, the theory of municipal liability, and the

defenses set forth. See Speer v. City of Wynne, 276 F.3d 980,

986 (8th Cir. 2002). The plaintiff in this case alleged that

the failure to respond to Smith’s medical requests

caused his death and violated his right to due process.

The jury instructions on the claim listed three elements,

each of which the jury had to find by a preponderance

of the evidence: “1. Norman Smith had a serious

medical need; 2. [t]he [d]efendant was deliberately indif-

ferent to Norman Smith’s serious medical need; and 3. [t]he

[d]efendant’s conduct caused harm to Norman Smith.”

(emphasis added). Based on these instructions, the jury

could have found that the CMTs were not deliberately

indifferent to Smith’s medical needs, but simply could

not respond adequately because of the well-documented

breakdowns in the County’s policies for retrieving

medical request forms. It is not difficult to reconcile the

verdicts in this instance, and we see nothing amiss in

holding the County liable even though none of the CMTs

were individually responsible.3

3

The County also makes a somewhat undeveloped argument

that it cannot be held liable based on the actions of the

Sheriff’s officers alone. That may be true because, in Illinois, the

Sheriff is an independently elected officer who is accountable

only to the people, rather than to the County board. Thompson

v. Duke, 882 F.2d 1180, 1187 (7th Cir. 1989) (citing Ill. Const. Art.

VII, § 4(c)); see also Franklin v. Zaruba, 150 F.3d 682, 686 (7th

(continued...)

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 19

C. Insufficient Evidence to Impose Liability Against

Sheriff

The Sheriff also challenges whether he can be held liable

for damages under Monell. The jury found the Sheriff

liable based on the policy/practice of severely under-

staffing correctional officers, and the Sheriff believes the

evidence is legally insufficient to sustain this verdict. The

Sheriff argues that under-staffing cannot be a basis for

liability under § 1983, that there is no causal link between

under-staffing and Smith’s death, and that the Sheriff

has limited control of the budget so any fault lies with

Cook County.

(...continued)

Cir. 1998) (“the lack of identity between the county sheriff’s

department and the general county government indicates

that § 1983 suits against sheriffs in their official capacities are

in reality suits against the county sheriff’s department rather

than the county board.”); Ryan v. County of DuPage, 45 F.3d

1090, 1092 (7th Cir. 1995) (“Illinois sheriffs are independently

elected officials not subject to the control of the county.”).

However, because the jury had sufficient basis to find that the

failure to retrieve and act on the detainees’ medical requests

(which implicates the County’s unofficial practice or custom)

caused Smith’s death, we need not address the additional

arguments. Nor must we decide whether the evidence sup-

ported the other allegedly harmful policies or practices. The

evidence supported the plaintiff’s first theory of liability, and

we can uphold the jury’s verdict on that ground alone. Cf.

Griffin v. United States, 502 U.S. 46, 60 (1991) (noting that a

jury verdict should not be set aside merely on the chance that

it was not supported by sufficient evidence “when there

existed other grounds for which the evidence was sufficient”).

20 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

We begin with what appears to be the Sheriff’s strongest

argument: the absence of any causal link between its

policies and Smith’s death. Monell recognized that the

premise behind a § 1983 action against a government body

is “the allegation that official policy is responsible for

the deprivation of rights.” Monell, 436 U.S. at 690

(emphasis added). In applying the different theories of

liability recognized under Monell, we have always

required plaintiffs to show that their injuries were

caused by the policies or practices complained of. See

Klebanowski v. Sheahan, 540 F.3d 633, 637 (7th Cir. 2008).

This is an explicit requirement of § 1983 and an uncontro-

versial application of basic tort law. But in cases such as

this, where individual defendants are commingled

with governmental bodies, and the plaintiff alleges a

litany of policy failures that interact to create some consti-

tutional harm, it is sometimes easier to obscure the

causal links between different actors.

The individual officers in this case (the Sheriff’s deputies)

were found liable because they displayed deliberate

indifference to Smith’s medical needs, yet the Sheriff

was also found liable for its policy of severely under-

staffing the prison. The only way to reconcile these two

verdicts is to find that both the officers’ deliberate indif-

ference and the policy of under-staffing caused Smith’s

death. We find the latter unsupported by the evidence

presented at trial. A number of inmates testified that they

either complained or witnessed others complain to the

officers about Smith’s condition. At that point, the

officers should have taken the steps necessary to investi-

gate and ensure that Smith received medical attention.

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 21

The theory that under-staffing may have also caused

Smith’s death, on the other hand, is too remote to support

a verdict against the Sheriff. A governmental body’s

policies must be the moving force behind the constitu-

tional violation before we can impose liability under

Monell. Woodward, 368 F.3d at 927. In § 1983 actions, the

Supreme Court has been especially concerned with the

broad application of causation principles in a way that

would render municipalities vicariously liable for their

officers’ actions. Bd. of County Com'rs of Bryan County

v. Brown, 520 U.S. 397, 405 (1997) (“Where a plain-

tiff claims that the municipality has not directly

inflicted an injury, but nonetheless has caused an em-

ployee to do so, rigorous standards of culpability and

causation must be applied to ensure that the municipality

is not held liable solely for the actions of its employee.”);

see also City of Springfield v. Kibbe, 480 U.S. 257, 267-68

(1987) (O’Connor, J., dissenting). That is why some courts

distinguish between the acts that caused the injury and

those that were merely contributing factors. See Rodriguez

v. Sec’y for Dep’t of Corr., 508 F.3d 611, 625 (11th Cir. 2007).

We need not make such a distinction here because the

evidence presented at trial does not even establish that

under-staffing was a contributing factor. Because the

jury held the individual officers liable, it must have

found that the officers deliberately ignored Smith’s condi-

tion. But the evidence does not demonstrate that their

actions had anything to do with under-staffing. No

one testified or even argued that the officers would

have acted differently if more of them were on duty.

How many officers would the Sheriff need to hire to

22 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

ensure that no one deliberately ignores a complaint or

medical request? We do not know.

One possible theory that the plaintiff proposes is that

the Sheriff’s policy of under-staffing prevented the CMTs

from retrieving the medical request forms submitted on

Smith’s behalf. Generally, inmates place their request

forms in lockboxes, which are located within the tiers. The

officers on duty must first grant the CMTs access into

the tiers, after which the CMTs must use their own keys

to retrieve the forms from the lockboxes. In other

words, when the officers are under-staffed, they may not

be available to grant CMTs access to the tiers, and, by

extension, the lockboxes. That is what the plaintiff

suggests may have happened here. But the only

evidence supporting this conclusion was testimony that

CMTs have complained previously of being unable to

access the tiers to retrieve the medical requests. Assuming

the jury believed the witnesses who claimed to have

submitted request forms on Smith’s behalf, the plaintiff

presented no evidence as to why those forms were not

retrieved. No one testified that they could not have

access to the tiers on the days Smith or the other

inmates submitted requests. Some CMTs reported not

having keys to the medical request lockboxes, and

others did not turn in their daily encounter forms, so

there was no way of knowing if they picked up the

request forms. The plaintiff even argues (albeit to

establish a widespread practice of CMTs failing to

retrieve request forms) that one of the CMTs on duty

on April 29, 2004, did not have a key to the lockbox

and could not have opened it anyways. The relevant

question for the causation requirement is whether the

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 23

Sheriff’s policy of under-staffing was the reason the CMTs

could not access the forms on those days that Smith and

the other inmates claimed to have submitted their re-

quests. We see no evidence to suggest that it was.

Nothing occurs in a vacuum, and we have no doubt

that additional factors, other than the officers’

malfeasance, may be at play. Perhaps if the officers re-

ceived better training, or if the jail was less crowded, they

might not have ignored Smith’s condition. All of this

may be true, but it does not satisfy the causation require-

ment here. To hold otherwise would significantly

expand Monell and lead us down the road to vicarious

liability. So when individual officers are aware of, and

make the conscious decision not to respond to, reports of

an inmate’s poor health, we cannot infer, without more

evidence, that under-staffing was the moving force

behind the resulting injury.

D. Trial Court’s Evidentiary Rulings

Cook County, the Sheriff, and the individual officers

provide a long list of evidentiary rulings that they claim

amounted to an abuse of discretion and warrant a new

trial. Among the testimony and other evidence

challenged on appeal are: Carlos Matias’s deposition

testimony, which was read to the jury; a doctor’s state-

ments contained in the Sheriff’s death investigation

report; hearsay statements admitted through Gilbert

Yorke, an inmate; and a list of names that the plaintiff

obtained of other inmates who had information on

Smith’s death. We review the district court’s decision to

admit testimony for an abuse of discretion, and we will

24 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

only reverse if the district court’s evidentiary ruling

was not harmless. Dadian v. Vill. of Wilmette, 269 F.3d

831, 842 (7th Cir. 2001).

1. Carlos Matias’s Deposition Testimony

Federal Rule of Civil Procedure 32 governs the use of

deposition testimony during trial. That provision states,

in part, that “a party may use for any purpose the deposi-

tion of a witness, whether or not a party, if the court

finds: . . . that the party offering the deposition could not

procure the witness’s attendance by subpoena . . . .” Fed. R.

Civ. P. 32(4)(D). Implicit in this rule is an obligation to

use reasonable diligence to secure the witness’s

presence, and the district court has broad discretion to

determine whether the proponent has satisfied this re-

quirement. Griman v. Makousky, 76 F.3d 151, 154 (7th Cir.

1996). After two subpoenas, a show cause order, numerous

phone calls, and a search by a private investigator,

the plaintiff could not get Matias, who had since been

released from custody, into court to testify. Pursuant to

Rule 32, the district court allowed the plaintiff to read

Matias’s deposition testimony at trial, over the defen-

dants’ objections. The defendants argue that the plaintiff

did not exercise reasonable diligence in procuring

Matias’s presence because: (1) the plaintiff was in

constant contact with Matias, who was in Chicago, and

should have been able to secure his presence; and (2) the

district court should have compelled Matias to appear

by issuing an arrest warrant but chose not to based on

the plaintiff’s reassurances that Matias would appear.

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 25

Neither Rule 32 nor our case law required the district

court to issue an arrest warrant for Matias before

admitting his deposition testimony. In Rascon v. Hardiman,

for instance, we upheld the district court’s decision to

admit a potential witness’s deposition testimony after a

private investigator and a process server were unable to

subpoena the witness. 803 F.2d 269, 277 (7th Cir. 1986).

Their efforts had satisfied the magistrate judge that the

plaintiff exercised reasonable diligence, and we found no

abuse of discretion in the judge’s determination. Id. The

defendants, however, attempt to distinguish Rascon on

the grounds that the plaintiff in this case knew that

Matias was in Chicago, and the plaintiff represented that

Matias would appear to discourage the district court

from issuing an arrest warrant. But knowledge of

Matias’s whereabouts does not detract from the court’s

finding that the plaintiff exercised reasonable diligence.

Matias’s location was never in dispute. In fact, he was sub-

poenaed twice. The problem was that Matias did not

abide by court orders. And the district court found that

the plaintiff’s attempts to ensure Matias’s compliance,

including hiring a private investigator to transport

Matias to the courthouse, met the reasonable diligence

standard. We find no abuse of discretion here.

Reasonable diligence aside, it seems an additional step

could have been taken to ensure Matias’s presence in

court. In most cases, courts understandably elect live or

even recorded testimony over transcripts read to the jury.

See, e.g., Murillo v. Frank, 402 F.3d 786, 790 (7th Cir. 2005);

Griman, 76 F.3d at 153. This preference should be even

more pronounced for witnesses, like Matias, who may be

26 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

instrumental to a party’s case. Iragorri v. Int’l Elevator,

Inc., 203 F.3d 8, 17 (1st Cir. 2000) (“[T]he live testimony

of [key] witnesses for the purposes of presenting

demeanor evidence [is] essential to a fair trial.”) (citation

omitted). The court had anticipated the possibility that

Matias would not appear, and advised the parties to

review his deposition. Under these circumstances,

where everyone has notice that the witness may not

comply with court orders, and the plaintiff knows his

whereabouts, it would make sense to issue an arrest

warrant. Nonetheless, that we may have done things

differently in hindsight is beside the point. The court

had broad discretion to determine whether the

plaintiff’s actions satisfied Rule 32’s requirements, and

we see no reason to reverse its ruling.

And even if we did find error, a number of other live

witnesses corroborated the more significant or prejudicial

statements in Matias’s testimony. For example, Matias

testified that, on April 24, 2004, Smith’s first day in cus-

tody, Smith asked him to fill out a medical request form.

Robotis said he had filled out a request form for Smith

after Matias sent his form in, and Robinson stated that

Smith was sick from the first day he arrived at jail. Both

Matias and Mitchell also testified that they witnessed

Smith fill out a medical request form. By Smith’s

second day in custody, Matias claimed that he cleaned

the vomit Smith left behind in the day room, and

Mitchell testified that he too saw Smith vomiting in the

day room. Also, Matias said that on April 28, 2004, a

number of inmates told officers that “a man was really

sick,” referring to Smith. Robotis made similar state-

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 27

ments when he testified to personally informing the

guards working on the 28th that Smith was ill, and

Mitchell recalled witnessing inmates approach medical

technicians to request help for Smith. Finally, Matias

testified that Smith could not walk and was lying on the

floor, but Mitchell corroborated this statement when

he described Smith as lethargic and “not moving” on

April 29, 2004. The defendants had the opportunity to

cross-examine Matias during his deposition, as well as

the other inmates whose testimony corroborated Matias’s

accounts. Under these circumstances, the minimal preju-

dice to the defendants does not warrant a new trial.

2. Hearsay and Other Objections

The remaining evidentiary challenges can also be

quickly resolved. Officer Raher testified that while in-

vestigating Smith’s death, Dr. Analgate, the physician on

duty when Smith was transported to the emergency

room, told him (Raher) that he had heard that Smith had

been complaining of illness. The problem with this testi-

mony is that it is not very probative at all. See Fed. R. Evid.

403. It only shows that Raher spoke to Dr. Analgate, and

learned of Matias’s complaints, on April 30—the day

Smith was taken to the emergency room. His failure

to interview more witnesses after the fact says nothing

about the County’s response to requests for medical

attention. Similarly, Dr. Analgate did not indicate when

he heard about Smith’s complaints (whether before or

on the 30th), so his statements do not tell us much about

County policy either. Nonetheless, if any error occurred,

28 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

it does not warrant a new trial. A number of inmates

testified that they submitted medical request forms and

complained directly to the officer, and it is unlikely that

this testimony had an injurious effect on the verdict.

The other inmates’ testimony also renders harmless

the admission of Gilbert Yorke’s statement and the

alleged hearsay statements in Matias’s deposition testi-

mony. Yorke testified that Matias told him to sleep on the

top bunk because Smith had been sick since he arrived on

the tier (Smith and Yorke shared bunk beds), possibly

inferring that the guards should have known that Smith

was sick and responded. Even if Yorke’s testimony could

be read to allow this inference, the jury heard ample other

testimony that other inmates had put the officer defen-

dants on notice of Smith’s condition, and so any error in

admitting Yorke’s testimony was harmless.

We find the defendants’ remaining evidentiary chal-

lenges meritless. These include: Matias’s deposition

statement that he heard a nurse say that Smith was just

“dope sick” and that there was nothing she could do

about it; the admission of the list given to the plaintiff

containing the names of inmates who wanted her to

know what happened to her son; the plaintiff’s testi-

mony about Smith’s past jobs; the admission of Smith’s

resumè; and the district court’s decision to exclude evi-

dence of Smith’s previously unknown child. Matias’s

statement that a nurse told him that Smith was just

“dope sick” is not hearsay. Federal Rule of Evidence

801(d)(2)(D) states that “[a] statement is not hearsay if . . .

the statement is offered against a party and is the

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 29

party’s own statement, in either an individual or a repre-

sentative capacity . . . or a statement by the party’s agent

or servant concerning a matter within the scope of the

agency or employment, made during the existence of the

relationship . . . .”. The plaintiff used the statement, made

by a Cook County employee, to show that the County

employees were deliberately indifferent to Smith’s illness

and had a widespread practice of ignoring medical re-

quests; therefore, it was admissible.

Regarding the list of inmates, the plaintiff argues that the

list was only offered to show how the plaintiff found the

inmates who testified at trial. For this purpose, the list

is not hearsay, but it is unclear why it was relevant in

the first place. Many inmates on the list testified and

described in detail Smith’s condition in the days leading

up to his death. As the district court noted, how the

plaintiff found the inmate witnesses is of limited

probative value. But for that same reason, its admission

was also harmless. We cannot think of any reasonable

inference the jury could have made from the list that it

could not have made from the inmates’ testimony.

We also agree with the district court that the admission

of Smith’s resumé and testimony about his past employ-

ment and education do not warrant a reversal. Rule 901(a)

of the Federal Rules of Evidence states that the authentica-

tion requirement “is satisfied by evidence sufficient to

support a finding that the matter in question is what its

proponent claims.” Smith’s mother (the plaintiff) and

girlfriend testified, based on their personal knowledge,

to Smith’s past employment and education, which in-

30 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

cluded jobs at McDonald’s, Dominicks, Clark gas station,

T.E.A.M.S., and Commander Packaging. Any information

in his resumé was also presented through their

testimony, which the defendants had an opportunity to

challenge during trial. Finally, we see no error in the

district court’s decision to exclude any evidence of

Smith’s previously unknown fourth child. The County

claims that the evidence would have enabled it to

challenge the plaintiff’s credibility because she had stated

that Smith had only three children. The district court

determined that evidence of a previously unknown

child would not impeach the plaintiff, and the

defendants have not demonstrated otherwise. None of

these alleged infirmities entitle the defendants to a new

trial.

E. The Jury’s Verdict

Although the district court instructed the jury against

duplicative compensatory damage awards, the verdict

form, to which the defendants did not object, provided

spaces for the jury to enter damages for both the denial

of medical care (against the individual defendants) and

policy and practice (against the County) claims, both of

which resulted in the same injury. The district court

remitted the jury’s total damage award from $4,450,000

to $4,300,000, ($300,000 of which were for the wrongful

death and survival claims) but the defendants argue

that the verdict is still inconsistent and excessive. We

review the district court’s decision not to grant a new trial

on damages for an abuse of discretion. Houskins v. Sheahan,

549 F.3d 480, 498 (7th Cir. 2008).

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 31

On the federal claims, the jury entered $150,000 in

damages against the officers collectively, $3,000,000 in

damages against Cook County, and $1,000,000 against

the Sheriff. As a result, it is unclear whether the jury

meant to allocate duplicate awards for the same injury,

or whether it merely calculated total damages and allo-

cated the amounts separately based on what it perceived

to be each party’s relative fault. Because we presume

that juries follow the court’s instructions, we will

assume the latter, Soltys v. Costello, 520 F.3d 737, 744

(7th Cir. 2008), which is more consistent with the

district court’s instruction that the jury not award com-

pensatory damages twice for the same injury.

This raises another question, however, because the

defendants were jointly and severally liable, and allocating

damages between the parties for the indivisible injury

alleged in this case was improper. See Transcraft, Inc. v.

Galvin, Stalmack, Kirschner & Clark, 39 F.3d 812, 821 (7th Cir.

1994). To remedy this error, the district court decided to

place a ceiling at the highest assessment of compensatory

damages against any of the jointly liable defendants as

opposed to totaling all of the allocated amounts. See Bosco

v. Serhant, 836 F.2d 271, 281 (7th Cir. 1987). The highest

damage award was $3,000,000 assessed against Cook

County; however, the district court also added the

$1,000,000 award assessed against the Sheriff.

It appears that the district court adopted two

approaches in interpreting the compensatory damage

awards. It attempted to place a ceiling on the highest

assessment of damages, and, at the same time, added the

32 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

awards allocated to different defendants (the Sheriff and

Cook County). As the district court recognized, we have

previously suggested that a ceiling at the highest assess-

ment of compensatory damages may be appropriate

when a jury improperly allocates the award among defen-

dants who are jointly and severally liable. Bosco, 836

F.2d at 281; Watts v. Laurent, 774 F.2d 168, 180 (7th Cir.

1985). But those cases do not require us to apply that

rule in every instance. One can just as easily argue that,

instead of a ceiling, the total damage award should be

the sum of all damages allocated among the defendants.

See Watts, 774 F.2d at 180. Ultimately we interpret jury

awards to avoid inconsistency, Majeske v. City of Chi.,

218 F.3d 816, 823 (7th Cir. 2000), and presume that juries

follow the court’s instructions. Soltys, 520 F.3d at 744. If

the jury avoided duplicate compensatory damage

awards, as the court ordered, then a ceiling at the

highest assessment would not accurately reflect the

amount that the jury determined would compensate the

plaintiff. Therefore, adding the damage awards would be

more consistent with the presumptions we apply to jury

verdicts.

Under either theory, a $4,000,000 award does not add

up. If the district court sought out to establish a ceiling

based on the highest damage assessment allocated to a

defendant, that number is $3,000,000—the damage

award entered against Cook County. To add the $1,000,000

award originally entered against the Sheriff defeats the

purpose of placing a ceiling. If, on the other hand, the

district court decided to add the allocated damages

based on the presumption that the jury heeded its in-

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 33

struction not to issue duplicate awards, then there was

no reason to exclude the $150,000 award against the

officers. The plaintiff, however, does not challenge the

$150,000 adjustment so we will not address it. Cf. Luellen

v. City of E. Chi., 350 F.3d 604, 612 n.4, 5 (7th Cir. 2003)

(noting that arguments not raised on appeal are

waived). Other than the reduction, we agree with the

district court’s decision to award the damages allocated

to both Cook County and the Sheriff. The court

presumed that the jury followed its instruction not to

issue duplicate awards, and it appropriately interpreted

the verdict.

Moreover, our conclusion that the evidence was insuffi-

cient to hold the Sheriff’s office liable under Monell does

not affect the damages calculation. The defendants were

jointly and severally liable for one indivisible injury, and

the damage award represents the amount required to

compensate the plaintiff for that harm. See Peterson v.

Gibson, 372 F.3d 862, 864 (7th Cir. 2004); Maul v. Constan,

928 F.2d 784, 787-88 (7th Cir. 1991). That amount

remains the same because it is tied to the injury itself.

The plaintiff may collect the full amount from any one

of the defendants, and the jury’s decision to include the

Sheriff among those liable merely added another

source of collection. Watts, 774 F.2d at 180. Removing

the Sheriff from this list, therefore, only removes that

potential source but does not affect the amount of

damages to which the plaintiff is entitled.

The defendants also argue that the award was excessive.

In particular, they note the discrepancy between the

34 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

jury’s allocation of damages against the individual and

institutional defendants, and also point to damage

awards in other cases in an attempt to show that the

jury’s verdict was unreasonable. “When the district

court has remitted a portion of the jury’s award and the

defendant claims that the remitted award is still exces-

sive,” we review the evidence of damages in the light

most favorable to the jury verdict and will only reverse

if there is no rational connection between the evidence

and the damage award. Deloughery v. City of Chi., 422

F.3d 611, 619 (7th Cir. 2005).

Under the federal standard for reviewing com-

pensatory damages we assess whether the award is

“monstrously excessive,” “whether there is no rational

connection between the award and the evidence,” and

whether the award is comparable to those in similar

cases. Naeem v. McKesson Drug Co., 444 F.3d 593, 611 (7th

Cir. 2006). As we stated earlier, the jury’s allocation of

damages does not render the verdict unreasonable. Nor

is it excessive in comparison to similar cases. Estate of

Moreland v. Dieter, for example, involved a § 1983 claim

based on the death of a inmate, and, while the officers’

conduct in that case was much more egregious, the jury

awarded $29,000,000 in compensatory damages. 395

F.3d 747 (7th Cir. 2005). Cf. DeBiasio v. Ill. Cent. R.R., 52

F.3d 678 (7th Cir. 1995) (upholding a $4,201,000 damage

award for a plaintiff who was injured and lost his left

arm while employed with Illinois Central Railroad). The

defendants, however, point to various state court cases

with lower compensatory damage awards. Aside from

the fact that these cases allege different claims, “[a]

Nos. 08-2232, 08-2233, 08-2482, 08-2597 & 08-2948 35

court should not substitute a jury’s damages verdict with

its own figure merely because . . . a plaintiff in a similar

case was perhaps not able to plead his facts to the jury

as well.” Lampley v. Onyx Acceptance Corp., 340 F.3d 478,

485 (7th Cir. 2003).

Finally, we find sufficient evidence to support the

award. Smith was only thirty-two years old and died of a

treatable illness while in custody. Numerous witnesses

testified that their attempts to obtain medical care for

Smith, or to alert officials about Smith’s condition were

largely ignored. Smith had three children whom he

supported and with whom he had a close relationship.

The jury also heard evidence about Smith’s employment

history through witness testimony and the admission of

Smith’s resumé. He had a solid work history that

included McDonald’s, Dominicks, Clark gas station,

T.E.A.M.S., and working for Commander Packaging as a

machine operator. Our review of the facts supporting

the damage award and the district court’s decision to

uphold it is deferential. “We are reluctant to substitute

our assessment of the evidence in place of the discretion

of the district court, exercised in light of what it wit-

nessed at trial,” Deloughery, 422 F.3d at 620, and we see

no reason to do so here.

III. CONCLUSION

For these reasons, we A FFIRM the district court’s denial

of Cook County and the individual officers’ motion for

judgment as a matter of law, and we A FFIRM the

district court’s denial of the defendants’ motion for a

36 Nos. 08-2232, 08-2233, 08-2482 & 08-2597 & 08-2948

new trial. We R EVERSE, however, the district court’s

denial of the Sheriff’s motion for judgment as a matter of

law and R EMAND with instructions that the district

court enter judgment in the Sheriff’s favor.

12-1-09