Q1 2026 MDL Snapshot: 158 Dockets, 197K Cases, and Where the Mass Tort Landscape Stands

The federal multidistrict litigation system entered 2026 carrying 158 active MDL dockets and 197,965 pending actions spread across 46 transferee districts. The concentration at the top is striking: the 25 largest MDLs account for 95.2% of all pending cases. Everything else—133 dockets—shares the remaining 4.8%.

That concentration matters because trial dates, settlement frameworks, and records preparation windows are converging across multiple dockets simultaneously. Firms managing portfolios in any of the major MDLs face overlapping deadlines, shifting causation standards, and case volumes that demand infrastructure built for scale. This is where the landscape stands heading into Q1 2026.

The Top 10 MDLs by Case Count

The January 2026 data from MDL Update ranks every active docket by pending actions. Here are the ten largest.

1. Johnson & Johnson Talcum Powder (MDL-2738) — 67,580 cases. The single largest MDL by a wide margin. J&J's third-party bankruptcy strategy through subsidiary LTL Management has been rejected twice by federal courts, keeping tens of thousands of ovarian cancer claims in active litigation.

2. Bard Hernia Mesh (MDL-2846) — 23,749 cases. Bellwether trials have already produced plaintiff verdicts, and settlement tiers are being shaped by the severity of complications—adhesion, infection, chronic pain, and organ perforation.

3. AFFF Firefighting Foam (MDL-2873) — 15,213 cases. PFAS personal injury claims grew nearly 99% in 2025. Municipal water system settlements have exceeded $12 billion, but individual plaintiff claims remain unresolved.

4. Proton-Pump Inhibitor II (MDL-2789) — 11,322 cases. Kidney injury claims against manufacturers of drugs like Nexium and Prilosec. The docket has seen slower movement relative to its size.

5. Hair Relaxer (MDL-3060) — 10,948 cases. Cases alleging chemical hair straightening products caused uterine cancer and endometriosis. Approximately 247 new cases are filing per month, with critical Daubert motions scheduled for April 2026.

6. Bair Hugger Warming (MDL-2666) — 8,666 cases. Alleging 3M's forced-air warming device caused deep joint infections following hip and knee replacements.

7. Cook Medical IVC Filters (MDL-2570) — 6,896 cases. Claims that inferior vena cava filters fractured, migrated, or perforated organs. One of the longer-running device MDLs.

8. Paraquat (MDL-3004) — 6,476 cases. Plaintiffs allege the herbicide caused Parkinson's disease. Settlement framework discussions are ongoing following early bellwether outcomes.

9. Roundup (MDL-2741) — 4,511 cases. The Bayer/Monsanto herbicide litigation continues despite $10+ billion in settlement commitments. Remaining cases involve plaintiffs who opted out of prior settlement rounds.

10. Paragard IUD (MDL-2974) — 3,800 cases. Claims that the copper IUD fractured during removal, causing injury, additional surgeries, or infertility.

The Fast Movers

Raw case count doesn't capture momentum. Several MDLs outside the top 10 are growing at rates that signal significant litigation ahead.

GLP-1/Ozempic (MDL-3094) is the headline growth story. The docket has surpassed 3,191 pending actions with a 130% year-over-year increase, fueled by gastroparesis and vision loss claims against drugs used by over 31 million Americans. Bellwether selection is expected by mid-2026.

Depo-Provera (MDL-3140) moved from consolidation to over 2,100 cases in a matter of months, with plaintiffs alleging the contraceptive injection caused meningioma brain tumors. Plaintiff fact sheets and initial case management orders are shaping the early litigation framework.

NEC Baby Formula sits at 750+ cases in the federal MDL with bellwether trials scheduled for August 2026, November 2026, and February 2027. The litigation alleges cow's milk-based formula caused necrotizing enterocolitis in premature infants.

Camp Lejeune occupies a unique position with 3,600+ federal lawsuits and 409,910 administrative claims pending under the Camp Lejeune Justice Act. More than $530 million has been paid, but the vast majority of claims remain in the pipeline with bellwether trials set for 2026.

Key Dates to Watch

The next 12 months carry a dense calendar of milestones that will shape settlement values and case trajectories across multiple MDLs.

Each of these milestones carries downstream effects. A Daubert ruling in hair relaxer affects how firms evaluate existing inventory. A bellwether verdict in NEC sets the range for formula case values. Firms tracking multiple MDLs simultaneously need visibility into these timelines to prioritize case preparation.

The Records Dimension

MDL scale creates a distinct set of medical record retrieval challenges that compound as docket sizes grow.

Each of the top 10 MDLs requires a different mix of medical specialties, record types, and provider networks. Talcum powder cases need gynecological oncology records spanning decades. Hernia mesh requires surgical records, follow-up imaging, and complication documentation. AFFF cases demand records from military, occupational health, and civilian providers across 10- to 30-year exposure windows. GLP-1 cases require pharmacy records, gastroenterology specialist notes, and objective diagnostic testing that courts have mandated as a threshold requirement.

When a firm holds inventory across three or four of these MDLs, the retrieval complexity multiplies. Different providers, different record formats, different clinical vocabularies—all feeding into different causation standards.

Platforms built for this kind of volume and variety, including AI-powered retrieval services like LlamaLab, address the problem by automating provider discovery, pulling records from multiple source types simultaneously, and flagging the specific clinical evidence each MDL requires.

The Bottom Line

The Q1 2026 MDL landscape is defined by concentration and convergence. Nearly all of the case volume sits in a handful of dockets, and those dockets are approaching trial dates, Daubert deadlines, and settlement milestones within overlapping windows. The firms that will be positioned to move when verdicts come in are the ones building complete, evidence-ready case files now—not after bellwether results set the value floor.

For any firm tracking mass tort portfolios, this data should drive two decisions: which MDLs justify continued investment, and whether the operational infrastructure is in place to prepare cases at the pace the courts are demanding.

Sources: JPML Pending MDLs, MDL Update — January 2026, MDL Update — February 2026. Case counts reflect January 2026 JPML data unless otherwise noted. Growth rates calculated from publicly available MDL statistics.