Ozempic NAION Lawsuit Filings Nearly Double as the GLP-1 Vision-Loss MDL Frontloads Causation and Preemption

The Ozempic NAION lawsuit count nearly doubled over the summer, and two courts are now running the same fight

The federal Ozempic NAION lawsuit inventory stood at 216 actions on the Judicial Panel on Multidistrict Litigation (JPML)'s 1 September 2026 report, against a reported 110 three months earlier, and on 21 and 22 September a wave of national coverage — The Hill, the Boston Globe, ConsumerAffairs, Fox News and a run of Gray Television stations — put Novo Nordisk and Eli Lilly back in front of a general audience over claims that their GLP-1 drugs caused sudden, usually permanent, one-eye blindness. Nothing was decided in those two days; what changed is that a docket most practitioners had filed under "watch list" is now growing at roughly a case a day, on a schedule that puts general causation and federal preemption in front of the court a full year before any jury sees the litigation.

That schedule is the part the consumer coverage missed, and it is the part that decides the case. In Case Management Order No. 12, signed on 2 July 2026 and entered on 6 July, Judge Karen Spencer Marston granted the defendants' request for early discovery and motion practice on two cross-cutting issues: whether GLP-1 receptor agonists are capable of causing non-arteritic anterior ischemic optic neuropathy, and whether the failure-to-warn claims are preempted because the Food and Drug Administration would not have approved the warning the plaintiffs say was owed. Expert challenges and summary judgment motions are not due until 2 July 2027, with oppositions on 13 August and replies on 31 August. There is no Bellwether Trial date. On the public record there cannot realistically be one before 2028.

This piece sets out where the Ozempic NAION lawsuit docket actually stands — federal and state — what the epidemiology does and does not establish, why the United States label says nothing about NAION when the European one does, and what the frontloading order means for anyone holding or funding these claims.

How many Ozempic NAION lawsuits are pending, and where?

Two coordinated proceedings hold the bulk of the inventory, and they are not the same litigation as the better-known gastroparesis cases.

Proceeding	Court	Judge	Created	Injury	Actions pending
MDL No. 3163, In re: GLP-1 RAs NAION Products Liability Litigation, No. 2:25-md-03163	E.D. Pa.	Karen Spencer Marston	Transfer order 15 December 2025	NAION and related vision loss	216 (JPML report, 1 September 2026); 110 reported at 1 June 2026
MDL No. 3094, In re: GLP-1 RAs Products Liability Litigation	E.D. Pa.	Karen Spencer Marston	Transfer order 2 February 2024	Gastroparesis, ileus and related gastrointestinal injury	approx. 4,022 (1 September 2026)
New Jersey NAION multicounty litigation	Superior Court of New Jersey, Bergen County	Gregg A. Padovano	Supreme Court orders 16 October 2025; Notice to the Bar 12 November 2025	NAION vision loss	not separately published; one plaintiffs' firm alone reported more than 90 New Jersey filings
New Jersey GLP-1 gastrointestinal multicounty litigation	Superior Court of New Jersey, Bergen County	Gregg A. Padovano	Supreme Court orders 16 October 2025	Gastrointestinal injury	not separately published

The growth rate is the number that should move a practitioner's assessment. Going from a reported 110 actions on 1 June 2026 to 216 on 1 September is a 96% increase across the JPML's summer reporting cycle — roughly 106 net new federal filings in 92 days. For comparison, the gastroparesis Multidistrict Litigation (MDL) took its own first year to reach a few hundred actions before its steep curve began. A vision-loss docket that adds a case a day in its ninth month is not a boutique inventory; it is an inventory in the early part of a growth curve, and the filing pace is running well ahead of the schedule the court has set for deciding whether any of it is viable.

Two cautions on the counts. First, the 110 figure at 1 June 2026 appears in litigation trackers rather than in a document this desk was able to retrieve, and is reported here as such. Second, the federal number is not the total claim population. New Jersey's state-court track carries its own inventory, direct-filed cases and tolled claims sit outside both, and firm-side pages circulating aggregate figures in the thousands do not reconcile with the JPML's published count. The only number with a public, dated, institutional source behind it is 216.

Who are the defendants in the GLP-1 vision loss litigation, and what do the complaints allege?

The defendants are Novo Nordisk and Eli Lilly, and the products span three molecules. Novo Nordisk markets semaglutide as Ozempic and Rybelsus for type 2 diabetes and as Wegovy for weight management, and liraglutide as Victoza and Saxenda. Eli Lilly markets tirzepatide as Mounjaro and Zepbound, and dulaglutide as Trulicity. The complaints reported in the 21-22 September coverage name semaglutide, tirzepatide and dulaglutide products, which means the litigation is no longer a single-molecule case against a single manufacturer even though semaglutide sits at its centre and carries almost all of the published epidemiology.

The core theory is Failure to Warn. Plaintiffs allege that the manufacturers knew or should have known of a signal linking GLP-1 receptor agonists to NAION, that the United States prescribing information warns about diabetic retinopathy complications and generalised "vision changes" but nowhere identifies NAION or the risk of sudden permanent monocular blindness, and that a physician who had been told would have counselled, monitored or prescribed differently. Because prescription pharmaceuticals run through the Learned Intermediary Doctrine, the duty is owed to the prescriber rather than to the patient, so the operative question at trial is not what the claimant read but what the neuro-ophthalmologist or endocrinologist would have done with a warning that did not exist. Design Defect and negligence counts follow, along with the usual consumer-protection and warranty claims that vary by filing state.

Both companies deny causation and are defending. The position reported across the 21-22 September coverage is consistent and narrow: the epidemiological record does not establish that these drugs cause NAION, and association in observational data is not causation. That is not a throwaway line. It is precisely the ground on which Judge Marston has ordered the parties to fight first.

Does Ozempic cause NAION? What the epidemiology actually says

NAION is an infarction of the optic nerve head — reduced blood flow to the anterior optic nerve — that typically presents as painless, sudden vision loss in one eye, often noticed on waking. It is uncommon in the general population, it is strongly associated with a crowded optic disc ("disc at risk"), diabetes, hypertension, sleep apnoea and other vascular risk factors, and the deficit is usually permanent though generally stable after onset. Every one of those baseline associations is also a confounder in a population taking drugs prescribed for diabetes and obesity, which is the single most important fact about the evidence base.

Study	Design and population	Result	Principal limitation
Hathaway et al., JAMA Ophthalmology, 3 July 2024 (Mass Eye and Ear; senior author Joseph Rizzo)	Retrospective single-centre matched cohort of neuro-ophthalmology patients; 710 patients with type 2 diabetes	Hazard ratio 4.28 (95% CI 1.62-11.29) at 36 months in the diabetes cohort; 7.64 in the overweight/obesity cohort	Single institution, referral population, small sample, short follow-up, limited adjustment for confounders including BMI and surgical history; wide confidence interval
Simonsen et al., Diabetes, Obesity and Metabolism, 2025;27(6):3094-3103	National registry cohort, Denmark 2018-2024 and Norway 2018-2022; 44,517 Danish and 16,860 Norwegian semaglutide initiators compared with SGLT-2 inhibitor initiators; 32 NAION events	Pooled adjusted hazard ratio 2.81 (95% CI 1.67-4.75); incidence rate difference +1.41 per 10,000 person-years	Only 32 outcome events across two countries; active-comparator design mitigates but does not eliminate confounding by indication
Danish registry cohort, International Journal of Retina and Vitreous, 2024	All persons with type 2 diabetes in Denmark 2018-2024, n = 424,152, stratified by once-weekly semaglutide exposure	Roughly doubled five-year risk of NAION	Registry coding of NAION; residual confounding
EMA Pharmacovigilance Risk Assessment Committee, 6 June 2025	Regulatory review of the accumulated epidemiology for semaglutide	NAION classified as a "very rare" side effect, up to 1 in 10,000; approximately two-fold relative increase; approximately one extra case per 10,000 person-years	A regulatory frequency classification, not a causation finding by a court

Read together, those results point in one direction on relative risk and in a very different direction on absolute risk. A hazard ratio somewhere between two and four, applied to a condition whose background incidence is on the order of a few cases per 10,000 person-years, produces roughly one additional case per 10,000 patient-years of treatment — which is what the European regulator said in terms. That combination is what makes this litigation legally interesting rather than straightforward. A consistent relative signal across independent designs is good material for a General Causation expert. A tiny absolute effect on a condition with heavy vascular confounding, and a total of 32 events across two national registries, is good material for a Daubert Challenge.

The first author of the study that started the whole sequence has been explicit about the limits of his own work. Dr Joseph Rizzo, whose group published the 2024 JAMA Ophthalmology analysis, has said: "To be perfectly clear, I would not take my findings and use them to recommend that patients stop taking their medications." Expect that sentence to appear in the defendants' Rule 702 briefing. Expect plaintiffs to answer that a scientist's clinical caution about individual prescribing decisions is not a concession about whether a drug is capable of causing an injury — a distinction that maps exactly onto the difference between General Causation and Specific Causation.

Why the US Ozempic label does not warn about NAION when the European one does

This is the fact that will decide the preemption motion, and it is the fact almost none of the consumer coverage develops.

Jurisdiction	Regulator	Status of NAION in the product information
United States	Food and Drug Administration	Not listed for Ozempic, Wegovy or Rybelsus; labels address diabetic retinopathy complications and general vision changes
European Union	European Medicines Agency / PRAC	NAION added as a "very rare" undesirable effect following the PRAC conclusion of 6 June 2025; product information for Ozempic, Rybelsus and Wegovy updated 30 September
United Kingdom	Medicines and Healthcare products Regulatory Agency	Drug Safety Update of 5 February 2026 warning of a likely association between semaglutide and NAION

The World Health Organization issued its own statement on semaglutide and NAION on 27 June 2025. The pattern is therefore that three non-US regulators have acted on the same evidence base that the FDA has, to date, not acted on in the same way.

Under settled law that divergence cuts both ways, which is why the parties are willing to litigate it early. Preemption (Products) in branded pharmaceutical failure-to-warn cases runs through Wyeth v. Levine, 555 U.S. 555 (2009), which held that a manufacturer may ordinarily strengthen a warning unilaterally through the changes-being-effected process and that state-law claims are preempted only where there is "clear evidence" the FDA would have rejected the stronger warning, and Merck Sharp & Dohme Corp. v. Albrecht, 587 U.S. 299 (2019), which held that the question is one of law for the judge and requires the manufacturer to show the agency was fully informed and nonetheless refused.

Plaintiffs will say the EU and UK actions prove the warning was both scientifically supportable and practically achievable: a company that can add NAION to a European label on this record cannot claim it was disabled from adding it in the United States. Defendants will say the opposite inference is available — that the FDA has had the same studies, the same PRAC conclusion and the same foreign labelling since mid-2025, and has not required a NAION warning, which is itself evidence about what the agency would have permitted. Which of those readings prevails depends on the administrative record: what Novo Nordisk and Eli Lilly submitted to the FDA, when, and what the agency said back. That record is exactly what the early discovery authorised by Case Management Order No. 12 is designed to produce.

One related item belongs in the file with a clear health warning attached. The FDA has published a warning letter to Novo Nordisk Inc. (CMS reference 716495) dated 9 September 2025, described in secondary coverage as concerning the company's adverse-event reporting procedures. No public source available to this desk connects that letter to NAION specifically, and it should not be characterised as a NAION finding. It is, however, the kind of document that plaintiffs' counsel will seek to put in front of a jury on the question of what the company knew and how it handled signals, and defence counsel should assume it will be pressed.

Case Management Order No. 12: the defence asked for the fight to come early, and got it

Frontloading is the defining structural choice in modern pharmaceutical Mass Tort practice, and Judge Marston has now made it twice in the same building.

Case Management Order No. 12 granted the defendants' request for early discovery and motion practice on general causation and on preemption/warning adequacy, and directed the parties to meet and confer on a proposed scheduling order covering discovery and motion deadlines on those issues, together with a schedule for exchanging Plaintiff Fact Sheet (PFS) submissions and the medical records establishing proof of use and proof of diagnosis, with proposals due 13 July 2026. A Science Day — the non-adversarial tutorial in which each side's experts educate the court — was held on 2 June 2026, a month before the order. Leadership was in place by the first quarter of 2026: Jonathan Orent of Motley Rice and Parvin Aminolroaya of Seeger Weiss as co-lead counsel, with Jason Goldstein of Parker Waichman appointed by order of 23 February 2026 as co-chair of the Plaintiffs' Executive Committee and federal-state court liaison.

Date	Event
3 July 2024	Hathaway et al. publish the first semaglutide-NAION association in JAMA Ophthalmology
6 June 2025	EMA's PRAC concludes NAION is a "very rare" side effect of semaglutide
27 June 2025	World Health Organization issues a statement on semaglutide and NAION
30 September 2025	EU product information for Ozempic, Rybelsus and Wegovy updated to include NAION
16 October 2025	New Jersey Supreme Court orders designating separate gastrointestinal and NAION multicounty litigations, both to Bergen County
12 November 2025	New Jersey Notice to the Bar published
15 December 2025	JPML transfer order creates MDL No. 3163 in the Eastern District of Pennsylvania before Judge Marston
23 February 2026	Order appointing co-chair of the Plaintiffs' Executive Committee and federal-state liaison
5 February 2026	UK MHRA Drug Safety Update on semaglutide and NAION
1 June 2026	110 actions reported pending in MDL 3163
2 June 2026	Science Day before Judge Marston
2 July 2026	Case Management Order No. 12 signed, frontloading general causation and preemption; entered 6 July
13 July 2026	Parties' proposed schedule on cross-cutting issues due
1 September 2026	216 actions pending in MDL 3163; approx. 4,022 in MDL 3094
10-18 September 2026	Rule 702 general causation hearing held in the separate gastroparesis MDL 3094
25 September 2026	Proposed Plaintiff Fact Sheet reported due in the New Jersey NAION multicounty litigation
28 October 2026	Master complaint reported due in the New Jersey NAION multicounty litigation
2 July 2027	Expert challenges and summary judgment motions due in MDL 3163
13 August 2027	Oppositions due
31 August 2027	Replies due

The precedents for what frontloading does to a pharmaceutical docket are unhelpfully varied, which is why nobody should be pricing this inventory with confidence. In the Zantac litigation, MDL No. 2924, Judge Rosenberg excluded all of the plaintiffs' general causation experts on 6 December 2022 and roughly 50,000 federal claims fell. In the acetaminophen autism litigation the Second Circuit vacated Judge Cote's exclusion on 13 July 2026 in Rutledge v. Walgreen Co. and revived around 550 cases, demonstrating that a Rule 702 ruling is not the end of the road it is often described as. In the Depo-Provera litigation, MDL No. 3140, the parties reached a global settlement in mid-2026 while the general causation and preemption motions were still under advisement, and the court kept the evidentiary machinery alive for the claims the deal did not reach.

Those three outcomes — annihilation, revival, and settlement-with-a-residue — are the realistic range here, and the schedule means none of them arrives before the second half of 2027.

What is the difference between MDL 3163 and MDL 3094?

They involve the same judge, largely the same defendants and substantially overlapping counsel, but they are separate dockets with separate injuries, separate science and separate label sections.

MDL No. 3094, created by transfer order of 2 February 2024, is the gastrointestinal litigation: gastroparesis, ileus, bowel obstruction. Its general causation record concerns gastric motility. Judge Marston frontloaded three cross-cutting issues there as well, deciding the first on 15 August 2025 when she excluded the plaintiffs' diagnostic opinions and held that a gastroparesis claim requires a gastric emptying study performed at the time of diagnosis, and reserving the balance for a Rule 702 hearing held over 10-18 September 2026 and taken under advisement.

MDL No. 3163, created 15 December 2025, is the ophthalmic litigation. Its general causation record concerns optic nerve head perfusion, disc morphology and vascular confounding. Nothing decided in MDL 3094 binds it. The expert sets do not overlap, the relevant label sections are different, and the regulatory history is different — there is no EU-level regulatory conclusion on gastroparesis comparable to the PRAC's June 2025 conclusion on NAION.

The Panel's decision to create a second MDL rather than fold the vision cases into the existing one is a judgment that common factual questions run along injury lines rather than product lines. Assigning both to the same judge captures the efficiencies that do exist — overlapping corporate custodians, overlapping regulatory files, overlapping counsel — without forcing one general causation record to carry two unrelated biological mechanisms. For practitioners the practical consequence is blunt: a client with both gastrointestinal injury and NAION has claims in two federal dockets that are coordinated by geography and personnel but not by outcome, and a defeat in one does not dispose of the other.

What is the New Jersey GLP-1 NAION multicounty litigation?

New Jersey's multicounty litigation is the state-court analogue of an MDL, and it matters here more than the state track usually does, because Novo Nordisk's United States corporate presence sits in New Jersey and a large share of the state filings come from a single plaintiffs' firm inventory — Weitz & Luxenberg alone has reported bringing more than 90 New Jersey NAION cases since 2025.

By orders dated 16 October 2025, published to the bar on 12 November 2025, the New Jersey Supreme Court declined to combine the GLP-1 gastrointestinal claims and the NAION claims and instead designated them as two separate and distinct multicounty litigations, assigning both to Bergen County for centralised case management before Superior Court Judge Gregg A. Padovano. That is the same structural judgment the JPML made two months later in Washington: the injuries are different enough that one record cannot carry both.

Litigation trackers report the near-term New Jersey schedule as a proposed Plaintiff Fact Sheet due 25 September 2026 — two days from today — and a master complaint due 28 October 2026. Those dates come from secondary sources rather than from an order this desk could retrieve, and should be confirmed against the Multicounty Litigation Center postings before anyone calendars them. If they hold, New Jersey will have a pleaded master complaint on file roughly eight months before the federal parties finish briefing general causation, which gives the state court the first look at the sufficiency of the warning theory.

The federal-state liaison appointment made by Judge Marston's 23 February 2026 order is the mechanism by which the two tracks are supposed to stay aligned. In practice the alignment is asymmetric: the New Jersey court is not bound by anything Judge Marston decides on Rule 702, but a federal exclusion order would be cited in Bergen County within the week, and a federal ruling that the failure-to-warn claims are preempted would be equally portable, since preemption is a question of federal law that binds state courts on the merits.

Who qualifies to file an Ozempic NAION lawsuit?

Eligibility in this litigation is documentary before it is legal, and the frontloading order has tightened it. Case Management Order No. 12 expressly contemplated a schedule for exchanging fact sheets and the medical records establishing proof of use and proof of diagnosis. That is the court telling both sides it does not intend to carry unverified inventory into an expert fight.

Three elements do the work. The first is proof of use: pharmacy records, prescription history or dispensing records showing the specific GLP-1 product, dose and dates. The second is proof of diagnosis, and it is a higher bar here than in most drug torts, because NAION is a clinical diagnosis of exclusion made by an ophthalmologist or neuro-ophthalmologist on examination and imaging, and must be distinguished from arteritic anterior ischemic optic neuropathy, optic neuritis and other causes of acute optic neuropathy. A chart note reading "vision loss" will not survive a fact-sheet audit. The third is temporality: onset during or reasonably proximate to exposure, which is why prescription dates and the date of first symptom are the two entries most likely to be contested.

Then there is time. The Statute of Limitations for personal injury runs from one to six years depending on the filing state, with most between two and three, and a Statute of Repose applies in a minority of jurisdictions. The Discovery Rule matters unusually much in this litigation because the injury is sudden and obvious while the alleged cause was not publicly identified until the July 2024 publication and, in regulatory terms, until the June 2025 PRAC conclusion. Where the accrual clock started for a 2021 NAION diagnosis is a genuinely open question that will be litigated state by state, and it is the kind of question that produces early dismissals long before any expert is deposed.

How much are Ozempic NAION settlements worth?

There is no answer to this question, and the honest version of the answer is more useful than the numbers circulating.

No settlement has been reached in MDL 3163 or in the New Jersey multicounty litigation. No Settlement Matrix exists. No bellwether has been tried, so there is no verdict data point of any kind. The figures a reader will find — ranges of a few hundred thousand dollars for unilateral vision loss, more for bilateral — appear exclusively on law-firm marketing pages and are extrapolations from unrelated litigations, not terms disclosed by any party or approved by any court. This desk has deliberately published none of them.

What can be said is structural. Damages in a NAION case are driven by a small number of facts: whether the loss is monocular or binocular, visual acuity and field deficit at stabilisation, age at onset, occupational impact including loss of a driving licence or a licensed occupation, and the presence or absence of the competing vascular risk factors that give the defence a Specific Causation argument in the individual case. That last item is why this litigation is likely to produce an unusually wide spread between the strongest and weakest claims within the same inventory. A 45-year-old Wegovy user with no diabetes, no hypertension and bilateral sequential NAION is a very different claim from a 68-year-old with 20 years of type 2 diabetes, sleep apnoea and a crowded disc — and the second description fits a large share of the exposed population.

Anyone building a valuation model before the 2 July 2027 motions are decided is modelling a binary, not a distribution.

What it means for claimants' counsel, defence counsel and litigation funders

For claimants' counsel, the frontloading order converts the next nine months into a records exercise rather than a filing exercise. Inventory acquired without ophthalmology records and pharmacy data is inventory that will be audited out, and a fact-sheet regime negotiated in mid-2026 will be enforced in 2027. The second-order point is jurisdictional: where a client has a viable New Jersey venue, the state track is currently ahead on pleading and behind on causation, which is a different risk profile from the federal docket and may suit a different claim.

For defence counsel, the label-divergence problem is the file. The EU and UK actions of 2025 and early 2026 are on the record, they are dated, and they will be the first exhibits in any opposition to a preemption motion. Preserving and marshalling the FDA correspondence — submissions, safety-signal evaluations and any agency response on NAION — is the work that decides whether Albrecht is available at all. Separately, the pace of filing means the population of claimants whose diagnoses predate July 2024 is growing, and limitations and repose defences are the cheapest dispositive motions on the board.

For litigation funders and portfolio buyers, this is a pre-causation asset with a dated binary event in July 2027 and no trial until 2028 at the earliest. Third-Party Litigation Funding priced against a 2027 Rule 702 ruling is priced against Zantac on one side and Rutledge on the other, and the spread between those two outcomes is close to the full value of the book. The growth in filings does not reduce that risk; it concentrates it, because every new case is exposed to the same single ruling.

For everyone, the discipline is the same: treat the 216 figure as the only published count, treat the New Jersey dates as reported rather than verified, and confirm both from the dockets before relying on either. This is analysis of a public record, not legal advice, and nothing here should be used to assess an individual claim.

Frequently asked questions

What is the Ozempic NAION lawsuit about?

It is a products liability litigation alleging that GLP-1 receptor agonists — semaglutide, tirzepatide and dulaglutide, sold as Ozempic, Wegovy, Rybelsus, Mounjaro, Zepbound and Trulicity — can cause non-arteritic anterior ischemic optic neuropathy, a sudden and usually permanent loss of vision in one eye, and that Novo Nordisk and Eli Lilly failed to warn United States prescribers of that risk. The federal cases are consolidated as MDL No. 3163 in the Eastern District of Pennsylvania before Judge Karen Spencer Marston.

How many Ozempic NAION lawsuits are pending in MDL 3163?

216 actions were pending on the JPML's report of 1 September 2026, up from a reported 110 on 1 June 2026. The separate gastroparesis docket, MDL No. 3094, held approximately 4,022 actions on the same date. New Jersey's state multicounty litigation carries additional claims that are not included in either federal count.

Does Ozempic cause NAION?

No court has decided that question, and it is the first issue Judge Marston has ordered litigated. The published epidemiology consistently reports an elevated relative risk — hazard ratios of roughly 2.8 in a Danish-Norwegian registry cohort and 4.28 in the 2024 JAMA Ophthalmology single-centre study — while the absolute effect is small, on the order of one additional case per 10,000 person-years, which is the figure the European Medicines Agency used when it classified NAION as a "very rare" side effect of semaglutide on 6 June 2025. Whether that record satisfies Federal Rule of Evidence 702 is the subject of motions due 2 July 2027.

When will the first GLP-1 vision loss trial happen?

No bellwether trial date has been set. Expert challenges and summary judgment motions on general causation and preemption are due 2 July 2027, with briefing closing on 31 August 2027. A bellwether pool would be selected after those rulings, so on the current schedule the first trial is unlikely before 2028.

What is the difference between MDL 3163 and MDL 3094?

MDL 3094 is the gastrointestinal litigation — gastroparesis and ileus — centralized on 2 February 2024. MDL 3163 is the vision-loss litigation, centralized on 15 December 2025. Both are before Judge Marston in the Eastern District of Pennsylvania, but they have separate dockets, separate general causation records, separate experts and separate label theories, and a ruling in one does not bind the other.

Who qualifies to file an Ozempic NAION lawsuit?

At the threshold, a claimant needs documented use of a GLP-1 product with dates and dosing, an NAION diagnosis made by an ophthalmologist or neuro-ophthalmologist and distinguished from arteritic optic neuropathy and other causes, and onset during or proximate to exposure. Beyond that, the claim must be timely under the filing state's Statute of Limitations, which runs from one to six years and may be affected by the Discovery Rule given that the alleged association was not published until July 2024.