Daniela Palme
Oct 3, 2025
As of September 2025, over 800 lawsuits are pending in the federal MDL, with the litigation growing by approximately 10 new cases per day. A critical federal preemption ruling expected in late September/October 2025 could determine the future of the entire MDL. The litigation is moving quickly, with aggressive discovery deadlines and potential bellwether trials on the horizon.
Understanding the Depo-Provera Litigation
Women across the United States are filing lawsuits claiming that Depo-Provera, a popular birth control injection, caused them to develop brain tumors called intracranial meningiomas. These cases have been consolidated into a rapidly growing multidistrict litigation that could affect thousands of women who used this contraceptive.
Bottom Line Up Front: As of September 2025, over 800 lawsuits are pending in the federal MDL, with the litigation growing by approximately 10 new cases per day. A critical federal preemption ruling expected in late September/October 2025 could determine the future of the entire MDL. The litigation is moving quickly, with aggressive discovery deadlines and potential bellwether trials on the horizon.
Key Information About the Depo-Provera MDL
MDL Number: MDL 3140 (In re: Depo-Provera [Depot Medroxyprogesterone Acetate] Products Liability Litigation)
Court Location: U.S. District Court for the Northern District of Florida
Presiding Judge: Judge M. Casey Rodgers
Date Established: February 7, 2025
Current Case Count: Over 800 cases as of September 2025 (up from 550 in August)
Special Master: The Honorable David Herndon (Retired)
Data Administrator: BrownGreer PLC
Leadership Team
Judge Rodgers appointed a comprehensive leadership structure on March 16, 2025, to coordinate the litigation on behalf of the plaintiffs.
Lead and Co-Lead Counsel:
Lead Counsel:
Christopher Seeger - Seeger Weiss LLP
Co-Lead Counsel:
Bryan Aylstock - Aylstock, Witkin, Kreis & Overholtz PLLC (AWKO)
Ellen Relkin - Weitz & Luxenberg PC
Plaintiffs' Liaison Counsel:
Christopher Paulos - Levin Papantonio
Plaintiffs' Executive Committee:
The six-member Executive Committee includes:
Virginia Buchanan (Co-Chair) - Levin Papantonio (also serves on Trial Subcommittee)
Additional committee members coordinating strategy and discovery
Plaintiffs' Steering Committee:
A ten-member committee focused on organization and efficiency, including:
Savannah Green - Aylstock, Witkin, Kreis & Overholtz PLLC
Science Committee:
Doug Kreis (Co-Chair) - Aylstock, Witkin, Kreis & Overholtz PLLC
This diverse leadership team brings extensive experience from other major pharmaceutical litigations, including the massive 3M Combat Arms Earplug cases that Judge Rodgers previously oversaw.
Who Are the Defendants?
The primary defendants in the Depo-Provera litigation include:
Pfizer Inc. - Current manufacturer and marketer of Depo-Provera
Pharmacia & Upjohn Company LLC - Pfizer subsidiary involved in manufacturing
Pharmacia LLC - Related Pfizer entity
Generic Manufacturers:
Initially included Greenstone LLC, Viatris Inc., and Prasco LLC.
Prasco has been dismissed from the litigation.
Greenstone and Viatris remain as defendants for the generic versions.
What is Depo-Provera?
Depo-Provera (medroxyprogesterone acetate or DMPA) is a hormonal contraceptive injection administered every three months. It has been widely used in the United States since the 1960s and works by:
Preventing ovulation
Thickening cervical mucus
Thinning the uterine lining
Medical Uses:
Birth control (primary use)
Managing endometriosis
Treating abnormal uterine bleeding
Managing heavy or irregular periods
Brand Names and Products:
Depo-Provera (150 mg intramuscular injection)
Depo-SubQ Provera 104 (104 mg subcutaneous injection - lower dose alternative)
Various generic equivalents
The Science: What Are Meningiomas?
Meningiomas are tumors that develop in the meninges, the protective membranes surrounding the brain and spinal cord. While often benign (non-cancerous), they can cause serious health complications.
Symptoms and Complications:
Severe headaches
Seizures
Vision or hearing loss
Memory impairment
Motor function problems
Cognitive changes
Personality changes
Treatment: Many meningiomas require surgical removal (craniotomy), radiation therapy, or ongoing monitoring.
Key Scientific Studies
French Study (2024): The landmark research that triggered the litigation revealed a significant association between Depo-Provera use and an increased risk of meningioma.
University of British Columbia Study (February 2025): Found a 3.55 times higher risk of meningiomas in Depo-Provera users compared to those using other hormonal contraceptives like ethinylestradiol-levonorgestrel.
JAMA Neurology Study (September 2025): Published research showing women who used depot medroxyprogesterone acetate had a "statistically significant increased relative risk of developing a meningioma diagnosis" compared to those using other birth control or no birth control. The risk was highest in women who:
Began using the injection after age 31
Used it for 4 years or more
New Zealand Regulatory Action (March 2025): Medsafe, New Zealand's drug regulatory agency, issued an updated safety notice identifying meningioma as a "very rare" but serious side effect and advised discontinuation of the medication if meningioma is diagnosed.
European Warnings: In Europe, Depo-Provera labels already include warnings about the risk of meningioma, raising questions about why U.S. labels lack similar warnings.
What Are Plaintiffs Alleging?
Lawsuits allege that Pfizer and other defendants:
Knew or should have known that prolonged Depo-Provera use significantly increases the risk of brain and spinal tumors
Failed to adequately warn patients and healthcare providers about these serious risks
Concealed evidence linking the drug to meningiomas despite having access to scientific research
Failed to promote safer alternatives like Depo-SubQ Provera 104, which uses a lower dose (104mg vs 150mg) administered subcutaneously rather than intramuscularly.
Continued marketing the drug without updating warning labels, even as European regulators required warnings
The Federal Preemption Battle
The most critical issue currently facing the MDL is Pfizer's federal preemption defense. This legal argument could potentially dismiss hundreds of cases before full discovery is completed.
Pfizer's Argument:
The FDA rejected Pfizer's proposed warning label about meningioma risk in 2024
Since the FDA said "no" to the warning, state law cannot require Pfizer to warn about the risk.
Federal law (FDA authority) preempts state failure-to-warn claims.
Plaintiffs' Response:
Pfizer's proposed label language was too vague and lacked scientific specificity.
The FDA rejected the inadequate language, not the concept of a warning.
Pfizer could have provided better scientific support and clearer warning language.
Pfizer had the authority to independently strengthen warnings.
Other claims (design defect) remain viable even if preemption succeeds.
The Stakes: If Judge Rodgers rules in favor of preemption, failure-to-warn claims could be dismissed, though design defect claims would survive. If she rules against preemption, the full litigation moves forward with all claims intact.
Expected Ruling: Most legal analysts predict Judge Rodgers will rule in favor of plaintiffs on this issue, but the outcome remains uncertain.
The Safer Alternative Argument
A key aspect of the litigation focuses on Depo-SubQ Provera 104, an alternative product that:
Contains a lower dose (104mg vs 150mg)
Is administered subcutaneously instead of intramuscularly
Is equally effective as a contraceptive
Is FDA-approved but minimally marketed by Pfizer in the U.S.
Plaintiffs argue that this represents a design defect claim: Pfizer had a safer alternative available but continued to market the higher-dose version without adequate warnings.
This claim is not affected by federal preemption arguments and could survive even if failure-to-warn claims are dismissed.
State Court Activity
While the federal MDL is the center of activity, state court litigation is also developing:
Philadelphia: Initially appeared to be a major venue with approximately 100 cases, but after a judge severed nearly all plaintiffs from a consolidated case, only one remains. Pfizer withdrew its petition for coordination. Philadelphia is currently not a significant venue.
Delaware: In October 2025, 100 plaintiffs filed a consolidated lawsuit in Delaware Superior Court (where Pfizer and subsidiaries are incorporated), pursuing parallel claims outside the federal MDL.
Other States: Additional cases are proceeding in California, Illinois, and other jurisdictions, with Judge Rodgers appointing liaison counsel to help coordinate state-level cases.
Who May Qualify for a Depo-Provera Lawsuit?
Women who may be eligible to file include:
Exposure Requirement:
Received at least two injections of Depo-Provera or generic equivalent (DMPA)
Used the medication for an extended period (longer use = higher risk)
Diagnosis Requirement:
Diagnosed with an intracranial meningioma, another brain tumor, or a spinal tumor
Diagnosis occurred after use of Depo-Provera.
Must have medical imaging (MRI or CT scans) confirming diagnosis
Documentation:
Prescription history
Medical records documenting diagnosis and treatment
Proof of Use/Injury Questionnaire completed
Special Provision: Women who stopped using Depo-Provera before June 2005 can now file with a signed declaration and supporting documentation under Pretrial Order No. 22A.
Proof of Use Challenge and Solutions
One significant challenge in this litigation is proving that plaintiffs actually received Depo-Provera injections years or even decades ago, as many medical records have been lost or destroyed.
Court's Solution:
All plaintiffs must complete a "Plaintiff Proof of Use/Injury Questionnaire" within 120 days.
The court has authorized subpoenas to third parties, including:
Pharmacies
Clinics and hospitals
Insurance companies
Military medical providers
These entities must provide records confirming DMPA injections, even if traditional medical records are unavailable.
What Happens Next?
Immediate Critical Milestone (September-October 2025)
The preemption ruling will determine whether the litigation moves forward with all claims or faces significant dismissals. This is the most important near-term development.
Discovery and Expert Testimony
General causation discovery continues through early 2026
Expert witness depositions due by January 10, 2026
Daubert challenges to expert testimony due by February 10, 2026
Bellwether Trial Preparation
Five pilot cases have been selected for early discovery and trial preparation.
These cases will help establish the strength of the plaintiffs' claims.
No specific trial dates set yet, pending preemption ruling
Leadership Accountability
Judge Rodgers has made it clear that leadership attorneys must file their cases promptly or risk being removed from leadership positions. She has expressed concern about "warehousing" cases and has ordered leadership to disclose the number of unfiled cases they hold.
Settlement Outlook
Current Status: No settlement discussions or offers have been reported at this early stage.
Expected Timeline: Given that the litigation was only established in February 2025, settlements are likely years away. The case must first survive the preemption challenge, complete discovery of general causation, and potentially undergo bellwether trials.
Potential Value: It's too early to predict settlement values, but factors that could influence compensation include:
Severity of meningioma
Whether surgery was required
Permanent cognitive or neurological damage
Duration of Depo-Provera use
Age at diagnosis
Impact on quality of life
Why This Matters
The Depo-Provera litigation represents a significant issue in women's health. Hundreds of thousands of women have used this contraceptive over the past several decades, trusting that it was safe. The lawsuits raise critical questions about:
Corporate accountability: Did Pfizer prioritize profits over patient safety?
Regulatory oversight: Why do European labels include warnings that U.S. labels lack?
Informed consent: Were women adequately informed of potential risks?
Medical alternatives: Why wasn't the lower-dose alternative promoted?
Healthcare disparities: Depo-Provera has been disproportionately used in certain communities
Judge Rodgers' Approach
Judge M. Casey Rodgers is known for running efficient, aggressive MDLs. She previously presided over the 3M Combat Arms Earplug litigation, one of the largest product liability cases in U.S. history. Her approach includes:
Tight deadlines: Discovery schedules are aggressive and non-negotiable
Direct filing: Allowing cases to be filed directly in the MDL speeds the process
Strict compliance: Defendants who miss deadlines face consequences
Transparency: Requiring disclosure of unfiled cases to prevent warehousing
Efficiency focus: Monthly case management conferences keep litigation moving
Key Takeaways
Over 800 federal cases are pending in the Northern District of Florida MDL.
A critical preemption ruling, expected in September/October 2025, could determine the litigation's future.
Strong scientific evidence links Depo-Provera to increased meningioma risk (3.55x higher risk)
Diverse leadership team led by Christopher Seeger (Lead), Bryan Aylstock, and Ellen Relkin (Co-Lead)
Judge M. Casey Rodgers is known for efficient management and strict deadlines.
A safer alternative exists (Depo-SubQ 104) with a lower dose, supporting design defect claims.
Rapid growth: Cases increasing by approximately 10 per day as awareness spreads
Early stage litigation: Established February 2025; discovery ongoing through 2026
This article is for informational purposes only and does not constitute medical or legal advice. If you have used Depo-Provera and have been diagnosed with a meningioma or other brain tumor, consult with a qualified attorney to discuss your specific situation. If you have medical concerns, speak with your healthcare provider.