Ozempic Lawsuit: Gastroparesis MDL 3094 and NAION Vision Loss MDL 3163

Ozempic, Wegovy, and Rybelsus are semaglutide drugs made by Novo Nordisk. Trulicity and Mounjaro are made by Eli Lilly. All are glucagon-like peptide-1 receptor agonists (GLP-1 RAs), prescribed for type 2 diabetes or long-term weight management. They slow how fast the stomach empties, which is part of how they reduce appetite.

The court overseeing the federal cases describes them as personal injury actions in which each plaintiff says the drugs caused gastrointestinal injuries such as gastroparesis, ileus or intestinal obstruction, cholecystitis, and severe nausea and vomiting. The claims say the manufacturers knew or should have known of these risks, failed to warn patients and doctors adequately, and made misleading statements about safety. Novo Nordisk and Eli Lilly deny the allegations.

Gastroparesis and bowel obstruction claims (MDL 3094)

Gastroparesis means the stomach empties far too slowly, causing vomiting, pain, and malnutrition. Ileus is a stall in the intestines that can mimic a blockage. In September 2023, the FDA-approved Ozempic label was updated to list ileus among reports received after approval, with the label noting that voluntary reports make it hard to establish cause.

NAION vision loss claims (MDL 3163)

Non-arteritic anterior ischemic optic neuropathy (NAION) is a loss of blood flow to the optic nerve that can cause sudden, often permanent, vision loss in one eye. These cases allege semaglutide and other GLP-1 drugs raise the risk. On June 6, 2025, the European Medicines Agency's safety committee concluded that NAION is a very rare side effect of semaglutide, meaning it may affect up to 1 in 10,000 people taking it. The agency said large studies in adults with type 2 diabetes suggested roughly a two-fold higher risk compared with people not taking the drug.

These are individual cases gathered into a mass tort, not a class action. No court has found that the drugs caused anyone's injuries.

The federal cases are centralized as a multidistrict litigation in the U.S. District Court for the Eastern District of Pennsylvania before Judge Karen Spencer Marston.

Early in MDL 3094, the court chose to resolve three "cross cutting" questions before bellwether trials: (1) whether gastroparesis can be reliably diagnosed without a gastric emptying study, (2) preemption and the adequacy of the warnings, and (3) general causation. On August 15, 2025, Judge Marston held that plaintiffs' experts could not diagnose drug-induced gastroparesis from symptoms alone and that objective testing of delayed gastric emptying is required. Cases without that proof face dismissal of their gastroparesis claims.

Issues 2 and 3 went through expert briefing in 2026, and the court held a Rule 702 evidentiary hearing (often called a Daubert hearing) on them from September 14 to 18, 2026. How the judge rules on the experts and on preemption will decide how many cases move toward bellwether trials. No trial date had been set.

The NAION cases are at an earlier stage, with leadership appointed and early proceedings on the science.

The schedule leading to the September hearing was set in Case Management Order No. 32 on April 30, 2026: motions to exclude experts and summary judgment motions were due May 19, 2026, oppositions in June, and replies by July 15 and August 7, 2026. Judge Marston also holds monthly in-person status conferences with leadership counsel, which the public can watch remotely under the court's posted instructions. Every one of the 216 cases in the NAION MDL was still pending on September 1, 2026, which reflects how new that docket is.

Attorneys handling these cases generally screen for:

• The drug. Ozempic, Wegovy, Rybelsus, Trulicity, or Mounjaro for the GI cases. Pharmacy records are the best proof.
• A qualifying GI injury with objective proof. For gastroparesis, that now means a gastric emptying study. Accepted methods discussed in the case include gastric scintigraphy, a breath test, and a wireless motility capsule. Ileus or obstruction usually shows up on imaging or in hospital records.
• Or a NAION diagnosis from an eye specialist after starting a GLP-1 drug.
• Seriousness. Hospital stays, surgery, feeding tubes, or permanent vision loss.

You probably do not qualify if you had the common, expected side effects (nausea, diarrhea, constipation) that resolved, if your gastroparesis was diagnosed without testing and cannot be tested now, or if you had the condition before starting the drug. Compounded semaglutide from outside pharmacies raises separate questions about who made the product; bring those records to an attorney.

No Ozempic case has gone to trial or settled, so there is no per-person figure and anyone quoting one is guessing. If the cases survive the expert and preemption rulings, settlements in drug mass torts usually score each claim by:

• the injury (test-confirmed gastroparesis, surgery for obstruction, permanent vision loss);
• hospitalization and ongoing treatment;
• lost income and effect on daily life;
• how strong the proof of drug use and timing is.

Damages in an individual case can include medical costs, lost wages, and pain and suffering. Mass tort attorneys typically work on contingency, which means no fee unless there is a recovery. See class action vs. mass tort for how these payouts differ from class settlements.

If a settlement ever comes, it will not arrive as a check in the mail to everyone who took the drug. Mass tort programs typically require each claimant to submit records proving use and injury, assign points or tiers, and then deduct attorney fees, case costs, and any health insurer or Medicare liens. People with a test-confirmed diagnosis and hospital records usually fare best in those programs.

The claims are state-law product liability claims, mainly failure to warn and misrepresentation. Two defenses dominate:

• Preemption. Brand-name drug makers argue federal law blocked them from adding the warnings plaintiffs want without FDA approval. Courts ask whether the company could have strengthened its label on its own and whether there is clear evidence the FDA would have rejected the change.
• General causation. Plaintiffs must show, with reliable expert science under Federal Rule of Evidence 702, that the drugs can cause the injury at all, before any single plaintiff proves the drug caused theirs.

The August 2025 ruling showed how strict Rule 702 can be: a diagnosis must rest on objective testing, not a clinician's impression of symptoms. That same scrutiny now applies to the warning and causation experts.

Each case is governed by the statute of limitations in the plaintiff's state for personal injury, often two or three years, and many states start the clock when you knew or should have known the injury might be linked to the drug. For many people, publicity about GLP-1 stomach injuries in 2023 or about NAION in 2024 and 2025 could be argued as the start of the clock.

The MDL allows direct filing in federal court, but that does not pause state deadlines. If you have a diagnosis, get it reviewed promptly.

Claims for a person who died, or for a minor, often follow different timing rules, and some states pause the clock while a claimant is legally incapacitated. If a family member had a serious GI injury or vision loss while on a GLP-1 drug and has since died, the estate's deadline may run from the date of death. These rules are state specific, so the safest step is an early review rather than waiting for a ruling in the MDL.

The court's MDL page lists these five brands as the drugs in the gastrointestinal cases. Mounjaro is a dual GLP-1 and GIP receptor agonist, and the court's orders group it with the others as "GLP-1 RAs." In August 2024, the court noted that the JPML was also considering whether to add cases involving Saxenda, another Novo Nordisk drug.

How the court chose to manage the cases

When the court entered Case Management Order No. 18 on August 23, 2024, there were 842 cases in the MDL, and plaintiffs' leadership told the court they knew of roughly 5,000 Novo-only cases, 1,200 Lilly-only cases, and 1,400 combined cases under investigation. Plaintiffs wanted six bellwether cases to move ahead right away; the court instead sided with the defendants and ordered early work on gastroparesis testing and on preemption and warnings, while reserving the general causation question at that time. That choice is why the August 2025 diagnosis ruling came before any trial.

The same order noted that two cases involving venous blood clots were stayed while the parties asked the JPML whether such cases belong in the MDL. As defined when it was created, the MDL covers gastrointestinal injuries, and vision loss claims now have their own MDL 3163.

What the diagnosis ruling means in practice

According to a summary of the August 15, 2025 decision, both sides' experts agreed that objective evidence of delayed gastric emptying is needed for every kind of gastroparesis except drug-induced gastroparesis. Plaintiffs' experts argued a doctor could diagnose the drug-induced form from symptoms alone; the court disagreed after reviewing clinical guidelines and literature. For a person thinking about a claim, the practical question is simple: do your records include a gastric emptying study showing delayed emptying? If not, ask your doctor whether testing is appropriate for your care, and bring the result to an attorney.

1. Keep treating and do not stop or change a prescription without your doctor. A lawsuit never replaces medical care.
2. Request your pharmacy history showing each GLP-1 fill.
3. Get the key test results: the gastric emptying study, imaging for obstruction, or the eye exam confirming NAION.
4. Write a timeline of dose increases and when symptoms started.
5. Be wary of payout promises. No settlement exists.

Independent attorneys who handle GLP-1 cases can check whether your records meet the court's standards and your state deadline. A free case review takes about two minutes. Related reading: what an MDL is, the Depo-Provera lawsuit, and the metformin contamination lawsuit.