Pharmaceutical MDL-3094 Eastern District of Pennsylvania
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Ozempic & GLP-1 Drug Lawsuit (Gastroparesis & GI Injuries)

Federal litigation alleging GLP-1 receptor agonist drugs like Ozempic, Wegovy, and Mounjaro caused severe gastroparesis, intestinal blockages, and other gastrointestinal injuries without adequate warnings to patients and physicians.

Last Updated: May 1, 2026
20 min read
JPML Data Verified
9 sources cited

Key Takeaways

  • Over 3,300 cases pending as of May 2026 with 153% growth
  • October 2025: FDA added gastroparesis warning to Ozempic label
  • Vision loss claims now in separate MDL-3163
  • Defendants include Novo Nordisk (Ozempic, Wegovy) and Eli Lilly (Mounjaro)
  • First bellwether trials expected mid-2026

May 2026 Updates Latest

3,636 cases pending (3,580 total filed in MDL 3094) — rapid growth continues with hundreds of new filings monthly. Roughly 75% of complaints allege gastroparesis/stomach paralysis, 18% ileus, and 8% gallbladder injuries. Judge Karen S. Marston continues to require objective diagnostic testing for gastroparesis claims, and the post-CMO 23 schedule has now moved past expert depositions and the April 28, 2026 Daubert motions deadline.

Summary judgment briefing continues through July 2026. Bellwether trial selection is still expected around mid-2026, with first trials possible in late 2026 and mass settlements considered unlikely before late 2027. A separate MDL-3163 handles NAION vision-loss claims, now at 73 cases. Legal analysts estimate total liability across both MDLs could exceed $2 billion. No settlements have been announced.

3,636
Pending Actions
173%
Growth Since Jan 2025
Oct 2025
FDA Label Update
Mid-2026
First Bellwethers

Key Facts (May 2026)

Pending Actions 3,636+ cases in federal MDL
Total Actions Filed 3,670+ cases
Key Defendants Novo Nordisk Inc./A/S, Eli Lilly and Company
Presiding Judge Hon. Karen S. Marston (E.D. Pennsylvania)
MDL Created February 2024
JAMA Study (Oct 2023) Increased risk of gastroparesis and bowel obstruction (PMID: 37796527)
FDA Label Update October 2025: "Not recommended in patients with severe gastroparesis"
Can You Still File? Yes, lawsuits are actively being filed

Rapid Case Growth

This MDL is growing rapidly as patients report gastroparesis and GI injuries from GLP-1 drugs. Case count has more than doubled, growing 173% since January 2025.

Jan 25
1,331
Feb 25
1,511
Mar 25
1,761
Apr 25
1,926
May 25
2,121
Jun 25
2,312
Jul 25
2,487
Aug 25
2,553
Sep 25
2,665
Oct 25
2,732
Nov 25
2,838
Dec 25
2,947
Jan 26
3,063
Feb 26
3,191
Mar 26
3,363
Apr 26
3,546
May 26
3,636

Source: JPML MDL Statistics Reports, February 2025-May 2026

JAMA GI Study (October 2023)

A study by Sodhi et al. found that patients using GLP-1 drugs for weight loss had significantly increased risk of gastrointestinal adverse events:

9.09x
Higher risk of pancreatitis
4.22x
Higher risk of bowel obstruction
3.67x
Higher risk of gastroparesis

Source: Sodhi M, et al. JAMA. 2023;330(18):1795-1797 (PMID: 37796527)

1 What Is This Lawsuit About?

Thousands of patients are suing the makers of popular GLP-1 receptor agonist drugs, alleging these medications caused severe gastrointestinal injuries that were not adequately disclosed. The drugs include Ozempic, Wegovy, Rybelsus (Novo Nordisk) and Mounjaro, Zepbound, Trulicity (Eli Lilly). Vision loss claims are now handled by a separate MDL-3163.

GLP-1 drugs work by mimicking a natural hormone that stimulates insulin release and delays gastric emptying. While delayed stomach emptying is a known mechanism of action, plaintiffs allege manufacturers failed to warn that this can progress to severe, persistent gastroparesis (stomach paralysis), intestinal blockages, and other serious complications.

From the FDA Label: "Semaglutide causes a delay of early postprandial gastric emptying, thereby reducing the rate at which glucose appears in the circulation." This intended effect is now at the center of litigation over when it becomes a harmful adverse event.

2 Alleged Injuries & Complications

Plaintiffs allege these drugs caused serious injuries that were not adequately warned about on product labels until after thousands of patients were harmed.

Gastroparesis (Stomach Paralysis)

A disorder that slows or stops food movement from the stomach to the small intestine. Symptoms include severe nausea, vomiting, bloating, and malnutrition. Per NIDDK, diagnosis requires gastric emptying study showing >10% retention at 4 hours.

October 2025 FDA Label Update: "OZEMPIC is not recommended in patients with severe gastroparesis."

Ileus & Intestinal Obstruction

The FDA-approved label lists "ileus, intestinal obstruction, small intestinal obstruction" as postmarketing adverse events. These conditions can require emergency surgery and be life-threatening.

NAION / Vision Loss Claims

Vision loss (NAION) claims are now handled by a separate MDL-3163, created December 2025 and also assigned to Judge Marston.

View Vision Loss MDL (MDL-3163)

Acute Pancreatitis

The FDA label warns: "Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with GLP-1 receptor agonists."

Other Reported Adverse Events

Acute kidney injury (some requiring dialysis)
Gallbladder disease (cholelithiasis)
Pulmonary aspiration during anesthesia
Severe nausea, vomiting, diarrhea
Hair loss (alopecia)
Thyroid C-cell tumors (boxed warning)

3 Why Two GLP-1 MDLs?

In December 2025, the JPML created a separate MDL-3163 for vision loss (NAION) claims rather than adding them to this MDL. Here's how they differ:

Factor MDL-3094 (This Page) MDL-3163 (Vision)
Primary Injuries Gastroparesis, ileus, intestinal obstruction NAION, sudden vision loss, blindness
Case Count ~3,300+ cases ~54 cases
Established February 2024 December 2025
Expert Type Gastroenterology Ophthalmology, Neuro-ophthalmology
FDA Warning Oct 2025: Gastroparesis warning added No U.S. warning
Same Judge, Same Defendants: Both MDLs are before Judge Karen S. Marston in the Eastern District of Pennsylvania. Both involve Novo Nordisk and Eli Lilly. Coordination is expected on common legal issues.

4 Products Involved in the Litigation

Novo Nordisk Products

Ozempic
Semaglutide injection
Type 2 Diabetes
Wegovy
Semaglutide injection
Weight Management
Rybelsus
Semaglutide oral tablet
Type 2 Diabetes
Victoza
Liraglutide injection
Type 2 Diabetes
Saxenda
Liraglutide injection
Weight Management

Eli Lilly Products

Mounjaro
Tirzepatide injection
Type 2 Diabetes
Zepbound
Tirzepatide injection
Weight Management
Trulicity
Dulaglutide injection
Type 2 Diabetes

Note: Tirzepatide is a dual GIP/GLP-1 receptor agonist

5 Regulatory & Litigation Timeline

Dec 2017
Ozempic Approved by FDA

First semaglutide product approved for Type 2 diabetes. GI side effects listed but gastroparesis risk language limited.

Jun 2021
Wegovy Approved for Weight Loss

Higher-dose semaglutide approved for chronic weight management, dramatically expanding patient population.

Sep 2023
FDA Adds Ileus Warning

FDA updates label to include warning for ileus (intestinal paralysis) based on postmarketing reports.

Oct 2023
JAMA Study on GI Adverse Events (PMID: 37796527)

Sodhi et al. publish research showing increased risk of gastroparesis, bowel obstruction, and pancreatitis with GLP-1 drugs for weight loss.

Feb 2024
MDL-3094 Created

JPML creates GLP-1 MDL in Eastern District of Pennsylvania. Initially assigned to Judge Pratter.

Jul 2024
JAMA Ophthalmology NAION Study (PMID: 38958939)

Harvard/Mass Eye and Ear study finds 4-7x higher risk of vision loss (NAION) in semaglutide users.

Sep 2024
Science Day in MDL

Court holds Science Day to understand GLP-1 mechanisms and gastroparesis diagnosis issues.

Jan 2025
Pulmonary Aspiration Warning Added

FDA updates label warning about aspiration risk during general anesthesia due to delayed gastric emptying.

Aug 2025
78-Page Gastroparesis Diagnosis Ruling

Judge Marston issues major ruling on gastroparesis diagnosis requirements after 3,700+ pages of briefing and evidentiary hearings.

Oct 2025
FDA Updates Severe GI Warning

Label updated: "OZEMPIC is not recommended in patients with severe gastroparesis."

Dec 2025
NAION MDL-3163 Created

Separate MDL created for vision loss (NAION) claims, also assigned to Judge Marston in E.D. Pennsylvania.

6 Do You Qualify for Compensation?

You may be eligible to file a claim if you meet these criteria:

Eligibility Requirements

  • Took a GLP-1 drug — Ozempic, Wegovy, Rybelsus, Mounjaro, Zepbound, Trulicity, Victoza, Saxenda, or similar
  • Experienced a qualifying injury — Gastroparesis (with gastric emptying study), intestinal obstruction/ileus, severe pancreatitis, or other serious GI complications
  • Medical documentation — Records showing drug use and diagnosis of the qualifying condition
  • Within statute of limitations — Generally 2-3 years from injury discovery, varies by state
Important Note on Gastroparesis: Judge Marston's August 2025 ruling addressed diagnostic requirements. For strongest claims, plaintiffs should have a gastric emptying study (scintigraphy) confirming delayed stomach emptying.
Vision Loss / NAION Claims: If you experienced sudden vision loss after taking GLP-1 drugs, see MDL-3163 instead.

7 Frequently Asked Questions

What is gastroparesis and how is it diagnosed?
Gastroparesis is a condition where the stomach cannot empty food properly. It's diagnosed through a gastric emptying study (scintigraphy) where you eat a meal containing a small amount of radioactive material and imaging tracks how quickly food leaves your stomach. Diagnosis typically requires more than 10% retention at 4 hours.
Doesn't the drug label warn about delayed gastric emptying?
Yes, delayed gastric emptying is listed as an intended mechanism of action. However, plaintiffs argue the labels did not adequately warn that this effect could persist after stopping the drug or progress to severe, pathological gastroparesis. The October 2025 label update adding "not recommended in patients with severe gastroparesis" came after thousands of injury reports.
What's the difference between MDL-3094 and MDL-3163?
MDL-3094 covers gastrointestinal injuries (gastroparesis, ileus, intestinal obstruction). In December 2025, a separate MDL-3163 was created specifically for NAION (vision loss) claims. Both are assigned to Judge Marston in the Eastern District of Pennsylvania.
Are compounded/generic semaglutide products included?
The MDL focuses on brand-name products from Novo Nordisk and Eli Lilly. The FDA has issued warnings about compounded semaglutide products, noting 605+ adverse event reports for compounded semaglutide as of July 2025. Compounded products have separate legal issues regarding dosing errors and salt form differences.
When will bellwether trials begin?
Expert depositions completed in April 2026 and summary judgment briefing was submitted on April 30, 2026 with full briefing through July 2026. Daubert motions are also fully briefed. Bellwether trials are expected to begin mid-to-late 2026 at the earliest, depending on the outcome of pending motions. No settlements have been announced as of May 2026.
What about the thyroid cancer boxed warning?
GLP-1 drugs carry a boxed warning about thyroid C-cell tumors based on rodent studies. The label states the drug is contraindicated in patients with personal or family history of medullary thyroid carcinoma (MTC) or MEN 2 syndrome. The human relevance of the rodent findings hasn't been determined.

Sources & References

9 official sources cited

• Judicial Panel on Multidistrict Litigation (JPML) — Official MDL statistics

• FDA DailyMed/NIH National Library of Medicine — Ozempic Prescribing Information (October 2025)

• Hathaway JT, et al. "Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide." JAMA Ophthalmol. 2024;142(8):732-739 (PMID: 38958939)

• Sodhi M, et al. "Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss." JAMA. 2023;330(18):1795-1797 (PMID: 37796527)

• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) — Gastroparesis information

• FDA Drugs@FDA Database — Drug approval histories and supplements

• CDC National Diabetes Statistics Report (May 2024)

• FDA.gov — "FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss" (September 2025)

• U.S. District Court, Eastern District of Pennsylvania — MDL-3094 docket

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