Novo Nordisk and Eli Lilly GLP-1 injury MDL tops 4,000 cases as briefing closes
The lawsuits do not change what the labels say or what doctors prescribe, and no settlements have been announced.
Summary judgment briefing in the federal litigation over GLP-1 medications ran through July 2026, closing a phase in which a judge can decide whether cases go to trial at all [1]. The consolidated case, known as MDL 3094, now holds about 4,022 pending lawsuits against Novo Nordisk and Eli Lilly [1].
MDL 3094 was created in February 2024 and sits before Judge Karen S. Marston in the Eastern District of Pennsylvania [1]. About 4,056 cases have been filed in total [1]. The page tracking the docket describes growth of 202% since January 2025 in one section and 195% in another [1]. Roughly 75% of complaints allege gastroparesis, sometimes called stomach paralysis, 18% allege ileus, and 8% allege gallbladder injuries [1].
The products named in the litigation include Ozempic, Wegovy and Rybelsus, which are semaglutide; Mounjaro and Zepbound, which are tirzepatide; and Trulicity, which is dulaglutide [1]. Vision loss claims are handled separately in MDL-3163, created in December 2025, which has about 200 cases and is also before Judge Marston [1].
Expert depositions finished in April 2026. The deadline for Daubert motions, the challenges that determine which expert opinions a jury can hear, was April 28, 2026, and those motions are now fully briefed [1]. No date has been reported for a hearing on them, and the specific arguments raised in the summary judgment motions have not been disclosed.
Judge Marston has required objective diagnostic testing for gastroparesis claims [1]. Per the National Institute of Diabetes and Digestive and Kidney Diseases, diagnosis requires a gastric emptying study showing more than 10% retention at four hours [1].
The FDA added an ileus warning to the label in September 2023, an aspiration warning in January 2025, and stated in October 2025 that "OZEMPIC is not recommended in patients with severe gastroparesis" [1]. An October 2023 study by Sodhi and colleagues in JAMA found that patients using GLP-1 drugs for weight loss had 3.67 times the risk of gastroparesis, 4.22 times the risk of bowel obstruction and 9.09 times the risk of pancreatitis [1].
The docket page is inconsistent about trial timing. Its key takeaways say first bellwether trials are expected in mid-2026, while the same page says selection is expected around mid-2026 with first trials possible in late 2026 [1]. Legal analysts estimate total liability across both MDLs could exceed $2 billion, and mass settlements are considered unlikely before late 2027 [1]. No settlements have been announced [1].
Why it matters for patients
The litigation has not changed the FDA-approved labels, the approved uses of these drugs, or what any clinician prescribes [1]. Nothing in the docket record shows money paid to any patient, and no settlement has been announced [1].
People who believe they were injured may face a specific hurdle. For gastroparesis claims, the court has required objective diagnostic testing, and the commonly cited standard is a gastric emptying study showing more than 10% retention at four hours [1]. Many cases will turn on whether that testing exists.
The MDL covers brand-name products from Novo Nordisk and Eli Lilly [1]. Compounded semaglutide is not part of it; the FDA has reported more than 605 adverse event reports for compounded semaglutide as of July 2025, and those products raise separate legal questions about dosing errors and differences in drug form [1].
Vision loss claims follow a different path. MDL-3163 covers NAION, and the page notes there is no U.S. warning for that condition [1]. Injuries listed on the labels include acute pancreatitis, acute kidney injury, gallbladder disease, pulmonary aspiration during anesthesia, and a boxed warning about thyroid C-cell tumors based on rodent studies, whose human relevance has not been determined [1].
What happens next
Bellwether trial selection is expected around mid-2026, with the first trials possible in late 2026 depending on pending rulings [1]. As of September 2026, the page lists no new updates and no settlements [1]. The page also states that claims are generally subject to a two- to three-year window from discovery of an injury, varying by state [1].
Sources
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