nginx called send(file), then polled the socket for write with the timeout, closing the connection if the timeout was hit. It has everything to do with poll/select timeouts, and especially with Linux letting poll hit timeouts when waiting on effectively writable sockets.

The goal of NGINX here is not to measure whether a socket can consume any data whatsoever. A connection that consumes 1 byte every 15 seconds is still considered stalled, and should be killed. Using the time between sendfile invocations is not the goal, it's a means toward implementing a minimum rate, and they implemented a minimum rate the wrong way. It's an X Y problem and that's not the kernel's fault.