NEC Formula State Court Litigation

Updated August 3, 2026. The largest NEC jury verdicts have come from state courts, not the federal MDL, but the state landscape is narrowing. Two recent rulings, the learned intermediary reversal of the Watson verdict and the Deppa forum dismissal, have made Illinois harder for plaintiffs. This page maps the state venues and flags what is not verified.

Key Takeaways

The largest NEC verdicts came from state courts: St. Louis, Missouri and Cook County, Illinois

Illinois's Fifth District adopted the learned intermediary doctrine for preterm formula in a published opinion, reversing the $60M Watson verdict

The Deppa ruling dismissed 23 of 29 Cook County cases on forum grounds, narrowing that venue

Missouri's contrary ruling is unpublished and non-precedential, so it carries less weight

Case counts for Madison and St. Clair counties, and any Philadelphia program, are not verified and not stated here

Missouri

St. Louis, Missouri has produced both the largest plaintiff verdict and defense results. The $495 million Gill v. Abbott verdict came out of St. Louis and was affirmed in May 2026, though in an unpublished opinion, and Abbott is now applying to the Missouri Supreme Court, so it is not final. A St. Louis jury also returned a defense verdict in the K.H. case on July 2, 2026, finding against the plaintiff on specific causation, and an earlier St. Louis defense verdict in Whitfield was vacated in March 2025 and set for a new trial. Missouri courts have so far declined to apply the learned intermediary doctrine to preterm formula, but that ruling is unpublished and non-precedential.

Illinois

Illinois has been the most active state venue and is where the law shifted most against plaintiffs in 2026. A Cook County jury returned a $70 million verdict for four families in April 2026. But two rulings changed the picture. First, in December 2025, the Deppa decision dismissed 23 of 29 Cook County cases on forum non conveniens grounds, leaving only the six Illinois-resident cases and largely closing that venue to out-of-state plaintiffs. Second, on June 12, 2026, Illinois's Fifth District adopted the learned intermediary doctrine for preterm formula in a published opinion and reversed the $60 million Watson v. Mead Johnson verdict out of St. Clair County. Because it is published, that opinion raises the proof burden across Illinois.

What we are not stating

We flag rather than invent. We have not verified current case counts for Madison County or St. Clair County, Illinois, and we could not confirm whether a formal Philadelphia NEC program exists, so those numbers do not appear here. The verified state-court facts are the venues and the rulings described above. Where a family can file depends on residence, where the child was treated, and each state's rules, which is a question for a licensed attorney.

Frequently Asked Questions

Which state courts hear NEC formula cases?

The most active NEC state-court venues have been in Missouri (St. Louis) and Illinois (Cook County, and Madison and St. Clair counties). The largest state verdicts came from St. Louis (the $495 million Gill verdict) and Cook County (a $70 million verdict for four families), and the reversed $60 million Watson verdict came from St. Clair County. We have not verified current case counts for Madison or St. Clair county, or whether a formal Philadelphia program exists, so we do not state those numbers.

What is the learned intermediary split between the states?

The learned intermediary doctrine holds that a manufacturer's duty to warn runs to the prescribing physician rather than the patient. Missouri and Illinois have split on whether it applies to preterm formula. A Missouri court rejected it, but that ruling is unpublished and non-precedential. On June 12, 2026, Illinois's Fifth District adopted it in a published opinion and used it to reverse the $60 million Watson verdict. A published appellate opinion carries more weight, so the doctrine now raises the proof burden across Illinois.

What was the Deppa forum ruling?

On December 12, 2025, an Illinois appellate court dismissed 23 of 29 Cook County cases on forum non conveniens grounds, leaving only the six Illinois-resident cases. Cook County had been a favorable venue for out-of-state plaintiffs, so the ruling materially narrows where these cases can be brought.

Can out-of-state families still file in Illinois?

It is harder than it was. After the Deppa ruling, Cook County is largely closed to out-of-state NEC plaintiffs, and the learned intermediary doctrine now applies across Illinois after the Watson reversal. Where a family can file depends on residence, where the child was treated, and each state’s rules, so this is a question for a licensed attorney rather than a general answer.