Ozempic / GLP-1 gastroparesis lawsuit MDL 3094: the 3,600+ pending cases, the gastroparesis and intestinal obstruction claims, the gastric emptying study evidence standard, and the separate MDL 3163 for vision loss
If you took Ozempic, Wegovy, Rybelsus, Mounjaro, or Zepbound and subsequently developed gastroparesis (stomach paralysis), severe intestinal blockage, or persistent vomiting, this is the active litigation that may apply to your case. The MDL is In Re: GLP-1 Receptor Agonists Products Liability Litigation, MDL 3094, consolidated in the U.S. District Court for the Eastern District of Pennsylvania before Judge Karen Spencer Marston. As of May 2026, the MDL has more than 3,600 pending cases, and the case count has been growing steadily since consolidation.
The litigation alleges that the manufacturers of GLP-1 receptor agonist drugs failed to adequately warn patients and healthcare providers about the risk of serious gastrointestinal injuries. The drugs slow gastric emptying as part of their mechanism of action (which contributes to the appetite-suppression and blood-sugar-control effects), but the plaintiffs allege that the manufacturers knew or should have known that this mechanism could produce severe and sometimes permanent gastrointestinal dysfunction, and failed to warn adequately.
The substantial popularity of these drugs (tens of millions of prescriptions written in the United States, driven by both diabetes management and off-label weight loss use) means the potential plaintiff population is large. The case count is expected to continue rising as more patients recognize that their symptoms may be connected to their medication.
The drugs and the mechanism
GLP-1 receptor agonists work by mimicking the glucagon-like peptide-1 hormone, which regulates blood sugar and appetite. Part of the mechanism involves slowing gastric emptying (the rate at which food leaves the stomach and enters the small intestine). The slowed gastric emptying contributes to the feeling of fullness and the reduced appetite that drive both the diabetes-management and the weight-loss effects.
The drugs at issue:
Semaglutide (Novo Nordisk): marketed as Ozempic (diabetes), Wegovy (weight loss), and Rybelsus (oral diabetes formulation). Semaglutide was originally FDA-approved in 2017 for type 2 diabetes management.
Tirzepatide (Eli Lilly): marketed as Mounjaro (diabetes) and Zepbound (weight loss). Tirzepatide is a dual GIP/GLP-1 receptor agonist.
The plaintiffs allege that the slowed gastric emptying, in some patients, progresses to gastroparesis (a condition where the stomach cannot empty normally), ileus (intestinal paralysis), or intestinal obstruction. These conditions can be severe, can require hospitalization and surgery, and in some cases can be permanent.
The injuries
The gastrointestinal injuries at the center of MDL 3094:
Gastroparesis (stomach paralysis). The stomach loses its ability to empty normally, causing severe nausea, vomiting, abdominal pain, early satiety, and malnutrition. Gastroparesis can be diagnosed through a gastric emptying study (GES), which measures the rate at which food leaves the stomach. Gastroparesis can be temporary or permanent.
Ileus (intestinal paralysis). The intestines lose their normal muscular activity (peristalsis), preventing the passage of intestinal contents. Ileus can cause severe pain, distension, vomiting, and can require hospitalization.
Intestinal obstruction/blockage. A blockage in the intestines that prevents the passage of food and fluid. Bowel obstruction can be a surgical emergency.
These injuries can require hospitalization, surgery, feeding tubes, and ongoing medical management. In severe cases, the conditions are permanent and substantially affect the patient's quality of life.
The MDL structure
The Judicial Panel on Multidistrict Litigation consolidated the GLP-1 cases into MDL 3094 in February 2024, with the structure refined in September 2024. Judge Karen Spencer Marston of the Eastern District of Pennsylvania presides.
The defendants:
Novo Nordisk (Ozempic, Wegovy, Rybelsus — semaglutide products). Novo Nordisk's US headquarters are in New Jersey; the parent company is Danish.
Eli Lilly (Mounjaro, Zepbound — tirzepatide products).
The core legal theory is failure to warn: the allegation that the manufacturers knew or should have known about the gastrointestinal risks and failed to disclose them adequately on the drug labels and in physician communications. The plaintiffs point to the FDA Adverse Event Reporting System (FAERS), which has accumulated thousands of adverse event reports linking GLP-1 drugs to gastrointestinal complications, as evidence of the manufacturers' awareness.
The separate vision loss MDL 3163
In December 2025, a separate MDL was created specifically for vision loss claims: MDL 3163 covers claims that semaglutide causes NAION (non-arteritic anterior ischemic optic neuropathy), a form of sudden and potentially permanent vision loss. MDL 3163 is also assigned to Judge Marston in the Eastern District of Pennsylvania.
The vision loss litigation traces to a July 2024 study from Massachusetts Eye and Ear published in JAMA Ophthalmology (Hathaway JT, et al., JAMA Ophthalmol. 2024;142(8):732-739, PMID 38958939). The study found that patients taking semaglutide had a significantly higher risk of developing NAION compared to patients not taking the drug.
The vision loss MDL is at an earlier stage than the gastrointestinal MDL. The court scheduled a Science Day for June 2, 2026 to address the scientific evidence, and has appointed leadership counsel to organize the litigation. The NAION MDL had 86 cases as of May 2026, substantially smaller than the gastrointestinal MDL but growing.
The two MDLs are separate because the injuries, the scientific evidence, and the causation analysis differ substantially. A plaintiff with both gastrointestinal and vision injuries could have claims in both MDLs.
The procedural posture
The MDL 3094 procedural timeline is well-advanced:
Fact discovery was completed October 24, 2025 per the case management orders.
Expert disclosures followed in November and December 2025.
Expert discovery is scheduled to complete by March 2026.
Summary judgment motions are due April 2026.
Bellwether trial selection is expected in mid-2026, though specific trial dates have not been confirmed as of May 2026.
The court conducts monthly status conferences to manage the litigation. The next 12 to 24 months are critically important: the bellwether trials will establish liability findings, causation thresholds, and damages benchmarks that will anchor settlement values across the litigation.
The substantial discovery process has surfaced internal manufacturer documents regarding what the companies knew about the gastrointestinal risks and when they knew it. The adequacy of the warning labels is the central question; the internal documents are the primary evidence on the manufacturers' knowledge.
The gastric emptying study evidence standard
The strongest gastroparesis cases involve objective diagnostic confirmation through a gastric emptying study (GES). The GES measures the rate at which food leaves the stomach; delayed emptying confirms the gastroparesis diagnosis.
Cases with a confirmed GES showing delayed gastric emptying are generally considered substantially stronger from an evidentiary standpoint than cases relying on clinical symptoms alone. The GES provides objective, measurable confirmation of the injury, which is critical for both causation (linking the symptoms to gastroparesis) and damages (documenting the severity).
For patients who have been diagnosed with gastroparesis or who suspect they have the condition, the GES is the diagnostic test to discuss with a gastroenterologist. The objective documentation substantially strengthens a potential claim.
The plaintiffs must establish:
Medication history (prescription records documenting the GLP-1 drug use).
Diagnostic confirmation (the GES for gastroparesis, or equivalent objective documentation for other injuries).
Causal link (expert testimony connecting the GLP-1 drug exposure to the specific injury).
The boxed warning context
GLP-1 drugs carry a boxed warning (the FDA's most serious warning category) about the risk of thyroid C-cell tumors, based on rodent studies. The boxed warning is for a different injury (thyroid cancer) than the gastrointestinal injuries at the center of MDL 3094. The existence of the thyroid boxed warning is relevant to the litigation because it demonstrates that the manufacturers and the FDA were engaged in warning-label analysis for these drugs; the plaintiffs argue that the gastrointestinal risks should similarly have been the subject of adequate warnings.
The compounded semaglutide issue
The MDL focuses on brand-name products from Novo Nordisk and Eli Lilly. Compounded semaglutide products (made by compounding pharmacies during the period of brand-name shortage) have separate legal issues regarding dosing errors and salt-form differences.
The FDA has issued warnings about compounded semaglutide products, noting more than 605 adverse event reports for compounded semaglutide as of July 2025. The compounded products are not part of MDL 3094 (which focuses on the brand-name manufacturers), but patients injured by compounded products may have separate claims against the compounding pharmacies and the entities that marketed the compounded products.
Settlement framework expectations
There is no global settlement as of May 2026. Settlement discussions typically intensify after the first bellwether trial produces a verdict.
Legal analysts project settlement values ranging from $100,000 to over $2,000,000 per case, depending on injury severity and the strength of the evidence of corporate knowledge. The total liability across the litigation is projected to exceed $2 billion.
The valuation factors:
Injury severity (permanent gastroparesis with ongoing complications values substantially higher than temporary symptoms that resolved).
Diagnostic documentation (GES-confirmed cases value higher than symptom-only cases).
Medication history (clear prescription records for the brand-name products value higher than uncertain medication history).
Causation strength (cases with clear temporal relationship between drug use and injury onset, without confounding factors, value higher).
The substantial number of pending cases and the large potential plaintiff population make individual case-by-case settlement unrealistic. The likely framework is a structured settlement program with claim categorization and tier-based payments, similar to the framework used in other large pharmaceutical mass torts.
How GLP-1 cases compare to other mass torts
The framework shares features with several Halstonberg-covered mass torts:
Hair relaxer uterine cancer (MDL 3060) similarly involves a substantial population of product users, a failure-to-warn theory, and bellwether proceedings determining settlement values.
Elmiron pigmentary maculopathy involves a pharmaceutical product with delayed onset of injury and substantial post-market data; the vision loss component of the GLP-1 litigation (NAION) is structurally similar.
Risperdal gynecomastia involves a pharmaceutical product with substantial endocrine effects; the failure-to-warn framework is similar.
Valsartan NDMA contamination involves chemical exposure through medication; the MDL settlement framework for valsartan may inform the GLP-1 framework.
The GLP-1 litigation is distinctive in the substantial size of the user population (tens of millions of prescriptions), the dual-injury structure (gastrointestinal injuries in MDL 3094, vision loss in MDL 3163), and the substantial commercial profile of the defendants (Novo Nordisk's GLP-1 products are among the best-selling pharmaceuticals globally).
Practical guidance
For someone who took a GLP-1 drug and developed gastroparesis or another serious gastrointestinal injury:
The MDL is actively accepting new cases. Filing during the bellwether phase positions the case within the framework that will shape settlement values.
Obtain objective diagnostic documentation. The gastric emptying study (GES) is the gold standard for gastroparesis claims; the objective confirmation substantially strengthens the case. If you have symptoms but no GES, discuss the test with your gastroenterologist.
Gather your prescription records. Pharmacy records documenting which GLP-1 drug you took, the dosage, and the duration are the foundation of the medication-history element.
Document the injury timeline. The temporal relationship between drug use and symptom onset is critical for causation. Records showing symptoms developing during or after the medication period support the causal link.
For vision loss (NAION) claims, the separate MDL 3163 framework applies. The vision loss litigation is at an earlier stage; cases filed now are positioned for the developing framework.
For compounded semaglutide injuries, the claims are against the compounding pharmacies rather than the brand-name manufacturers, and are not part of MDL 3094. Counsel familiar with the compounded product issues is the appropriate contact.
Be cautious about advertised "claims companies" that are not actual law firms. The GLP-1 litigation has substantial advertising activity; counsel actively practicing in MDL 3094 is the correct contact.
The litigation is in the high-leverage phase. The next 12-24 months will define the settlement framework. Cases worked up during this phase typically benefit from the structural posture of the MDL.
For someone who took a GLP-1 drug and is concerned about potential injury but has not been diagnosed: the litigation framework applies to actual injuries, not to mere exposure. If you have symptoms, seek medical evaluation; the diagnosis (and the supporting GES) is the foundation of any potential claim.
The GLP-1 litigation is among the most significant pharmaceutical mass torts currently pending. The substantial user population, the developing scientific record, and the active bellwether proceedings make the next two years critically important for the resolution of these claims.