Ozempic and Mounjaro injury lawsuits top 4,000 cases as vision claims grow
More than 4,200 GLP-1 injury lawsuits are now before one Philadelphia judge, with vision-loss claims growing, but no trial or settlement has resolved any of them.
As of September 2026, 4,022 cases were pending in the federal multidistrict litigation for gastrointestinal injuries linked to GLP-1 medications, and roughly 200 were pending in a separate docket for NAION vision loss [1][2]. Both are before Judge Karen S. Marston in the Eastern District of Pennsylvania [1][2]. No trials have been held and no settlement has been announced [1][2].
Two dockets, different injuries
The gastrointestinal MDL, MDL-3094, was created in February 2024, when a federal panel combined 55 lawsuits [1]. The docket has grown quickly: 1,331 cases in January 2025 and 4,022 in September 2026, a rise of about 202% [2]. Total filings in that MDL are listed at 4,056 [2]. About 75% of complaints allege gastroparesis, also called stomach paralysis; 18% allege ileus, a blockage of the intestine; and 8% allege gallbladder injuries [2]. Defendants include Novo Nordisk, which makes Ozempic, Wegovy and Rybelsus, and Eli Lilly, which makes Mounjaro, Zepbound and Trulicity [2].
The vision docket, MDL-3163, was approved on December 15, 2025 [1]. Its size is reported at 216 pending cases in one count and about 200 in another [1][2]. The claims involve NAION, a rare blockage of blood flow to the optic nerve that usually affects one eye and is typically permanent [1]. About 15% of people who develop NAION in one eye develop it in the other within five years, and roughly 20% see some improvement, with full recovery rare [1]. A 2024 study in JAMA Ophthalmology found that people with obesity taking semaglutide had more than seven times the risk of NAION, and people with Type 2 diabetes had four times the risk [1]. Another account of the study describes a four- to sevenfold higher risk [2]. No NAION warning has been added to U.S. labels [2].
Where the cases stand
In August 2025, Judge Marston issued a 78-page ruling on how gastroparesis is diagnosed, after more than 3,700 pages of briefing; the ruling requires objective testing, typically a gastric emptying study showing more than 10% retention at four hours [2]. In October 2025, the Ozempic label was updated to say the drug is "not recommended in patients with severe gastroparesis" [2]. A "Science Day" for the vision-loss cases was scheduled for June 3, 2026, where lawyers and medical experts present evidence to the judge [1]. In state court, the New Jersey Supreme Court approved consolidating gastroparesis and vision-loss lawsuits into two multicounty litigations in October 2025 [1].
On the federal schedule, the deadline for Daubert motions, which challenge expert testimony, was April 28, 2026, and summary judgment briefing ran through July 2026 [2]. As of August 25, 2026, that summary judgment process was playing out for the gastroparesis cases [1]. The FDA had received more than 207,000 adverse event reports related to Ozempic, Wegovy, Zepbound and Mounjaro as of May 20, 2026 [1].
Why it matters for patients
The lawsuits are allegations that have not been tested at trial, and none has produced a verdict or settlement [1][2]. Nothing about the litigation changes what these drugs do or how they are prescribed, and the label changes made so far — the 2023 ileus warning, the January 2025 aspiration warning and the October 2025 gastroparesis language — came through the FDA, not the courts [1][2].
For anyone weighing a claim, the practical details are procedural. Filing deadlines vary by state; one account says most places allow three or four years to file while some allow as little as one [1], and another says two to three years from discovery of the injury [2]. Gastroparesis claims are strongest when backed by a gastric emptying study, and NAION claims generally involve a diagnosis of that specific condition [1][2]. Gastroparesis has no cure, though treatments may offer temporary relief [1].
What happens next
Bellwether trial selection is expected around mid-2026, with the first trials possible in late 2026 at the earliest [2]. Mass settlements are considered unlikely before late 2027, and legal analysts estimate total liability across both dockets could exceed $2 billion [2]. If a settlement is reached, individual amounts would depend on injury severity, medical history, medical bills, lost income and the evidence in each case, and no settlement amounts have been disclosed [1].
Sources
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