Ozempic Lawsuit: Injuries, Allegations, and Case Status

The Ozempic lawsuit is a mass tort consolidating thousands of individual product liability claims against Novo Nordisk and Eli Lilly, alleging their GLP-1 receptor agonist drugs caused severe gastrointestinal injuries and sudden vision loss without adequate warnings. As of June 2026, 3,763 cases are pending in the primary federal multidistrict litigation in the Eastern District of Pennsylvania, with no settlements or verdicts yet and bellwether trials potentially beginning in late 2026 or early 2027.¹ The drugs at issue include Ozempic, Wegovy, and Rybelsus (Novo Nordisk) and Mounjaro and Trulicity (Eli Lilly).²

What Injuries the Lawsuits Cover

Federal cases are split across two multidistrict litigations, both before Judge Karen Spencer Marston in the Eastern District of Pennsylvania.³

Gastrointestinal Injuries

The larger MDL (3094), established in February 2024, covers claims that GLP-1 drugs cause gastroparesis, ileus, bowel obstruction, gallbladder disease, pancreatitis, and related conditions.²

Gastroparesis is the most common claim. It is a condition where the stomach muscles stop functioning properly and food sits undigested, producing severe bloating, persistent vomiting, malnutrition, and chronic pain. Plaintiffs argue that while the Ozempic label mentioned “delayed gastric emptying” in the context of drug interactions, it did not disclose the severity or permanence of full-blown stomach paralysis until years after the drug reached the market.²

Other alleged gastrointestinal injuries include ileus (intestines that stop moving food through the digestive tract), bowel obstruction sometimes requiring surgery, necrotizing pancreatitis, gallbladder disease leading to emergency removal, and chronic vomiting severe enough to require intravenous fluids.²

Vision Loss (NAION)

A separate, newer MDL (3163), established in December 2025, consolidates claims that semaglutide causes non-arteritic anterior ischemic optic neuropathy, a form of sudden and often permanent optic nerve damage that patients frequently notice upon waking. That MDL currently holds roughly 73 to 100 cases and is growing.⁴¹

A 2024 study in JAMA Ophthalmology by researchers at Harvard Medical School and Massachusetts Eye and Ear examined 16,827 patients and found that diabetic patients taking semaglutide had a 4.28 times higher risk of developing NAION compared to those on other diabetes medications. For patients using semaglutide for weight loss, the risk was 7.64 times higher.⁵ A Danish study of more than 424,000 Type 2 diabetes patients found a 2.19 times higher risk.⁴ The Harvard researchers have described their findings as a “potential but not definitive link,” noting the study is observational.⁶

As of June 2026, the FDA has not mandated a specific NAION warning on Ozempic’s U.S. label, though the European Medicines Agency classified NAION as a “very rare” side effect in May 2025 and the World Health Organization issued an advisory in June 2025.⁷

What the Litigation Does Not Center On

Thyroid cancer, pancreatic cancer, and standalone pancreatitis claims occupy a smaller and more contested corner of the litigation. The FDA has kept a boxed warning on semaglutide regarding medullary thyroid cancer risk since the drug’s 2017 approval, based on rodent studies, but a 2025 study of more than 351,000 adults with Type 2 diabetes found no statistically significant overall increase in thyroid cancer risk among GLP-1 users, attributing the observed association to detection bias rather than causation.⁸ Pancreatitis is included within the MDL but is treated as a precursor condition that can lead to gastroparesis rather than as a standalone qualifying injury.⁹

What the Drugmakers Are Accused of Doing

The core theory is failure to warn. Plaintiffs allege Novo Nordisk and Eli Lilly knew, or should have known, that their GLP-1 drugs carried a significantly higher risk of severe side effects than the original labels disclosed, and that both companies delayed or minimized warnings to protect sales.²

The Ozempic labeling timeline is central to that argument:

2017: FDA approved Ozempic with a boxed warning about thyroid C-cell tumors and standard warnings about pancreatitis and common gastrointestinal side effects like nausea and vomiting.¹⁰
September 2023: The FDA added “ileus” under postmarketing adverse reactions after reports of intestinal blockages accumulated. At that point, FDA data showed 8,571 reports of gastrointestinal disorders associated with semaglutide, including 33 cases of ileus and two reported deaths.¹¹
January 2025: The label added a specific section on “Severe Gastrointestinal Adverse Reactions” and warned about fatal and non-fatal hemorrhagic or necrotizing pancreatitis.¹⁰
October 2025: The label was revised to state that “Ozempic is not recommended in patients with severe gastroparesis.”¹²

The current label, revised May 2026, also lists intestinal obstruction, severe constipation including fecal impaction, acute kidney injury, and pulmonary aspiration among postmarketing adverse reactions.¹² Plaintiffs contend these changes came years too late.

How the Companies Are Defending Themselves

Novo Nordisk and Eli Lilly rest their defense on three main arguments. First, they contend the FDA-approved labels were adequate as a matter of law and that federal regulatory approval preempts state-law failure-to-warn claims. Judge Marston designated preemption and warning adequacy as a “cross-cutting” issue for early resolution, and summary judgment briefing has been underway through 2026.¹³

Second, they invoke the learned intermediary doctrine, arguing that a drugmaker’s duty to warn is satisfied by informing the prescribing physician, not the patient directly. Plaintiffs are pushing back with an “overpromotion exception” theory, pointing to what they describe as $884 million in Novo Nordisk television advertising since July 2018 and $34 million paid to physicians for consulting and promotional speaking in 2022 alone.¹⁴ Judge Marston has deferred discovery into the marketing campaigns until she rules on whether those claims survive preemption.¹³

Third, the defendants challenge causation. Gastroparesis and ileus, they argue, are independently associated with diabetes and obesity, the very conditions the drugs treat.¹⁴ For gallbladder claims, they contend rapid weight loss, not the medication, is responsible.¹⁵

Where the Cases Stand

No settlements, verdicts, or payouts have occurred as of June 2026.² The often-cited “$2 billion” figure is not a settlement or a court-ordered amount. It is an analytical projection from mid-2025 estimating Novo Nordisk’s total potential financial exposure across thousands of cases.¹⁶ Pharmaceutical MDLs of this scale often take three to six years from consolidation to resolution, placing a potential global settlement window somewhere between 2027 and 2029.¹⁷

Two rulings from Judge Marston are shaping the path forward. In August 2025, she ruled on a defense motion to dismiss 12 of the 17 counts in the master complaint. She dismissed the design defect claims and medical monitoring requests, found certain fraudulent omission allegations “too vague,” but sustained the majority of the complaint and allowed plaintiffs to amend.³¹⁸ In the same ruling, she struck two plaintiffs’ experts and ordered that any plaintiff claiming gastroparesis must support the diagnosis with objective testing such as a gastric emptying study.¹⁹

In May 2026, she denied Eli Lilly’s motion to restrict expert testimony from former FDA Commissioner Dr. David Kessler, allowing plaintiffs to present his opinions on how GLP-1 drugs affect gastric emptying, why he believes the warning labels were inadequate, and what he describes as flaws in Eli Lilly’s internal safety analysis.²⁰

Who Can File a Claim

This is a mass tort, not a class action. Each plaintiff files an individual lawsuit that gets consolidated into the MDL for pretrial proceedings, and each person must separately establish their claim.²¹ To qualify, you generally need the following:

Use of a qualifying brand-name GLP-1 drug: Ozempic, Wegovy, Rybelsus, Mounjaro, Zepbound, Victoza, Saxenda, or Trulicity. Compounded versions are excluded.²¹
A qualifying diagnosis. For the gastrointestinal MDL, accepted injuries include gastroparesis (supported by a gastric emptying study, per Judge Marston’s ruling), necrotizing pancreatitis, ileus or bowel obstruction, gallbladder removal, severe vomiting requiring IV fluids, and gastrointestinal injury requiring surgery. For the vision MDL, qualifying conditions include NAION, optic nerve stroke, and sudden blindness.²¹
Documentation: prescription records, pharmacy receipts, hospitalization records, and specialist consultations linking the medication to the injury.²¹
Timely filing. State statutes of limitations typically run one to three years from the date the injury was discovered or should have been discovered.²²

People who had bariatric surgery or abdominal radiation within 12 months before symptom onset are generally excluded.²¹ Filing does not require stopping the medication, and attorneys handling these cases typically work on contingency, collecting fees only if the case results in a recovery.²³

1
MDL Update. Glucagon-Like Peptide-1 Receptor Agonists MDL 3094
2
Motley Rice. Ozempic Lawsuit
3
Verus LLC. Ozempic MDL GLP-1 Lawsuits Complete Overview
4
Seeger Weiss. GLP-1 NAION Vision Loss Lawsuit
5
JAMA Network. Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide
6
NANOS. Semaglutide and NAION Patient Information
7
Drugwatch. Ozempic Lawsuit
8
Mayo Clinic. GLP-1RA and Thyroid Cancer: New Study Suggests Detection Bias Not Causation
9
TruLaw. Ozempic Pancreatitis Lawsuit
10
FDA. Ozempic Prescribing Information
11
The Hill. Ozempic Label Now Notes Potential Side Effect of Intestinal Blockage
12
Novo Nordisk. Ozempic Prescribing Information
13
U.S. District Court, Eastern District of Pennsylvania. MDL 3094 Case Management Order No. 18
14
University of Richmond Public Interest Law Review. Informed or Influenced: An Overview of the GLP-1 Receptor Agonist MDL
15
Boesen Law. Gallbladder Removal After Ozempic
16
Robert King Law Firm. Ozempic Lawsuits Facing $2 Billion in Settlements
17
Spencer Law. Ozempic Lawsuit 2026 MDR Updates, Eligibility, Settlements
18
The Legal Intelligencer. Judge Strikes Some Claims, Plaintiffs’ Experts in Ozempic Lawsuits
19
Robert King Law Firm. Court Order, Gastroparesis Diagnostic Testing
20
CaseMine. In Re GLP-1 RAs Products Liability Litigation, MDL 3094
21
Slepkow Law. Wegovy and Ozempic Lawsuits
22
Morris James. Who Is Eligible to File a GLP-1 Vision Loss Lawsuit
23
Davis Saperstein & Salomon. Ozempic Lawsuit Attorney