GLP-1 MDL Explained (2026)

MDL vs. Class Action

The following material was consolidated from the former standalone MDL-versus-class-action resource.

Understanding How GLP-1 Lawsuits Are Handled in U.S. Courts

If you’ve been following GLP-1 drug litigation — or if you’re considering whether you have a viable claim involving Ozempic, Wegovy, Mounjaro, or Zepbound — you’ve almost certainly encountered two terms that tend to generate confusion: multidistrict litigation, universally abbreviated as MDL, and class action. News coverage often uses these terms interchangeably, and some attorneys are not always careful about the distinction. But these are fundamentally different legal structures, and understanding how they work — and which one applies to GLP-1 cases — is essential for anyone navigating this litigation.

The short version: GLP-1 lawsuits are being handled as MDLs, not class actions. The distinction matters enormously for how your case is managed, how compensation is determined, and what rights you retain as a plaintiff. There is also a New Jersey state court litigation that is being handled as a multi-county litigation and not a class action.

May lay people regularly discuss what they call an “ozempic class action.” First of all, the glp-1 cases are not class actions in the United States. Secondly, there is no such thing as an “ozempic class action.”

What Is an MDL (Multidistrict Litigation)?

Multidistrict litigation is a procedural mechanism built into federal law that allows cases filed in different federal districts across the country to be transferred to a single federal court for coordinated pretrial proceedings. The governing statute — 28 U.S.C. § 1407 — authorizes the Judicial Panel on Multidistrict Litigation (JPML), a body of seven federal judges, to order these transfers when cases involve common questions of fact and when consolidation would serve the convenience of the parties and promote efficient judicial administration.

The key conceptual point is that an MDL does not merge individual lawsuits into a single case. Each plaintiff retains their own lawsuit, their own attorney, and their own path to resolution. What changes is the pretrial process. Rather than having hundreds or thousands of federal judges across the country independently managing identical discovery disputes, hearing duplicative expert testimony, and issuing potentially inconsistent rulings on the same legal questions, those pretrial functions are handled once, by one judge, in one court. In the GLP-1 MDL, that court is the Eastern District of Pennsylvania, and the presiding judge is the Honorable Karen S. Marston. The MDL functions as follows:

• Similar lawsuits from across the country are grouped together and assigned to a single federal judge
• Pretrial proceedings — including discovery, expert challenges, and dispositive motions — are coordinated across all cases
• Evidence and discovery developed in the MDL are shared among all participating plaintiffs
• Each case nonetheless remains separate and individual throughout the process

Key Features of an MDL

Understanding the structural features of MDL proceedings helps clarify why they are so commonly used in mass pharmaceutical tort litigation and what plaintiffs can realistically expect. The defining characteristics of an MDL include:

• Each plaintiff files and maintains an individual lawsuit with their own specific allegations
• Cases are consolidated for pretrial purposes only — not for trial. However, each case will have a number of bellwether trials to help the parties resolve the claims.
• Shared discovery means expert witnesses, depositions, and documentary evidence are developed once and available to all plaintiffs
• Cases may ultimately be remanded (returned) to their original district courts for individual trials if they do not resolve through settlement

Why MDLs Are Used in Mass Tort Litigation

MDLs were specifically designed for situations where a single product, event, or course of conduct has produced a large volume of similar but not identical lawsuits. They are not appropriate for every multi-plaintiff dispute, but they are the standard procedural vehicle for pharmaceutical mass torts, and for good reason. MDLs are deployed when:

• Thousands of people across different states have been injured by the same product
• The underlying factual and legal questions — such as what the manufacturer knew and when — are substantially the same across cases
• Judicial efficiency and consistency in pretrial rulings are important priorities

The GLP-1 MDL encompasses claims related to gastroparesis, bowel obstruction, and other gastrointestinal injuries. A separate MDL has been established specifically for NAION vision loss claims. Both are pending before Judge Marston in the Eastern District of Pennsylvania.

What Is a Class Action Lawsuit?

A class action is a fundamentally different legal structure. Rather than grouping individual lawsuits together while keeping them separate, a class action merges all claims into a single lawsuit. One or a small number of named plaintiffs — called class representatives — litigate on behalf of an entire defined group, known as the class. The class representative’s case is tried, and the outcome — whether a judgment or a settlement — applies to every member of the class, typically without those members having any meaningful individual participation in the litigation.

For a case to proceed as a class action under Rule 23 of the Federal Rules of Civil Procedure, plaintiffs must satisfy a number of requirements. The class must be sufficiently numerous, the legal questions must be common across class members, the named plaintiffs must be typical of the class, and the named plaintiffs and their counsel must adequately represent the class’s interests. Class actions tend to work well for a particular type of dispute:

• Consumer fraud cases where many people suffered identical or nearly identical harm
• Defective products that caused standardized, relatively modest damages across a large population
• Securities fraud cases where a standard class-wide remedy makes sense
• Situations where individual lawsuits would be economically impractical given the size of each person’s claim

Key Features of a Class Action

The structural characteristics of a class action stand in direct contrast to those of an MDL. The core features include:

• One lawsuit represents the entire class of plaintiffs
• Named class representatives control the litigation on behalf of all class members
• Individual plaintiffs generally do not participate in the litigation and have no independent attorney-client relationship with class counsel
• Settlements apply to all class members and are typically divided according to a standardized formula
• Individual circumstances, medical histories, and injury severity are generally not evaluated on a plaintiff-by-plaintiff basis

The Key Differences Between MDL and Class Action

The distinctions between these two procedural structures are not merely technical — they have real and significant consequences for plaintiffs in terms of compensation, control, and the trajectory of their cases. The following comparison captures the most important differences.

What Are Bellwether Trials in an MDL?

Bellwether trials are one of the most strategically important features of MDL proceedings, and they are worth understanding in some depth. After the pretrial phase of an MDL is complete — once discovery has been conducted, experts have been designated, and dispositive motions have been resolved — the presiding judge typically selects a small number of representative cases to proceed to trial. These are the bellwether cases.

The term comes from the practice of hanging a bell on the lead sheep in a flock, whose movement signals where the others will follow. In litigation, bellwether trials serve an analogous function: they test the strength of the legal theories and evidence, expose weaknesses on both sides, and — perhaps most importantly — give both plaintiffs and defendants a concrete data point on what juries are likely to do. The specific purposes bellwether trials serve in an MDL include:

• Testing the persuasiveness of key legal arguments and the admissibility of expert testimony
• Evaluating how juries respond to the evidence and the parties’ respective narratives
• Generating settlement value benchmarks that inform global resolution negotiations

In the GLP-1 MDL, bellwether trials are anticipated in 2026 and beyond. The outcomes of those trials are expected to be the single most significant driver of any eventual global settlement, as they will give both sides a much clearer picture of litigation risk.

Why GLP-1 Lawsuits Are Not Class Actions and there is no ozempic class action

Some plaintiffs — and some members of the public following this litigation — have asked whether GLP-1 cases could or should be structured as a class action. The answer is almost certainly no, and the reason comes down to the fundamental incompatibility between the class action requirements and the nature of GLP-1 injuries.

Class actions work when the harm suffered by class members is substantially uniform — when one resolution genuinely fits all. GLP-1 injuries are the opposite of uniform. The range of claimed injuries spans gastroparesis of varying severity, bowel obstruction requiring emergency surgery, permanent vision loss from NAION, and other serious complications. The drugs involved include multiple different products with different mechanisms and labeling histories. Patients’ medical backgrounds, comorbidities, dosing histories, and the duration of their treatment vary enormously. Consider the contrast between two hypothetical plaintiffs:

• One plaintiff experienced transient nausea and mild gastric symptoms that resolved within weeks of stopping treatment
• Another spent weeks hospitalized following emergency surgery for bowel obstruction, required a period of rehabilitation, and sustained permanent functional limitations

A class action settlement structure — which would divide a fixed fund among all class members using standardized criteria — would almost certainly undercompensate severely injured plaintiffs while providing marginal recoveries to those with minor injuries. An MDL, by contrast, allows each plaintiff’s compensation to be calibrated to the specific facts of their case.

Advantages of MDLs for GLP-1 Plaintiffs

For individuals with legitimate GLP-1 injury claims, the MDL structure offers several meaningful advantages over both individual litigation and the class action model.

A. Individualized Compensation

Because each plaintiff maintains their own case within the MDL, compensation can be tailored to the specific nature and severity of their injuries. Relevant factors in assessing individual claim value include:

• The severity and duration of the injury
• Medical costs incurred, both past and anticipated future expenses
• Lost wages and diminished earning capacity
• Long-term functional impact and quality of life effects

B. Shared Resources Reduce Cost and Complexity

One of the most significant practical benefits of MDL consolidation is the sharing of litigation resources across the plaintiff pool. Developing expert testimony on complex medical and scientific questions — such as the causal relationship between semaglutide and NAION, or the adequacy of Novo Nordisk’s warnings — is extraordinarily expensive. In an MDL, those costs are borne collectively rather than duplicated in every individual case. Shared resources include:

• Expert witnesses on medical causation, pharmacology, and regulatory standards
• Document discovery and the review of millions of pages of manufacturer records
• Legal research and motion practice on common legal questions

C. Judicial Efficiency

Centralizing pretrial proceedings before a single judge produces faster and more consistent outcomes than having the same disputes litigated independently in courts across the country. Judge Marston and her team develop deep familiarity with the scientific evidence, the parties’ arguments, and the factual record — expertise that benefits all parties in the litigation.

D. Increased Negotiating Leverage

The sheer scale of the GLP-1 MDL — which already encompasses thousands of cases and is expected to grow significantly — creates substantial pressure on Novo Nordisk and Eli Lilly to reach a global resolution. No pharmaceutical company wants to face thousands of individual trials. That dynamic, combined with the evidence developed through coordinated discovery, gives plaintiffs considerably more negotiating leverage than they would have filing individually.

Disadvantages and Realistic Expectations for MDL Plaintiffs

MDLs are not without their limitations, and plaintiffs and their attorneys should approach this litigation with clear-eyed expectations about what the process realistically involves.

A. Extended Timelines

Large pharmaceutical MDLs are not resolved quickly. The coordination of discovery across thousands of cases, the development and vetting of expert testimony, bellwether trials, and global settlement negotiations all take time. Plaintiffs entering the GLP-1 MDL should be prepared for a process that may extend over several years before any individual resolution is reached.

B. No Guaranteed Outcome

Participation in an MDL does not guarantee a settlement or any particular recovery. Some cases will settle globally; others may be remanded for individual trial; some may not survive dispositive motions. The strength of an individual plaintiff’s case — including the nature of their injury, the quality of their medical documentation, and the evidentiary basis for causation — will significantly influence their outcome.

C. Procedural Complexity

MDL proceedings involve layers of procedural structure — case management orders, leadership committees, master complaints, short-form complaint processes — that can be difficult to navigate without experienced counsel. Plaintiffs should ensure they are represented by attorneys with demonstrated experience in pharmaceutical mass tort litigation specifically.

How Settlements Work in GLP-1 MDL Cases

The vast majority of large pharmaceutical MDLs ultimately resolve through negotiated global settlements rather than individual trials. The GLP-1 litigation is expected to follow this pattern, though the timing and structure of any eventual settlement will depend heavily on the outcomes of bellwether trials and the parties’ assessment of overall litigation risk.

In a typical MDL global settlement, a defendant agrees to pay a total sum into a settlement fund, and that fund is distributed among participating plaintiffs according to a point-based or tiered compensation matrix. The factors that typically drive individual allocation within a settlement matrix include:

• The severity of the injury and its impact on daily function
• The duration of GLP-1 use prior to the onset of symptoms
• The medical treatment required, including hospitalizations and surgeries
• The long-term prognosis and any permanent effects
• The strength of the causal connection between GLP-1 use and the claimed injury

Why This Distinction Matters for Your Claim

Understanding the difference between an MDL and a class action is not just an academic exercise — it has direct practical implications for anyone considering whether to pursue a GLP-1 injury claim. The MDL structure means that you are not simply “joining” a class action where your outcome is determined by what happens to everyone else. You are filing your own individual lawsuit, with your own attorney, based on your own specific medical history and injuries.

This structure also means that the quality of your documentation — your medical records, your prescription history, your treating physicians’ findings — matters. In a class action, individual circumstances are largely averaged away. In an MDL, they are the foundation of your case. Several important points follow from this:

• GLP-1 lawsuits are not and will not be structured as class actions, given the variability of injuries involved. As a result, there is no ozempic class action.
• Each plaintiff’s compensation potential is tied to the specific facts and severity of their individual case
• Bellwether trial outcomes in 2026 are expected to be the primary driver of eventual global settlement terms
• Plaintiffs with well-documented, severe injuries are generally best positioned within the MDL framework

Frequently Asked Questions

Are GLP-1 lawsuits a class action?

No. GLP-1 injury lawsuits are proceeding as multidistrict litigation — specifically MDL No. 3094 in the Eastern District of Pennsylvania, as well as a separate MDL for NAION vision loss claims, both before Judge Karen S. Marston. In an MDL, each plaintiff maintains their own individual lawsuit rather than being absorbed into a single collective case.

If I join the MDL, do I give up control of my case?

No. Joining the MDL does not mean surrendering control of your individual claim. You retain the right to accept or reject any settlement offer, and your case is evaluated on its own merits. The MDL structure coordinates the pretrial process — it does not merge your case into a single uniform outcome.

How long will the GLP-1 MDL take to resolve?

Large pharmaceutical MDLs typically take several years from centralization to global resolution. The GLP-1 MDL, which is not an ozempic class action, was established in early 2024. Bellwether trials are anticipated in 2026. A global settlement, if reached, would likely follow the bellwether outcomes, potentially in 2027 or later depending on how the litigation develops.

New Jersey Multicounty Litigation

The following material explains how the New Jersey state-court proceedings relate to the federal GLP-1 multidistrict litigation.

Understanding New Jersey State Court GLP-1 Litigation for Ozempic, Wegovy, Mounjaro, and Related Drugs

The national GLP-1 drug litigation is not a single proceeding. It is a collection of legal actions unfolding simultaneously in federal courts and state courts, each governed by different procedural rules and presenting different strategic considerations for plaintiffs and defendants alike. While the federal multidistrict litigation in the Eastern District of Pennsylvania has received the most public attention, New Jersey state courts have quietly become one of the most important venues in the entire GLP-1 litigation landscape.

New Jersey has established coordinated state-court proceedings — known as multicounty litigation, or MCL — for GLP-1 injury claims involving both gastrointestinal injuries and vision loss. These proceedings operate in parallel with the federal MDL and are expected to play a significant role in shaping the overall trajectory of the litigation, including how manufacturers assess their settlement exposure and what damages ultimately become available to injured plaintiffs.

• The New Jersey Supreme Court established two separate Multicounty Litigation (MCL) programs for state-court lawsuits involving GLP-1 medications
• Ozempic®, Wegovy®, Mounjaro®, Zepbound™, The Ozempic pill® (FKA Rybelsus®), and Trulicity®
• Two litigations centrally managed by Superior Court Judge Gregg A. Padovano.
• Bergen County, NJ
• Case Type ID: 643- Gastrointestinal Injuries MCL
• Case Type ID: 644- NAION Vision Loss MCL
• Defendants: Novo Nordisk and Eli Lilly

What Is New Jersey Multicounty Litigation (MCL)?

Multicounty litigation is New Jersey’s state-court equivalent of the federal MDL process. When a large number of similar lawsuits are filed across multiple New Jersey counties, the state Supreme Court can designate the matter as an MCL and transfer all pending and future cases to a single judge in a single county for coordinated pretrial management. The goals of that coordination mirror those of the federal MDL system:

• Improving efficiency by eliminating duplicative proceedings across different county courts
• Ensuring consistent pretrial rulings across all cases in the litigation
• Centralizing discovery so that depositions, expert witness development, and documentary evidence are managed once rather than repeated thousands of times

The critical distinction from a class action is that MCL does not merge individual lawsuits into a single collective case. Every plaintiff retains their own individual claim, their own attorney, and their own path to compensation. Coordination is a pretrial procedural mechanism — not a substantive merger of the underlying cases.

Why New Jersey Became a Major GLP-1 Litigation Venue

New Jersey’s emergence as a primary state-court venue for GLP-1 litigation is not coincidental. The state has a well-established reputation as a significant jurisdiction for pharmaceutical mass tort litigation, and several structural factors make it a natural forum for cases of this kind.

The most important of those factors is geography: Novo Nordisk maintains its U.S. headquarters in Plainsboro, New Jersey. That corporate presence gives plaintiffs a well-established basis for asserting jurisdiction in New Jersey state courts and provides a litigation rationale that courts in other states could not as readily accommodate. Beyond that threshold consideration, New Jersey brings several additional advantages to plaintiffs in complex pharmaceutical litigation:

• The state has deep institutional experience managing large-scale mass tort proceedings, having previously hosted major litigations involving talc, opioids, pelvic mesh, Accutane, and Risperdal
• New Jersey’s procedural rules and judicial infrastructure for coordinated litigation are well-developed and predictable
• The Bergen County Superior Court, which is presiding over the GLP-1 MCL, is experienced in handling complex commercial and pharmaceutical litigation

That combination of corporate nexus, judicial infrastructure, and established mass tort precedent made New Jersey an obvious destination for plaintiffs’ counsel as GLP-1 filings began to accelerate.

The Two Litigation Tracks in New Jersey State Court

The New Jersey GLP-1 MCL is divided into two distinct tracks, each addressing a different category of alleged injury. The two tracks proceed in parallel under the same presiding judge but involve separate case management, separate expert development, and potentially different litigation timelines.

Track One: Gastrointestinal Injury MCL

In October 2025, the New Jersey Supreme Court formally designated multicounty litigation for GLP-1-related gastrointestinal injury claims. The designation consolidated all pending and future New Jersey state court cases involving GI injuries allegedly caused by GLP-1 medications under a single coordinated proceeding. (New Jersey Courts)

The gastrointestinal injury track covers a range of serious digestive complications that plaintiffs allege were caused or significantly worsened by their use of GLP-1 medications. The injuries at issue in this track include:

• Gastroparesis — a condition in which the stomach’s ability to empty its contents is severely impaired, causing chronic nausea, vomiting of undigested food, and inability to eat normally
• Bowel obstruction and ileus — intestinal blockages or functional failures of intestinal motility, sometimes requiring emergency surgery
• Delayed gastric emptying and chronic gastrointestinal dysfunction
• Severe, persistent vomiting leading to dehydration and hospitalization

Gastroparesis is by far the most frequently cited injury across all GLP-1 litigation, accounting for the majority of claims in both the federal MDL and the New Jersey MCL. Plaintiffs allege that their gastroparesis was caused or materially worsened by the gastric-slowing mechanism of GLP-1 drugs, and that Novo Nordisk and Eli Lilly failed to adequately warn them or their physicians of this risk.

Track Two: Vision Loss / NAION MCL

The second litigation track covers GLP-1-associated vision loss, specifically non-arteritic anterior ischemic optic neuropathy — NAION — a sudden and irreversible loss of blood flow to the optic nerve that causes permanent vision impairment. By mid-2025, New Jersey plaintiffs had sought coordinated multicounty treatment for NAION claims involving Ozempic and Wegovy, and those claims are now proceeding as a coordinated track within the New Jersey MCL.

The NAION litigation in New Jersey is being driven by the same body of scientific evidence that underpins the federal MDL 3163 vision loss proceedings. Multiple large peer-reviewed studies — including landmark research published in JAMA Ophthalmology in December 2024 and an epidemiological review by the European Medicines Agency in January 2025 — have identified elevated NAION risk in GLP-1 users. Lawsuits alleging GLP-1-linked blindness have grown rapidly, and New Jersey state court has become one of the primary venues for those claims. (Reuters)

the precipating evnt that set in motion the NAION MCL was a groundbreaking study in 2024.

Landmark Harvard Study Linking Ozempic/Wegovy to Vision Loss Fueled the Semaglutide MDL Litigation

A pivotal July 2024 study published in JAMA Ophthalmology by researchers at Massachusetts Eye and Ear/Harvard Medical School is widely credited as the scientific catalyst behind the litigations nationwide. The retrospective matched cohort study, led by Dr. Jimena Tatiana Hathaway and colleagues, examined 16,827 patients evaluated at a single academic neuro-ophthalmology practice over six years and found a statistically significant association between semaglutide prescriptions and nonarteritic anterior ischemic optic neuropathy (NAION), a rare, currently untreatable condition causing sudden, permanent vision loss. Patients with type 2 diabetes prescribed semaglutide were over four times more likely to develop NAION than those on other diabetes medications (hazard ratio 4.28), while overweight or obese patients prescribed the drug for weight loss faced a more than sevenfold increased risk (hazard ratio 7.64) compared to those using non-GLP-1 alternatives.

For litigators, what makes this study particularly significant isn’t just the size of the reported risk increase, but its methodological rigor relative to typical pharmacovigilance signals. Researchers used propensity score matching to control for confounding variables — age, sex, hypertension, diabetes, sleep apnea, obesity, and cardiovascular disease — and every NAION diagnosis was manually confirmed by fellowship-trained neuro-ophthalmologists rather than relying solely on ICD-10 coding, which the authors noted is notoriously imprecise for this specific condition. The survival analysis also showed the sharpest spike in NAION risk occurred within the first 12 months of starting semaglutide, a temporal pattern plaintiffs’ counsel have pointed to as circumstantial support for causation, even though the authors themselves were careful to characterize their findings as an observational association requiring further study, not proof of a causal drug effect.

The study has not gone unchallenged, and defense counsel will likely lean heavily on its acknowledged limitations. Peer commentary published alongside and after the article — including from Dr. Sreeram Ramagopalan and from Dr. Michael Larsen — raised concerns about residual confounding, noting the biological implausibility of a drug causing optic nerve damage within weeks of the Kaplan-Meier curves separating, and suggesting the effect could instead reflect rapid glycemic reduction itself (a phenomenon independently linked to worsening diabetic retinopathy) rather than semaglutide specifically. The authors also disclosed a single-center design, an inability to confirm medication adherence, a small number of underlying NAION events (37 and 32 across the two cohorts), and a study population with a lower proportion of Black patients than the general population, a group with an independently lower baseline NAION risk — all limitations likely to feature prominently in Daubert-style challenges to causation experts relying on this paper.

Despite those caveats, the Hathaway study’s publication marked a turning point: it was the first peer-reviewed research to identify this signal, prompting rapid attention from the FDA, replication attempts in other cohorts, and a wave of individual lawsuits alleging Novo Nordisk failed to warn patients and prescribers of NAION risk. Those cases have since been coordinated into an MDL, where causation — and the strength, limitations, and generalizability of studies like this one — will be front and center in the litigation’s early bellwether and general-causation proceedings.

Which Drugs Are Covered?

The New Jersey MCL is not limited to a single drug or manufacturer. The litigation encompasses the full range of GLP-1 receptor agonist medications from both Novo Nordisk and Eli Lilly that have been linked to the injuries alleged, including:

• Ozempic (semaglutide injectable) — Novo Nordisk
• Wegovy (semaglutide injectable, higher dose) — Novo Nordisk
• Rybelsus (oral semaglutide) — Novo Nordisk
• Saxenda (liraglutide) — Novo Nordisk
• Mounjaro (tirzepatide injectable) — Eli Lilly
• Zepbound (tirzepatide injectable) — Eli Lilly
• Trulicity (dulaglutide) — Eli Lilly

How the New Jersey MCL Differs From the Federal MDL

For plaintiffs and their attorneys, understanding the distinction between the New Jersey MCL and the federal MDL proceedings is essential. These are parallel but separate legal processes, and the choice between them — or the decision to pursue claims in both simultaneously — involves meaningful strategic considerations.

The Federal MDL Proceedings

The federal GLP-1 litigation is consolidated in the Eastern District of Pennsylvania before Judge Karen S. Marston and is divided into two MDLs. MDL 3094 covers gastrointestinal injury claims and currently encompasses more than 3,600 pending cases. MDL 3163 covers NAION vision loss claims and is growing rapidly since its establishment in December 2025. Both MDLs involve plaintiffs from across the country whose cases were filed in or transferred to federal court, and both operate under federal procedural rules.

The New Jersey MCL

The New Jersey MCL is a state-court proceeding. Cases filed in New Jersey state courts — or transferred there under the MCL designation — remain within the New Jersey judicial system and are governed by New Jersey procedural rules and substantive law. The presiding judge is Judge Gregg A. Padovano of the Bergen County Superior Court. The key practical differences between the two systems include:

• Governing law: federal MDL cases are governed by federal procedural rules; New Jersey MCL cases are governed by New Jersey Rules of Court
• Jury pool: state and federal courts draw from different jury pools, which can affect the composition and tendencies of juries in bellwether trials
• Substantive law: while failure-to-warn and products liability theories are broadly similar across jurisdictions, state-specific legal nuances can affect how claims are evaluated and what damages are available
• Discovery and case management: while federal and state proceedings may share expert witnesses and scientific evidence, their formal discovery processes are governed by separate rules and managed by separate judges

Why Plaintiffs Choose New Jersey State Court

The decision to file in New Jersey state court rather than federal court — or in addition to federal court — reflects a combination of legal strategy and practical circumstances. Plaintiffs and their counsel may prefer the New Jersey MCL for several reasons:

• State procedural rules may be more favorable for certain types of claims or evidence
• New Jersey’s established mass tort infrastructure provides a predictable and well-managed forum
• Novo Nordisk’s U.S. headquarters in New Jersey provides a robust jurisdictional basis that is difficult for the company to challenge
• State court litigation creates additional litigation pressure on manufacturers, increasing their overall settlement exposure across two parallel systems

Are the New Jersey Cases Class Actions?

No — and this is a distinction worth understanding clearly. The New Jersey GLP-1 proceedings are not class actions. They are coordinated individual lawsuits. Each plaintiff in the MCL maintains their own independent claim, based on their own medical history, their own injuries, and their own damages. Coordination is a procedural tool for managing the litigation efficiently — it does not merge claims or create a shared, undifferentiated plaintiff pool.

This structure means that compensation in the New Jersey MCL, as in the federal MDL, is evaluated on a case-by-case basis. A plaintiff with severe, well-documented injuries that required multiple hospitalizations and caused lasting disability is in a fundamentally different position than a plaintiff with a single adverse event that resolved without permanent consequences. The MCL structure ensures that both plaintiffs can be part of the coordinated litigation while having their individual circumstances fully considered at the resolution stage.

Core Legal Theories

The legal claims advanced in the New Jersey MCL are grounded in the same failure-to-warn and products liability framework that underlies the federal MDL proceedings. New Jersey products liability law provides plaintiffs with several distinct theories of recovery, each addressing a different aspect of the manufacturers’ alleged misconduct.

Failure to Warn

The central allegation across all GLP-1 litigation — in both federal and state proceedings — is that Novo Nordisk and Eli Lilly knew or should have known about serious risks including gastroparesis, bowel obstruction, and NAION, and failed to provide adequate warnings to patients and their physicians. The failure-to-warn theory examines not just whether warnings were eventually added to drug labels, but whether those warnings were provided in a timely manner and whether the manufacturers acted on available safety data promptly.

Negligence

Plaintiffs allege that the manufacturers were negligent in the design, testing, and post-market monitoring of their GLP-1 products — specifically, that they failed to adequately investigate and respond to adverse event reports that were accumulating well before any meaningful label changes were made.

Product Liability

Under New Jersey’s Products Liability Act, manufacturers can be held liable for harm caused by products that are not reasonably fit, suitable, or safe for their intended or reasonably foreseeable uses. GLP-1 plaintiffs argue that the drugs’ documented capacity to cause serious gastrointestinal and optic nerve injuries — without adequate warning — renders them defective under this standard.

Misrepresentation

Some plaintiffs also allege that the manufacturers’ marketing communications affirmatively minimized or misrepresented the risk profile of their GLP-1 products, contributing to a false impression of safety that influenced both prescribing decisions and patients’ informed consent.

What Plaintiffs Must Establish

As in the federal MDL, New Jersey MCL plaintiffs must build their claims on a foundation of objective medical evidence. The elements that plaintiffs are generally required to establish include the following:

• Confirmed use of a qualifying GLP-1 medication, documented through prescription records or pharmacy records
• A qualifying injury — typically gastroparesis confirmed by gastric emptying study for GI claims, or NAION confirmed by ophthalmological evaluation for vision loss claims
• Medical causation — evidence supporting the connection between GLP-1 use and the claimed injury
• Damages — documented medical costs, lost income, pain and suffering, and other quantifiable harm resulting from the injury

The evidentiary standards being applied in the New Jersey MCL are informed by developments in the federal MDL, including Judge Marston’s August 2025 ruling in MDL 3094 requiring objective gastric emptying study confirmation for gastroparesis claims. New Jersey plaintiffs and their attorneys should expect similarly rigorous documentation requirements, and patients who have not yet undergone appropriate diagnostic testing should prioritize doing so.

Bellwether Trials in New Jersey

Like the federal MDL, the New Jersey MCL is expected to utilize bellwether trials as a mechanism for testing the strength of the legal theories, evaluating jury response to the evidence, and generating settlement value benchmarks. Bellwether trials are not binding on other plaintiffs — they are representative test cases — but their outcomes are among the most powerful inputs into global settlement negotiations in pharmaceutical mass tort litigation.

The timing and selection of New Jersey bellwether cases will depend on the pace of pretrial proceedings and the state court’s case management orders. Coordination between the New Jersey MCL and the federal MDL — both formal and informal — is likely to influence how the two systems’ bellwether timelines interact, and legal analysts are watching both proceedings closely for signals about when early trials might begin.

The Relationship Between the New Jersey MCL and the Federal MDL

Although the New Jersey MCL and the federal MDL are separate legal proceedings governed by different rules and presided over by different judges, they are not operating in complete isolation. Both proceedings involve the same defendants, the same underlying drugs, the same categories of injury, and substantially the same scientific evidence. In practice, there is significant overlap in:

• Scientific and medical expert witnesses, many of whom are likely to be engaged by plaintiffs’ counsel in both proceedings
• Documentary discovery, including internal manufacturer records, clinical trial data, and regulatory correspondence
• Legal theory, with failure-to-warn arguments in New Jersey tracking closely with those being advanced in the federal MDL

Courts in both systems are aware of the parallel proceedings and may coordinate informally to avoid redundancy and promote efficiency. At the same time, each system’s rulings are independent and could potentially diverge in important ways — creating both strategic complexity and strategic opportunity for plaintiffs’ counsel managing cases in both venues.

Why the New Jersey MCL Matters Nationally

The significance of the New Jersey MCL extends beyond its impact on individual New Jersey plaintiffs. State court mass tort proceedings of this scale create systemic pressure on pharmaceutical defendants that the federal MDL alone cannot replicate. The practical consequences of parallel federal and state litigation include:

• Expanded discovery risk for manufacturers, who must respond to document requests and depositions in two parallel systems
• Additional bellwether trial exposure, with state court juries potentially producing outcomes that differ from federal court bellwether results
• Increased aggregate settlement pressure as the total litigation footprint — federal and state combined — grows larger
• A broader evidentiary record, as state and federal proceedings may develop different aspects of the scientific and regulatory record

The history of major pharmaceutical mass tort litigation confirms this pattern. Both the talc and Risperdal litigations, which New Jersey previously managed at scale, involved significant parallel state and federal proceedings that collectively shaped the manufacturers’ ultimate settlement decisions. GLP-1 litigation is following the same trajectory.

Current Status and What to Expect

As of May 2026, the New Jersey GLP-1 MCL is in active pretrial proceedings. Both the gastrointestinal injury track and the NAION vision loss track are accepting new filings, and case counts continue to grow as more injured patients come forward. No global settlement has been reached in either the New Jersey MCL or the federal MDL proceedings, and the litigation timeline is expected to run well into 2027 and beyond before global resolution discussions are likely to advance meaningfully.

The compensation available to New Jersey MCL plaintiffs will depend on the specific facts of each case. Damages that may be available include:

• Economic damages: medical expenses incurred, future treatment costs, lost wages, and diminished earning capacity
• Non-economic damages: pain and suffering, emotional distress, and loss of enjoyment and quality of life
• In cases involving permanent disability — such as irreversible vision loss from NAION or chronic gastroparesis — long-term care costs and ongoing quality-of-life impairments are significant components of the damages calculus

Key Takeaways

For plaintiffs, attorneys, and observers following the GLP-1 litigation, the New Jersey MCL represents a significant and growing component of the national legal response to these injuries. The essential points to understand are:

• New Jersey has established multicounty litigation (MCL) for GLP-1 lawsuits, covering both gastrointestinal injuries and NAION vision loss claims
• The MCL is presided over by Judge Gregg A. Padovano of the Bergen County Superior Court and operates under New Jersey procedural rules
• The New Jersey MCL is a separate proceeding from the federal MDL but involves substantially the same legal theories, injuries, and defendants
• Cases in the MCL are individual lawsuits — not a class action — and compensation is evaluated on the specific facts of each plaintiff’s case
• Novo Nordisk’s New Jersey headquarters and the state’s established mass tort infrastructure make it a strategically significant venue for GLP-1 plaintiffs
• The parallel state and federal proceedings collectively increase the litigation pressure on manufacturers and expand the evidentiary and bellwether trial record

Injured patients who are evaluating their legal options should consult with a qualified attorney to determine whether filing in New Jersey state court, the federal MDL, or both is appropriate for their specific circumstances. The procedural and substantive differences between the two systems can materially affect litigation strategy and, ultimately, outcomes.