Sara O. Couch


Sara Couch is a trial lawyer who contributes to litigation across several of the firm’s practice areas, including defective medical devices, toxic exposure, consumer protection, and technology & privacy actions.

Sara spearheads Motley Rice’s litigation for victims who suffered pancreatic cancer, intestinal blockages, stomach paralysis and other ailments after taking Ozempic® or Wegovy® for weight loss. As part of this litigation, Sara filed the first complaint in the nation alleging harms caused by Wegovy and strongly believes in holding companies accountable for products that target and harm women.

This litigation builds upon Sara’s work on other litigations that have caused harm to women. This includes representing women who suffered devastating effects caused by medical products including Essure® permanent birth control and transvaginal mesh. Sara’s extensive work with experts in Essure provided the foundation for her current service on the Science & Expert Committees for the Hair Relaxer MDL and Social Media MDL , of which Motley Rice holds leadership positions. She also serves on the Plaintiffs Steering Committee overseeing litigation filed in the District of New Jersey for women who developed BIA-ALCL, a rare form of non-Hodgkin’s lymphoma, allegedly caused by textured Allergan breast implants.

As a member of nearly a dozen Motley Rice trial teams, she also helped achieve multiple plaintiff verdicts for tobacco victims and a multi-million verdict for victims of toxic lead paint exposure.* 

Sara is also part of the opioid litigation team representing dozens of governmental entities, including states, cities, towns, counties and townships in litigation targeting the alleged misrepresentation and fraudulent distribution of harmful and addictive prescription opioids by manufacturers and distributors. Sara is proud of the various settlements that have been reached that will benefit states like Kentucky and her hometown in Appalachia. 

Prior to joining Motley Rice, Sara was a law clerk with the North Carolina Department of Justice, where she researched and drafted briefs and memoranda regarding the False Claims Act and Stark Law for the North Carolina Medicaid Civil Enforcement Division. She also investigated allegations of healthcare fraud and presented findings to the division. 

Sara also volunteered with Legal Aid of North Carolina, assisting advocates for Children’s Services with a school-to-prison pipeline project by researching education policy issues, North Carolina case law and education data to be used in education litigation. Sara completed a total of 50 hours of pro bono service while a student at UNC School of Law.

Active in her community, Sara previously served on the Board of Directors for East Cooper Habitat For Humanity, and currently serves on the Board of Slow Food Charleston. Sara also is part of the Roper St. Francis Xavier Society, which supports Roper Rehabilitation Hospital. An avid rower, Sara was a varsity member of the NCAA Division-I Duke University’s Women’s Rowing. 
* Please remember that every case is different. Any result we achieve for one client in one matter does not necessarily indicate similar results can be obtained for other clients.


  • “Don’t Shy Away from Damages", TRIAL Magazine (July 2023) 



J.D., University of North Carolina School of Law, 2013

A.B., Duke University, 2009

Licensed In

  • Florida
  • South Carolina

Admitted to Practice Before

U.S. District Court for the Middle District of Florida, District of South Carolina


American Association for Justice, Co-Chair – Women’s Trial Caucus Publications Committee

Awards and Accolades

Charleston, SC
2022–2024  Ones to Watch list: Mass tort litigation / class actions – plaintiffs; Personal injury litigation–plaintiffs; Product liability litigation–plaintiffs

2023 Forty Under 40 

2023–2024 Diversity and Inclusion Leadership Academy, Class 10