Quick answer: the “Ozempic lawsuit” is really two groups of federal cases before Judge Karen S. Marston in the Eastern District of Pennsylvania. MDL 3094 covers stomach and bowel injuries such as gastroparesis (“stomach paralysis”), with 4,025 pending actions as of October 1, 2026. MDL 3163 covers sudden vision loss from NAION, with 247.[1][2][3] The court records we reviewed show no settlement and no trial date. In October 2026, the judge was still weighing expert evidence on whether the drugs can cause the injuries and whether the labels were adequate.[9]
This page uses only court records and the FDA-approved label. It is not legal advice, and we do not link to or name law firms. For the drug itself, see our semaglutide profile.
Two separate federal cases
A multidistrict litigation (MDL) groups many individual lawsuits in one court for shared pretrial work. It is not a class action; each person’s case stays separate.
| MDL 3094 | MDL 3163 | |
|---|---|---|
| Alleged injury | Gastrointestinal (GI) injuries, including gastroparesis | Non-arteritic anterior ischemic optic neuropathy (NAION) |
| Centralized | February 2, 2024 | December 15, 2025 |
| Pending actions (Oct. 1, 2026) | 4,025 | 247 |
| Judge | Karen S. Marston | Karen S. Marston |
Sources: Judicial Panel on Multidistrict Litigation statistics.[3][4]
Both MDLs name Novo Nordisk, which makes Ozempic, Wegovy and Rybelsus, and Eli Lilly, which makes Trulicity, Mounjaro and Zepbound. In MDL 3094, both companies deny the allegations.[1][10]
The stomach paralysis cases (MDL 3094)
The GI cases involve eight drugs: Ozempic, Wegovy, Rybelsus, Victoza and Saxenda from Novo Nordisk, and Trulicity, Mounjaro and Zepbound from Lilly.[5] When the Judicial Panel grouped the cases, it said they share questions about whether the companies knew or should have known the drugs can cause gastroparesis and other GI injuries, and whether they warned adequately.[1]
The master complaint lists injuries including severe cyclical vomiting, gastroparesis, ileus (bowel that stops moving), intestinal obstruction, gallbladder injury, vitamin deficiency, Wernicke’s encephalopathy, ischemic bowel and necrotizing pancreatitis.[5]
Key rulings so far
- Gastroparesis needs a test (August 15, 2025). Judge Marston ruled that anyone claiming drug-induced gastroparesis must have had a gastric emptying study confirming delayed emptying. It had to be properly performed at the time of diagnosis, by scintigraphy, breath test or wireless motility capsule. The court acknowledged that some plaintiffs will be unable to prove gastroparesis because of this.[6]
- Motion to dismiss (August 15, 2025). The court let some claims proceed, including express and implied warranty, negligent undertaking, and fraud claims tied to what the FDA-approved labels said. It dismissed others, including design defect, negligence and medical monitoring, with permission to file amended versions.[5] At that point there were more than 2,600 cases.[5]
- Animal study slides (October 23, 2025). Plaintiffs asked for tissue slides from 22 animal studies the companies ran on these drugs. The court denied the request, finding the slides only minimally relevant and their production out of proportion to the needs of the case.[7]
What’s happening now
The court ordered early, limited discovery on three “cross cutting” issues: (1) diagnosing gastroparesis, (2) federal preemption and the adequacy of the warnings, and (3) general causation, meaning whether the drugs can cause these injuries at all.[7] Issue 1 was decided in 2025. For issues 2 and 3:
- Expert-exclusion (Rule 702) and summary judgment briefing ran from May to August 2026.[8]
- An evidentiary hearing on the expert motions was scheduled for September 2026.[8]
- Closing arguments were scheduled for October 13, 2026.[9]
A ruling on these issues could narrow the cases or let them move toward bellwether (test) trials. No ruling had been posted on the court’s MDL page when we checked on October 18, 2026.[1]
The vision loss cases (MDL 3163)
NAION is a type of optic nerve damage. The court describes it as a condition that results in sudden, permanent vision loss.[10] These cases involve Ozempic, Wegovy, Rybelsus, Saxenda, Trulicity, Mounjaro and Zepbound. Plaintiffs bring claims for failure to warn, design defect and breach of warranties.[10]
- Size: more than 130 cases in June 2026. Only 19 of 137 cases were against Lilly as of June 15, 2026.[10] By October 1, 2026, 247 actions were pending.[3]
- Schedule: on July 2, 2026, the court ordered early discovery and motions on general causation and preemption/warning adequacy, the same approach used in MDL 3094.[10]
- Records required: the court asked the parties to agree on a schedule for plaintiffs to provide fact sheets and medical records confirming proof of use and proof of diagnosis.[10]
- Related state cases: the order notes related state court cases that, as of July 2026, were all still at the pleadings stage.[10]
The same order notes that Novo Nordisk stopped marketing the Rybelsus brand name in 2026 and now sells the semaglutide pill as Ozempic or Wegovy tablets, depending on dose.[10] See Rybelsus vs Ozempic for the difference.
What the Ozempic label says
The lawsuits turn partly on the FDA-approved label. Here is what the current U.S. Ozempic label (revised June 2026) states:[11]
- Severe GI reactions: Ozempic “has been associated with gastrointestinal adverse reactions, sometimes severe.” In trials, these occurred in 0.4% of people on 0.5 mg and 0.8% on 1 mg, versus 0% on placebo. The label says Ozempic is not recommended for people with severe gastroparesis.
- Post-marketing reports: ileus, intestinal obstruction, severe constipation including fecal impaction, and acute pancreatitis including necrotizing pancreatitis, sometimes fatal.
- Anesthesia: rare reports of pulmonary aspiration in people having surgery or deep sedation, because Ozempic slows stomach emptying. See GLP-1s before surgery.
- Vision: in its section on diabetic retinopathy complications, the label tells patients to report vision changes. The label does not list NAION.
More on these side effects is in our guides to semaglutide and heartburn, GLP-1 eye health and the gallbladder.
If you have symptoms
Medical care comes first. The label tells patients to contact their clinician about severe or persistent stomach or bowel symptoms.[11] Treat sudden vision loss in one eye as an emergency.
- Don’t stop or restart the drug without talking to your prescriber.
- Keep records: prescriptions, dates, doses, test results and imaging.
- You or your clinician can report side effects to the FDA through MedWatch or at 1-800-FDA-1088.[11][12]
Questions to ask your clinician
- Could my symptoms be from the medicine, and do I need a gastric emptying study or an eye exam?
- Should I change my dose or pause the drug?
- What symptoms should send me to urgent care?
- Is a different medicine safer for my history? Compare options in Wegovy vs Ozempic.
