Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) that works by mimicking a hormone that the body uses to signal that it’s full or satisfied. It was originally approved for treating type 2 diabetes (under the Ozempic brand name), but the U.S. Food and Drug Administration soon approved it to help patients lose weight (under the Wegovy brand name).

Ozempic and Wegovy have received considerable attention for various reasons, including their side effects. I’ve discussed some of these in earlier blog posts about gastroparesis and vision problems, like NAION. Unfortunately, additional serious side effects continue to be brought up, including complications from blood clots, such as deep vein thrombosis (DVT). Let’s take a closer look at semaglutide and its connection to DVT.

What Is Deep Vein Thrombosis?

According to the Mayo Clinic, DVT is where a thrombus (blood clot) forms in a deep vein. Because some of the largest veins in the body are located in the legs, DVTs often form there. When they do, there are sometimes no noticeable symptoms, but DVTs are often characterized by pain and/or swelling in the leg.

A DVT can be dangerous because it can lead to a pulmonary embolism (PE). This is where the blood clot in the vein can break loose and travel to the lungs and get stuck in an artery.

Does Ozempic Increase the Risk of DVT?

Potentially. The primary basis for connecting Ozempic to deep vein thrombosis is a study from 2021 where researchers looked at patients who took semaglutide to treat type 2 diabetes. They found that it increased the risk of DVT by 266%.

Before jumping to any conclusions about whether Ozempic causes DVT, we need to recognize that some people who take Ozempic or Wegovy may already be at greater risk for DVTs. So the classic question becomes, “Does Ozempic cause DVTs or are those already at risk for DVTs more likely to take Ozempic?” The answer to this question isn’t 100% clear, but some of the risk factors for developing DVT include:

• Lack of movement of the legs (like sitting for hours at a time)
• Obesity
• Heart problems
• Cancer
• Smoking
• Birth control pills
• Advanced age

Diabetes also increases the risk of blood clots. One reason is that those with diabetes are at higher risk of plaque buildup in the arteries. Then there’s the fact that diabetics often have higher levels of fibrinogen, which makes the blood thicker and the red blood cells more likely to stick together. So someone who decides to take Ozempic to treat their diabetes is likely already at higher risk for developing DVTs, but it’s quite possible that Ozempic could further increase this risk.

How Ozempic May Cause Blood Clots

More research is probably needed to know for sure if Ozempic increases the risk of blood clots and if so, how much that increase is. But several factors support the conclusion that Ozempic may increase the risk of developing a DVT:

• It’s widely accepted that Ozempic affects the digestive system, with recognized side effects that include diarrhea. Diarrhea can lead to dehydration, which can increase the viscosity (thickness) of blood.
• Ozempic slows down digestion, which can result in slower blood circulation, which increases the risk of blood clots.
• GLP-1 RAs affect platelets, which play a key role in coagulation.
• Rapid weight loss could increase the risk of experiencing DVT.

Current Status of GLP-1 RA Litigation

The bulk of litigation relating to Ozempic and similar drugs seems to focus on gastrointestinal side effects, such as gastroparesis, and vision problems, like NAION. Many of these cases are part of the GLP-1 RA multidistrict litigation (MDL). However, attempts to add DVT and blood-clot-related lawsuits involving GLP-1 RAs to this MDL have been unsuccessful so far.

If you’ve taken Ozempic, Wegovy, or another GLP-1 RA medication and suffered from a DVT, PE or other complication from blood clots, this doesn’t mean you can’t sue. It only means that, for now, your case won’t get added to the current MDL. That being said, the litigation involving semaglutide and similar pharmaceuticals is fairly recent. Depending on how strong the connection between Ozempic and blood clots is, we could see many more DVT lawsuits getting filed in the future and perhaps a new MDL will be created to handle many of them.

The legal future of Ozempic is very fluid right now. As more and more people take the drug and research gets done, we’ll learn more about its risks. Whether you’re currently on Ozempic or stopped taking it, if you have any health concerns relating to that medication, please reach out to your primary care provider. If you want to learn more about your legal rights, I’m happy to help. You can reach me at (919) 830-5602 or use the online contact form to schedule an initial consultation. Good luck!

People who get medical implants don’t do so out of boredom. They get the surgery because they have a serious medical problem or they want to prevent one. Many of these implants have benefits for patients while some, in addition to doing some good, also can do great harm. The Cook IVC filter may be a medical implant that not only may do you no good but can also do great harm, according to a recent study published in the medical journal Annals of Surgery.

What is a Cook IVC filter?

The Cook IVC filter is a wire device that looks like a cone shaped net. It is manufactured by Cook Group, Inc. The IVC filters are surgically inserted into a major vein, the inferior vena cava (IVC), of a patient who is at risk for a pulmonary embolism (or PE, a blood clot that passes into a lung, which can be fatal). The filter is supposed to trap or break up blood clots coming from the lower or middle part of the body. On first look it appears to be a great idea. But many medical emergencies have resulted from implantation of these IVC filters.

Hundreds of lawsuits have been filed by those injured by Cook IVC filters and by the families of people who died because of them. The filters are often in patients too long; they can break up (with pieces going into the heart or lungs) or the entire filter can be pushed up near or into the heart, causing death or injuries.

more Study finds no upside to using IVC filters but does find a down side

Often physicians will use a Cook IVC filter after a patient has suffered an accident or some kind of trauma fearing a blood clot may form and move into the heart or lungs. Researchers did the study to see if they could establish a benefit for trauma patients treated with implantation of IVC filters.

After looking at the records of 803 patients from 2010 to 2014 who had an IVC filter implanted in them after a traumatic event, those conducting the study not only found no benefit but also an increased risk of injury. The survival rates of patients with IVC filters implanted to prevent potential injuries were no better than those without them. In addition to this lack of benefit they found use of the filters resulted in an increased chance of getting deep vein thrombosis.

• Deep vein thrombosis (DVT) is the term for when a blood clot forms in a vein deep in the body.
• This condition occurs in the lower leg or thigh most often but may occur in other parts of the body as well.
• One of the dangers of DVT is that the clot may break off and move through the bloodstream possibly ending up in the heart or lungs.

The purpose of the study was to see if IVC filters prevented health problems, so those already diagnosed with DVT or PE were not made part of the study. Further, the use of the filters varied widely depending on which hospital treated the patient. In some areas the local doctors inserted them at a much higher rate than others.

What the study means for doctors, patients, and lawsuits

Use of any kind of medical implant involves weighing the costs and benefits for the patient. Given this study,

• There was no benefit for those who were injured in an accident to use an IVC filter to prevent possible future blood clots from moving into the heart or lungs. That is to say, there was no evidence that the patient will live a shorter life without one, but
• There are risks (an increased risk of DVT along with the dangers posed by a defective filter breaking up and causing harm).

In legal proceedings this kind of information may also be helpful to show those involved in the manufacture and sale of Cook IVC filters (and other IVC filters) may have acted negligently and should pay damages to those harmed by the device. Without any measurable benefit to the patient, exposing that patient to a known risk would be evidence of negligence.

I have to say, this one looks a little terrifying. Check out the photo to the right. This is an IVC filter. As with most things, when you first learn what the object is and what it is intended to be used for, you should think “Brilliant! What took so long to invent this thing?” The problem is, the IVC filter can move, turn, or break apart inside a blood vessel, causing all kinds of problems, including death of the patient. So let’s take a look at the product and the lawsuits that have resulted from the medical device.

What Is IVC?

IVC is the acronym for “inferior vena cava,” which is the primary vein running from your lower body to your heart and which carries deoxygenated blood. (And just for completeness, the superior vena cava is the large vein carrying deoxygenated blood from the upper body to the heart.) The vena cava veins move this deoxygenated blood into the right atrium of the heart, where it can be oxygenated and sent back out into the body. Obviously the IVC is a vitally important vein inside the body, and when problems occur they can become serious and even life-threatening.

more What Is Deep Vein Thrombosis?

Deep Vein Thrombosis (DVT) is one of those problems that can occur. DVT is a blood clot that forms in a vein. Often these blood clots originate in the leg or thigh. If the blood clot becomes loose it can travel through the inferior vena cava and settle in the lung, a condition called pulmonary embolism. I’ll get to that.

Sitting for long stretches can cause DVT. Blood clots can form during lengthy surgeries (where your body remains still for a long period), or on a long plane ride, or while driving a car for a great distance. Cancer patients can also develop DVT.

What Is Pulmonary Embolism?

Pulmonary embolism (PE) occurs when the blood clot (DVT) travels to the lung and creates a blockage in one of the arteries in the lung. This condition is very serious. It can cause permanent damage to your lung, reduce the oxygen levels in your blood, which can damage other organs (suddenly starved of oxygenated blood), and if the clot is large, it can even cause death.

What is an IVC Filter?

Deep vein thrombosis and pulmonary embolism are serious, life-threatening conditions, so it is no wonder that very smart people attempted to develop a device which might prevent death in such medical crises. (But very smart people also designed lawn darts.)

The IVC filter is a small metal cone-shaped device which is situated in the inferior vena cava, usually by inserting it surgically through a vein in the neck. See photograph above. The filter allows blood to flow freely, but is intended to capture a blood clot moving through the inferior vena cava. When the IVC filter catches these blood clots, it has effectively prevented the clot from traveling to the lungs and has thus prevented the onset of pulmonary embolism. That’s a good thing.

Once on the market, the filters became quite popular. It is estimated that 250,000 people have an IVC filter implanted each year, and that well over a million people have received the IVC filter in the last ten years.

So What Went Wrong With IVC Filters?

The IVC filter was designed with the idea that it would be placed at a specific location along the inferior vena cava and stay there. Unfortunately, the filters have been shown to migrate along the IVC, to travel all the way to the heart in some cases. A medical device with metal spikes does not belong in a person’s heart.

Also, the IVC filters have been shown to break apart. As you can see in the photo, the filter is made of very thin metal spikes or fingers, and these spikes have broken off in some patients. Surgeons have removed IVC filters with one or many spikes missing, which means those spikes are floating somewhere in the blood vessels, lungs, or heart of the patient. In many cases, the IVC filter simply cannot be retrieved through surgery.

The IVC filters can also rotate or turn, making them useless for capturing blood clots but also causing complications inside the blood vessel.

There is much more to this part of the story, which I will write about in future posts.

Two corporations have manufactured the majority of IVC filters on the market: C.R. Bard, Inc. and Cook Medical, Inc. Both companies (and their subsidiary companies) have been sued by hundreds of injured people.

Two IVC Filter Multidistrict Litigation Sites Have Been Created

So far two multidistrict litigation (MDL) sites have been established relating to IVC Filter products:

MDL No. 2570 IN RE: Cook Medical, Inc., IVC Filters Marketing, Sales Practices and Products Liability Litigation.

On July 21, 2014, the first MDL was formed, involving Cook Medical IVC Filters. The Cook Medical MDL was situated in the Southern District of Indiana and assigned to Judge Richard L Young. You can check out the website for the Cook MDL by clicking the link above.

IN RE: Bard IVC Filters Products Liability Litigation

The MDL involving C.R. Bard, Inc. was established on May 18, 2015 in the District of Arizona. The MDL is focused on C.R. Bard and its “G2” and “Recovery” IVC Filters. Judge David G. Campbell is overseeing the Bard IVC MDL. For more information on the Bard MDL, click the link.

The cases in both MDLs generally allege defective design, misrepresentation in marketing, and failure to warn doctors and patients.

If you had an IVC filter implanted and now face complications, call me: (919) 830-5602.

Note: Photo taken by user: BozMo URL at http://catesfamily.org.uk. Photo can be accessed here. Used with permission pursuant to Creative Commons License. Licensor does not endorse the author or this article. Photo is for illustrative purposes only and is not intended to represent any specific brand of IVC Filter.