Ozempic & Wegovy Gastroparesis Lawsuit: MDL 3094 Status, Eligibility & What Plaintiffs Need to Know (2026)

Legal Disclaimer: This article is for general informational purposes only and is not legal advice. Individual case outcomes vary. Consult a licensed attorney in your state for advice specific to your situation.

GLP-1 Drugs Are Under Scrutiny — Here Is Why MDL 3094 Matters

Ozempic transformed diabetes management. Wegovy reshaped obesity treatment. But for a growing cohort of patients, these blockbuster GLP-1 receptor agonists left something far more disruptive than a lower A1C reading: a paralyzed stomach that cannot empty properly.

MDL 3094 — In re: Glucagon-Like Peptide-1 Receptor Agonists Products Liability Litigation — is the federal mass tort that has collected those claims into a single coordinated proceeding. As of November 2025, more than 2,900 lawsuits were pending before Judge Karen Spencer Marston in the Eastern District of Pennsylvania. The litigation targets Novo Nordisk and Eli Lilly on a core theory: they knew, or should have known, that their GLP-1 drugs could cause severe, sometimes permanent gastroparesis and intestinal obstruction — and they failed to adequately warn prescribers and patients.

This guide explains the litigation structure, who qualifies, what evidence you need, and the realistic road ahead.

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Key MDL 3094 Facts at a Glance

Element	Detail
MDL Number	3094
Full Case Name	In re: GLP-1 Receptor Agonists Products Liability Litigation
Court	US District Court, Eastern District of Pennsylvania
Judge	Hon. Karen Spencer Marston (assigned June 2024 after Judge Pratter’s passing)
Established	February 2024 (JPML Transfer Order)
Pending Cases	2,900+ as of November 2025 (check JPML statistics for current count)
Primary Defendants	Novo Nordisk; Eli Lilly
Separate NAION MDL	MDL 3163 (vision-loss claims, created December 2025 — distinct from 3094)

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Which Drugs Are Named in MDL 3094?

The litigation covers the entire GLP-1 receptor agonist class marketed by both defendants:

Novo Nordisk

• Ozempic (semaglutide injection — Type 2 diabetes)
• Wegovy (semaglutide high-dose injection — obesity/weight management)
• Rybelsus (oral semaglutide — Type 2 diabetes)
• Saxenda (liraglutide — obesity; within investigation scope)

Eli Lilly

• Mounjaro (tirzepatide — Type 2 diabetes)
• Zepbound (tirzepatide — obesity/weight management)
• Trulicity (dulaglutide — Type 2 diabetes)

All of these drugs slow gastric emptying as part of their pharmacological mechanism — the same mechanism that plaintiffs allege, when taken to an extreme, produces gastroparesis without adequate warning.

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The Legal Theory: What Plaintiffs Must Prove

Failure to Warn — The Heart of the Case

Prescribing information for GLP-1 drugs acknowledged nausea and vomiting. What plaintiffs argue was missing was adequate disclosure of the risk of chronic, clinically confirmed gastroparesis — a condition where the stomach’s motility is so impaired that normal eating becomes impossible, frequently requiring feeding tubes, repeated hospitalizations, or surgical intervention.

The legal test in most states asks: did the manufacturer provide warnings adequate to allow a reasonable physician to understand and communicate the material risks? Plaintiffs argue the answer is no. The manufacturers argue their labeling complied with FDA requirements — triggering the federal preemption defense.

The Preemption Defense — A Key Legal Battleground

Federal drug labeling preemption (from Wyeth v. Levine, 555 US 555, 2009) does not automatically bar state-law failure-to-warn claims. Plaintiffs can defeat preemption by showing the manufacturer had newly acquired information about the risk that it could have used to update labeling unilaterally under the Changes Being Effected (CBE) regulation, without prior FDA approval.

Internal documents from Novo Nordisk and Eli Lilly — clinical trial adverse event data, pharmacovigilance reports, internal safety communications — are expected to be central to this inquiry during discovery.

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Judge Marston’s September 2025 Order: Objective Diagnosis Required

One of the most consequential rulings in MDL 3094 came in September 2025, when Judge Marston issued an order clarifying which plaintiffs have sufficiently documented their injuries to proceed.

The ruling requires objective diagnostic confirmation of gastroparesis through at least one of:

1. Gastric Emptying Scintigraphy (GES) — the gold-standard nuclear medicine test measuring how quickly radiolabeled food exits the stomach
2. C-13 Breath Test — an indirect measure of gastric emptying
3. Wireless Motility Capsule (SmartPill) — a swallowed capsule recording pressure and pH throughout the GI tract

Practical implication: Plaintiffs who relied only on subjective symptom complaints without formal diagnostic testing face a heightened risk of dismissal. If you have not undergone objective testing, consult a gastroenterologist before proceeding with a claim.

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Three Hypothetical Case Profiles: Where Cases Stand or Fall

Profile 1 — Strong Claim A 48-year-old with Type 2 diabetes took Ozempic for 14 months. She began experiencing persistent vomiting, unintentional weight loss, and was hospitalized twice for dehydration. A gastric emptying scintigraphy test showed 74% retention at 4 hours (normal < 10%). Her pre-Ozempic records show no GI pathology. After stopping Ozempic, her symptoms partially resolved over 6 months.

Analysis: Objective diagnostic confirmation, clear temporal link to medication, no competing GI diagnoses. Strong candidate for MDL claim.

Profile 2 — Contested Claim A 55-year-old man with longstanding Type 2 diabetes and 20 years of uncontrolled blood sugar took Mounjaro for 10 months. He reports nausea and bloating but has no formal gastroparesis workup. His gastroenterologist suspects diabetic gastroparesis — a well-established complication of uncontrolled diabetes itself.

Analysis: Causation is genuinely disputed. Diabetic gastroparesis existed as an independent risk before Mounjaro. Defendants will argue the drug did not cause the injury; the underlying disease did. Without objective testing distinguishing drug-induced vs. diabetes-induced gastroparesis, this case faces significant headwinds under Judge Marston’s standard.

Profile 3 — Ileus and Obstruction A 39-year-old non-diabetic woman took Wegovy for weight loss for 7 months. She presented to the ER with acute abdominal pain and was diagnosed with ileus (intestinal paralysis) requiring emergency surgery. No prior GI history. She was discharged after 12 days with continuing GI motility issues.

Analysis: Non-diabetic plaintiff removes a major causation defense. Acute diagnosis, hospitalization, surgery, and documented ongoing symptoms point to a severe injury claim. Likely a priority candidate in bellwether selection.

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The Bellwether Process and Settlement Trajectory

MDL mass torts do not resolve through 2,900 individual trials. The mechanism is the bellwether: Judge Marston will select a small pool of representative cases for trial. Those verdicts serve as data points that inform the negotiating positions of both sides.

The Roundup MDL remains the instructive parallel. Bayer faced its first bellwether loss — $289 million (later reduced) — in August 2018. That single verdict, combined with subsequent bellwethers, drove a settlement exceeding $10 billion announced in 2020. The pharmaceutical defendants here will be watching those numbers carefully.

As of May 2026, no bellwether trial schedule has been formally announced for MDL 3094. Given the litigation timeline (February 2024 establishment, active discovery in 2025–2026), bellwether trials would historically be expected sometime in 2026–2027, with broad settlement negotiations following thereafter.

See also: Mass Tort Settlement Payout Timeline | How Class Action Settlements Work

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What Your Attorney Will Be Looking For

If you consult an MDL attorney, they will ask you to establish four things:

Element	What to Show
Product use	Prescription records, pharmacy receipts, medical records confirming you received the drug
Qualifying injury	Gastroparesis, ileus, or bowel obstruction confirmed by objective testing
Causal link	Temporal relationship between drug use and symptom onset; ideally no prior GI pathology
Timely filing	Injury within your state’s statute of limitations from the date of diagnosis or discovery

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Finding an Experienced MDL Attorney

Not all personal injury lawyers handle pharmaceutical MDL litigation. The procedural complexity — consolidated discovery, Plaintiffs’ Steering Committee involvement, bellwether selection, federal preemption arguments — requires specialists.

What to look for:

• Prior MDL experience: Roundup, talcum powder, opioids, hernia mesh
• Knowledge of GLP-1 pharmacology: Ability to challenge (or obtain) expert witnesses on gastric motility
• Access to Plaintiffs’ Executive Committee filings: Lawyers plugged into MDL 3094 strategy
• Transparent fee agreement: Clear contingency rate (33–40%) with itemized cost deductions in writing
• Free initial consultation: Standard in mass tort practice

See also: Personal Injury Lawyer Fee Guide

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The Novo Nordisk and Eli Lilly Defense Playbook

Understanding the defense strategy helps you and your attorney anticipate obstacles:

Defense Argument 1: FDA Preemption

Both companies will argue that FDA-approved labeling shields them from state tort law failure-to-warn claims. The argument: because the FDA reviewed and approved Ozempic’s and Mounjaro’s prescribing information, adding a stronger gastroparesis warning would have required FDA permission — and thus the companies cannot be held liable under state law for not doing something they were legally constrained from doing.

The counter-argument (already noted in Wyeth v. Levine, 555 US 555, 2009): brand-name drug manufacturers can update safety labeling under the Changes Being Effected (CBE) regulation if they have “newly acquired information” about a risk. If internal pharmacovigilance data at Novo Nordisk or Eli Lilly showed a gastroparesis signal that was underrepresented in the official label, the companies could have — and arguably should have — acted earlier without waiting for FDA direction.

Defense Argument 2: Causation Dispute — Diabetic Gastroparesis

Many GLP-1 users have Type 2 diabetes. Diabetic gastroparesis — stomach paralysis caused by longstanding poorly controlled diabetes — is a well-established, independent condition affecting an estimated 1–5% of Type 2 diabetics. Defendants will argue that any gastroparesis diagnosis in a diabetic patient is more likely attributable to their underlying disease than to the medication.

This is why Judge Marston’s September 2025 ruling — requiring objective diagnostic testing — matters so much. A plaintiff who was diagnosed with gastroparesis before starting a GLP-1 drug, or whose diabetes has been poorly controlled for decades, faces a more difficult causation hurdle than a non-diabetic Wegovy user with no prior GI history.

Defense Argument 3: Learned Intermediary Doctrine

Under the learned intermediary doctrine (recognized in most US states), a drug manufacturer discharges its duty to warn by adequately informing the prescribing physician, not the patient directly. If Novo Nordisk or Eli Lilly can show that physicians were adequately informed of the gastroparesis risk through medical education and prescribing information, individual patient claims may be deflected.

Plaintiffs will argue that nausea warnings are categorically different from warnings about chronic, debilitating gastroparesis — and that even prescribing physicians were not given information adequate to evaluate the chronic gastroparesis risk.

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What MDL Plaintiffs Actually Experience Day-to-Day

One of the most common misconceptions about MDL participation is that plaintiffs must travel to Pennsylvania or actively manage the litigation. In reality:

Your role is primarily documentary. Once you retain an attorney, your main obligation is cooperating with document requests — providing records, answering questionnaires about your medical history, and potentially sitting for a deposition if your case is selected for deeper scrutiny.

You will not be in court. The MDL is managed by your attorney and the Plaintiffs’ Steering Committee. Individual plaintiffs attend court proceedings rarely, if ever, during the MDL phase.

Communication matters. Your attorney’s ability to represent you effectively depends on complete and accurate information. Gaps in your medical history, undisclosed prior GI conditions, or inconsistencies in your narrative weaken your case. Transparency with your attorney — protected by attorney-client privilege — is essential.

Case value assessment takes time. Do not expect a quick valuation of your case. It typically takes months to years of discovery before reliable settlement ranges emerge. Any attorney who quotes you a specific number during an initial consultation is speculating.

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Geographic and State-Law Considerations for US Plaintiffs

While MDL 3094 is consolidated in Pennsylvania, your case is governed by the substantive law of the state where you were treated and diagnosed. This matters for several reasons:

State Law Factor	Why It Matters
Statute of limitations	Ranges from 1–6 years across states; discovery rule application varies
Damages cap	Some states cap non-economic damages (pain and suffering)
Contributory negligence	A few states bar recovery if plaintiff is even 1% at fault
Punitive damages standard	Varies from “clear and convincing evidence” to “malice”
Joint and several liability	Affects apportionment when multiple defendants are involved

This is another reason why your individual attorney — licensed in your state — is critical even within an MDL proceeding.

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Evidence Gathering Checklist

Begin collecting these materials immediately — before time and access erode:

• All prescriptions for GLP-1 drugs (dates, doses, prescribing physician)
• Pharmacy fill records (confirming actual dispensing)
• Complete gastroenterology records from the injury period
• Gastric emptying scintigraphy, breath test, or motility capsule results
• ER visit and hospitalization records
• Surgical records (if applicable)
• Follow-up care records documenting ongoing or permanent impairment
• Physician notes linking GI injury to medication
• Documentation of lost wages, out-of-pocket expenses, and quality-of-life impact

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Statute of Limitations: The Time Bar You Cannot Miss

The most common reason plaintiffs lose the right to sue is not the merits — it is missing the filing deadline. State statutes of limitations for product liability claims vary. Some states apply the “discovery rule” (the clock starts when you knew or should have known the drug caused your injury); others apply a strict date-of-injury rule.

The warning is simple: do not wait. Every day you delay is a day closer to a deadline that, once missed, is permanent. A consultation costs nothing in this practice area.

See also: Medical Malpractice Lawsuit Guide | Hernia Mesh Lawsuit Overview | Paragard IUD Breakage Lawsuit

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How Compensation Is Actually Distributed in a Mass Tort

If MDL 3094 results in a global settlement — the most likely endpoint given the scale of the litigation — how does the money actually get divided among 2,900+ plaintiffs? This is a question most potential claimants never think to ask until it matters.

The Points Matrix System

Most large pharmaceutical MDLs use a points-based matrix developed by the Plaintiffs’ Steering Committee (PSC) and typically negotiated with the defense as part of any global deal. Each plaintiff receives a point score based on:

• Injury category (gastroparesis with scintigraphy confirmation vs. less severe GI injury)
• Severity tier (outpatient treatment vs. hospitalization vs. surgery vs. permanent damage)
• Duration of drug use
• Age at time of injury
• Pre-existing conditions (reduce points)
• Economic damages (out-of-pocket costs, documented lost wages)

Aggregate-to-Individual Translation

The global settlement pot (if reached) is divided by the total points across all qualifying plaintiffs to get a per-point dollar value. Individual plaintiff payouts = their point score × per-point value, before attorney fees and litigation cost deductions.

This system means plaintiffs with severe, well-documented injuries in the high-tier categories receive proportionally more than those with minor or contested claims. It also means the matrix negotiation is a critical leverage point — one reason having an attorney connected to the Plaintiffs’ Executive Committee matters.

Attorney Fee Deduction

Before you receive anything, the contingency fee (33–40%) and any litigation expenses advanced on your behalf (expert witness fees, court costs, document processing) are deducted from the gross recovery. Understanding this math upfront prevents surprises.

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Non-Litigation Options: What to Do While the MDL Proceeds

Joining MDL 3094 does not preclude other avenues for managing your situation:

1. Health Insurance Coverage for Gastroparesis Treatment

Gastroparesis is a recognized medical diagnosis covered by most private health insurance, Medicaid, and Medicare. Treatment — prokinetic medications, dietary modifications, feeding tube placement, gastric electrical stimulation (GES) — is generally covered. If your insurer has denied claims for gastroparesis treatment while you were on a GLP-1 drug, document those denials carefully; they may be relevant to your legal claim.

2. Disability Benefits

Severe gastroparesis may constitute a disabling condition qualifying for short-term disability insurance, FMLA leave, or Social Security Disability Insurance (SSDI). If your gastroparesis prevents you from working, consult with both a disability attorney and your MDL attorney.

3. GLP-1 Insurance Coverage Disputes

Separate from the litigation, insurance denials for GLP-1 prescriptions — particularly Wegovy for obesity — are their own legal landscape with administrative appeal rights.

See also: GLP-1 and Ozempic Insurance Coverage Guide

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Related Coverage

If you are researching broader GLP-1 issues:

• Insurance coverage disputes for Ozempic/Wegovy: GLP-1 Insurance Coverage Guide
• Structured settlement options if you receive a payout: How to Sell a Structured Settlement

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What Discovery Will Likely Uncover: The Internal Document Question

The most consequential phase of any pharmaceutical MDL is discovery — particularly the production of internal company documents. In Roundup litigation, Bayer’s internal emails showed scientists acknowledging cancer risk data that was never reflected in public labeling. In the opioid MDL, manufacturers’ internal marketing documents showed they knew about addiction potential and downplayed it. MDL 3094 will have its own version of this inquiry.

The key questions plaintiffs’ attorneys will pursue in document discovery from Novo Nordisk and Eli Lilly:

1. When did the companies first receive adverse event reports of gastroparesis? The FDA’s own Adverse Event Reporting System (FAERS) is publicly searchable, but internal pharmacovigilance systems hold far more granular data. If internal databases showed a gastroparesis signal years before adequate label warnings, that evidence is potentially devastating for the defense.

2. What did clinical trial data show? GLP-1 drugs underwent extensive clinical trials before approval. Trial participants who experienced significant GI events — hospitalizations, GI motility studies — generated data that was reported to the FDA but may have been framed in ways that underemphasized gastroparesis severity. Internal communications about how to characterize this data will be scrutinized.

3. Were there internal risk assessments? Drug manufacturers maintain internal safety risk assessment files. These documents, sometimes called PSURs (Periodic Safety Update Reports), aggregate adverse event signals. The content of these reports — and what the companies decided to do or not do with them — will be central to the litigation.

4. What did sales and marketing know? Sales representatives interact daily with prescribing physicians. Internal training materials, physician complaint tracking, and sales team communications often capture real-world adverse event signals that have not yet made it into official reporting. These materials can be highly revealing.

The production of these documents is typically the inflection point that drives pharmaceutical defendants toward settlement. The prospect of a jury seeing internal emails discussing known risks against a backdrop of inadequate public warnings has historically proven to be the most powerful settlement driver in mass tort history.

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Choosing Between MDL and State Court: A Strategic Note

Most GLP-1 gastroparesis plaintiffs will file into MDL 3094. But in limited circumstances, filing in state court may offer advantages:

When state court may be preferable:

• Your state has no cap on non-economic damages, and your injuries are severe
• Your state applies more favorable failure-to-warn standards than federal law
• You have a particularly strong, stand-alone case that does not benefit from MDL common discovery (rare for individual plaintiffs)
• Your statute of limitations is running and you need to preserve a claim while MDL develops

MDL advantages for most plaintiffs:

• Common discovery infrastructure — you benefit from documents other plaintiffs’ attorneys obtained
• PSC management — coordinated strategy across thousands of cases
• Economies of scale — expert witnesses, medical consultants shared across cases
• Settlement efficiency — global resolution mechanisms

Your attorney should evaluate both pathways for your specific facts and state law. This is a strategic decision that varies case by case.

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Tracking MDL 3094 Going Forward

MDL litigation moves on a court-controlled schedule that can shift with rulings, appeals, and party negotiations. Here is how to stay informed:

JPML Statistics Reports — The Judicial Panel on Multidistrict Litigation publishes monthly statistics reports listing pending case counts for every active MDL. These are publicly available at jpml.uscourts.gov and represent the authoritative source for current case numbers.

Court Docket (PACER) — MDL 3094 docket entries are searchable through PACER (Public Access to Court Electronic Records). Your attorney will monitor this; individual plaintiffs rarely need to do so directly.

Plaintiffs’ Steering Committee Updates — The PSC periodically issues updates through the common benefit fund structure. Your individual attorney should relay relevant developments to you.

Legal News Sources — Publications like Law360, Reuters Legal, and AboutLawsuits.com track major MDL rulings. These are useful for context but should never replace communication with your attorney about your specific case.

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Frequently Overlooked Damages: Beyond Medical Bills

Most people filing GLP-1 gastroparesis claims focus on hospitalization costs and medical bills. But experienced MDL attorneys will identify several categories of damages that plaintiffs frequently undervalue or fail to document:

Loss of Consortium: If your gastroparesis significantly impaired your relationship with a spouse or partner — reduced ability to eat together, participate in family activities, or maintain intimacy due to pain and illness — your spouse may have a separate loss of consortium claim in many states. These claims are typically filed alongside the primary plaintiff’s claim.

Loss of Enjoyment of Life (Hedonic Damages): Gastroparesis does not merely cause pain — it disrupts the fundamental human activities that constitute a meaningful life. The inability to eat normal food, the constant uncertainty about whether a meal will trigger vomiting, the social isolation that follows chronic severe GI disease — these losses are compensable as “loss of enjoyment of life” in most jurisdictions.

Future Medical Expenses — Lifetime Cost Projection: Severe gastroparesis may require lifelong management: prokinetic medications, periodic hospitalizations, gastric electrical stimulation devices, enteral nutrition products, or even surgical interventions. A medical economist or life care planner expert witness can project these lifetime costs — which can reach into six figures — as part of your compensatory damages claim.

Wage Loss and Earning Capacity: If gastroparesis forced you to reduce work hours, change occupations, or leave the workforce entirely, your lost earning capacity — not just past wages — is compensable. This requires expert testimony comparing pre- and post-injury earnings trajectory, which your attorney should arrange.

Documenting all of these categories — starting now, regardless of where the litigation stands — is essential to maximizing any eventual recovery.

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Key Terminology Glossary for GLP-1 MDL Plaintiffs

Understanding the language of MDL litigation reduces anxiety and improves communication with your attorney:

MDL (Multidistrict Litigation): A federal mechanism that consolidates similar lawsuits from different districts before a single judge for coordinated pretrial proceedings. Not a class action — each plaintiff retains individual rights.

Bellwether Trial: A representative trial from the MDL pool whose outcome informs settlement negotiations for the broader litigation. Verdict does not bind other plaintiffs but creates powerful precedent pressure.

Plaintiffs’ Steering Committee (PSC) / Executive Committee: A group of plaintiff-side attorneys appointed by the MDL judge to coordinate litigation strategy, manage common discovery, and negotiate with defendants on behalf of the entire plaintiff pool.

Gastric Emptying Scintigraphy: The gold-standard objective test for gastroparesis diagnosis. A patient eats a radiolabeled meal, and gamma camera images track how quickly the stomach empties. Retention of more than 10% of contents at 4 hours is diagnostic of gastroparesis.

Daubert Hearing: A pretrial proceeding where the judge evaluates whether expert witness testimony meets the Federal Rules of Evidence standard for scientific reliability. MDL 3094’s Daubert hearings on GI causation experts will be pivotal in shaping which evidence reaches a jury.

Short Form Complaint: The simplified pleading used by individual plaintiffs to join an MDL. It references the Master Complaint filed by the PSC rather than restating all allegations from scratch.

Contingency Fee: Attorney compensation paid only upon successful recovery — a percentage (typically 33–40%) of the settlement or judgment amount, deducted before the plaintiff receives their net payment.

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This article reflects publicly available litigation records and legal reporting as of May 2026. Case counts are based on data through November 2025 (Levin Law / JPML reporting); for the current pending case number, refer to the JPML’s official statistics report at jpml.uscourts.gov. Nothing in this article constitutes legal advice or creates an attorney-client relationship.