A 26-year-old man has been charged with murder in connection with last week's shooting death of UnitedHealthcare CEO Brian Thompson in New York City.
Luigi Mangione was taken into custody at a McDonald's in Altoona, Pennsylvania, about 450 miles west of New York City on Monday after a customer at the fast food restaurant recognized him.
An Ivy League graduate from a prominent Maryland family, he was found with a gun and a handwritten note indicating “interest and intelligence”, according to police.
Mr. Mangione then appeared in a Pennsylvania court to face the first five charges and was denied bail.
Hours later, New York investigators charged Mr. Mangione with murder and four other counts, including gun charges.
Mr. Thompson, 50, was shot in the back early Wednesday morning outside the Hilton Hotel in Midtown Manhattan where UnitedHealthcare, the medical insurance giant he led, was holding an investor meeting.
Police said he was targeted for a planned murder.
Mr. Mangione is in prison in Pennsylvania, where he has been charged with illegal possession of a firearm, forgery and giving false information to police.
His hands, feet, wrists and ankles were tied when he appeared in court on Monday.
Dressed in jeans and a blue sweater, Mr. Mangione appeared calm during the hearing, occasionally glancing around at those in attendance, including the media.
Last week's shooting sparked a massive manhunt, with New York City investigators using one of the world's largest digital surveillance systems as well as police dogs, helicopters and divers in Central Park's lake to find the attacker.
Investigators said Mr Mangione's discovery was a surprise, as his name had not been on the suspect list before Monday.
It was finally a McDonald's customer in Altoona who saw the suspect through media coverage and told an employee, who then tipped off the police.
When police arrived, Mr. Mangione showed them a fake New Jersey driver's license with the name Mark Rosario on it, court documents said.
He “became silent and began to shake” when the officer asked if he had been to New York recently, the criminal complaint added.
When told he would be arrested if he lied about his name, he revealed his real name, according to court documents.
When asked why he lied, he told the police that “obviously I shouldn't have had them”.
A search of his backpack turned up what police called a “ghost gun” – which could be 3D printed – and a magazine full of six 9mm rounds.
Prosecutors say he also has an American passport and up to ten thousand dollars, $2,000 in foreign currency, although Mr. Mangione disputed the amount in court.
A three-page handwritten document found on him suggests he has a “bad heart for American business”, officials said.
Detectives say the words “deny”, “protect” and “demolish” were written on shell casings found at the scene of Mr Thompson's murder.
Officials believe this may refer to what critics call the “three D's of insurance” – tactics used by insurance companies to deny payment requests from patients in America's complex health care system.
Earlier, New York Police Commissioner Jessica Tisch said that the weapon and suppressor taken by investigators from the suspect “are both consistent with the weapon that was used in the murder” of Mr. Thompson.
Mr. Mangione is expected to be given the opportunity to not be extradited to New York, or to contest.
If he quits, he will be immediately available to New York authorities. If he joins it, the process may take between 30 and 45 days.
Mr Mangione's family said they were shocked and saddened by his arrest.
“We are praying for Brian Thompson's family and we are asking people to pray for all involved,” said their statement, posted on social media Monday night by the defendant's cousin, Maryland legislator Nino Mangione.
As a teenager, Mr. Mangione attended an all-boys private school in Maryland, where he was class valedictorian, a title usually awarded to top students.
He graduated from the University of Pennsylvania, an Ivy League college.
His LinkedIn account says he worked as a data engineer in California. Car buyers website TrueCar confirmed that he was employed there but left in 2023.
Mr. Mangione's last known address was in Honolulu, Hawaii.
Several posts on X's account, formerly known as Twitter, which appeared to be Mr Mangione's, revealed that friends were trying to contact him, with one in October writing that “no one has heard from you in months”.
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