GLP-1 gastrointestinal MDL passes 4,000 with no trial date set

The multidistrict litigation covering gastrointestinal injury claims against GLP-1 drugmakers has passed 4,000 pending cases, according to a litigation tracker that follows monthly counts from the Judicial Panel on Multidistrict Litigation (JPML). As of September 2026, MDL 3094 held 4,022 pending cases, with 4,056 filed in total ^[1]. The JPML's own August 1, 2026 report put the count slightly lower, at 3,928, reflecting the usual lag between filings and official tallies ^[1]. Either way, the case count has grown 202% since January 2025, when it stood at 1,331 ^[1].

The MDL, based in the Eastern District of Pennsylvania before Judge Karen S. Marston, consolidates claims against Novo Nordisk (Ozempic, Wegovy, Rybelsus) and Eli Lilly (Mounjaro, Zepbound, Trulicity) ^[1][2]. Roughly 75% of complaints allege gastroparesis, or stomach paralysis; 18% allege ileus, a type of intestinal blockage; and 8% involve gallbladder injuries ^[1]. A separate MDL, created in December 2025 and also assigned to Judge Marston, now handles about 200 vision-loss claims tied to NAION, a form of optic nerve damage ^[1].

The case sits behind a set of expert-evidence rulings rather than a firm trial calendar. Daubert motions, which test whether expert testimony meets legal standards, were due April 28, 2026, and summary judgment briefing was expected to run through July 2026 ^[1]. Bellwether trials — test cases used to gauge how juries might rule on common claims — are still expected around mid-2026, with actual trials possible in late 2026 ^[1]. Legal analysts cited by the tracker say mass settlements are unlikely before late 2027, and no settlements have been announced ^[1]. Analysts also estimate total liability across both the gastrointestinal and vision-loss MDLs could exceed $2 billion, though this is an estimate, not a court finding ^[1].

The litigation follows a string of regulatory and research developments. In October 2023, a JAMA research letter by Sodhi and colleagues found GLP-1 users had roughly 3.67 times the risk of gastroparesis, 4.22 times the risk of bowel obstruction, and 9.09 times the risk of pancreatitis compared with people taking bupropion-naltrexone (Contrave) ^[1][2]. Separately, in 2023 the FDA added an ileus warning to labels after receiving 33 reports of blockages among semaglutide users, including two deaths ^[2]. In October 2025, the FDA further updated Ozempic's label to state the drug "is not recommended in patients with severe gastroparesis" ^[1][2].

Why it matters for patients

For people currently taking or considering semaglutide (Ozempic, Wegovy, Rybelsus) or tirzepatide (Mounjaro, Zepbound), the growing case count does not by itself prove the drugs caused any individual's injury; no verdicts, trials, or settlements have occurred in this MDL ^[1][2]. The court has required objective diagnostic testing, such as a gastric emptying study, for gastroparesis claims, which means legal recognition of an injury depends on specific medical documentation, not just symptoms ^[1]. Patients weighing risks may find it useful to know that delayed gastric emptying is a known, intended effect of these drugs, and the legal dispute centers on when and how that effect became a more severe, undisclosed harm ^[1].

What happens next

Summary judgment briefing was expected to continue through July 2026 ^[1]. Bellwether trial selection remains tied to the outcome of pending Daubert and summary judgment rulings, with trial selection expected around mid-2026 and first trials possible in late 2026 ^[1]. The separate NAION-focused MDL 3163 will continue to develop on its own track, also before Judge Marston ^[1].