At 6:45 a.m. on December 4, 2024, Brian Thompson, 50 years old and chief executive of UnitedHealthcare, in Manhattan for his company's annual investor day, walked toward the entrance of the New York Hilton Midtown. A man who had been standing near the sidewalk for several minutes, letting other pedestrians pass, stepped out and shot him in the back and leg, according to the sequence CNN reconstructed from police accounts. Thompson was pronounced dead at 7:12 a.m. at Mount Sinai West, formerly Roosevelt Hospital, twenty-four minutes after the first 911 call, NBC News reported that day.

The gunman did not run in a panic. He jogged half a block, mounted an e-bike, and rode north into Central Park, where investigators would later lose his trail for five days, per ABC News's reconstruction of his movements.

Police recovered three shell casings at the scene. Scratched into them, by hand, were three words: deny, defend, depose, an apparent echo of "Delay, Deny, Defend," a 2010 book by Rutgers law professor Jay Feinman about the tactics insurers use to avoid paying claims, as Forbes laid out within a day of the shooting. Whether the inscriptions were the gunman's own indictment of the health-insurance industry, or simply designed to look like one, was the first question the case raised. It would not be the last.

Evidence Log · Recovered by investigators
A — Shell casings inscribed "deny / defend / depose"
B — 3D-printed 9mm pistol with suppressor, in a backpack
C — Fake New Jersey identification, used to check into a hostel
D — Handwritten spiral notebook, later described in court as a manifesto

Five days, then a McDonald's

The NYPD released still images of the suspect (first masked, later smiling for a hostel clerk) and offered a reward that climbed past $10,000. For five days, nothing. Then, on the morning of December 9, a customer at a McDonald's on East Plank Road in Altoona, Pennsylvania, told an employee the man eating breakfast in the corner looked like the person in the news, according to the 911 call played later in court. The employee called it in.

Officers who responded arrested 26-year-old Luigi Mangione shortly after 10 a.m., initially on Pennsylvania charges of forgery and giving a false name to police, after he produced fake identification, CNN's account of the arrest shows. A search of his bag turned up the loaded ghost gun with its suppressor, a passport, and the notebook. He was denied bail at an evening arraignment in Blair County and held at SCI Huntingdon.

That same day, Manhattan prosecutors filed a warrant charging Mangione with second-degree murder, weapons possession, and forgery, CNN reported that night. He was later indicted on eleven New York State counts, including two charges of murder in the first degree in furtherance of terrorism, a theory built partly on the notebook.

What the notebook said

According to handwritten pages CBS News obtained and published, and a fuller version Newsweek later reproduced, the notes trace roughly four months of planning. In one entry, from August 2024, Mangione wrote that he finally felt "confident about what I will do" and had "no doubt about whether it's right/justified." Elsewhere, he wrote about the ethics of his own plan directly:

"So, say you want to rebel against the deadly, greed-fueled health insurance cartel. Do you bomb the HQ? No. Bombs = terrorism."

— From the notebook prosecutors say was recovered from Mangione's backpack

The pages go on to describe insurance executives as "parasites" who "had it coming," cite America's health-cost-to-life-expectancy ranking, and, in a passage prosecutors have leaned on for intent, reference the Unabomber's writing as making "some good points." Mangione's own notes also say he acted alone.

Two prosecutions, one death penalty fight

The case split into two parallel tracks that have moved, and stalled, independently for a year and a half; both judges have denied requests to push the trial dates back further.

New York State charged Mangione with murder, weapons possession, and forgery. In September 2025, a state judge dismissed the two terrorism-related murder counts, ruling the theory didn't fit the facts as charged, but let the core second-degree murder count stand along with the weapons and forgery charges, CBC News reported.

The federal government charged Mangione separately with murder through the use of a firearm (a capital-eligible count) plus stalking and firearms offenses. In April 2025, Attorney General Pam Bondi personally directed prosecutors to pursue the death penalty, calling the killing "a premeditated, cold-blooded assassination," according to the Justice Department's own announcement. Mangione's attorneys fought the designation as, in their words, driven by "politics, not merit." In January 2026, a federal judge dismissed the firearm and murder charges that had made Mangione death-penalty eligible, effectively ending the capital case while other federal counts remain, PBS NewsHour reported.

Mangione has pleaded not guilty to every charge, state and federal. He remains held at the Metropolitan Detention Center in Brooklyn.

Where the case stands now

In May 2026, the judge overseeing the state case ruled on what a jury will actually be allowed to see: the ghost gun recovered from the backpack and the notebook pages are admissible; some other items seized at the scene were suppressed, CNN reported, in a ruling legal analysts called mixed. That ruling cleared the last major obstacle to a trial date.

As of this writing, the state trial (second-degree murder, criminal possession of a forged instrument, and seven counts of weapons possession) is set to begin jury selection on September 8, 2026, in Manhattan. The separate federal trial has been pushed to the following year, with jury selection scheduled for January 5, 2027 and opening statements on January 25; the federal judge noted it was "simply impossible" to seat a federal jury while Mangione was mid-trial in state court, ABC News reported. Pennsylvania's original forgery and weapons charges, filed the day of his arrest, are still pending as well.

Reports in late 2025 that Mangione's attorneys had opened plea talks with federal prosecutors, first surfaced by NBC News, were publicly denied by his lead defense attorney, Karen Friedman Agnifilo, who said no such discussions took place. No deal has been announced on either the state or federal docket.

The killing has also become something larger than a homicide case: shorthand, for a large and vocal share of the public, for anger at how American health insurers handle claims. That reaction sits alongside, not inside, the legal case: a jury in Manhattan will decide facts, not sentiment, and Mangione is presumed innocent until it does.

CS Blackwoods will file the next dispatch on this case when jury selection opens in September.

Sources

Charging documents and judicial rulings referenced above are matters of public court record in People v. Mangione (New York County) and United States v. Mangione (S.D.N.Y.). This case is active and unresolved; details here will be corrected or updated as the public record changes.