Mangione, the suspect in the shooting death of insurance CEO Thompson in New York, struggled and shouted about “justice” as he was escorted by police to court.

Police escorted Luigi Mangione, 26, the suspect in the shooting death of UnitedHealthcare CEO Brian Thompson, to court in Pennsylvania on December 10. Police arrested Mangione a day earlier at a McDonald’s in Altoona, with a homemade gun, a silencer, and fake documents.

Mangione appeared in court in Pennsylvania on charges of possession of an unlicensed firearm, forgery, and providing false identification to police. As he was escorted into court, Mangione struggled and shouted, “This is clearly against the will of the American people, an insult to their intelligence and life experience.”

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Luigi Mangione screams as he is escorted by police to court in Pennsylvania, December 10. Photo: AP

During the hearing on December 10, Mangione mostly looked straight ahead, occasionally looking down at papers and rocking back and forth in his chair. At times, he tried to speak but was interrupted by defense attorney Thomas Dickey.

Manhattan prosecutors have begun taking steps to extradite Mangione to New York, where he faces charges of murder, illegal possession of a weapon and using false documents.

Attorney Dickey said his client will fight the extradition process and wants a hearing on the matter. A Pennsylvania judge denied Mangione bail after prosecutors said the suspect was too dangerous.

New York Governor Kathy Hochul announced on the evening of December 10 that she would sign an order to ensure the suspect is held accountable in New York.

Luigi Mangione screams as he arrives at court in Pennsylvania on December 10. Photo: AP

Brian Thompson, 50 years old, CEO of UnitedHealthcare, one of the largest health insurance companies in the world, was ambushed and shot dead by a gunman on the streets of New York on the morning of December 4.

Five days later, Mangione was arrested in Altoona, Pennsylvania, about 310 miles from New York, and identified as a suspect in Thompson’s murder. In addition to possessing weapons and false documents when arrested, Mangione also had a handwritten note of about two and a half pages “to the federal police.”

The NY Times, citing a source, said the letter directly addressed UnitedHealthcare and criticized the health insurance industry in general, accusing insurance companies of putting profits above customer care. The suspect said in the letter that he acted alone.