Luigi Mangione fights extradition to face charge of murdering CEO

The man accused of shooting dead healthcare insurance CEO Brian Thompson in New York jostled with police and shouted at reporters as he was bundled into court on Tuesday, as more details emerged about a potential motive in the killing.

Luigi Mangione appeared at an extradition hearing in Pennsylvania. His lawyer said the 26-year-old would contest being moved to New York to face murder charges.

"He's pleading not guilty to those offences," the lawyer said. "I haven't seen any evidence that he's the shooter."

Different US states have different laws and judicial systems, so there is a process involved in the transfer of fugitives, which can take days or weeks.

Wearing an orange jumpsuit, Mr Mangione tried to address reporters as he arrived for the hearing. He was heard shouting "completely unjust" and "insult to the intelligence of the American people" before being taken into court by officers.

Mr Mangione was arrested on Monday after being spotted at a Pennsylvania branch of McDonald's, following a days-long manhunt that spanned several states. He was allegedly found with a gun similar to the murder weapon, a silencer and a fake ID.

Three handwritten pages were allegedly also in his possession. New York police said they took these to be a claim of responsibility in Mr Thompson's fatal shooting, since they appeared to record frustrations with the US healthcare system.

The UnitedHealthcare chief executive, 50, was gunned down by a masked man outside a Manhattan hotel in what authorities have called a targeted attack.

Mr Mangione was denied bail for a second time on Tuesday, after prosecutors said he was too dangerous to be released.

The judge then gave prosecutors 30 days to seek a warrant from New York Governor Kathy Hochul to secure his extradition to the state.

Hochul later said she would provide one. "I am co-ordinating with the District Attorney's Office and will sign a request for a governor's warrant to ensure this individual is tried and held accountable," she said.

Defence lawyers also have a two-week window in which to submit motions against Mr Mangione being moved to New York. The challenge was described by a Pennsylvania prosecutor as creating "more hoops... to jump through".

Mr Mangione looked around at the rows of reporters in court and smiled at times. At one point, he interrupted his own lawyer, who quickly quietened him.

Following the hearing on Tuesday afternoon, that lawyer, Thomas Dickey, spoke to reporters outside court. "You can't rush to judgement in this case or any case," he said. "He's presumed innocent. Let's not forget that."

Mr Mangione has been charged with several offences in Pennsylvania, including providing fraudulent identification to police and possessing an unlicensed firearm. He is being held at a Pennsylvania state prison and will plead not guilty.

In New York, he faces separate charges including murder for Mr Thompson's killing on 4 December.

Mr Thompson was named chief executive of the company, which is the largest private insurer in the US, in April 2021.

He had received threats before his death relating to medical coverage, according to his widow, Paulette Thompson, but a motive for his killing has not been suggested by prosecutors.

On Tuesday, however, as police pored through evidence and worked to piece together Mr Mangione's movements after the shooting, more details emerged about his alleged grievances with the health insurance industry.

New York Police Department's Chief of Detectives Joseph Kenny told Good Morning America that he had read a three-page handwritten note allegedly found on the suspect when he was arrested.

"He does make some indication that he's frustrated with the healthcare system in the United States," he said. "He was writing a lot about his disdain for corporate America and in particular the healthcare industry."

The note, which has been seen by several US media outlets, reportedly refers to "parasites" that "had it coming". He also allegedly writes that he acted alone.

Former friends who spoke to the BBC said Mr Mangione had suffered from a back injury. They said he had left a surfing community in Hawaii over the summer of 2023 to undergo spinal surgery.

RJ Martin, a former roommate of the suspect who knew him in Hawaii, said the injury "prohibited him, at times, from just doing many normal things".

Various details of Mr Mangione's background have surfaced since his arrest. He was born in Maryland, to a wealthy, well-known family, and police say he has ties to San Francisco, California. His last-known address was in Honolulu, Hawaii.

He attended the University of Pennsylvania, an Ivy League college, where he earned a bachelor's and a master's degree in software engineering.

Local media reported that Mr Mangione's mother had reported him missing last month, telling authorities in San Francisco that she had not heard from her son since July.

"Our family is shocked and devastated by Luigi's arrest," Mr Mangione's family said in a statement posted on social media by his cousin. "We offer our prayers to the family of Brian Thompson and we ask people to pray for all involved."

With additional reporting from Nada Tawfik